Abstract:This standard has been formulated based on the experience from the United States and Germany, etc. and closely integrated the actual situation of dental diagnosis and treatment services in China. It proposes detailed infection prevention and control measures targeting multiple key aspects of healthcare-associated infection management in dental outpatient department and clinic, including infection management requirements, cleanliness of diagnosis and treatment environment and object surfaces, storage management of diagnosis and treatment supplies, manipulation specification for diagnosis and treatment, quality of dental diagnosis and treatment water, prosthodontics and laboratory work, facilities and equipment for dental radiology, etc. Additionally, from the perspective of architectural hygiene, specific regulations have been made on the basic principles of dental clinic building design, selection of building materials, and ventilation. The release and implementation of this standard will effectively promote the standardization and normalization processes of healthcare-associated infection management in the field of dentistry in China.

Abstract:Objective To detect carbapenemase types in strains isolated from patients with carbapenem-resistant Enterobacterales (CRE) infection, analyze bacterial resistance, clinical characteristics of infected patients, and related factors affecting patients’ prognosis. Methods Non-repetitive CRE strains isolated from adult inpatients in a secondary first-class general hospital from 2023 to 2024 were collected prospectively. Carbapenemase types were detected, patients’ clinical data were investigated, and factors affecting the clinical treatment outcome of patients with carbapenemase-procucing Enterobacterales (CPE) infection were analyzed with univariate and multivariate regression models. Results Clinical data of 151 CRE infected patients were collected, the detection of carbapenem-resistant Klebsiella pneumoniae (CRKP) took the highest proportion (n=134, 88.7%). All of the 151 CRE strains contained carbapenemase, including 111 strains(73.5%)containing only class A serine carbapenemase (all KPC type), 32 strains (21.2%)containing only class B metallo-β-lactamase (MBL), and 8 strains (5.3%)containing both KPC and MBL(double-carbapenemase-producing, DCP). KPC represented the main form in CRKP (82.1%). Both carbapenem-resistant Escherichia coli (CREC) and carbapenem-resistant Enterobacter cloacae (CRECL) produced MBL. The resistance rates of 151 CPE strains to ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, and ticarcillin/clavulanic acid were all over 90%. The resistance rates to ceftazidime/avibactam in only-MBL-producing strains and DCP strains were higher than those in only-KPC-producing strains (both P<0.05). The resistance rates of only-KPC-producing and DCP strains to aminoglycosides, doxycycline, and compound sulfamethoxazole were higher than those of only-MBL-producing strains (all P<0.05). All three types of CPE strains had good sensitivity to polymyxin B, with a resistance rate of 0-4.2%. The resistance rates of KPC- and MBL-producing strains to tigecycline were low (0-4.2%), while the resistance rate of DCP strains to tigecycline was 100%. 27.2% (n=41) of patients died within 30 days after infection. Multivariate regression analysis showed that healthcare-associated infection (HAI) (OR=12.88, 95% CI: 4.15-39.96), indwelling gastric tube (OR=10.51, 95% CI: 2.19-50.45), and high abdominal blood glucose level during infection (OR=1.24, 95% CI: 1.08-1.41) were all independent risk factors for death within 30 days after infection in patients with CPE infection, while high serum albumin level during infection (OR=0.80, 95% CI: 0.70-0.90) was an independent protective factor. Conclusion The prevalence of CPE in secondary general hospitals is high, and antimicrobial resistance is severe, especially in the cases of KPC-producing and DCP strains showing wider spectrum of antimicrobial resistance. Attention should be paid to CRE screening and enzyme type monitoring to prevent HAI. High-risk populations should also be paid attention to improve clinical prognosis.

Abstract:Objective To investigate the antimicrobial activity of the bacteriocin (Enterocin-162) secreted by Enterococcus faecalis SHAMU-EF162 strain against clinically common multidrug-resistant organisms (MDROs). Methods The growth kinetics curve of the SHAMU-EF162 strain was monitored through the microcultivation assay. The antagonistic activity of the SHAMU-EF162 strain against Staphylococcus aureus (S. aureus) was eva-luated using Oxford cup method. Enterocin-162 crude extract was prepared by macroporous resin adsorption, gradient ethanol elution, rotary evaporation drying, and reconstitution. The protein content in the crude extract was detected by Coomassie brilliant blue staining. The thermal, pH, and protease stability of Enterocin-162, as well as its antimicrobial activity against methicillin-resistant S. aureus (MRSA), multidrug-resistant Pseudomonas aeruginosa (MDR-PA), extended-spectrum β-lactamases-producing Escherichia coli (ESBLs-EC), and carbapenem-resistant Klebsiella pneumoniae (CRKP) clinical isolates were assessed by Oxford cup method. Results Enterocin-162 can withstand exposure to 100℃ heat, pH 2.0, pH 12.0, chymotrypsin, bromelain, trypsin, proteinase K, and the mixture of four proteases. The antimicrobial activity of 30 μL crude extract of Enterocin-162 (containing approximately 14.8 μg of protein or polypeptide)against clinical isolates of MRSA, MDR-PA, ESBLs-EC, and CRKP was superior to those of antimicrobial disks of vancomycin, polymyxin, epicycline, amikacin, and levofloxacin. Conclusion Enterocin-162 is likely to be a stable, efficient, and broad-spectrum new class I bacteriocin, with the potential to be developed into a novel antimicrobial agent, and providing a new option for the treatment of common MDRO infection in clinical practice.

Abstract:Objective To analyze the clinical characteristics, antimicrobial susceptibility profiles, and molecular typing features of clinically isolated Pasteurella multocida (P. multocida), and provide basis for clinical diagnosis and treatment. Methods Clinical data and strains of 19 confirmed cases with P. multocida infection in three tertiary first-class hospitals in Hainan Province from December 2020 to December 2024 were retrospectively collected. The strains were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and kmt gene polymerase chain reaction (PCR), and a phylogenetic tree was constructed by full-length 16S rRNA gene sequencing. Capsule serotypes (A/B/D/E/F) and LPS genotypes (L1-L8) were detected by multiplex PCR. Sequence typing analysis was performed based on the RIRDC-MLST typing system. The diameters of the inhibition zone of 8 antimicrobial agents were detected using Kirby-Bauer disc diffusion method, and the activity of β-lactamase activity was detected by nitrocefin test. Results 19 clinical strains were all identified as P. multocida, and 16S rRNA gene sequence analysis showed single nucleotide polymorphism differences among the strains. Based on RIRDC-MLST, 13 strains (68.42%) were identified as 7 known sequence types (ST5, ST7, ST9, ST50, ST129, ST287, ST487), and 6 strains (31.58%) didn’t match the existing database. The distribution of capsule serotypes showed that type A was dominant (13/19, 68.42%), and the L3 genotype had the highest proportion among LPS genotypes (8/19, 42.11%). Antimicrobial susceptibility testing results showed the highest susceptibility rate of 100% (n=19) for compound sulfamethoxazole and the susceptibility rate of 78.95% (n=15) for penicillin, ampicillin, and tetracycline. Ceftriaxone had a susceptibility rate of 89.47% (n=17). The resistance rate of erythromycin was 100% (n=19), and the susceptibility rate of azithromycin and levofloxacin were both 94.74% (n=18). The positive rate of β-lactamase was 21.05% (n=4). Conclusion The 19 clinical strains of P. multocida in this study showed a significant molecular diversity, and the sequence type ST7 and capsule type A may be the dominant types in this region. It is recommended to avoid empirical use of penicillin and ampicillin in clinical practice, and select susceptible antimicrobial agents based on antimicrobial susceptibility testing results.

Abstract:Objective To compare the risk of hepatitis B virus (HBV) reactivation (HBVr) in hepatitis C virus (HCV)-infected patients receiving direct-acting antiviral agents (DAAs), evaluate the effectiveness of prophylactic anti-HBV treatment in preventing HBVr. Methods Relevant literatures published up to February 13, 2025 were systematically retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Database, PubMed, Embase, and Cochrane Library databases. The literatures were screened according to the established inclusion and exclusion criteria, data were extracted and underwent quality assessment. Revman 5.4 and Stata 18.0 software were used for Meta-analysis, sensitivity analysis, and publication bias assessment. Results A total of 32 studies (31 cohort studies and 1 randomized controlled trial) involving 21 530 HCV-infected patients were included. Twenty-seven studies reported that the incidence of pooled HBVr was 30% (95%CI: 16%-45%) in HCV-infected patients combined with HBsAg-positive after DAAs treatment. Twenty-four studies showed that the pooled HBVr rate was 0 in HCV-infected patients with HBsAg negative but HBcAb-positive. HBVr rates reported in each study ranged from 0 to 15%. Fourteen literatures were chosen to compare the risk of HBVr after DAAs treatment between HCV-infected patients with HBsAg-positive and HCV-infected patients with HBsAg-negative but HBcAb-positive, and the relative risk(RR)=31.06 (95% CI: 17.98-53.65). Among HCV-infected patients with HBsAg-positive, there was no statistically significant difference in the risk of HBVr between the group with HBV DNA < LLOQ (lower limit of quantification) and the group with HBV DNA ≥ LLOQ (RR=0.75, 95% CI: 0.52-1.06). Among HCV-infected patients with HBsAg-positive, the risk of HBVr in patients receiving DAAs treatment combined with nucleoside analogues for prophylactic anti-HBV treatment was only 19% of that in the control group (RR=0.19, 95% CI: 0.06-0.58). Conclusion The HCV-infected patients with HBsAg-positive have a high incidence of HBVr after DAAs treatment. The existing data showed that the estimated value of incidence of pooled HBVr was 0 in HCV-infected patients with HBsAg negative but HBcAb positive after DAAs treatment, yet there were still individual reactivation reports, and the risk was not completely ruled out. The use of nucleoside analogues for prophylactic HBV treatment can reduce the risk of HBVr in HBsAg-positive HCV-infected patients after DAAs treatment. Prophylactic HBV treatment and continuous management of HCV-infected patients are helpful to improve the safety of DAAs treatment and optimize the overall treatment effect.

Abstract:Objective To systematically evaluate the risk factors for COVID -19-associated pulmonary aspergillosis (CAPA) in patients in intensive care unit (ICU). Methods Studies on risk factors for CAPA in ICU patients were retrieved from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database. The retrieval period was from the establishment dates of all databases to March 31, 2025. Two researchers independently screened literatures and extracted data, evaluated data quality with the Newcastle Ottawa (NOS) scale and conducted Meta-analysis using RevMan 5.4 software. Results A total of 38 observational studies were included in the analysis, including 11 312 patients. Meta-analysis results showed that male, age, smoking, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, simplified acute physiology score Ⅱ (SAPS Ⅱ), liver cirrhosis, diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular disease, EORTC/MSGERC host factors, solid organ transplantation, hematological malignancies, long-term use of glucocorticoids, immunodeficiency, Charlson comorbidity index, using vasoactive drugs and/or positive inotropic drugs, mechanical ventilation, invasive mechanical ventilation, mechanical ventilation duration, renal replacement therapy, interleukin-6 inhibitor therapy were all risk factors for CAPA in ICU patients. High body mass index (BMI) and obesity were protective factors for CAPA in ICU patients (both P<0.05). Conclusion There are multiple risk factors for CAPA in ICU patients. Timely identification of relevant risk factors can help to implement standardized antifungal treatment as early as possible, so as to improve patient prognosis.

Abstract:Objective To establish standard surveillance procedure for central line-associated bloodstream infection (CLABSI), implement full-process quality management for improving surveillance quality, and provide basis for effective prevention and control for CLABSI. Methods Through multidisciplinary team management, the entire surveillance process of CLABSI was sorted out, including problems related to culture of blood specimen, capture of catheterization information, and diagnosis of infection. Targeted quality management interventions were carried out. Intervention measures included unifying surveillance standards, optimizing medical orders for catheterization, and standardizing blood culture collection. The consistency between the catheterization information captured by the system and the manually filled data, as well as the changes in blood culture contamination before and after intervention were compared, and the effectiveness of quality management intervention was evaluated. Results A unified CLABSI surveillance process and a scheme of medical order for central venous catheterization (CVC) were established. In 2024, CVC days was 229 439, 60 cases of CLABSI occurred, and the incidence of CLABSI was 0.26 ‰. CLABSI occurred mainly in the department of hematology and intensive care units. 65 strains of pathogenic bacteria were detected, and coagulase negative Staphylococcus was the main pathogen of CLABSI, accounting for 49.23% (n=32). After intervention, the consistency between the number of catheterization days according to medical orders obtained by the information system and the manually filled clinical data significantly improved, from 61.72% before intervention to 78.18% after intervention (P<0.05). The contamination rate of blood culture remained at a low level before and after intervention. Conclusion The full-process quality management of CLABSI surveillance can significantly improve surveillance efficiency and effectiveness.

Abstract:Objective To evaluate the effect of healthcare failure mode and effect analysis (HFMEA) combined with enhanced link quality management as a strategy on the prevention and control of ventilator-associated pneumonia (VAP) in the respiratory intensive care unit (RICU), and provide evidence for optimizing clinical infection control processes. Methods A retrospective study was conducted. Invasively mechanically ventilated RICU patients who received routine prevention and control of VAP in Wuhan Pulmonary Hospital from January to December 2023 were selected as the control group. Patients who underwent HFMEA combined with enhanced link quality management for VAP prevention and control in RICU of the same hospital from January to December 2024 were selected as the trial group. Differences in quality score of VAP prevention and control key links, compliance rate of prevention and control measures, VAP incidence, and satisfaction of healthcare workers (HCWs) under different management modes between the two groups of patients were compared. Results The control group consisted of 129 patients who received mechanical ventilation for 1 526 days, and the trial group consisted of 161 patients who received mechanical ventilation for 1 409 days. The total score for the quality assessment of key links in VAP prevention and control was (60.15±5.52) points for the control group and (90.00±4.05) points for the trial group. The total score and quality score of each link quality in the trial group were all higher than those in the control group, and differences were all statistically significant (all P<0.05). The compliance rate of VAP prevention and control core measures was 62.64% in the control group and 85.09% in the trial group. The overall compliance rate and compliance rate of various measures in the trial group were all higher than those in the control group, and differences were all statistically significant (all P<0.05). The average mechanical ventilation time of patients in the trial group was (8.75±4.20) days, which was shorter than (11.83±5.80) days of the control group, with statistically significant difference (P<0.001). The incidences of VAP in trial group and control group were 9.23‰ and 19.00‰, respectively, difference was statistically significant (P=0.026). The job satisfaction rate of HCWs in the trial group was 93.94%, while that in the control group was 72.73%, with statistically significant difference (P=0.007). Meanwhile, the trial group had a higher percentage of "very satisfied" (27.27% vs 15.15%) and a lower percentage of "dissatisfied" (6.06% vs 27.27%). Conclusion The joint strategy of HFMEA combined with enhanced link quality management can help to improve the implementation efficiency of VAP prevention and control measures, reduce the incidence of VAP, and enhance the satisfaction of HCWs towards VAP prevention and control.

Abstract:Objective To analyze the willingness and actual behavior to influenza vaccination among healthcare workers (HCWs) in a tertiary general hospital, and provide a stratified intervention basis for improving the vaccination rate of HCWs. Methods In March 2025, a cross-sectional survey among HCWs was conducted through the "Questionnaire Star". The survey participants were divided into willing/unwilling group and vaccinated/unvaccinated group, with "willingness to vaccination" and "actual vaccination" as dependent variables. The influencing factors of different dimensions were analyzed by χ²-test and logistic regression. Results A total of 720 questionnaires were distributed, and 708 valid questionnaires were collected, with an effective rate of 98.3%. The vaccination willingness rate (80.1%) was higher than the actual vaccination rate (45.9%) (χ²=72.65, P<0.01). The willingness group scored higher in influenza knowledge ([76.9±9.3] points vs [67.8±12.5] points, P<0.001). Previous influenza vaccination history (OR=4.33, 95%CI: 2.85-6.56, P<0.001) and influenza vaccine high awareness level (OR=1.08, 95%CI: 1.06-1.10, P<0.001) were the promoting factors. The actual vaccination behavior was influenced by multiple factors. Older age (OR=1.04, 95%CI: 1.01-1.07, P=0.020), medical technology series (OR=3.94, 95%CI: 1.68-9.25, P=0.002), management personnel (OR=14.97, 95%CI: 1.16-193.76, P=0.038), personnel with senior professional title (OR=4.69, 95%CI: 1.42-15.55, P=0.011), key departments (OR=1.71, 95%CI: 1.08-2.72, P=0.023), previous vaccination history (OR=12.21, 95%CI: 7.97-18.70), and high score of awareness level (OR=1.02, 95%CI: 1.01-1.04) had higher vaccination rates. Conclusion The willingness of HCWs to influenza vaccination is mainly driven by their internal cognition and previous experience, while their actual vaccination behavior is further influenced by the combination of occupational structure characteristics and external environmental factors, resulting in a significant gap between willingness and behavior. Medical institutions should optimize their education strategies for improving the awareness of HCWs, take multiple measures to eliminate barriers to behavior transformation, so as to increase vaccination rate and reduce the risk of influenza transmission within hospitals.

Abstract:Objective To analyze an incident of bedbug-bite in the department of neurology of a tertiary hospital, including clinical manifestations, isolation and protection, epidemiological characteristics, as well as disinfection, killing and control measures, so as to provide reference for vector control in medical institutions. Methods The on-site epidemiological investigation was adopted to investigate suspected bitten persons and their close contacts. The temporal, spatial, and population distribution characteristics of the bitten persons were analyzed. Insect vectors were identified timely and their living characteristics were understood. The bitten persons were isolated, and the plan was adjusted dynamically according to disinfection, killing and control effect. The intervention effect was followed up and evaluated. Results From June 3 to 10, 2025, the neurology ward of a hospital successively reported 6 bitten persons, including 4 patients and 2 caregivers. The bite incidents all occurred at night, relatively concentrated on June 8, with 5 (83.3%) persons being bitten on that night. Six bitten persons were distributed in 4 adjacent wards. The bite sites concentrated in the contact areas with the bed surface, such as the arms, abdomen, and back. The ward has a long building history, outdated facilities, and an irrational structural layout. Except for 2 special wards, all other wards did not have separate bathrooms and only had public restroom. The hospital quickly implemented centralized isolation, high-temperature treatment of contaminated fabrics, closed disinfection and killing in ward as well as other comprehensive disposal measures for the bitten persons. The incident was finally effectively controlled, no bedbugs were found in the ward, and no bites occurred in the following patients. Conclusion Bedbugs have strong concealment and transmission ability in environments of wards with concentrated elderly patients and poor hygiene conditions. Adoption of comprehensive prevention and control system with multi-departmental collaboration, early identification of bite vectors and cases, early intervention measures, and dynamic adjustment of plans based on control status of incident can effectively curb the risk of bedbug transmission.

Abstract:Objective To analyze the impact of different infection sources on the mortality risk of patients with secondary bloodstream infection (BSI), and provide reference for precise prevention and treatment for secondary BSI. Methods Clinical data of 340 patients with secondary BSI at the First Affiliated Hospital with Nanjing Medical University from January 2020 to December 2024 were collected for a retrospective cohort study. According to the sources of infection, patients were divided into abdominal infection group, lower respiratory tract infection group, urinary tract infection group, and other infection group. The impact of different infection sources on the mortality risk of patients with secondary BSI was analyzed using COX regression model. Results The sources of secondary BSI from high to low were abdominal infection (n=135, 39.71%), lower respiratory tract infection (n=105, 30.88%), urinary tract infection (n=68, 20.00%), and other infection (n=32, 9.41%). The mortality of secondary BSI from different infection sources from high to low were as follows: lower respiratory tract infection (59.05%), other infection (34.38%), abdominal infection (27.41%), and urinary tract infection (10.29%). Multivariate COX regression analysis result showed that patients with secondary BSI from lower respiratory tract infection had a higher risk of mortality than those from abdominal infection (HR=2.22, 95% CI [1.34-3.67], P=0.002), urinary tract infection (HR=4.10, 95% CI [1.79-9.40], P<0.001), and other infection sources (HR=2.26, 95% CI [1.01-5.04], P=0.046). Conclusion There are differences in the mortality risk of patients with secondary BSI from different infection sources. Lower respiratory tract infection is higher than abdominal infection, urinary tract infection, and other infection sources. Strengthening the prevention and control of lower respiratory tract infection and multidrug-resistant organism (MDRO) infection, and paying attention to the diagnosis and treatment of secondary BSI from lower respiratory tract infection source can help to reduce the mortality risk of patients.

Abstract:Objective To compare the effect of two cycle modes of automated endoscope reprocessor (AER) on the reprocessing of flexible endoscopes, and provide evidence-based guidance for selecting the optimal cleaning and disinfection protocol in clinical practice. Methods A total of 206 endoscopes after gastrointestinal endoscopy examination in the gastrointestinal endoscopy center of a tertiary first-class hospital in Jiangxi Province from June to October 2024 were selected and randomly divided into two groups using a random number table: group A (standard cycle mode, n=103) and group B (no-cleaning cycle mode, n=103). All endoscopes underwent standardized processing (bedside preprocessing-transfer-side leakage detection-manual cleaning-rinsing-visual inspection), then were reprocessed using different cycle modes of AER accordingly. After AER treatment, microbial sampling and culture were conducted on the endoscope biopsy channel, water/gas channel, and auxiliary water delivery channel respectively. The primary observation indicators included disinfection qualified rate, reprocessing time, as well as cleaning and disinfection costs. Results The qualified rates of disinfection for groups A and B were 96.12% and 92.23%, respectively, with no statistically significant difference (χ²=1.42, P>0.05). The single-endoscope reprocessing times for groups A and B were (46.98±0.64) and (34.02±0.66) minutes, respectively, with statistically significant difference (t=143.65, P<0.001). The unit costs for groups A and B were 45.81 and 42.65 Yuan, respectively, with cost-effectiveness ratios (C/E) of 49.09 and 47.63. Incremental cost-effectiveness analysis revealed that group A required an additional investment of 83.67 Yuan per 1% increase in qualified rate (ICER [incremental cost-effectiveness ratio]=83.67). Microbial culture results showed that the detected bacterial species in both groups were essentially the same, primarily including opportunistic pathogens such as Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Pseudomonas putida, and Enterobacter aerogenes. Conclusion On the basis of standardized manual cleaning, there is no significant difference in the reprocessing effectiveness of flexible endoscopes between the two circle modes of AER. The additional cleaning provided in the standard circle mode offers limited safety levels. All medical institutions at various levels should attach great importance to manual cleaning before placing endoscopes into the AER. Compared with the standard cycle mode, the absence of cleaning cycle in the AER can save time in endoscope reprocessing and reduce cleaning and disinfection costs. Sticking to standardized manual cleaning procedures, medical institutions at all levels may choose the no-cleaning cycle mode after comprehensively considering cost factors and endoscope turnover requirements.

Abstract:ObjectiveA tertiary first-class hospital installed a new purified water system, in order to ensure that the final rinse water in the digestive endoscopy center met the regulatory requirements, microbial monitoring was conducted on the main purified water pipeline and endoscope final rinse water. The causes of limit-exceeding of microbes were analyzed, and solutions were proposed to provide reference for disposal of similar incidents. Methods Water specimens from the automated endoscope reprocessor (AER) and cleaning workstation were collected, and microbial contamination level was analyzed. By implementing measures such as installing filter membranes, insta-lling ultraviolet lamp (UV) lamps, and conducting pipeline cleaning at AER and the front end of final rinse tank in endoscope cleaning workstations, bactericidal effects of different combinations of filtration-disinfection on microbes in purified water were evaluated to verify the feasibility of synergistic intervention of filtration-disinfection combination and pipeline disinfection. Results 0.2 μm filter membrane+0.45 μm filter membrane+UV lamp, 0.2 μm filter membrane+0.2 μm filter membrane, 0.2 μm filter membrane+0.2 μm filter membrane+UV lamp, and 0.1 μm filter membrane could all ensure the total number of bacteria in purified water entering AER and final rin-sing tank ≤10 CFU/100 mL. After the qualified purified water reaching AER and endoscope cleaning workstation, the total bacterial count in the final rinse water exceeded the limit. After disinfection AER and the pipelines of endoscope cleaning workstation, the microbial qualified rate of the final rinse water increased from 0 to 100%. Conclusion The synergistic strategy of optimizing the filtration-disinfection combination and conducting thorough pipeline clea-ning can effectively reduce microbial content in purified water, ensuring the safety of water used for flexible endoscopy diagnosis and treatment.

Abstract:Objective To analyze the causes for the unqualified surveillance result of endoscopic disinfection in a medical institution, summarize the investigation and disposal process, and provide reference for similar events. Methods The causes for the unqualified surveillance result of endoscopic disinfection in the endoscopy center of a medical institution in April 2023 was investigated and analyzed. Measures were adopted, such as stopping using unqualified endoscopes, investigating the cleaning and disinfection operations of endoscopes, maintenance and management of water treatment equipment, and conducting microbiological detection, etc. Disposal measures were formulated based on the existing problems, and problems were rectified. Results The investigation found that the ozone device used for pure water disinfection didn’t work properly; the connection port of the pure water storage tank was broken with water leakage; the waterline was not disinfected after replacing the connection port; and the maintenance of water treatment equipment and waterline disinfection system was incomplete. Twelve disinfected endoscopes were redetected, and 2 were found to be qualified, with a qualified rate of 16.7%. Fifteen pure water specimens were detected. Except that the pure water behind reverse osmosis (RO) membrane was qualified, the remaining 14 specimens, including the final rinse tank for manual cleaning of gastroscopes and colonoscopes, the water inlet of endoscope washer-disinfectors (EWDs), the water outlet of pure water storage tanks, and the return water inlet, were all unqualified, with a qualified rate of 6.7%. The use of pure water equipment was ceased. Endoscope disinfection work was relocated to another endoscope cleaning and disinfection room. All endoscopes were reprocessed, then redetected results were all qualified. Waterline was disinfected with peracetic acid. The raw water treatment equipment was reused since results from three detections were qualified, afterwards, the microbial detection for pure water was strengthened, and the maintenance of the pure water equipment and waterline disinfection were improved. No unqualified pure water occurred. Conclusion Contamination of final rinse water is the main cause for the unqualified surveillance result for endoscopic disinfection quality in this study. Establishing a management system for the operation and maintenance of pure water equipment is crucial to the improvement of endoscopic disinfection quality.

Abstract:Epidemic cerebrospinal meningitis (CSM) is an acute respiratory infectious disease caused by Neisseria meningitidis (Nm) infection, often occurring and spreading in winter and spring. It primarily manifests as meningitis and bloodstream infection, which may occur simultaneously, but often presents with either meningitis or bloodstream infection alone as the main symptom. Based on the antigenic components of capsular polysaccharides, Nm can be classified into 12 serotypes, with A, B, C, W, X, and Y being the most common serotypes. On February 14, 2025, the Second Hospital of Lanzhou University reported one suspected adult case of epidemic CSM. Based on epidemiological characteristics, clinical manifestations, and laboratory test results, the case was diagnosed with group Y CSM. This case was the first adult case of epidemic CSM caused by group Y Nm in Gansu Province, with secondary brain abscess and bacteremia. The clinical team strived for the survival opportunity for the patient through precise diagnosis, multimodal life support and standardized critical care management, and successfully preventing permanent neurological deficits. This case highlights the need to strengthen pathogen surveillance and prevention of group Y epidemic CSM, with a focus on early identification of severe cases, precise selection of antimicrobial agents, and comprehensive treatment.

Abstract:Objective To provide reference for clinical diagnosis and treatment of persistent bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods This paper reports the anti-infection treatment process of a patient with persistent bloodstream infection caused by CRKP. Clinical pharmacists participated in the development of selective digestive decontamination (SDD) scheme to assist anti-infection, therapeutic efficacy was monitored and long-term follow-up after discharge was conducted. Results after SDD adjuvant treatment, patient’s blood culture turned negative, condition was improved, and he was discharged from hospital. Six-month follow-up showed that the patient recovered well. Conclusion SDD adjuvant treatment may have therapeutic value for persistent bloodstream infection originating from the digestive tract, which is helpful to control the infection of such patient.

Abstract:Salmonella infection has always been a global public health problem. Patients with Salmonella sepsis are critically ill, difficult to treat, resulting in high mortality. At present, the pathogenesis of Salmonella sepsis is still unclear, and the virulence of strains with different serotypes and host immune status are key factors determining the severity of Salmonella infection. In order to deeply understand Salmonella sepsis, this article reviews the research progress on its pathogenesis, so as to assist clinical doctors in making timely diagnosis and accurate treatment.

Abstract:Staphylococcus aureus infection is one of the common clinical infectious diseases. Its clinical treatment encounters significant challenges. Peroxisome proliferator-activated receptor γ (PPARγ), as a member of the nuclear receptor family, has multiple mechanisms in regulating inflammatory response, immune cell function, and skin barrier repair, and plays a key role in Staphylococcus aureus infection. PPARγ can inhibit excessive inflammatory response, reconstruct immune response, and promote epidermal regeneration, thus is expected to be a new target for the treatment of Staphylococcus aureus infection. This review systematically summarizes the molecular network of PPARγ in inflammation regulation, immunoregulation, and barrier repair, aiming to provide theoretical basis for the development of targeted therapy strategies.

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