Chinese Journal of Infection Control |
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Editor in Chief：Wu, Anhua ISSN：1671-9638 CN：43-1390/R Sponsor：Ministry of Education of the People's Republic of China Organizer：Central South University, Xiangya Hospital of Central South University Publication cycle：monthly Telephone：0731-84327658 84327237 Email：zggrkz2002@vip.sina.com |
Ranking list
- 01 Molecular epidemiological study of methicillin resistant Staphylococcus aureus FREE4902
- 02 Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare associated infection4150
- 03 Homology analysis on ICU multidrug resistant Acinetobacter baumannii nosocomial infection FREE4037
- 04 Distribution and change of microbial population of clinical isolated bacteria from a hospital between 1999 and 2008 FREE3913
- 05 Colonization and drug resistance of multidrug resistant bacteria in intensive care unit FREE3777
- 06 A new glycopeptide antibiotic——dalbavancin3744
- 07 A case control study on risk factors for nosocomial infection of Acinetobacter baumannii in internal medicine intensive care units FREE3495
- 08 Antimicrobial activity of linezolid and other antimicrobial agents against Enterococci spp. in vitro FREE3447
- 09 Change in drug resistance of Pseudomonas aeruginosa to β lactam antibiotics FREE3434
- 10 Catheter associated nosocomial infection in surgical intensive care unit :a 5 year data analysis3349
- 01 Epidemiological and clinical analysis on bacillary dysentery in 175 children in three years250059
- 02 Comparison of the effectiveness of different disinfectants on blood donors before donation124788
- 03 National healthcare associated infection surveillance system point prevalence survey of antimicrobial use in 740 Chinese hospitals in 2010121278
- 04 Study on resistant mechanism of two clinical strains of Enterobacter aerogenes to ertapenem119242
- 05 Distribution and antimicrobial resistance of major gram negative bacilli in ICU and non ICU wards in a grass roots hospital117381
- 06 Adverse drug reactions of ganciclovir in treating infants with cytomegalovirus hepatitis112131
- 07 Drug resistance and disinfectant resistant genes of Staphylococcus aureus from neonates at a neonatal ward111562
- 08 Monitoring on occupational exposure of health care workers at a general tertiary hospital107961
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From Nightingale to the AI era: a century of evolution and future perspectives on healthcare environmental hygiene
•2025,24(3):295-300 ,Doi: 10.12138/j.issn.1671-9638.20257380
Abstract:： Healthcare-associated infections (HAIs) remain a significant challenge to patient safety worldwide. Over the past decade, contaminated inanimate surfaces have been recognized as a ...Healthcare-associated infections (HAIs) remain a significant challenge to patient safety worldwide. Over the past decade, contaminated inanimate surfaces have been recognized as a major source of infections in susceptible patients and a primary pathway for healthcare workers’ hand contamination. The critical role of healthcare environmental hygiene in infection prevention and control (IPC) has been re-evaluated and is now considered one of the important non-pharmacological interventions (NPIs) for patient safety and HAI prevention in healthcare facilities. Improving the environmental hygiene of healthcare facilities can not only significantly reduce the incidence of HAIs and the colonization rates of pathogens in patients, but also demonstrate substantial cost-effectiveness. These perspectives have gained widespread consensus within the industry. This article aims to explore the historical evolution of environmental hygiene in healthcare facilities, the substantial progress achieved, and the key directions for future development, providing references for research and practice in related fields. Show
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Expert consensus on reprocessing of medical ultrasound probes
• YAO Xi, CHEN Luzeng, WU Anhua, ZHANG Liubo, MA Chunyan, WANG Li, JIA Huixue, HUANG Xun, CAI Meng, ZHANG Qing, CHEN Tao, FEI Hongwen, LIU Yunxi, CHEN Guiqiu, GAO Xiaodong, LI Xin, LI Baohua, HU Guoqing, LIANG Ping, LI Liuyi
•2025,24(3):301-307 ,Doi: 10.12138/j.issn.1671-9638.20252129
Abstract:： Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice. Ultrasound probes, which are directly contact with patients, pose a potential risk of p...Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice. Ultrasound probes, which are directly contact with patients, pose a potential risk of pathogen transmission. This expert consensus was developed by a multidisciplinary team based on international guidelines, standards in China, and the results of a national survey, aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes, and formulating consensus recommendations with the Delphi method. The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks: external-use ultrasound probes, interventional percutaneous ultrasound probes, and internal-use ultrasound probes, puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents, the reprocessing procedures and methods of ultrasound probes, as well as architectural layout and management of reprocessing, so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety. Show
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Status of washing and disinfection management of medical textiles in China
• XU Huiqiong, YANG Yun, ZHU Renyi, XIONG Lijuan, HUANG Hao, CHEN Xiaomin, LIANG Jiansheng
•2025,24(3):308-315 ,Doi: 10.12138/j.issn.1671-9638.20256500
Abstract:： Objective To understand the implementation of WS/T 508-2016 and the status of washing and disinfection of medical textiles in China, and provide basis for the revision of th...Objective To understand the implementation of WS/T 508-2016 and the status of washing and disinfection of medical textiles in China, and provide basis for the revision of the standard. Methods A questionnaire survey was conducted on the management of medical institutions and washing and disinfection workplace, building layout, personnel protection, equipment and supplies, washing and disinfection principles, and hygiene quality monitoring of medical textiles in 323 medical institutions and 31 washing institutions in China. Meanwhile, microbiological index sampling was conducted on 234 pieces of medical textiles in 9 medical institutions and 8 washing institutions in Hubei, Shanxi, Shanghai, and Sichuan Provinces before and after washing and disinfection. Results The awareness rates of WS/T 508-2016 among medical institutions and washing institutions were 96.90% and 96.77%, respectively, and the implementation rates were 94.12% and 96.77%, respectively. 47.99% medical institutions use purchasing services for washing and disinfecting medical textiles, and the higher the level of the medical institution was, the higher the proportion of purchasing services was (χ2=15.312, P<0.001). 85.16% medical institutions have conducted risk assessments on service providers, and 52.99% were responsible for or participated in pre-job training by the medical institution. Washing institutions were higher than medical institutions in terms of system soundness rate, pre-job training rate, proportion of quality management leaders and full-time (part-time) quality inspectors, setting rate of hand-washing facilities in zones, passages, isolation barriers, dressing (buffer) room, and toilets, configuration rate of hygiene isolation washing equipment, tunnel washing unit, washing equipment with heating functions, drying equipment and mechanical ventilation facilities, and specialty machine washing rate. Among 234 medical textiles specimens, 11.97% were detected fungi, and the total fungal colonies in 5 clean textiles exceeded 100 CFU/100 cm2. Conclusion WS/T 508-2016 can further standardize the washing and disinfection of medical textiles in China through strengthening institutional management, improving the supervision level of service providers, perfecting hardware facilities and layout, introducing new technologies, and increasing the monitoring on fungi in clean textiles. Show
KeyWord：medical textiles;washing;cleaning;disinfection;management
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Surface disinfection efficacy of 254 nm continuous ultraviolet and pulsed ultraviolet laser
• ZHAO Jie, ZHAO Lei, SHANG Yiran, WU Jinhui, YI Ying, DENG Cheng, QI Jiancheng, ZHANG Zongxing
•2025,24(3):316-322 ,Doi: 10.12138/j.issn.1671-9638.20256933
Abstract:： Objective To compare and analyze the germicidal efficacy of continuous ultraviolet and pulsed ultraviolet (UV) lasers on pathogenic microorganisms. Methods Spore slid...Objective To compare and analyze the germicidal efficacy of continuous ultraviolet and pulsed ultraviolet (UV) lasers on pathogenic microorganisms. Methods Spore slides of Escherichia coli and Bacillus atrophaeus were irradiated using a 254 nm ultraviolet mercury lamp and UV laser. The carrier quantitative germicidal test was conducted to determine the disinfection efficacy at different irradiation doses. Results When the irradiation dose of the ultraviolet mercury lamp was 245.52 mJ/cm2, the logarithmic killing values of Escherichia coli and Bacillus atrophaeus spores were 5.00 and 2.92, respectively, and the mean logarithmic killing doses were 49.10 and 84.08 mJ/cm2, respectively; When the UV laser irradiation doses were 208.39 and 206.80 mJ/cm2, the logarithmic killing values for the two microorganisms were 6.29 and 3.32, respectively, and the mean logarithmic killing doses were 33.13 and 62.29 mJ/cm2, respectively. Conclusion Compared with continuous UV radiation, pulsed UV laser has stronger penetration ability, better killing efficacy on pathogenic microorganisms at the same radiation dose, and can conduct targeted disinfection and sterilization on the surface of objects directionally. Show
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Effectiveness and duration of point-of-use filter in improving endoscopic final rinse water quality
• ZHANG Xinyue, DING Jing, WU Dawei, CHEN Shuangfeng, JIN Suxiang, WANG Wenlong, ZHANG Yongxiang, CHEN Wensen, ZHANG Weihong, LI Zhanjie
•2025,24(3):323-328 ,Doi: 10.12138/j.issn.1671-9638.20255455
Abstract:： Objective To study the effect and duration of point-of-use filters on the improvement of endoscopic final rinse water quality. Methods The final rinse water end at th...Objective To study the effect and duration of point-of-use filters on the improvement of endoscopic final rinse water quality. Methods The final rinse water end at the gastroscope manual cleaning workstation in the Endoscopy Centre of the First Affiliated Hospital with Nanjing Medical University was selected to install a tap terminal filter; five specimens of final rinse water were collected consecutively before the installation, immediately after the installation, and 1-11 weeks after the installation. At each sampling time, the staff responsible for clea-ning and disinfecting were asked whether the flow rate of discharged water could satisfy the working demand; the final rinse water was inoculated on R2A culture medium with membrane filter method, bacterial colony forming unit (CFU) was calculated after 30℃ incubation for 5 days. Results The qualified rates of endoscopic final rinse water before point-of-use filter installation was 0, immediately after and 1-9 weeks after installation were both 100%, 10 and 11 weeks after installation were 80.0% and 20.0%, respectively. The mean CFU of endoscopic final rinse water before point-of-use filter installation was 102 CFU/100 mL, immediately after and 1-9 weeks after installation were both ≤2 CFU/100 mL, 10 and 11 weeks after installation were 8 and 18 CFU/100 mL, respectively. The feedback from the cleaning and disinfection staff before installation, immediately after installation, and 1-11 weeks after installation indicated that the flow rate of discharged water gradually slowed down over time, but could still meet the work requirements. Conclusion The point-of-use filter can quickly and effectively improve the quality of endoscopic final rinse water, with use duration of up to 9 weeks after installation; Its biggest advantage is that it can serve as the final barrier to all integrated measures, playing a supplementary role in case of any problems occu-rring in the front-end process, and ensuring the microbial quality of the final rinse water to the greatest extent possible. Show
KeyWord：point-of-use filter;endoscope;final rinse water;microbial;duration
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Current status of healthcare-associated infection management for transesophageal echocardiography: a nationwide investigation
• WU Lianxuan, JIA Huixue, YAO Xi, ZHANG Bingli, LI Liuyi
•2025,24(3):329-335 ,Doi: 10.12138/j.issn.1671-9638.20255459
Abstract:： Objective To understand the current status of healthcare-associated infection (HAI) management for transesophageal echocardiography (TEE) examination in China, and provide a...Objective To understand the current status of healthcare-associated infection (HAI) management for transesophageal echocardiography (TEE) examination in China, and provide a scientific basis for formulating guidelines and standards for infection prevention and control in ultrasound diagnosis and treatment. Methods A stratified sampling survey was conducted in 162 medical institutions (MIs) in 14 provinces (autonomous regions, municipalities) in China. A unified questionnaire was designed, and on-site surveys were conducted in the TEE examination room of each MI, with questionnaires filled out based on the results of the on-site survey. Results 162 MIs were surveyed, out of which 114 (70.4%) carried out TEE examination. TEE examination was undertaken by ultrasound medicine department (66.7%) and cardiology department (36.0%) in most MIs, and 91.0% of HAI departments had specially-assigned infection prevention and control professional to responsible for the management of HAI rela-ted to examination. 32.4% (n=36) of TEE examinations used ultrasound probe isolation sleeves, mainly sterilized isolation membranes. The overall high-level disinfection or sterilization rate of TEE probes was 79.3%, 19.8% of MIs chose medium-level disinfection. However, based on the number of equipped probes, the interval between patient examination, and the disinfection method of probes, it was inferred that the proportion of effective high-level disinfection was only 67.6%. The most commonly adopted sterilization, high-level disinfection and medium-low le-vel disinfection methods for probes were low-temperature hydrogen peroxide sterilization, o-phthalaldehyde disinfection and quaternary ammonium wiping disinfection, respectively. 92.8% of examination rooms stored the probes in special storages cabinets (boxes) after disinfection. 32.4% of examination rooms cleaned and disinfected ultrasound devices other than TEE probe between each patient examination, all were with medium-level disinfection. Most exa-mination rooms equipped complete hand hygiene (HH) facilities and ventilation, 59.5% of the operators had the HH compliance rate of more than 90%. The wearing of disposable medical rubber examination gloves and glove changing for each patient was ideal. However, the change of bedding and the change of medical operators’ overalls for each patient were not ideal. Conclusion TEE examination is generally carried out in large MIs across the country, but the high-level disinfection rate of TEE probes still needs to be improved, and the appropriate disinfection methods still need further discussion and research. The disinfection awareness of ultrasound devices other than TEE probes still needs to be enhanced, and the compliance of hand hygiene of operators, the awareness of timely changing of bedding of patients’ examination beds, and the awareness of changing of overalls of diagnosis and treatment operators need to be enhanced. Show
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Analysis and countermeasures for abnormal final rinse water in a newly-built endoscopy center
• ZHAO Jing, REN Xiaorui, HE Ziyang, MENG Xiangyu, GUO Ze, ZHOU Chunlian
•2025,24(3):336-342 ,Doi: 10.12138/j.issn.1671-9638.20255462
Abstract:： Objective To conduct microbiological monitoring before the operation of the purified water treatment system in a newly-built endoscopy center, comprehensively analyze the ca...Objective To conduct microbiological monitoring before the operation of the purified water treatment system in a newly-built endoscopy center, comprehensively analyze the causes for the standard-exceeding results of microbial detection of final rinse water, propose solutions, and provide reference for handling similar events in the future. Methods Microbial detection data of the final rinse water in the newly-built digestive endoscopy center of a tertiary first-class general hospital in Beijing from April to July 2024 were monitored. The potential causes for standard-exceeding results of microbial detection of final rinse water were analyzed from the perspectives of equipment maintenance and management of the purified water treatment system as well as the improvement of cleaning and disinfection methods for the purified water supply pipeline in the endoscopy center, targeted improvement mea-sures were proposed accordingly. Results The microbial monitoring result of final rinse water in the newly-built digestive endoscopy center built in April 2024 was 1 400 CFU/100 mL, with the main bacterial type being Cupriavidus pauculus. After five rounds of improvement measures and rechecks, microbial monitoring result of the final rinse water in the newly-built endoscopy center was 0 CFU/100 mL, with a qualification rate of 100%. Analysis suggested that the main causes for the standard-exceeding results of microbial detection of final rinse water were due to the damage of the reverse osmosis membrane, lack of cleaning for the pure water storage tank before use, and non-standard cleaning and disinfection process for the pure water supply pipeline, after targeted improvement, the problem was solved. Conclusion Medical institutions should continuously conduct periodic monitoring on water used for endoscope, regularly perform cleaning and disinfection of the purified water treatment system, standardize cleaning and disinfection procedures, ensure medical quality and patient safety. Show
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Current status of construction and monitoring of healthcare-associated infection system in Guangxi area
• WEI Yanni, LIAO Guiyi, LIANG Minglan, MA Zhangjie, LIANG Wenting, LIAO Dan
•2025,24(3):343-353 ,Doi: 10.12138/j.issn.1671-9638.20255453
Abstract:： Objective To investigate the current status of construction and monitoring of healthcare-associated infection (HAI) system in maternal and child health care institutions in ...Objective To investigate the current status of construction and monitoring of healthcare-associated infection (HAI) system in maternal and child health care institutions in Guangxi Zhuang Autonomous Region, and provide reference for improving the quality of HAI management. Methods After discussed by members of expert group of HAI Prevention and Control Professional Committee of Guangxi Maternal and Child Health Care Association, the "Questionnaire on the construction and monitoring of HAI system in maternal and child health care institutions in Guangxi Zhuang Autonomous Region" was designed. The questionnaires were distributed to all maternal and child health care institutions in the region via "Questionnaire Star", and a WeChat group was established to address any questions in questionnaires. Results A total of 104 maternal and child health care institutions were included in the study, including 6 primary, 74 secondary, and 24 tertiary level institutions. All maternal and child health care institutions have established HAI management departments, 95.19% (n=99) of institutions held HAI management committee meeting at least once every six months. Among 201 HAI management professionals, most were female (90.55%), with nursing specialty (72.64%), with a bachelor’s degree (66.17%), and aged 31-50 years old (73.13%). Only 30.77% of the maternal and child health care institutions had HAI monitoring system. Seventy institutions (67.30%) have carried out the special action of improving the pathogen detection rate before antimicrobial therapy for hospitalized patients, out of which 55 (78.57%) were led by the HAI management department. Ninety-seven (92.27%) maternal and child health care institutions conducted surgery-related monitoring, with 50.96% of institutions relying on manual monitoring; only 30.77% of institutions have carried out the special action of "Strengthening perioperative infection prevention and control to ensure surgical quality and safety". Conclusion HAI management system in maternal and child health care institutions in Guangxi has been basically established and can carry out monitoring work, but personnel compostion is limited and talent reserve is insufficient. The information construction of HAI monitoring is underdeveloped, with a lagged implement of special action. Administrative support is needed to enhance infection prevention and control at the grassroots level. All levels of maternal and child health care institutions should communicate and exchange work experience. Hospitals should increase their support for the construction of HAI information technology, improve level of HAI monitoring as well as prevention and control capabilities. Show
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Current status of job competency of full-time healthcare-associated infection management professionals in 31 provinces across China
• LIU Xin, XIE Mengnai, SUN Jihua, SONG Hongfang, LIU Fang, FAN Guoai, WEI Jia, CAI Meng
•2025,24(3):354-360 ,Doi: 10.12138/j.issn.1671-9638.20256780
Abstract:： Objective To understand the current status of the job competency of full-time healthcare-associated infection (HAI) management professionals in all levels and types of medic...Objective To understand the current status of the job competency of full-time healthcare-associated infection (HAI) management professionals in all levels and types of medical institutions across China, and provide information and basis for professional training, competency improvement, and career planning. Methods The stratified sampling method was adopted to select HAI management professionals from medical institutions in 31 provincial-level administrative regions across the country as the research subjects. The designed content of questionnaire involved four parts, including the surveyed personnel’s basic information, daily job competency assessment, satisfaction level towards the job, as well as opinions and suggestions on the management of full-time HAI management professionals. The assessment on daily job competency was divided into 13 dimensions, ranging from very incompetent to very competent in 5 levels. The scores of HAI management professionals with different professional backgrounds were compared and analyzed. Results A total of 8 709 valid questionnaires were collected, with 3 475 and 3 697 surveyed personnel from tertiary and secondary medical institutions, respectively, and 1 537 from primary or unclassified medical institutions. The overall average score for the competency assessment of full-time HAI management professionals was (4.17±0.80) points. The scores of professionals with different professional backgrounds, from high to low, were as follows: nursing (［4.12±0.81］ points), clinical medicine (［4.07±0.86］ points), preventive medicine (［3.93±0.92］ points), laboratory medicine (［3.88±0.93］ points), pharmacy (［3.86±0.94］ points), and health management (［3.85±0.95］ points). For the core competency of HAI management professio-nals, such as monitoring and analyzing HAI cases, identifying and investigating HAI outbreaks, the assessment scores for professionals with medical backgrounds were the highest (both P<0.05). For the basic work of HAI prevention and control, such as checking and guiding the implementation of rules and regulations, guiding occupational protection, management and communication, and implementing HAI management training, professionals with a nursing background had the highest assessment scores (all P<0.05). Full-time HAI management professionals were relatively satisfied with their training, while those with a background in preventive medicine had lower satisfaction with their training, career development, and job benefits (all P<0.05). Conclusion There are significant differences in the competency of HAI management professionals with different professional backgrounds. It is nece-ssary to optimize division of labor and leverage the strengths, providing ideas and models for promoting the construction of a specialized and professional HAI management team. Show
KeyWord：healthcare-associated infection management;professionals;job competency;core competency
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Characteristics of gut microbiota in elderly patients with severe pneumonia
• YU Steven, ZHOU Hao, JIANG Juan, HU Xinyue, LI Tiao, LI Yuanyuan
•2025,24(3):361-371 ,Doi: 10.12138/j.issn.1671-9638.20256565
Abstract:： Objective To summarize and analyze the main clinical characteristics, feature and composition changes of gut microbiota in elderly patients with severe pneumonia, and to fur...Objective To summarize and analyze the main clinical characteristics, feature and composition changes of gut microbiota in elderly patients with severe pneumonia, and to further explore the potential correlation between the gut characteristics and the etiology of severe pneumonia in elderly patients. Methods Patients with severe pneumonia admitted to the respiratory intensive care unit of a tertiary teaching hospital in Changsha were selected as the research subjects.Patients aged ≥65 years were assigned to the elderly severe pneumonia group, while those aged <65 years were assigned to the non-elderly severe pneumonia group. Based on clinical characteristics and pathogen detection of lower respiratory secretion, the elderly severe pneumonia group was further divided into a pulmonary bacterial infection group and a pulmonary fungal infection group. The pulmonary bacterial infection group was subdivided into Gram-positive bacteria group and Gram-negative bacteria group based on Gram-staining results. Clinical data of patients were collected, and fecal specimens within 24 hours after admission were obtained for 16S rRNA sequencing. Differences in gut microbiota characteristics between two groups of patients were compared, and the correlation between clinical characteristics of patients in the elderly severe pneumonia group and the abundance of differential microbiota was analyzed. Subsequently, the gut microbiota characteristics of elderly patients in severe pneumonia group infected by different pathogens were analyzed. Results Gut microbiota analysis showed no significant statistical differences in α- and β-diversity indicices between patients in the elderly and non-elderly severe pneumonia groups (both P>0.05). Linear discriminant analysis effect size (LEFSe) analysis indicated that, compared with patients in the non-elderly severe pneumonia group, the relative abundance of opportunistic pathogens, including Pseudomonadales, Moraxellaceae, and Acinetobacter, was significantly higher in patients in the elderly severe pneumonia group (all P<0.05). Some differential gut microbiota in two groups of patients were correlated with clinical indicators in patients in the elderly severe pneumonia group (all P<0.05). β-diversity analysis (principal coordinate analysis) combined with Anosim analysis revealed that in patients in elderly severe pneumonia group, there was significant differences in gut colony structures between patients in the bacterial and fungal infection groups (R=0.149, P=0.02). Compared with the fungal infection group, patients in bacterial infection group showed a significantly reduced abundance of probiotics, including Verrucomicrobiales and Collinsella, and opportunistic pathogens such as Akkermansia (all P<0.05). Conclusion Elderly patients with severe pneumonia have a dysregulated gut microbiota with significantly increased abundance of pathogenic bacteria compared with non-elderly patients. Differential gut microbiota of two groups of patients are correlated with some infection-related and organ function indicators in elderly patients with severe pneumonia. Compared with elderly patients with severe fungal pneumonia, those with severe bacterial pneumonia have significant differences in gut colony structures and a notably reduction in probiotics abundance. Show
KeyWord：severe pneumonia;elderly patient;gut microbiota;16S rRNA
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Metabolomics of oropharyngeal specimens from postoperative pneumonia patients with gastric cancer
• CHEN Bizhen, LI Zimeng, JIANG Yaxin, WEI Tingyu, JIA Rui, SHI Chao
•2025,24(3):372-380 ,Doi: 10.12138/j.issn.1671-9638.20256645
Abstract:： Objective To explore the characteristics of oropharyngeal metabolites of postoperative pneumonia (POP) and non-POP patients with gastric cancer by non-targeted metabolomics,...Objective To explore the characteristics of oropharyngeal metabolites of postoperative pneumonia (POP) and non-POP patients with gastric cancer by non-targeted metabolomics, and to provide reference for revealing the pathogenesis as well as clinical prevention and control. Methods Oropharyngeal swabs were collected from patients who underwent surgical treatment for gastric cancer in the department of gastrointestinal surgery of a tertiary hospital in Fujian Province from January 2022 to December 2023, nested case-control study was adopted, with 30 cases in POP group and non-POP group, respectively, ultrahigh performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) technique was adopted for detection, and multivariate statistical analysis was performed. Results The metabolites of POP group and non-POP group preoperatively, POP group and non-POP group postoperatively, POP group preoperatively and postoperatively, as well as non-POP group preoperatively and postoperatively did not show a clear trend of separation on the score graph of principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), and orthogonal partial least squares discriminant analysis (OPLS-DA), but the screening of the differential metabolites revealed that the relative abundances of ascorbic acid and lipoic acid in the POP group preoperatively were lower than non-POP group preoperatively. The relative abundance of 5’-adenylic acid in the POP group preoperatively was lower than postoperatively, while the relative abundances of succinic acid and phenylacetaldehyde were higher. There were differences in metabolic pathways such as phenylalanine. Conclusion Alteration of metabolite level due to abnormalities in specific metabolic pathways presents in the deve-lopment of gastric cancer POP and may be related to the development of POP. Show
KeyWord：gastric cancer;postoperative pneumonia;oropharyngeal metabolites;non-targeted metabolomics
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Clinical characteristics and prognosis of Pseudomonas aeruginosa peritoneal dialysis-associated peritonitis
• WANG Zhigang, GENG Yingzhou, WANG Xiaopei, LI Zhao, LIANG Changna, LU Wanhong, LYU Jing
•2025,24(3):381-387 ,Doi: 10.12138/j.issn.1671-9638.20255327
Abstract:： Objective To analyze the clinical characteristics and prognosis of Pseudomonas aeruginosa peritoneal dialysis-associated peritonitis (PaeP). Methods Peritoneal dialys...Objective To analyze the clinical characteristics and prognosis of Pseudomonas aeruginosa peritoneal dialysis-associated peritonitis (PaeP). Methods Peritoneal dialysis-associated peritonitis (PDAP) patients who were followed up in the nephrology outpatient department of a hospital from January 2019 to December 2020 were analyzed retrospectively. According to bacterial culture results, patients were divided into the PaeP group and non-PaeP group. Clinical characteristics of PaeP patients and antimicrobial susceptibility testing results of Pseudomonas aeruginosa were analyzed, clinical manifestations, laboratory test results, and prognosis of two groups of patients were compared. Results A total of 124 peritoneal dialysis patients were included in analysis, 164 cases of peritonitis occurred, 16 cases were in the PaeP group and 148 in the non-PaeP group. 11 patients developed 16 episodes of Pseudomonas aeruginosa infection, accounting for 8.9% of PDAP patients. Among them, 4 patients had peritoneal dialysis catheter exit-site infection, with 5 recurrence cases, 1 case cured, 1 case died, and 9 cases were extubated. Among the extubated patients, 1 withdrew dialysis, 3 were recovered to peritoneal dialysis after hemodialysis, 5 changed to permanently hemodialysis, with a technical failure rate of 54.5%. Compared with the non-PaeP group, patients in the PaeP group had a shorter dialysis time (13.83±4.92 vs 38.53±35.77 months). During the infection period, C-reactive protein levels were higher (96.61±6.17 vs 45.87±44.65 mg/L), while albumin levels were lower (25.62±4.42 vs 29.46±8.25 g/L). At the onset of infection, the proportion of polymorphonuclear cells in peritoneal dialysis fluid was relatively higher. On the 5th day of treatment, the negative conversion rate of white blood cell count in peritoneal dialysis fluid was relatively low. Differences were all statistically significant (all P<0.05). The cure rate of patients in the PaeP group was lower than that in the non-PaeP group, the technical failure rate was higher than that in the non-PaeP group, both with statistically significant differences (both P<0.05). There was no statistically significant difference in the mortality between two groups of patients (P>0.05). Conclusion PaeP patients have severe clinical manifestations, poor clinical treatment prognosis, high recurrence and extubation rates. For patients with repeated episodes, resetting and replacing the tunnel after extubation is an effective means to reduce technical failures. Show
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Clinical characteristics of SARS-CoV-2 infection-related encephalitis
•2025,24(3):388-395 ,Doi: 10.12138/j.issn.1671-9638.20256672
Abstract:： Objective To summarize the clinical characteristics and pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-related encephalitis, aiming t...Objective To summarize the clinical characteristics and pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-related encephalitis, aiming to provide new theoretical basis for clinical diagnosis and treatment. Methods Clinical characteristics as well as diagnosis and treatment process of 25 patients with SARS-CoV-2 infection-related encephalitis in the Second Affiliated Hospital of Shandong First Medical University were analyzed, and the pathogenesis was evaluated. Results The main prodromal symptoms were fever (80.0%), the initial symptoms were consciousness disturbance (56.0%), epileptic seizures (52.0%), and mental symptoms (36.0%). The subsequent symptoms were mainly autonomic nerve dysfunction (88.0%), epileptic seizures (68.0%), cognitive dysfunction (68.0%), motor impairment (64.0%), and language dysfunction (52.0%). The auxiliary examination results were mainly increase of content of cerebrospinal fluid (CSF) protein and increase of C-reactive protein (CRP); electroencephalogram (EEG) showed slowing down of a non-specific background rhythm, followed by abnormal discharges; the most common manifestation of magnetic resonance imaging (MRI) was abnormal high signal in the insular cortex and medial temporal lobe, followed by diffuse or focal microbleeds. The first-line treatment agents were glucocorticoid combined with immunotherapy, and the second-line treatment agent was monoclonal antibody. The prognosis was poor. Conclusion Patients with a history of exposure to SARS-CoV-2 infection, consciousness disturbance, epileptic seizures and mental symptoms should be vigilant to the possibility of encephalitis. CSF, EEG, and MRI auxiliary examination should be given. Once diagnosed, early intervention is necessary. The main pathogenesis include direct invasion, cytokine storm, excessive immune inflammation, specific lymphocyte response, etc. Show
KeyWord：SARS-CoV-2;encephalitis;electroencephalogram;magnetic resonance imaging;tocilizumab
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Perioperative antimicrobial prophylaxis in class Ⅰ incisional ophthalmic surgeries in Shanghai City, 2017-2022
• HU Tao, SUN Wei, SHEN Yan, CHEN Xiang, LIN Jiabing, CUI Yixin, HAN Mengge, GAO Xiaodong, HU Bijie, SHI Qingfeng
•2025,24(3):396-401 ,Doi: 10.12138/j.issn.1671-9638.20255460
Abstract:： Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in ...Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City, and provide a basis for the rational use of antimicrobial agents in such surgeries. Methods Perioperative antimicrobial prophylaxis (PAP) in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively. The prophylactic use rate, types, rationality of selection, and timing of use of antimicrobial agents were analyzed comprehensively. Results From 2017 to 2022, a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City. The PAP rates in tertiary comprehensive hospitals, tertiary specialty hospitals, tertiary traditional Chinese medicine hospitals, and secondary comprehensive hospitals were 4.72%, 1.79%, 3.22%, and 6.63%, respectively. The overall PAP rate showed a yearly decreasing trend, from 6.39% in 2017 to 2.31% in 2021. Among different types of hospitals, the PAP rate in secondary comprehensive hospitals decreased most significantly, from 12.72% in 2017 to 0.53% in 2022. The main types of prophylactic antimicrobial use were first-, second- and third-generation cephalosporins, and quinolones. The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals (17.13%) and lowest in tertiary specialty hospitals (1.08%). The PAP rates in systemic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals (88.17%) and lowest in tertiary comprehensive hospitals (71.53%). The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals (80.87%) and lowest in tertiary specialty hospitals (13.26%). Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes. The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved. Enhanced management is necessary to promote more rational use of antimicrobial agents. Show
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Epidemiological characteristics and treatment outcome of pulmonary tuberculosis patients combined with diabetes mellitus in Bijie City from 2017 to 2022
• ZHANG Mai, YANG Jingyuan, YU Qin, YU Miao, LI Jinlan, LIU Yong
•2025,24(3):402-409 ,Doi: 10.12138/j.issn.1671-9638.20256714
Abstract:： Objective To analyze the epidemiological distribution characteristics and influencing factors of treatment outcome of pulmonary tuberculosis (PTB) patients complicated with ...Objective To analyze the epidemiological distribution characteristics and influencing factors of treatment outcome of pulmonary tuberculosis (PTB) patients complicated with diabetes mellitus (DM) in Bijie City from 2017 to 2022, and provide reference for formulating prevention and control measures of PTB-DM. Methods The registered management cases of PTB patients combined with DM from the tuberculosis surveillance report information management system in Bijie City in 2017-2022 were collected. Changing trends in annual registration rates and successful treatment rates were analyzed with Joint-point regression models. Different characteristics between patients with PTB-DM and PTB alone were conducted comparative analysis; the influencing factors of treatment outcome were analyzed by χ2 test and binary logistic regression analysis. Results A total of 679 PTB-DM patients were registered in Bijie City from 2017 to 2022, accounting for 1.53% of total PTB patients, the annual registration rate increased from 1.11/100 000 in 2017 to 3.08/100 000 in 2022, with an increasing trend in the annual percentage change (APC=26.67%, 95%CI: 5.36%-52.29%, t＝3.564, P＝0.024). In the analysis on characteristics, the proportion of PTB-DM male patients, age ≥45 years and farmers, the ratio of direct consultation to transfer treatment, the pathogenicity positive rate, the proportion re-treatment, and rate of delay in consultation were all higher than those of PTB alone; successful treatment rate and proportion of floating population were all lower than PTB alone, difference were all statistically significant (all P<0.05). The successful treatment rate of PTB-DM patients in Bijie City from 2017 to 2022 was 87.80%. Age, occupation, pathogenicity diagnosis results were influencing factors for treatment outcome in patients with PTB-DM, with farmers (OR=3.68, 95%CI: 1.22-11.09), with pathogenicity positivity (OR=2.84, 95%CI: 1.24-6.50), and without pathogenic detection result+tuberculous pleurisy (OR=11.35, 95%CI: 2.16-59.74) being risk factors for successful treatment. Conclusion Although the proportion of PTB-DM in the total PTB patients in Bijie City from 2017 to 2022 was not high, it showed an upward trend; it is necessary to attach great importance to male, re-treated, farmer, and pathogenicity positivity comorbid patients in Bijie City, and strengthen the two-way screening of PTB-DM in high-risk populations. Show
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Evaluation of direct economic burden of surgical site infection in orthopedics based on propensity score matching
• HUA Zhijin, XIA Jiao, GAN Changyu, FU Qi, ZHANG Qingbi
•2025,24(3):410-416 ,Doi: 10.12138/j.issn.1671-9638.20255246
Abstract:： Objective To analyze the direct economic burden caused by surgical site infection (SSI) in orthopedics and joint surgery, and provide evidence-based support for intervention...Objective To analyze the direct economic burden caused by surgical site infection (SSI) in orthopedics and joint surgery, and provide evidence-based support for intervention measures. Methods 3 348 hospitalized patients in the department of orthopedics and joint surgery of a hospital from July 2021 to July 2023 were selected. They were divided into an infection group and a control group based on whether they had SSI. The propensity score matching (PSM) method was adopted to match the two groups of patients in a 1 ∶1 ratio. The length of hospital stay and various hospitalization expenses between patients with different types of SSI and control group were compared. Results Among 3 348 hospitalized patients, 259 had SSI, with an incidence of 7.74%. Superficial incisional wound infection had the highest number of patients (n=177, 68.34%), followed by deep incisional wound infection (n=65, 25.10%), organ/space infection had the lowest number of patients (n=17, 6.56%). After PSM matching, 257 pairs were successfully matched, with a matching rate of 99.23%. Infection group extended length of hospital stay by 18 days compared with the control group (P<0.001). The total hospitalization expenses and individual hospitalization expenses of infection group were all higher than those of the control group (all P<0.001). Among the various expenses, difference in drug expense was the largest, with an increase of 5 067.83 Yuan in Western medicine (P<0.001) and 957.30 Yuan in antimicrobial agents (P<0.001). Patients with different types of SSI all had longer hospital stay compared with the control group. Patients with deep incisional wound infection, superficial incisional wound infection, and organ/space infection had an extended hospital stay of 26,18, and 13 days, respectively (all P<0.05). The total hospitalization expenses, Western medicine expenses, and antimicrobial agent expenses of patients with different types of SSI were all higher than those of the control group (all P<0.05). Conclusion The occurrence of postoperative SSI in patients in the department of orthopedics and joint surgery can prolong the length of hospital stay, resulting in huge economic losses for the patient and the hospital. Effective control of healthcare-associated infection is of great significance for optimizing medical resources, improving medical quality, and ensuring patient safety. Show
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Characteristics of infection in 259 recipients after heart transplantation
• SONG Yapei, WU Yan, HUANG Baiyan, GUO Bingbing
•2025,24(3):417-421 ,Doi: 10.12138/j.issn.1671-9638.20255457
Abstract:： Objective To understand the epidemiological characteristics of infection in recipients after heart transplantation, and provide references for the prevention and control of ...Objective To understand the epidemiological characteristics of infection in recipients after heart transplantation, and provide references for the prevention and control of postoperative infections. Methods Clinical data of 259 heart transplant recipients in a hospital from April 2018 to December 2023 were collected for epidemiological analysis. Results Among 259 heart transplant patients, 55 developed 68 episodes of infection during the first hospitalization after surgery, the incidence of infection was 21.24%, and the case incidence of infection was 26.25%. The main infection sites were lower respiratory tract (n=30, 44.12%), blood system (n=21, 30.88%), and urinary system (n=8, 11.76%). Sixty-eight episodes of infections occurred primarily within 10 days after surgery (n=37, 54.41%), fo-llowed by within 11-20 days (n=14, 20.59%).A total of 74 pathogens were detected from the infected site, mainly Gram-negative bacteria (n=37, 50.00%), followed by fungi (n=19, 25.68%), Gram-positive bacteria (n=12, 16.22%), viruses (n=6, 8.11%). The multidrug-resistant rates of Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterococcus spp. were relatively high (57.1%-100%). During the period from discharge to one year after surgery, 31 patients developed 39 episodes of infection, mainly lower respiratory tract infection (n=29, 74.36%). Conclusion Heart transplant recipients have a high incidence of postoperative infection, with lower respiratory tract being the main infection site and with a high resistance rate of pathogen. The critical period for infection prevention and control is within 10 days after surgery. Show
KeyWord：heart transplantation;infection;pathogen;drug resistance
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One case of pulmonary infection in a patient with polymyalgia rheumatica caused by Legionella marssiliensis
• HU Yiran, ZHANG Sisi, WU Anhua, LI Chunhui
•2025,24(3):422-425 ,Doi: 10.12138/j.issn.1671-9638.20256809
Abstract:： A 70-year-old male patient was admitted to a hospital on March 1, 2024 due to "muscle soreness in his extremities for over a month". Diagnosis consideration: polymyalgia rheumatica...A 70-year-old male patient was admitted to a hospital on March 1, 2024 due to "muscle soreness in his extremities for over a month". Diagnosis consideration: polymyalgia rheumatica (with a high likelihood, the possibility of a tumor needs to be excluded). The patient was treated with methylprednisolone. After discharge from the hospital, the patient’s symptoms worsened due to self-withdrawal of medication (methylprednisolone treatment for 20 days),and developed fever and cough. He then revisited the hospital and was confirmed to have Legionella mar-ssiliensis infection through metagenomic sequencing of bronchoalveolar lavage fluid (nucleic acid of all microorga-nisms were extracted from the specimens and compared in the PMDB database to obtain species information of the suspected pathogenic microorganisms). Subsequently, the patient was treated with a combination of 0.75 g levofloxacin intravenous infusion qd + 0.1 g doxycycline enteric-coated capsules orally bid for anti-infective therapy. The patient’s symptoms, such as cough and muscle pain, improved significantly after anti-inflammatory and anti-infective treatment, and he was discharged on March 18. As the first reported case of Legionella marssiliensis pulmonary infection in China, this case highlights that among the multiple species of Legionella, there is another bacte-rium that can infect the human body and cause disease. This case report is beneficial for improving medical staff’s understanding on Legionella marssiliensis and providing reference for the diagnosis and treatment of future cases of Legionella marssiliensis infection. Show
KeyWord：Legionella marssiliensis;pulmonary infection;polymyalgia rheumatica;community-acquired pneumonia
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Pasteurella multocida infection caused by snow leopard bite: a case report
• DENG Shixia, LIU Chunping, YIN Li, ZHAI Jing, WANG Yawei, ZHAO Qian, ZHOU Jiewen
•2025,24(3):426-429 ,Doi: 10.12138/j.issn.1671-9638.20257202
Abstract:： Pasteurella is a genus of zoonotic pathogens that are widely distributed in both healthy and diseased ani- mals. Reports of human infections caused by wild animal bites are rare. T...Pasteurella is a genus of zoonotic pathogens that are widely distributed in both healthy and diseased ani- mals. Reports of human infections caused by wild animal bites are rare. This paper reports the first case of Pasteurella multocida infection caused by a snow leopard bite in China. The strains were identified using the DL-96Ⅱ bacterial identification system, BRUKER automatic microbial mass spectrometer, and Autof ms 1000 mass spectrometer. Antimicrobial susceptibility testing was performed using the DL-96Ⅱ bacterial assay system. After wound debridement, surgical incision and drainage, and combined antimicrobial treatment, the patient recovered and was discharged from the hospital. This paper aims to improve clinical health care workers’ understanding on this bacterium. Show
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Research progress of pannexin 1 in infection
• XU Zhiwei, WANG Pusen, ZHANG Shubin, ZHONG Lin
•2025,24(3):430-436 ,Doi: 10.12138/j.issn.1671-9638.20256688
Abstract:： Pannexin 1 (PANX1) interacts with purinergic receptors through regulating immune responses, releasing adenosine triphosphate (ATP), and the NLRP3/caspase-1/interleukin (IL)-1β sign...Pannexin 1 (PANX1) interacts with purinergic receptors through regulating immune responses, releasing adenosine triphosphate (ATP), and the NLRP3/caspase-1/interleukin (IL)-1β signaling pathway, then influences the activation of immune cells and promotes the production of reactive oxygen species (ROS), thus causing inflammation and tissue damage which exacerbates infection. This research group has synthesized new polypeptides named QE20 and EE20, which can specifically inhibit the opening of PANX1 channels under inflammatory stimulation, offering advantages such as reducing cellular ATP release, inhibiting inflammatory factor secretion, and preventing hepatocyte pyroptosis, et al. This review summarizes the roles and mechanisms of PANX1 in various infectious diseases, and predicts the feasibility of PANX1 as a potential therapeutic target in the future. Show
KeyWord：pannexin 1;infection;ATP;purinergic receptor;synthetic peptide;PANX1
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