Chinese Journal of Infection Control |
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Editor in Chief：Wu, Anhua ISSN：2096-9244(Online) ISSN：1671-9638(Pring) 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 Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare associated infection5677
- 02 Molecular epidemiological study of methicillin resistant Staphylococcus aureus FREE5397
- 03 Homology analysis on ICU multidrug resistant Acinetobacter baumannii nosocomial infection FREE4569
- 04 A new glycopeptide antibiotic——dalbavancin4375
- 05 Distribution and change of microbial population of clinical isolated bacteria from a hospital between 1999 and 2008 FREE4322
- 06 Colonization and drug resistance of multidrug resistant bacteria in intensive care unit FREE4252
- 07 A case control study on risk factors for nosocomial infection of Acinetobacter baumannii in internal medicine intensive care units FREE4022
- 08 Antimicrobial activity of linezolid and other antimicrobial agents against Enterococci spp. in vitro FREE3913
- 09 Change in drug resistance of Pseudomonas aeruginosa to β lactam antibiotics FREE3811
- 10 Catheter associated nosocomial infection in surgical intensive care unit :a 5 year data analysis3684
- 01 Epidemiological and clinical analysis on bacillary dysentery in 175 children in three years251771
- 02 Comparison of the effectiveness of different disinfectants on blood donors before donation126554
- 03 National healthcare associated infection surveillance system point prevalence survey of antimicrobial use in 740 Chinese hospitals in 2010122955
- 04 Study on resistant mechanism of two clinical strains of Enterobacter aerogenes to ertapenem121068
- 05 Distribution and antimicrobial resistance of major gram negative bacilli in ICU and non ICU wards in a grass roots hospital119034
- 06 Adverse drug reactions of ganciclovir in treating infants with cytomegalovirus hepatitis113998
- 07 Drug resistance and disinfectant resistant genes of Staphylococcus aureus from neonates at a neonatal ward113292
- 08 Monitoring on occupational exposure of health care workers at a general tertiary hospital109566
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Expert consensus on the diagnosis, treatment, prevention, and control of hypervirulent carbapenem-resistant Klebsiella pneumoniae infection
• Chinese Society of Infectious Disease Physicians, Chinese Medical Doctor Association, Healthcare-associated Infection Control Branch of Chinese Preventive Medicine Association, Chinese Hospital Association Clinical Microbiology Laboratory Specialized Committee, Society of Bacterial Infection, Resistance of Chinese Medical Association, Bacteriology, Mycology Group, National Medical Center for Infectious Diseases (Hangzhou), National Clinical Research Center for Infectious Diseases (Hangzhou), Infectious Disease Physicians Branch of Zhejiang Medical Doctors Association, Antimicrobial Resistance, Control Committee of Zhejiang Pharmaceutical Association
•2025,24(12):1691-1709 ,Doi: 10.12138/j.issn.1671-9638.20257418
Abstract:： Hypervirulent Klebsiella pneumoniae (hvKP) exhibits unique phenotypes (such as hypermucoviscosity, specific serotypes) and genotypes (such as carrying specific virulence genes), de...Hypervirulent Klebsiella pneumoniae (hvKP) exhibits unique phenotypes (such as hypermucoviscosity, specific serotypes) and genotypes (such as carrying specific virulence genes), demonstrating strong clinical pathogenicity. With the bacterial convergence evolution, the emergence of hypervirulent carbapenem-resistant Klebsiella pneumoniae (HCKP) poses significant challenges to global public health, as well as to clinical infection treatment and prevention. Early identification, timely diagnosis and treatment, as well as prevention and control of HCKP infection are crucial needs. This consensus aims to provide expert recommendations on the epidemiology, pathogenicity, antimicrobial resistance, clinical characteristics, laboratory testing, as well as prevention and control of HCKP, serving as a reference for diagnosis, treatment, as well as prevention and control of HCKP infections. Show
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Practice and discussion on the management of antimicrobial use density in Chinese medical institutions
• CHEN Yijian, WANG Bei, WANG Minggui
•2025,24(12):1710-1716 ,Doi: 10.12138/j.issn.1671-9638.20252968
Abstract:： The irrational use of antimicrobial agents will exacerbate the crisis of antimicrobial resistance. In recent years, China has attached great importance to the management of antimic...The irrational use of antimicrobial agents will exacerbate the crisis of antimicrobial resistance. In recent years, China has attached great importance to the management of antimicrobial agents, actively promoting the implementation of antimicrobial stewardship (AMS). Although the antimicrobial use density (AUD) has decreased significantly, numerous challenges still persist in the antimicrobial management practices within medical institutions. This paper systematically reviews the persistent issues related to antimicrobial use and management within medical institutions, summarizes the efficacy and practical outcomes of key intervention strategies. These strategies involve multidisciplinary collaboration, enhancement of infection management professional skills, data-driven management, building of informatization systems, and the application of the Plan-Do-Check-Act (PDCA) cycle. Evidence confirms that robust administrative support, high-level professional expertise in infection diagnosis and treatment, and reliable execution capacity together serve as the core pathway towards rational antimicrobial use. This review aims to provide a replicable scientific framework and practical reference for medical institutions at all levels to optimize their antimicrobial management protocols. Show
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Antimicrobial resistance of bacteria from different grades of hospitals: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
•China Antimicrobial Resistance Surveillance System
•2025,24(12):1717-1734 ,Doi: 10.12138/j.issn.1671-9638.20255414
Abstract:： Objective To investigate the distribution and antimicrobial resistance of common pathogens from clinical specimens nationwide in 2020-2024, provide scientific basis for clin...Objective To investigate the distribution and antimicrobial resistance of common pathogens from clinical specimens nationwide in 2020-2024, provide scientific basis for clinical rational application of antimicrobial agents, as well as for the government to timely grasp the antimicrobial resistance situation nationwide, formulate and evaluate clinical application management policies for antimicrobial agents. Methods According to the technical scheme of China Antimicrobial Resistance Surveillance System (CARSS), antimicrobial resistance of all bacterial isolates reported by CARSS in 2020-2024 were analyzed with WHONET 5.6 software. Results The top 5 isolated Gram-positive bacteria from tertiary hospitals nationwide were Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis, Staphylococcus epidermidis, and Streptococcus pneumoniae. The top 5 isolated Gram-positive bacteria from secondary hospitals were Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Staphylococcus epidermidis, and Enterococcus faecium. Isolation rate of Streptococcus pneumoniae from secondary hospitals was higher than that from tertiary hospitals. The percentage of top 5 isolated Gram-negative bacteria in 2020-2024 were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae. In 2024, the isolation rate of Haemophilus influenzae in tertiary and secondary hospitals ranked the fifth. Detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) have decreased in tertiary hospitals. Detection rates of vancomycin-resistant Enterococcus faecium (VREM) increased in tertiary and secondary hospitals. The detection rates of carba-penem-resistant Pseudomonas aeruginosa (CRPAE) decreased in hospitals of different levels, while those of carba-penem-resistant Acinetobacter baumannii (CRABA) showed no significant changes; in the same period, the detection rates of both pathogens in tertiary hospitals were higher than those in secondary hospitals. Detection rates of cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae have declined, but both were higher in tertiary hospitals than in secondary hospitals during the same period. Detection rates of imipenem- and meropenem-resistant Escherichia coli didn’t change much and both were lower than 1.8%; Resistance rates of Klebsiella pneumoniae to imipenem and meropenem decreased, with tertiary hospitals having a significantly higher resistance rate to imipenem and meropenem than secondary hospitals. Resistance rates of Haemophilus influenzae to most antimicrobial agents increased, and that from tertiary hospitals were higher than from secondary hospitals during the same period. Conclusion The detection rates of MRSA and MRCNS have decreased in tertiary hospitals, whereas the changes in secondary hospitals remain insignificant. The detection rates of VREM have increased in both tertiary and secondary hospitals. In tertiary hospitals, the detection rate of CRKPN (carbapenem-resistant Klebsiella pneumoniae) remains at a high level, and is notably higher than that in secondary hospitals. Acinetobacter baumannii exhibits severe resistance to various antimicrobial agents in hospitals of different levels, and the drug resistance rate of Haemophilus influenzae to multiple antimicrobial agents has increased. The management of rational use of antimicrobial agents as well as prevention and control of healthcare-associated infection should continue to be strengthened, and surveillance of antimicrobial resistance should be conducted well. Show
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Antimicrobial resistance of bacteria from peritoneal effusion specimens: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
•China Antimicrobial Resistance Surveillance System
•2025,24(12):1735-1745 ,Doi: 10.12138/j.issn.1671-9638.20255417
Abstract:： Objective To understand the distribution characteristics and antimicrobial resistance of pathogenic bacteria isolated from peritoneal effusion specimens from member units of...Objective To understand the distribution characteristics and antimicrobial resistance of pathogenic bacteria isolated from peritoneal effusion specimens from member units of China Antimicrobial Resistance Surveillance System (CARSS). Methods Bacterial strains isolated from peritoneal effusion specimens of CARSS member units from January 1, 2020 to December 31, 2024 were analyzed. Repetitive strains of the same bacteria from the same patient were excluded, only the first strain was retained for analysis. Antimicrobial susceptibility testing results were assessed according to the standards of American Clinical and Laboratory Standards Institute (CLSI). Results A total of 373 238 bacterial strains were isolated from peritoneal effusion specimens from CARSS member units in 2020-2024, 39.2% were Gram-positive and 60.8% were Gram-negative strains. The top 10 isolated bacteria were Escherichia coli (30.3%), Klebsiella pneumoniae (9.3%), Enterococcus faecium (7.6%), Staphylococcus epidermidis (5.4%), Enterococcus faecalis (5.3%), Pseudomonas aeruginosa (4.8%), Staphylococcus aureus (4.2%), Enterobacter cloacae (2.6%), Staphylococcus haemolyticus (2.4%), and Acinetobacter baumannii (2.3%). Among Staphylococcus aureus and coagulase negative Staphylococcus, the detection rates of methicillin-resistant strains (methicillin-resistant Staphylococcus aureus ［MRSA］ and methicillin-resistant coagulase negative Staphylococcus ［MRCNS］) were 27.9%-32.1% and 70.6%-72.9%, respectively. Resistance rates of methicillin-resistant strains to most antimicrobial agents were higher than methicillin-sensitive strains, while no strain was found to be resistant to vancomycin and teicoplanin. Among Enterococcus spp., Enterococcus faecium had higher resistance rates to most tested antimicrobial agents than Enterococcus faecalis. The resistance rates of Enterococcus faecalis to vancomycin and teicoplanin were 0.2%-0.4% and 0.3%-0.7%, respectively. The resistance rates of Enterococcus faecium to teicoplanin and vancomycin were 0.6%-5.7% and 0.7%-4.2%, respectively, both showing significant increase trends. The detection rates of carbapenem-resistant Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa were 11.1%-13.8%, 49.1%-56.1% and 11.8%-14.4%, respectively, all showing downward trends. Detection rates of carbapenem-resistant Escherichia coli were 1.9%-2.1%; resistance rates of Enterobacter cloacae to imipenem and meropenem were 5.9%-8.0% and 6.2%-8.1%, respectively; and resistance rates of Citrobacter freundii to imipenem and meropenem were 4.3%-10.9% and 3.9%-8.8%, respectively; all showing upward trends. Conclusion The number of clinical isolates detected from peritoneal effusion presents an increasing trend. Detection rates of most major antimicrobial-resistant strains present decreasing trends, while the detection rates of carbapenem-resistant Escherichia coli and vancomycin-resistant Enterococcus faecium have risen. Resistance rates of Enterobacter cloacae and Citrobacter freundii to carbapenem antibiotics have increased, which should be closely observed and given high priority, so as to avoid the spread within hospital. Show
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Antimicrobial resistance of bacteria from the elderly people: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
•China Antimicrobial Resistance Surveillance System
•2025,24(12):1746-1760 ,Doi: 10.12138/j.issn.1671-9638.20255418
Abstract:： Objective To understand the distribution characteristics and antimicrobial resistance trends of clinica-lly isolated bacterial strains from elderly patients in China, and pr...Objective To understand the distribution characteristics and antimicrobial resistance trends of clinica-lly isolated bacterial strains from elderly patients in China, and provide scientific basis for the clinical treatment of infection in the elderly people. Methods Data of clinically isolated bacterial strains from elderly patients from China Antimicrobial Resistance Surveillance System (CARSS) in 2020-2024 were analyzed retrospectively. Antimicrobial susceptibility testing results were interpreted according to the guidelines of American Clinical and Laboratory Stan-dards Institute (CLSI) and the standards of American Food and Drug Administration (FDA). Statistical analysis was performed using WHONET 5.6 software. Results Among clinical isolates of elderly patients, the ratio of Gram-positive bacteria to Gram-negative bacteria remained stable at 1.0 ∶3.5. Gram-positive bacteria were mainly Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis, and Staphylococcus epidermidis. In 2023-2024, Staphylococcus hominis replaced Streptococcus haemolyticus as the fifth frequently isolated Gram-positive bacteria. The top five Gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. In 2024, Streptococcus agalactiae ranked among the top 20 clinical isolates of elderly patients for the first time (0.6%). Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) showed slightly decreased detection rates, and their resistance rates to most antimicrobial agents also decreased. However, resistance rate of MRCNS to linezolid slightly increased. The resistance rates of methicillin-sensitive Staphylococcus aureus (MSSA) to multiple agents decreased, but its resistance rate to levofloxacin increased from 12.9% to 14.3%. No Staphylococcus aureus was found to be resistant to vancomycin, linezolid, or teicoplanin. Among Enterococcus spp., Enterococcus faecalis showed decreased resistance rate to ampicillin, but increased resistance rates to linezolid; Enterococcus faecium exhibited decreased resistance rate to high concentration streptomycin, while its resistance rates to vancomycin and teicoplanin increased. The resistance rate of Streptococcus pneumoniae isolated from non-cerebrospinal fluid specimens to cefepime decreased from 10.1% to 6.1%. Among Gram-negative bacteria, the resistance rate of Escherichia coli to amikacin has increased to 5.0% in 2024. The resistance rate of Klebsiella pneumoniae to carbapenems remained at 12%, higher than other Enterobacterales. The resistance rates of carbapenem-resistant Klebsiella pneumoniae (CRKPN) to most antimicrobial agents were >60%. In 2024, the resistance rates of Pseudomonas aeruginosa to imipenem and meropenem decreased to 16.2% and 13.2%, respectively, while the resistance rates of Acinetobacter baumannii to carbapenems remained at 52.4%-57.9%. The resistance rate of Salmonella spp., to ceftriaxone has been increasing year by year from 15.9% in 2020 to 23.4% in 2024, and the resistance rates to levofloxacin, compound sulfamethoxazole, and chloramphenicol also presented upward trends. The resistance rates of Haemophilus influenzae to ampicillin, cephalosporins, and azithromycin increased, but the non-sensitivity rate to levofloxacin decreased. Conclusion From 2020 to 2024, antimicrobial resistance of clinically isolated bacteria from the elderly people showed a certain degree of fluctuation, with a slight decreased in the detection rate in MRSA. However, problems such as the increased detection rate of vancomycin-resistant Enterococcus faecium and the persistent high resistance of CRKPN still remain serious, indicating that persistent antimicrobial resistance surveillance and prevention in the elderly people should be strengthened. Show
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Antimicrobial resistance of bacteria from bile: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
•China Antimicrobial Resistance Surveillance System
•2025,24(12):1761-1771 ,Doi: 10.12138/j.issn.1671-9638.20255415
Abstract:： Objective To understand the distribution and antimicrobial resistance of bacteria isolated from bile specimens in China in 2020-2024, and provide reference for clinical anti...Objective To understand the distribution and antimicrobial resistance of bacteria isolated from bile specimens in China in 2020-2024, and provide reference for clinical anti-infection treatment and rational antimicrobial use. Methods All data were collected from bacteria isolated from bile and antimicrobial susceptibility testing results reported by member units of China Antimicrobial Resistance Surveillance System (CARSS) in 2020-2024. Only the first strain of each patient was included. Constituent ratios and changing trends of antimicrobial resistance rates of bacterial strains were analyzed by Mantel-Haenszel χ2 test. Results From 2020 to 2024, a total of 407 605 bacterial strains were included in the analysis. The top 4 isolated bacteria were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, and Enterococcus faecalis. Trend analysis showed that the detection rate of Klebsiella pneumoniae was on the rise (P<0.01), while those of Enterococcus faecium and Enterococcus faecalis were on the decline (both P<0.05). Antimicrobial susceptibility testing results showed that the resistance rates of major Gram-negative bacteria to piperacillin/tazobactam were generally on the rise, with that of Escherichia coli increasing from 8.7% to 14.3%. Detection rate of vancomycin-resistant Enterococcus faecium (VREM) increased from 0.4% to 1.7%, and that of carbapenem-resistant Escherichia coli (CRECO) increased from 2.3% to 2.6%. The resis-tance rates of major pathogenic bacteria to most third-generation cephalosporins presented decreasing trends, and the resistance rate of Escherichia coli to ceftazidime decreased from 34.2% to 29.8%. Compared with the overall data nationwide (taking 2023 as an example), the detection rates of CRECO and carbapenem-resistant Pseudomonas aeruginosa (CRPAE) from bile specimens were higher (2.4% vs 1.7%, 25.6% vs 16.3%, respectively), while the detection rates of carbapenem-resistant Acinetobacter baumannii (CRABA) and Klebsiella pneumoniae (CRKPN) were lower (40.4% vs 55.5%, 7.0% vs 10.8%, respectively). Conclusion The constituent of bacteria isolated from bile specimens in China from 2020 to 2024 is relatively stable, and the increase in VREM and CRECO detection rates is currently the main problem. Attention should be paid to the resis-tance of Pseudomonas aeruginosa isolated from bile specimens to carbapenems. Show
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Antimicrobial resistance of bacteria from wound and pus specimens: surveillance report from China Antimicrobial Resistance Surveillance System, 2020-2024
•China Antimicrobial Resistance Surveillance System
•2025,24(12):1772-1784 ,Doi: 10.12138/j.issn.1671-9638.20255420
Abstract:： Objective To understand the distribution as well as antimicrobial resistance of bacteria isolated from wound and pus specimens of patients nationwide. Methods Data ab...Objective To understand the distribution as well as antimicrobial resistance of bacteria isolated from wound and pus specimens of patients nationwide. Methods Data about antimicrobial susceptibility testing of bacteria isolated from wound and pus specimens from member hospitals of China Antimicrobial Resistance Surveillance System (CARSS) in 2020-2024 were analyzed using WHONET 5.6 software. Antimicrobial susceptibility testing results were interpreted according to American Clinical and Laboratory Standards Institute (CLSI). Results In 2020-2024, a total of 1 808 994 bacterial strains were isolated from wound and pus specimens from member hospitals of CARSS, with the top 5 bacteria being Escherichia coli (28.5%), Staphylococcus aureus (18.9%), Klebsiella pneumoniae (10.1%), Pseudomonas aeruginosa (6.3%) and Staphylococcus epidermidis (3.1%). In 2020-2024, detection rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased from 26.2% to 24.9% (P＜0.001); detection rate of methicillin-resistant coagulase negative Staphylococcus (MRCNS) decreased from 67.9% to 64.9%(P＜0.001); vancomycin-resistant Staphylococcus were not found. The resistant rates of Enterococcus faecalis to most antimicrobial agents were all lower than Enterococcus faecium, but resistance rate to linezo-lid was higher than Enterococcus faecium (［2.4%-3.4%］ vs ［0.6%-1.3%］). The susceptibility rate of Escherichia coli to carbapenem antibiotics was >98%, resistance rates to quinolones, cefepime, and piperacillin/tazobactam increased (all P<0.05). Klebsiella pneumoniae showed lower resistance rates to ceftazidime,ceftriaxone, cefotaxime, cefepime, quinolones, and compound sulfamethoxazole than Escherichia coli, and increased resistance rates to piperacillin/tazobactam (P<0.001), while the resistance rates to other antimicrobial agents remained unchanged or decreased. The resistance rates of Pseudomonas aeruginosa to piperacillin and piperacillin/tazobactam increased (both P<0.001), while those to other antimicrobial agents decreased or showed no significant changes. The resis-tance rates of Acinetobacter baumannii to ampicillin/sulbactam, cefepime, gentamicin, and minocycline decreased (all P<0.05), while that to levofloxacin increased (P=0.012). Conclusion Antimicrobial resistance of pathoge-nic bacteria isolated from wound and pus specimens remains severe. It is necessary to regularly surveil the distribution and antimicrobial resistance changes of bacteria isolated from wound and pus specimens, and persistently strengthen the surveillance on rational use of antimicrobial agents, so as to provide basis for clinical empiric treatment. Show
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Antimicrobial resistance of bacteria isolated from fecal specimens: survei-llance report from China Antimicrobial Resistance Surveillance System, 2020-2024
•China Antimicrobial Resistance Surveillance System
•2025,24(12):1785-1793 ,Doi: 10.12138/j.issn.1671-9638.20255416
Abstract:： Objective To investigate the distribution and antimicrobial resistance of bacteria isolated from fecal specimens in China. Methods According to China Antimicrobial Re...Objective To investigate the distribution and antimicrobial resistance of bacteria isolated from fecal specimens in China. Methods According to China Antimicrobial Resistance Surveillance System (CARSS) technical scheme, data of bacteria isolated from fecal specimens and antimicrobial susceptibility testing results reported by CARSS member hospitals in 2020-2024 were analyzed using WHONET 5.6 software. Results A total of 118 539 bacterial strains were isolated, and the top 5 were Salmonella spp. (91.3%-93.9%), Shigella spp. (2.1%-4.7%), Aeromonas spp. (1.6%-2.0%), Vibrio spp. (0.9%-1.9%) and diarrheagenic Escherichia coli (0.4%-1.1%). The major bacteria in each genus were unclassified species of Salmonella (50.7%-55.6%), Shigella flexneri (41.8%-58.4%), Aeromonas hydrophila (32.0%-58.6%), Vibrio parahaemolyticus (73.4%-86.6%), and enteropathogenic Escherichia coli (72.0%-91.5%), respectively. Resistance rates of Salmonella spp. to levofloxacin (7.5%-10.9%)and ciprofloxacin (9.8%-11.6%) were low, while resistance rates of Shigella spp. to levofloxacin and ciprofloxacin presented upward trends, which increased from 18.6% and 33.5% to 63.0% and 71.0%, respectively. Resistance rates of Vibrio spp. to ampicillin (58.8%-68.9%) and cefazolin (88.9%-100%) were high, and that to cefuroxime has decreased (from 20.6% to 7.4%), while resistance rates to other antimicrobial agents were all low (<10%). The overall resistance of Aeromonas spp. was low. Carbapenem-resistant diarrheagenic Escherichia coli was detected (<3%). Conclusion The major bacteria isolated from fecal specimens were Salmonella spp. and Shigella spp.. Antimicrobial resistances of different bacterial species varied significantly. It is necessary to continue to strengthen the management of rational application of antimicrobial agents, and do a good job in the surveillance of antimicrobial-resistant bacteria. Show
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Antimicrobial resistance of bacteria from traditional Chinese medicine hospitals: surveillance report from China Antimicrobial Resistance Surveillance System, 2022-2024
•China Antimicrobial Resistance Surveillance System
•2025,24(12):1794-1802 ,Doi: 10.12138/j.issn.1671-9638.20257419
Abstract:： Objective To understand the distribution and antimicrobial resistance of bacteria from traditional Chinese medicine hospitals in China from 2022 to 2024, and provide referen...Objective To understand the distribution and antimicrobial resistance of bacteria from traditional Chinese medicine hospitals in China from 2022 to 2024, and provide reference for the rational use of antimicrobial agents in clinical practice. Methods Surveillance data of bacteria and antimicrobial susceptibility testing results were co-llected from traditional Chinese medicine hospitals as member units of China Antimicrobial Resistance Surveillance System (CARSS) from 2022 to 2024. Only the first strain of the same bacteria from the same patient was included in the analysis. Statistical analysis was conducted using WHONET 5.6 software. Results From 2022 to 2024, a total of 1 491 099 bacterial strains were included in the analysis. The top 4 isolated bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. Analysis showed that the detection rates of Klebsiella pneumoniae and Staphylococcus aureus were on the rise, while those of Escherichia coli and Pseudomonas aeruginosa were on the decline. The top 4 types of specimens were sputum, urine, pus, and blood. Antimicrobial susceptibility testing results showed that the resistance rate of Gram-negative bacteria to piperacillin/tazobactam has generally increased, with Pseudomonas aeruginosa increasing from 12.0% to 16.5%. The resis-tance rates of the main pathogenic bacteria to most third-generation cephalosporins presented decreased trends. The resistance rate of Klebsiella pneumoniae to cefotaxime has decreased from 30.3% to 27.0%. The detection rate of vancomycin-resistant Enterococcus faecium (VREM) increased from 2.8% to 4.3%, and the detection rate of carbapenem-resistant Escherichia coli (CRECO) increased from 1.9% to 2.1%. Compared with the overall data nationwide (taking 2023 as an example), the detection rates of CRECO (2.1% vs 1.7%) and carbapenem-resistant Pseudomonas aeruginosa (CRPAE, 19.5% vs 16.3%) from specimens from traditional Chinese medicine hospitals were higher, while the detection rates of carbapenem-resistant Acinetobacter baumannii (CRABA, 49.4% vs 55.5%) and cefotaxime- or ceftriaxone-resistant Escherichia coli (CTX/CRO-R ECO) (46.4% vs 48.9%) were lower. Conclusion The constituent of bacteria isolated from traditional Chinese medicine hospitals in China is relatively stable. Attentions should be paid to the increased detection rates of VREM and CRECO, and the management of antimicrobial agents should be strengthened further. Show
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Application of hypochlorous acid disinfectant in postoperative wound healing of orthopedic surgery: a pragmatic randomized controlled trial
• ZHANG Yan, ZHU Di, SUN Lei, WANG Renxian
•2025,24(12):1803-1809 ,Doi: 10.12138/j.issn.1671-9638.20252751
Abstract:： Objective To explore the clinical efficacy of hypochlorous acid in promoting postoperative wound hea-ling and reducing surgical site infection (SSI). Methods Hospital...Objective To explore the clinical efficacy of hypochlorous acid in promoting postoperative wound hea-ling and reducing surgical site infection (SSI). Methods Hospitalized patients from the Department of Foot and Ankle Surgery in a tertiary first-class hospital were included in the analysis and grouped according to surgery sequence: patients from the first stage (October 16 to December 16, 2024) were taken as the control group, and iodophor (4 500-5 500 mg/L) was used for their postoperative wound disinfection; patients from the second stage (December 17, 2024 to February 17, 2025) were taken as the trial group, whose surgical wounds were disinfected with hypochlorous acid (110±16.5 mg/L). On the 1st, 3rd, 5th, 7th, 10th, and 14th days post-operation, wounds were disinfected, indicators were evaluated and recorded. The main outcome indicator was surgical site infection, while secondary indicators included postoperative 48-hour redness and swelling, allergy, and pain severity scores. Results The control group showed an infection incidence of 0.96%, an incidence of postoperative 48-hour redness and swelling of 16.99%, and a pain score of (1.41±0.49) point. In the trial group, no infections occurred, the incidence of postoperative 48-hour redness and swelling was 9.58%, and the pain score was (1.36±0.48) point. There were no statistically significant differences in the incidence of infection and pain score between the two groups (both P>0.05), but the difference in the incidence of redness and swelling was statistically significant (P=0.006). Stratified analysis by wound types revealed that in the open trauma subgroup, the incidence of infection in the control group was 3.19%, the incidence of redness and swelling was 29.79%, and the pain score was (1.62±0.49) point; while the incidence of postoperative 48-hour redness and swelling in the trial group was 8.14%, with a pain score of (1.41±0.49) point. There was no statistically significant difference in the incidence of infection between the two groups (P>0.05), while differences in the incidences of redness and swelling (P<0.001) as well as pain severity score (P=0.005) were statistically significant. In the closed traumatic injury subgroup, there were no statistically significant differences in all outcome indicators between groups (all P>0.05). Conclusion The application efficacy of hypochlorous acid solution in wound healing after closed traumatic injuries is comparable to that of iodophor. In open traumatic injuries, hypochlorous acid demonstrates superior effectiveness in controlling postoperative redness and swelling as well as pain compared to iodophor. Show
KeyWord：hypochlorous acid;iodophor;orthopedics;wound healing;pragmatic randomized controlled trial
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Tracing analysis of Stenotrophomonas maltophilia contamination in medical devices
• LIN Liying, LIN Chuchu, HUANG Wei
•2025,24(12):1810-1817 ,Doi: 10.12138/j.issn.1671-9638.20252090
Abstract:： Objective To retrospectively analyze 1 strain of Stenotrophomonas maltophilia (S. maltophilia) from hospital environment and 3 strains of S. maltophilia from clinical patien...Objective To retrospectively analyze 1 strain of Stenotrophomonas maltophilia (S. maltophilia) from hospital environment and 3 strains of S. maltophilia from clinical patients, and explore the homology between environmental and clinical S. maltophilia strains. Methods On September 3, 2021, environmental hygiene surveillance was conducted in the intensive care unit (ICU) of a hospital, and 1 strain of S. maltophilia was isolated. Meanwhile, S. maltophilia strains isolated from 3 patients in the ICU from June to November 2021 were collected. The above 4 strains of S. maltophilia underwent antimicrobial susceptibility testing, whole genome sequencing (WGS), multilocus sequencing typing (MLST) analysis, antimicrobial resistance gene detection, average nucleotide identity (ANI) value calculation, minimum spanning tree (MST) calculation, and phylogenetic tree construction. Results One strain of ST1244 S. maltophilia was isolated from the surface of B-ultrasound probe in ICU, which was consistent with the ST and resistance genes of S. maltophilia strain isolated from a patient’s specimen. The ANI va-lues of both strains were 100%, and there was no difference in their MST results. Phylogenetic tree analysis showed that the two strains were in the same evolutionary branch. Combining epidemiological information, it suggested that the strain from B-ultrasound probe might originate from contamination of the patient. Conclusion Patients with S. maltophilia infection can contaminate the surfaces of medical devices during usage, and sharing these devices could lead to the spread of pathogens within hospital. Show
KeyWord：Stenotrophomonas maltophilia;medical device contamination;origin tracing
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Risk prediction models for surgical site infection following colorectal cancer surgery: a systematic evaluation
• HOU Suying, CHU Xin, XU Xiaohong, LUO Wei, XIAO Lingyi, LI Zili
•2025,24(12):1818-1828 ,Doi: 10.12138/j.issn.1671-9638.20252565
Abstract:： Objective To systematically evaluate the studies on existing risk prediction models for surgical site infection (SSI) in patients with colorectal cancer (CRC). MethodsObjective To systematically evaluate the studies on existing risk prediction models for surgical site infection (SSI) in patients with colorectal cancer (CRC). Methods Relevant studies on SSI prediction models for CRC patients were retrieved from PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang. The retrieval period was from the establishment dates of the databases to April 2025. Two researchers independently conducted literature screening and information extraction, and evaluated the risk of bias in the literatures using PROBAST tool. Results A total of 25 literatures were included in the analysis, and the incidences of SSI were 4.35%-29.47%, including 35 risk prediction models of SSI following CRC surgery. The areas under the curve (AUCs) of the receiver operating characteristic (ROC) of models were all >0.7. 12 studies underwent internal validation and 4 studies underwent internal and external validation. The final number of included predictors was 2-13. Diabetes, duration of operation, operation mode, preoperative hypoproteinemia, body mass index (BMI), and age were high frequency predictors. All studies were evaluated as with risk of high bias, while 14 studies were evaluated as with risk of low applicability. Conclusion The overall predictive performance of existing prediction models for SSI following CRC surgery is good, however, there are limitations such as insufficient sample size and lack of external validation, and the quality of models needs to be improved. Future model development should strictly follow the PROBAST standard, strengthen the design of prospective and multicenter study with large sample size, attach importance to and standardize external validation processes, scientific processing, and data reporting, so as to improve model quality and clinical applicability value. In clinical practice, special attention should be paid to patients with high-frequency risk factors, and targeted intervention measures should be taken to reduce the risk of SSI occurrence. Show
KeyWord：colorectal cancer;surgical site infection;risk prediction;predictive model;systematic review
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Impact of healthcare-associated infection on hospitalization expense of lung cancer patients under the background of DRG payment: a study based on mediation analysis and threshold regression
• WANG Ying, JIN Meijuan, LI Hui, WU Xuejuan
•2025,24(12):1829-1837 ,Doi: 10.12138/j.issn.1671-9638.20252467
Abstract:： Objective To explore the impact of healthcare-associated infection (HAI) on the economic burden of lung cancer patients and specific impact pathways under the background of ...Objective To explore the impact of healthcare-associated infection (HAI) on the economic burden of lung cancer patients and specific impact pathways under the background of diagnosis-related group (DRG) payment. Methods Data from the home page of medical record and HAI system of lung cancer patients in a hospital from Ja-nuary 2023 to June 2024 were collected retrospectively. Based on the occurrence of HAI, patients were grouped and matched according to propensity score. Correlation among various factors in patient’s hospitalization expense was analyzed using grey correlation method. The impact of HAI on hospitalization expense was explored by multivariate linear regression and threshold regression models. The mediation effect of length of hospital stay was explored by mediation effect model. Results The incidence of HAI in 2 808 lung cancer patients was 5.91%. After matching, data from 126 pairs of patients were included in the analysis, with the respiratory system being the major infection site (60.32%). Patients with catheter-related bloodstream infection had the highest hospitalization expense (142 582.01 Yuan). In the HAI group, the proportion of medicine expense was the highest (27.89%), and diagnostic expenses had the highest correlation with hospitalization expenses (0.946). Multivariate linear regression results showed that HAI could result in an increase in the average hospitalization expense of lung cancer patients by 47 203.27 Yuan and an extension of the length of hospital stay by 17.89 days. The length of hospital stay played a partial mediating role in the impact of HAI on hospitalization expense, with the mediating effect accounting for 53.30%. The threshold effect model showed that HAI had a significant promoting effect on the expense when the length of hospital stay exceeded 19 days, and the longer the length of hospitalization, the greater the impact. Conclusion HAI can significantly increase the economic burden on patients by prolonging the length of hospital stay. It is necessary to control the expenditure of medication and diagnostic expenses rationally, optimize the hospitalization expense structure of infected patients, reflect the value of knowledge and technical labor of healthcare workers, standardize medical procedures, as well as strengthen HAI prevention and control. Show
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Incidences and risk factors of healthcare-associated infection in adult patients during extracorporeal membrane oxygenation treatment period: a Meta-analysis
• WANG Yixuan, CHENG Lingling, WANG Wu, SHI Aili
•2025,24(12):1838-1847 ,Doi: 10.12138/j.issn.1671-9638.20252432
Abstract:： Objective To systematically evaluate the incidences and risk factors of healthcare-associated infection (HAI) in adult patients during extracorporeal membrane oxygenation (E...Objective To systematically evaluate the incidences and risk factors of healthcare-associated infection (HAI) in adult patients during extracorporeal membrane oxygenation (ECMO) treatment, and provide evidence-based reference for healthcare workers (HCWs) to early identify HAI and formulate preventive measures. Methods Literatures related to the incidences and risk factors of HAI in adult patients during ECMO treatment period were retrieved from Wanfang, China Biomedicine (CBM), China National Knowledge Infrastructure (CNKI), VIP Database, Cochrane Library, Web of Science, PubMed, and Embase. The search time was from the establishment of the databases to February 1, 2025. Stata 12.0 software was used for analysis. Results 28 literatures were included in this study, and a total of 24 690 patients receiving ECMO treatment were monitored, out of which 3 244 had HAI. Meta-analysis showed that the incidence of HAI in adult patients during ECMO treatment period was 31.0%. Subgroup analysis showed that in the studies that the survey time was 2020 and later, the main type of infection was lower respiratory tract infection, and the main infection flora was Pseudomonas aeruginosa, the incidences of HAI in patients were higher (36.5%, 41.4%, 40.6%, respectively). The risk factors for HAI in adult patients during ECMO treatment period included tracheal intubation or tracheotomy (OR=7.838), combined continuous renal replacement therapy (CRRT, OR=1.578), veno-venous ECMO (V-V ECMO) treatment mode (OR=2.022), duration of ECMO treatment ≥72 hours (OR=1.022), duration of mechanical ventilation ≥9 days (OR=1.051), body mass index (BMI) ≥24 kg/m2 (SMD=0.154), age ≥45 years old (OR=1.043), high score of sequential organ failure score (OR=1.058), infection on admission (OR=3.035), combined history of diabetes mellitus (OR=2. 242), and history of staying in intensive care unit(ICU) (OR=2.324). Conclusion There are multiple risk factors for HAI in adult patients during ECMO treatment period, and the incidence is high. HCWs should pay more attention to HAI, accurately identify high-risk populations and risk factors, and formulate comprehensive, detailed, and personalized intervention measures through multidisciplinary collaboration, so as to prevent HAI during treatment period. Show
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Pulmonary cryptococcosis with solitary ground-glass opacity as the initial CT findings: a case report
• LI Guo, PANG Min, FAN Pangshuang, WANG Peng, PANG Xianqiong, ZHOU Guohua, PU Hongshan, LIU Sinian, GUO Sanjun
•2025,24(12):1848-1850 ,Doi: 10.12138/j.issn.1671-9638.20252622
Abstract:： Pulmonary cryptococcosis (PC) exhibits diverse imaging manifestations, but solitary ground-glass opacity (GGO) as the initial finding on computed tomography (CT) is rarely reported...Pulmonary cryptococcosis (PC) exhibits diverse imaging manifestations, but solitary ground-glass opacity (GGO) as the initial finding on computed tomography (CT) is rarely reported. Limited clinical awareness may lead to misdiagnosis as tumors or tuberculosis, often resulting in unnecessary surgical intervention or anti-tuberculosis therapy. This paper reports a young immunocompetent female patient whose initial CT revealed a solitary GGO in the right lower lobe of lung. Over the course of nearly three months, the lesion progressed to a solid nodule and was ultimately diagnosed as PC through percutaneous lung biopsy. The patient achieved complete recovery with oral fluconazole therapy. This paper reviews the clinical characteristics and imaging progression patterns of such patients by combining relevant literatures, aiming to provide a reference for clinicians. Show
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Aerococcus urinae infective endocarditis: a case report
• HUANG Zongwei, YANG Cuiping, LIU Kaidi, HUANG Wanzhi, CUI Junchang
•2025,24(12):1851-1853 ,Doi: 10.12138/j.issn.1671-9638.20252508
Abstract:： This paper reports the diagnosis and treatment process of a patient with infective endocarditis caused by Aerococcus urinae (A. urinae). The incidence of A. urinae endocarditis is ...This paper reports the diagnosis and treatment process of a patient with infective endocarditis caused by Aerococcus urinae (A. urinae). The incidence of A. urinae endocarditis is low, research data from large number of specimens are lacking, and the clinical manifestations lack specificity. Multiple detection methods, including 16S ribosomal RNA gene sequencing, can assist in diagnosis. The susceptibility factors for this disease include being male, advanced age, and previous urinary tract diseases. This case was treated with a combination of β-lactam and aminoglycoside agents, and the symptoms relieved. However, vegetations did not shrink after antimicrobial treatment for 4 weeks, disease condition became serious and the valve were damaged even worse. Surgical treatment was finally performed and the patient recovered. Show
KeyWord：Aerococcus urinae;infective endocarditis;bacteremia;vegetation
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Research progress on the influence of physical behavior of personnel in medical buildings on the spread of infectious respiratory particles
• YANG Liuqing, DONG Ziyan, XIE Wen, ZHANG Yue, YANG Caiqing, ZHOU Ying, ZHENG Qi, LI Jie
•2025,24(12):1854-1861 ,Doi: 10.12138/j.issn.1671-9638.20252465
Abstract:： Airborne spread of infectious respiratory particles is a significant factor for healthcare-associated infection (HAI). Personnel activities within hospitals, such as personnel move...Airborne spread of infectious respiratory particles is a significant factor for healthcare-associated infection (HAI). Personnel activities within hospitals, such as personnel movements as well as operations of door-ope-ning and door-closing, can further increase the risk of infection. Therefore, it is necessary to study the effects of physical behaviors of personnel in medical buildings on the spread of infectious respiratory particles, so as to optimize medical procedures, improve building ventilation design, as well as enhance prevention and control systems. This paper systematically reviews the research progresses at home and abroad on how personnel movements as well as door-opening and door-closing behaviors influence the spread of infectious respiratory particles, analyzes current challenges, and looks forward to the future development directions, aiming to provide scientific basis for developing a more efficient HAI prevention and control system. Show
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Research progress in the role of autophagy in infectious diseases
• FANG Tongrui, YUE Linzhi, MA Tao, WANG Guofu, WU Lixian
•2025,24(12):1862-1868 ,Doi: 10.12138/j.issn.1671-9638.20252368
Abstract:： Autophagy, a highly conserved cellular metabolic process, serves as a vital mechanism for maintaining cellular homeostasis by forming autophagosomes to encapsulate and degrade dama...Autophagy, a highly conserved cellular metabolic process, serves as a vital mechanism for maintaining cellular homeostasis by forming autophagosomes to encapsulate and degrade damaged organelles, misfolded proteins, and invaded pathogens within cells. Although autophagy research has primarily focused on cancer and neurodegenerative diseases, growing evidence in recent years highlights its significant role in various infectious diseases (such as tuberculosis and fungal keratitis, etc). This review summarizes the molecular mechanisms of autophagy and its dynamic interplay with pathogen during infections, aiming to provide new insights for the prevention and treatment of infectious diseases. Show
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