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 FREE4773
- 02 Homology analysis on ICU multidrug resistant Acinetobacter baumannii nosocomial infection FREE3914
- 03 Distribution and change of microbial population of clinical isolated bacteria from a hospital between 1999 and 2008 FREE3831
- 04 Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare associated infection3703
- 05 Colonization and drug resistance of multidrug resistant bacteria in intensive care unit FREE3689
- 06 A new glycopeptide antibiotic——dalbavancin3639
- 07 A case control study on risk factors for nosocomial infection of Acinetobacter baumannii in internal medicine intensive care units FREE3407
- 08 Change in drug resistance of Pseudomonas aeruginosa to β lactam antibiotics FREE3360
- 09 Antimicrobial activity of linezolid and other antimicrobial agents against Enterococci spp. in vitro FREE3355
- 10 Catheter associated nosocomial infection in surgical intensive care unit :a 5 year data analysis3264
- 01 Epidemiological and clinical analysis on bacillary dysentery in 175 children in three years246419
- 02 Comparison of the effectiveness of different disinfectants on blood donors before donation121201
- 03 National healthcare associated infection surveillance system point prevalence survey of antimicrobial use in 740 Chinese hospitals in 2010117713
- 04 Study on resistant mechanism of two clinical strains of Enterobacter aerogenes to ertapenem115355
- 05 Distribution and antimicrobial resistance of major gram negative bacilli in ICU and non ICU wards in a grass roots hospital113972
- 06 Adverse drug reactions of ganciclovir in treating infants with cytomegalovirus hepatitis108762
- 07 Drug resistance and disinfectant resistant genes of Staphylococcus aureus from neonates at a neonatal ward108055
- 08 Monitoring on occupational exposure of health care workers at a general tertiary hospital104683
- Current Issue
- Online First Virtual Collection
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Antimicrobial susceptibility and molecular characterization of Streptococcus agalactiae in pregnant women with advanced maternal age in Tangshan City
• LIU Ze-liang, GONG Xin-yi, HAN Xiao, JIANG Xue-qi, MIAO Bei-bei, MENG Shuang, DONG Ai-ying, LI Juan
•2024,23(10):1199-1205 ,Doi: 10.12138/j.issn.1671-9638.20245195
Abstract:： Objective To analyze the antimicrobial susceptibility, molecular types, serotypes, virulence factors and resistance mechanisms of Streptococcus agalactiae (S. agalactiae) is...Objective To analyze the antimicrobial susceptibility, molecular types, serotypes, virulence factors and resistance mechanisms of Streptococcus agalactiae (S. agalactiae) isolated from pregnant women with advanced maternal age in Tangshan City, and provide basic data for the treatment, prevention and control of S. agalactiae infection. Methods 42 strains of S. agalactiae isolated from pregnant women with advanced maternal age in North China University of Science and Technology Affiliated Hospital as well as Tangshan Maternal and Child Health Hospital were collected. Detection of antimicrobial susceptibility and whole genome sequencing of 13 antimicrobial agents were performed. Results The percentage of tetracycline, erythromycin, levofloxacin, and chloramphenicol concurrently resistant strains was 7.1%, 35.7% of the strains presented multidrug resistance to erythromycin, clindamycin, and levofloxacin. The carriage rates of resistance genes ermB and tetM were 66.7% and 47.6%, respectively. 29 strains (69.0%) exhibited mutations in both gyrA and parC fluoroquinolone resistance determinants. 42 strains of S. agalactiae belonged to 4 serotypes, namely ⅠB (35.7%), Ⅲ (33.3%), Ⅴ (26.2%), and ⅠA (4.8%); and 11 sequence types (STs), with the highest proportion being ST10 (35.7%) and ST19 (31.0%); as well as 6 clonal complexes (CCs), among which CC19 (42.9%) and CC12 (35.7%) had the highest proportion. All S. agalactiae carried virulence factor-encoding genes of cfb, cylE, and pavA. Conclusion The molecular types and serotypes of S. agalactiae carried by pregnant women with advanced maternal age in Tangshan City pre-sent polymorphism, with obvious multidrug resistance, and carry multiple types of drug resistance genes and virulence genes. Show
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Comparison of in vitro and in vivo antimicrobial activity of ceftazidime/avibactam alone or in combination with aztreonam against carbapenem-resistant Enterobacterales
• BIAN Li-juan, GUO Jun-zhe, ZHENG Mei-juan
•2024,23(10):1206-1212 ,Doi: 10.12138/j.issn.1671-9638.20246028
Abstract:： Objective To investigate the in vivo and in vitro antimicrobial activity of ceftazidime/avibactam (CZA) alone or in combination with aztreonam (ATM) against carbapenem-resis...Objective To investigate the in vivo and in vitro antimicrobial activity of ceftazidime/avibactam (CZA) alone or in combination with aztreonam (ATM) against carbapenem-resistant Enterobacterales (CRE), and provide evidence for clinical anti-infective therapy. Methods The minimum inhibitory concentrations (MICs) of CZA and ATM against 52 clinically isolated non-repetitive CRE strains in a hospital from 2018 to 2022 were determined with microbroth dilution method, and the combined antimicrobial susceptibility testing was performed with the chessboard dilution method. Time-killing curve and Galleria mellonella infection model were used to test the bactericidal effect of CZA alone or in combination with ATM. Results Among the 23 KPC-producing CRE strains, 91.3% (n=21) had MIC ≤4 μg/mL for CZA, and 8.7% (n=2) had MIC ≥128 μg/mL for CZA. MIC of CZA to 29 CRE strains (strains producing NDM, IMP, KPC+IMP, and KPC+NDM) were all ≥128 μg/mL. Of the 31 CZA-resistant strains, 93.5% (n=29) strains had fractional inhibitory concentration (FIC) <0.5 for combination of CZA and ATM, while 6.5% (n=2) had FIC of 0-1. The time-killing curve showed that CZA had bactericidal effect on KPC-producing strains, and CZA combined with ATM had bactericidal effect on CZA-resistant strains. Compared with the monotherapy group, CZA combined with ATM treatment significantly improved the survival rate of CRE-infected Galleria mellonella (median survival time 120 hour, P=0.001). Conclusion CZA has good antimicrobial activity against KPC-producing bacteria. The combination of CZA and ATM had synergistic bacteriostatic effect on CZA-resistant strains. Show
KeyWord：ceftazidime/avibactam;aztreonam;carbapenem-resistant Enterobacterales;antimicrobial activity
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Homology analysis of Acinetobacter baumannii in intensive care unit before and after COVID-19 pandemic
• WANG Xiao, LIANG Yan-ru, ZHANG Yue, LU Xiang-hua, FENG Jun, WANG Yuan-ping, ZHAO Bing
•2024,23(10):1213-1219 ,Doi: 10.12138/j.issn.1671-9638.20246253
Abstract:： Objective To investigate the distribution of pathogens and change of homology of Acinetobacter baumannii (AB) in intensive care units (ICUs) of partial medical institutions ...Objective To investigate the distribution of pathogens and change of homology of Acinetobacter baumannii (AB) in intensive care units (ICUs) of partial medical institutions in Shanghai before and after the pandemic of coronavirus disease 2019 (COVID-19). Methods Pathogens were isolated and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), the whole genome of AB was sequenced using Illumina Miseq sequencing platform, and its genetic relationship was explored based on multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST). Results The total detection rate of pathogens in ICU environment after the pandemic was lower than before the pandemic ([6.10%, 101/1 656] vs [10.77%, 181/1 680]; P＜0.05). Before and after the pandemic, the proportion of AB detected on the surface of bedding in the ICU environment remained at the highest level. After the pandemic, the ST types showed a diverse distribution. MLST_Pasteur Results showed that 162 strains of AB were divided into 20 ST types, with ST2 (80.25%, n=130) being the main type. MLST_Oxford Results showed that there were 19 ST types among 162 strains, with ST208 (37.04%, n=60) being the main type. The clustering analysis based on cgMLST showed that ST208_Oxford had closer genetic relationship with ST540_Oxford and ST369_Oxford after the pandemic. ST164_Pasteur clone changed from ST234_Oxford before the pandemic to ST1418_Oxford after the pandemic, and 2 new types of ST_Pasteurr and 11 new types of ST_Oxford were discovered. Conclusion The detection rate of pathogens from ICU environment after the pandemic is lower than before the pandemic, and the distribution of ST types is slightly different at the same detection sites before and after the pandemic. ST2_Pasteur/ST208_Oxford is still the dominant epidemic clone before and after the pandemic, but some alleles have changed. cgMLST is more accurate than MLST_Oxford and MLST_Pasteur in homology analysis, evolution, spread, and outbreak analysis. Show
KeyWord：COVID-19;Acinetobacter baumannii;ST type;homology analysis;intensive care unit environment
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Construction of a prediction model for postoperative infection in elderly patients with hip fracture and analysis of economic burden
• SHI Hao-ning, DU Ying, QIAO Shuo, YANG Hao-ran, ZHANG Hui, SHI Yi-han, YANG Xiao, LI Jing
•2024,23(10):1220-1227 ,Doi: 10.12138/j.issn.1671-9638.20246280
Abstract:： Objective To construct a prediction model for postoperative healthcare-associated infection (HAI) in elderly patients with hip fracture, analyze the economic burden, provide...Objective To construct a prediction model for postoperative healthcare-associated infection (HAI) in elderly patients with hip fracture, analyze the economic burden, provide a reference and basis for the development of clinical prevention and control programs. Methods 627 elderly patients who underwent hip fracture surgery in a hospital from January 1, 2017 to May 31, 2023 were selected as the study subjects. Patients were randomly divided into a modeling group and a validation group at a 7∶3 ratio. A logistic regression prediction model was constructed based on data from the modeling group, the discriminant and consistency of the model were evaluated by receiver ope- rating characteristic (ROC) curve and Hosmer-Lemeshow test, and the direct economic burden of postoperative HAI in patients was analyzed with 1∶1 propensity score matching (PSM). Results The incidence of postoperative HAI in elderly patients with hip fracture surgery was 12.1%, with pulmonary infection being the most common (52.6%). Logistic regression analysis showed that male, old age, perioperative disturbance of consciousness, grade Ⅳ of American Society of Anesthesiologists (ASA) classification, low albumin level, and intensive care unit (ICU) admission were all independent risk factors for postoperative HAI in patients (all P<0.05). There was good model discrimination and consistency between the training and validation groups in predicting the risk of postoperative HAI. The direct economic burden of postoperative HAI in patients was 7 927.4 Yuan, of which the burden of wes-tern medicine was the largest (3 139.7 Yuan). HAI prolonged patients hospitalization time by 3.6 days. Conclusion Postoperative HAI increases the economic burden of patients, the nomogram model constructed in this study can effectively predict the risk of postoperative HAI in patients, which can provide a basis for the early identification, as well as the implementation of targeted preventive and diagnostic measures for high-risk patients in the clinic. Show
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Risk factors and survival of EBV-infected aplastic anemia patients after haploid allogeneic hematopoietic stem cell transplantation
• ZHANG Xin-he, FENG Jia, TAN Zheng-wei, ZHAO Yue-chao, HU Hui-jin, CHEN Jun-fa, WU Li-qiang, YU Qing-hong, WU Di-jiong, YE Bao-dong, LIU Wen-bin
•2024,23(10):1228-1235 ,Doi: 10.12138/j.issn.1671-9638.20246172
Abstract:： Objective To analyze the risk factors and survival status of Epstein-Barr virus (EBV) infection in patients with aplastic anemia (AA) after haploid allogeneic hematopoietic ...Objective To analyze the risk factors and survival status of Epstein-Barr virus (EBV) infection in patients with aplastic anemia (AA) after haploid allogeneic hematopoietic stem cell transplantation (Haplo-HSCT). Methods Clinical data of 78 AA patients who underwent Haplo-HSCT in the hematology department of a hospital from January 1, 2019 to October 31, 2022 were analyzed retrospectively. The occurrence and onset time of EBV viremia, EBV-related diseases (EBV diseases), and post-transplant lymphoproliferative disorders (PTLD) were observed, risk factors and survival status were analyzed. Results Among the 78 patients, 38 were males and 40 were females, with a median age of 33 (9-56) years old; 53 patients experienced EBV reactivation, with a total incidence of 67.9%, and the median time for EBV reactivation was 33 (13, 416) days after transplantation. Among patients with EBV reactivation, 49 cases (62.8%) were simple EBV viremia, 2 cases (2.6%) were possible EBV di-seases, and 2 cases (2.6%) were already confirmed EBV diseases (PTLD). Univariate analysis showed that age 1<40 years old at the time of transplantation, umbilical cord blood infusion, occurrence of acute graft-versus-host disease(aGVHD) after transplantation, and concurrent cytomegalovirus (CMV) infection were independent risk factors for EBV reactivation in AA patients after Haplo-HSCT. Multivariate analysis showed that concurrent CMV infection was an independent risk factor for EBV reactivation in AA patients after Haplo-HSCT (P=0.048). Ritu-ximab intervention before stem cell reinfusion was a factor affecting the duration of EBV reactivation (P<0.05). The mortality of EBV viremia, EBV diseases, and PTLD alone were 8.2%, 50.0%, and 100%, respectively. The 2-year overall survival rate of patients with and without EBV reactivation were 85.3%, and 90.7%, respectively, difference was not statistically significant (P=0.897). However, patients treated with rituximab had 2-year lower survival rate than those who did not use it, with a statistically significant difference (P=0.046). Conclusion EBV reactivation is one of the serious complications in AA patients after Haplo-HSCT, which affects the prognosis and survival of patients. Show
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Drug resistance and serotype distribution of Group B Streptococcus isolated from children
• CHEN Mei, DONG Fang, CHEN Huan, ZHEN Jing-hui, MENG Qing-ying
•2024,23(10):1236-1240 ,Doi: 10.12138/j.issn.1671-9638.20246128
Abstract:： Objective To analyze the drug resistance and serotype of Group B Streptococcus (GBS) isolated from pediatric patients, provide reference for the prevention and treatment of ...Objective To analyze the drug resistance and serotype of Group B Streptococcus (GBS) isolated from pediatric patients, provide reference for the prevention and treatment of GBS infection as well as vaccine development in children. Methods 163 non-repetitive GBS strains detected at Beijing Children’s Hospital of Capital Medical University from January 1, 2016 to December 31, 2023 were collected. Strains were conducted resistance analysis and serotype testing. Results Among the 163 GBS strains, 121 and 42 were invasive and non-invasive infection isolates, respectively. No strains were found to be resistant to penicillin, ceftriaxone, cefepime, linezolid, and vancomycin, and resistance rates to erythromycin, clindamycin, and levofloxacin were 91.4%, 90.8%, and 53.4%, respectively. Non-invasive infection isolates had a higher resistance rate to levofloxacin than invasive infection isolates. The distribution of bacterial serotypes from high to low was as follows: type Ⅰb (n=75, 46.0%), type Ⅲ (n=65, 39.9%), type Ⅴ (n=13, 8.0%), type Ⅰa (n=6, 3.7%), type Ⅱ (n=2, 1.2%), type Ⅳ and Ⅵ (n=1, 0.6%, each). There was a statistically significant difference in the distribution of serotypes between invasive and non-invasive infection isolates (P<0.05). Serotype distributions of erythromycin- and clindamycin-resistant GBS strains were both statistically different between two groups (both P<0.05), while serotype distribution of levoflo-xacin-resistant GBS strains was not statistically different between two groups (P>0.05). Conclusion GBS strains in children in Beijing have high resistance rates to erythromycin and clindamycin, with serotypes Ⅰb and Ⅲ being more frequent. Serotypes with high prevalence have higher resistance. Continuously monitoring on the epidemiology of GBS infection is crucial for the clinical prevention and treatment of GBS infection in children as well as the development of vaccines. Show
KeyWord：Group B Streptococcus;child;drug resistance;serotype;Streptococcus agalactiae
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Changes in antimicrobial resistance rates of Klebsiella pneumoniae in intensive care unit and comparison between Chinese and foreign databases
• FENG Cheng-yi, ZHANG Li-wei, WANG Yang-yang, JIANG Shu-fang, DI Jia, FAN Jin-nuo
•2024,23(10):1241-1248 ,Doi: 10.12138/j.issn.1671-9638.20246131
Abstract:： Objective To compare the detection rates and antimicrobial resistance rates of Klebsiella pneumoniae (KP) between the intensive care unit of The First People’s Hospital of C...Objective To compare the detection rates and antimicrobial resistance rates of Klebsiella pneumoniae (KP) between the intensive care unit of The First People’s Hospital of Changzhou (CZFPH-ICU) and the American Medical Information Mart for Intensive Care-IV (MIMIC-Ⅳ), as well as the changes in the antimicrobial resistance rate of KP and detection rate of carbapenem-resistant KP (CRKP) in CZFPH-ICU. Methods Differences in specimen distribution and antimicrobial resistance rate of KP detected from CZFPH-ICU and MIMIC-Ⅳ from 2017 to 2019, as well as the changing trends of specimen distribution, antimicrobial resistance rate, detection rates of KP and CRKP from different specimen sources in CZFPH-ICU from 2017 to 2023 were retrospectively analyzed. Results A total of 2 434 strains of KP were detected in CZFPH-ICU from 2017 to 2019, mainly from sputum specimens. A total of 1 137 strains of KP were detected from MIMIC-Ⅳ database, mainly from urine specimens. Compared with MIMIC-Ⅳ, KP detected from CZFPH-ICU showed higher resistance rate to commonly used antimicrobial agents. A total of 4 874 strains of KP were detected from CZFPH-ICU from 2020 to 2023, mainly from sputum specimens. The detection rates of CRKP from sputum, urine, drainage fluid and bile specimens decreased from 17.77%, 20.15%, 24.22% and 24.07% in 2017-2019 to 12.99%, 13.56%, 13.63% and 8.00% in 2020-2023, respectively (all P<0.05). The changing trend of resistance rate of KP isolated from CZFPH-ICU from 2017 to 2023 to commonly used antimicrobial agents such as piperacillin/tazobactam, imipenem, and meropenem increased in 2017-2019, decreased in 2020-2022, and slightly increased in 2023. In 2013, the resistance rates of KP isolated from CZFPH-ICU to ceftazidime/avibactam, polycolistin B and tigacycline were 21.28%, 10.22% and 7.03%, respectively. Conclusion In recent 7 years, resistance rate of KP from CZFPH-ICU showed a slow decline trend, but it was still higher than that in foreign MIMIC-Ⅳ database. Hospitals should strengthen various infection prevention and control measures to effectively control KP resistance and infection. Show
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Trend and genotype characteristics of single-center HPV infection in Tianjin area based on ARIMA model
• LI Yang, TAN Gui-lan, LI Yi, XIE Xiao-yuan, LI Shu, WU Fang, LIU Xia
•2024,23(10):1249-1257 ,Doi: 10.12138/j.issn.1671-9638.20246108
Abstract:： Objective To construct time-series by adopting autoregressive integrated moving average (ARIMA) model for analyzing the trend and genotype characteristics of single-center h...Objective To construct time-series by adopting autoregressive integrated moving average (ARIMA) model for analyzing the trend and genotype characteristics of single-center human papillomavirus (HPV) infection in Tianjin area. Methods A total of 7 236 female patients who underwent HPV testing in a hospital from January 2018 to December 2022 were selected. HPV infection status and genotype distribution in Tianjin area from 2018 to 2022 were compared. ARIMA model time-series was constructed, and model fitting was analyzed. The number of HPV infections in 2023 was predicted and compared with the actual occurrence, the predictive performance of the model was evaluated. Results HPV infection rate in Tianjin area from 2018 to 2022 was 14.41%, with the highest rate (15.47%) in the age group of 31-40 years. Among the positive specimens, the proportion of single type HPV infection was the highest, accounting for 73.54% (767/1 043), with high-risk HPV being the main type. The highest infection rates of low-risk and high-risk types were type HPV-6 (2.59%) and type HPV-16 (16.06%), respectively. ARIMA model was constructed, and the optimal model was ARIMA (0,1,2)(0,1,1)12, with akaike information criterion (AIC) and bayesian information criterion (BIC) values of 3.877 and 4.005, respectively. There was no statistical significance in Ljung-Box Q=8.828 showed by white noise test (P>0.05). The number of HPV infection in 2023 was predicted by the model. The overall trend of the actual value and the predicted value was basically consistent, RMSE, MAPE and MAE of the model were 6.289, 34.149 and 4.706, respectively, suggesting that the model had a good prediction effect. Conclusion Among the female population in Tianjin area, HPV infection is mainly caused by single, high-risk type, with HPV-16 having the highest infection rate. There is seasonal variation in HPV infection in Tianjin. ARIMA model has good prediction effect on the prevalence trend of HPV infection, which is suitable for short-term prediction. Show
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Status and typing of human papillomavirus infection in male patients in dermatology outpatient department
• ZUO An-xin, QIAN Ying-chen, ZHANG Xiao-mei, ZHOU Dan, TONG Fang, QIU Wei
•2024,23(10):1258-1263 ,Doi: 10.12138/j.issn.1671-9638.20244993
Abstract:： Objective To analyze the status and gene subtype distribution of human papillomavirus (HPV) infection in male patients in dermatology outpatient department, provide referenc...Objective To analyze the status and gene subtype distribution of human papillomavirus (HPV) infection in male patients in dermatology outpatient department, provide reference for the prevention and treatment of male HPV infection. Methods Male patients who visited and conducted HPV detection in the dermatology outpatient department of a hospital from January 2022 to March 2023 were retrospectively surveyed. Patients were divi-ded into five groups: viral warts group, dermatitis and rash group, urinary tract infection group, balanoposthitis group, and asymptomatic group. Relationship between genotype distribution and patient age, clinical diagnosis, and symptom types was statistically analyzed. Results A total of 1 035 male patients underwent HPV detection, out of which 567 were positive, with a positive detection rate of 54.78%. 286, 164, 6, 109, and 470 cases were from viral warts, dermatitis and rash, urinary tract infection, balanoposthitis, and asymptomatic group, respectively. 21 subtypes of HPV were detected, with the top three subtypes being type 6(17.97%), 11(12.37%), and 52(8.70%). The positive rate of single type HPV infection was 29.86%, accounting for 54.50%. Positive rates of infection, low-risk infection, and multiple mixed infection in different age groups were compared, differences were all statistically significant (all P<0.05). The positive infection rate in the age group of <20 years old was higher than that in the age groups of 20-<30, 30-<40, and 40-<50 years old, differences were all statistically significant (all P<0.05). Among the positive patients, 199 cases (35.10%) had no clinical symptoms, while 368 (64.90%) had clinical symptoms, mainly manifested as viral warts (40.74%, n=231). In viral warts group, HPV-positive patients were mainly of low-risk type, accounting for 80.95%; In balanoposthitis group, HPV-positive patients were mainly of high-risk type, accounting for 84.78%; In asymptomatic group, HPV-positive patients were mainly infected with high-risk types, accounting for 86.43%. Conclusion HPV infection in male outpatient department of dermatology is mainly single type infection. The clinical diagnosis of low-risk infection is mainly viral warts, while high-risk infection is mainly manifested as balanoposthitis. In asymptomatic group, positive infections are mainly of high-risk type. Show
KeyWord：human papillomavirus;male;genotype;clinical symptom;HPV
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Response strategies for emerging highly pathogenic respiratory infectious diseases in mega-cities: a study based on transmission dynamics model
• LUO Jia-yao, LEI Zhi-qun, YAN Xiao-long, WANG Qiu-yue, WANG Rui, JIANG Hong-wei, WEI Sheng
•2024,23(10):1264-1270 ,Doi: 10.12138/j.issn.1671-9638.20246200
Abstract:： Objective To explore the effectiveness of different intervention strategies in response to outbreaks of emerging highly pathogenic respiratory infectious diseases (RIDs) in ...Objective To explore the effectiveness of different intervention strategies in response to outbreaks of emerging highly pathogenic respiratory infectious diseases (RIDs) in mega-city in China, and provide decision-ma-king basis for effective response to emerging RIDs. Methods A susceptible-exposed-infectious-recovered (SEIR) transmission dynamics model was constructed, referencing to and combining the pathogenicity and infectivity para-meters of previous emerging RIDs. The outbreak of emerging highly pathogenic RIDs with low, moderate, and high infectivity in a mega-city with a population of 10 million in China was simulated, the development of the epidemic within 100 days after implementing different combinations of non-pharmaceutical interventions (NPIs) in response to the outbreak was compared. Results When highly pathogenic RIDs outbreak occurred, and if its infectivity was low (R0 was about 1.5), it was unnecessary to adopt strict NPIs to control epidemic. If its infectivity was moderate (R0 was about 6), different intensities of NPIs were needed based on its existing infection scale. When the initial number of infected cases was 50, moderate-intensity NPIs could keep the infection and death at a low level within 100 days, and the required bed number in hospital for cases could be kept below the national average reserve level. But when the scale of infection exceeded 100 cases, high-intensity NPIs were needed to control the development of the epidemic. In the case of extremely strong infectivity (R0 was about 10), regardless of the scale of infection, only immediate high-intensity NPIs could control the epidemic, infection and death scale. Conclusion In case of outbreaks of highly pathogenic RIDs, adopting appropriate NPIs as early as possible based on their epidemiological characteristics and infection scale is necessary to minimize the harm to the population. Show
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Investigation and control of a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae infection in neurosurgical intensive care unit
• HUANG Ping-ping, YUAN Jun, GAO Jia, SHEN Yan
•2024,23(10):1271-1278 ,Doi: 10.12138/j.issn.1671-9638.20246060
Abstract:： Objective To investigate the causes for the outbreak of healthcare-associated infection (HAI) with carbapenem-resistant Klebsiella pneumoniae (CRKP) in neurosurgical intensi...Objective To investigate the causes for the outbreak of healthcare-associated infection (HAI) with carbapenem-resistant Klebsiella pneumoniae (CRKP) in neurosurgical intensive care unit (NSICU), identify the infection sources and transmission routes, and provide basis for the effective control of HAI with multidrug-resistant organism. Methods Epidemiological investigation was conducted on 3 patients with CRKP infection in the NSICU of a hospital from July 28 to August 2, 2023. Specimens were taken according to environmental hygienic monitoring methods. CRKP in the environment of the ward was searched. Antimicrobial resistance and resistance genes carried by CRKP strains were analyzed. The homology between CRKP strains isolated from patients and environment was analyzed by enterobacterial repetitive intergenic consensus (ERIC) and multilocus sequence analysis (MLSA). Results There were 3 cases with CRKP HAI, with an incidence of 3.85% (3/78), which was statistically different from the incidence during the same period in 2022 and in May-June 2023 (P<0.05). Environmental hygienic monitoring revealed that CRKP was detected from the ventilator interface of bed 1, treatment table, and bedding of bed 9, with a detection rate of 4.84% (3/62). CRKP was not detected from 15 medical staff hand specimens and 3 NSICU air monitoring specimens. Three CRKP strains were detected through environmental hygiene monitoring, their antimicrobial resistance, resistance genes, and homology were consistent with those of CRKP strains detected from clinical specimens of patients. After taking a series of targeted measures, such as quarantine, strict cleaning and disinfection of the ward environment, strict implementation of disinfection and management of invasive devices, as well as strengthening the diagnosis and treatment in groups, disinfection of medical uniforms, and hand hygiene of medical staff, this event was effectively controlled. Conclusion This event can be classified as a suspected outbreak of CRKP HAI. It is speculated that inadequate disinfection management of invasive devices, incomplete disinfection of hospital environment, lack of grouping diagnosis and treatment of medical staff, and inadequate hand hygiene are the main causes for this suspected outbreak of HAI. Early identification of infection outbreaks, investigation of infection sources and transmission routes, and timely adoption of targeted measures are crucial to the control of infection outbreak. Show
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Is COVID-19 a risk factor for infection/colonization with multidrug-resistant organisms? A survey on multidrug-resistant organisms infection in hospitalized patients during the COVID-19 pandemic
• YE Yong-kang, ZHOU Zi-quan, QIN Jin-ai
•2024,23(10):1279-1285 ,Doi: 10.12138/j.issn.1671-9638.20245156
Abstract:： Objective To analyze whether coronavirus disease 2019 (COVID-19) is a potential risk for the infection/colonization with multidrug-resistant organisms (MDROs) in hospitalize...Objective To analyze whether coronavirus disease 2019 (COVID-19) is a potential risk for the infection/colonization with multidrug-resistant organisms (MDROs) in hospitalized patients during a surge admission of COVID-19 patients. Methods Data of hospitalized patients in a tertiary first-class hospital from December 1, 2022 to January 31, 2023 were retrospectively analyzed. Clinical data, antimicrobial therapy, and MDROs detection result between COVID-19 patients and non-COVID-19 patients were compared. Patients with detected pathogens were divided into MDRO group and non-MDRO group. Risk factors for infection/colonization with MDROs in hospitalized patients were analyzed by multivariate logistic regression. Results A total of 16 710 patients were admitted in hospital, 2 403 cases were in COVID-19 group, and 8.83% (113/1 280) were MDRO-infected cases; 14 307 cases were in non-COVID-19 group, and 4.43% (167/3 770) were MDRO-infected cases. The detection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP) in patients in COVID-19 group was higher than that in non-COVID-19 group (48.15% vs 30.89%, P=0.028). Multivariate analysis Results showed that critical illness (OR=4.796, 95%CI: 3.524-6.527), antimicrobial therapy ≥2 days before pathogen culture (OR=2.330, 95%CI: 1.699-3.196), positive fungi culture (OR=1.780, 95%CI: 1.318-2.405), long hospital stay (OR=1.036, 95%CI: 1.030-1.042) were risk factors for MDRO infection/colonization in hospitalized patients (all P<0.05). Conclusion During mass admission of COVID-19 patients, MDROs infection/colonization is related to critical illness, antimicrobial use, positive fungi culture and long hospital stay, while COVID-19 infection is not a risk factor for MDROs infection/colonization. Show
KeyWord：COVID-19;co-infection;antimicrobial therapy;multidrug-resistant organism
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Construction and simulation of medical resources demand model during epidemic events of infectious diseases
• WANG Dong, TIAN Yong-quan, ZHANG Wei, ZHOU Hong-shu, XIE Bo, LI Zhen-yan, FAN Si-hai, HUANG Su-juan
•2024,23(10):1286-1294 ,Doi: 10.12138/j.issn.1671-9638.20246044
Abstract:： Objective To construct the demand model of four types of medical resources including beds in hospital, beds in intensive care unit (ICU), ventilators and medical human resou...Objective To construct the demand model of four types of medical resources including beds in hospital, beds in intensive care unit (ICU), ventilators and medical human resources during the major infectious disease epidemic events, simulate and analyze the treatment of infectious diseases when different medical resources are in short supply. Methods Based on the susceptible-exposed-infectious-recovered (SEIR) model, considering the infectivity of infected persons, the susceptibility of the population and the immunity of convalescents, the characteristics of asymptomatic COVID-19 patients and different clinical types, the "COVID-19 infection-hospitalization model" was constructed. By collecting and setting the parameters of disease transmission, clinical course and medical resource shortage scenarios, an analysis model of allocation and supply of urban medical resources during infectious di-sease epidemic events was initially formed based on Anylogic platform, the supply and demand of medical resources during infectious disease events in different scenarios were analyzed. Results In the non-intervention scenario, the peak time of bed demand was on the 107th day, and the peak value was 160.92 beds per thousand people; the peak time of ventilator demand was on the 122nd day, and the peak value was 5.61 units per thousand people; the peak time of ICU bed demand was on the 117th day, and the peak value was 12.78 beds per thousand people; the peak time of the demand for medical human resources was on the 109th day, and the peak value was 151.12 persons per thousand persons. The simulation Results suggested that there were some differences in the impact of different medical resources on the outcome of medical treatment. Conclusion This study constructs an analytical tool for the allocation and supply of urban medical resources under the epidemic events of infectious diseases, and the Results of multiple simulation experiments suggest that bed resources and medical human resources play more important roles in the outcome of medical treatment. Show
KeyWord：COVID-19;medical resource;susceptible-exposed-infectious-recovered model;Anylogic platform
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Human infective endocarditis caused by Bartonella vinsonii subsp. berkhoffii: one case report and literature review
• YAN Jun-yan, MA Rui-yan, XIAO Ying-bin, HAO Jia, LI Ming-wen, LI Jian, CHEN Lin, JIANG Ying-jiu
•2024,23(10):1295-1301 ,Doi: 10.12138/j.issn.1671-9638.20245184
Abstract:： Objective To explore the clinical characteristics and treatment strategies of infective endocarditis caused by Bartonella vinsonii subsp. berkhoffii (Bvb). Methods Cl...Objective To explore the clinical characteristics and treatment strategies of infective endocarditis caused by Bartonella vinsonii subsp. berkhoffii (Bvb). Methods Clinical diagnosis and treatment of a 25-year-old male patient with infective endocarditis caused by Bvb in China was reported, combined with literatures about three similar cases reported abroad were summarized and analyzed. Results All 4 patients were young and middle-aged males with a history of close contact with canines in the past one year. The main symptoms were chest pain, fatigue, and dyspnea, accompanied by cerebrovascular accidents and severe anemia, as well as the formation of heart valve vegetations and valve function impairment. Multiple blood cultures were negative, 2 and 3 cases were confirmed to be infected with Bvb through metagenomic next-generation sequencing (mNGS) of pathogenic microorga-nisms and polymerase chain reaction respectively. All patients underwent surgical treatment due to heart failure, and all survived after surgery and targeted anti-infective treatment. Conclusion This case report is the first case of Bvb infective endocarditis in China. Patient’s diagnosis is confirmed by serum indirect immunofluorescence assay and mNGS, combination of surgery and anti-infective treatment has achieved ideal effect. Show
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Francisella philomiragia bloodstream infection: one cases report and literature review
• ZHANG Yun-chen, HUANG Wen-hui, CAI Gui-yan, ZHANG Jing-yun, XU Xiao-xin
•2024,23(10):1302-1306 ,Doi: 10.12138/j.issn.1671-9638.20246301
Abstract:： Francisella philomiragia (F. philomiragia) infection is a rare infectious disease. This article reported one case of bloodstream infection of F. philomiragia. Relevant literatures ...Francisella philomiragia (F. philomiragia) infection is a rare infectious disease. This article reported one case of bloodstream infection of F. philomiragia. Relevant literatures from at home and abroad were systematically reviewed, and clinical characteristics of infected patients were summarized and analyzed. The research found that people with chronic granulomatous disease, drowning, blood system diseases, diabetes, kidney transplantation, rheumatism, alcoholism, and other immunocompromised or immune barrier damaged people are susceptible to F. philomiragia. Salt water exposure is a risk factor. The combined anti-infection scheme based on amino-glycosides, fluoroquinolones and doxycycline can improve the success rate of treatment. Show
KeyWord：Francisella philomiragia;infection;bloodstream infection;case report
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Bloodstream infection secondary to skin and soft tissue infection after a tiger bites: one case report
• WANG Dao-han, MIAO Wei, WANG Ming-yu, BAO Dong-bo, PIAO Zhe-yu, PIAO Mei-hua
•2024,23(10):1307-1310 ,Doi: 10.12138/j.issn.1671-9638.20246006
Abstract:： Pasteurella multocida and Aeromonas hydrophila are rare human pathogens, and zoonotic infections caused by bites of big cats are rarely reported. This paper reported the first case...Pasteurella multocida and Aeromonas hydrophila are rare human pathogens, and zoonotic infections caused by bites of big cats are rarely reported. This paper reported the first case of wound infection caused by Pasteurella multocida and Aeromonas hydrophila after tiger bites in China. Strain identification and drug susceptibility testing were conducted by BD PHOENIXTM100 automatic microbial analyzer. The patient was discharged with a good prognosis after wound debridement, surgical intervention and combined antimicrobial treatment. This paper aims to advise emergency physicians to consider the possibility of co-infection of Pasteurella multocida and Aeromonas hydrophila when encountering rare big cat bites. Show
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Wash-hand basin and hand-rinse basin in UK healthcare buildings: an analysis based on infection prevention and control concepts
• XIE Hao, ZHANG Qi, LI Yang, LIU Fu-ying
•2024,23(10):1311-1318 ,Doi: 10.12138/j.issn.1671-9638.20246068
Abstract:： Effective infection prevention and control measures can reduce the risk of infection in patients, health care workers, and visitors in healthcare buildings. Hand hygiene facilities...Effective infection prevention and control measures can reduce the risk of infection in patients, health care workers, and visitors in healthcare buildings. Hand hygiene facilities, such as wash-hand basin and hand-rinse basin, play important roles in this. Based on a number of medical building guidelines issued by the UK Department of Health and Social Security, this paper analyzed the wash-hand basin and hand-rinse basin in medical buildings in the UK, and summarized similar problems in China. This paper clarified the differences between wash-hand basin and hand-rinse basin in the UK medical buildings, as well as classification of users, size and space requirements, classification and design requirements, and configuration requirements of wash-hand basin and hand-rinse basin. It also discussed the status of such problems in China as well as relevant experience and enlightenment from the UK. Some of the UK experience can provide reference for the future revision of Chinese standards such as Code for design of infectious diseases hospital, Code for design of general hospital, Standard for hand hygiene for healthcare workers in healthcare settings. Show
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Current status of health economic evaluation on the effectiveness of influenza vaccination
• ZHU Dan-ni, WANG Yao-gang, ZHANG Xin-yu
•2024,23(10):1319-1325 ,Doi: 10.12138/j.issn.1671-9638.20245370
Abstract:： Influenza is an acute respiratory infectious disease caused by influenza virus, which poses a serious risk to human health. People are generally susceptible to influenza virus. The...Influenza is an acute respiratory infectious disease caused by influenza virus, which poses a serious risk to human health. People are generally susceptible to influenza virus. There is an international consensus that influenza vaccination is the most effective way to prevent and control influenza. In China, influenza vaccination is a non-immunization programme vaccine that is vaccinated voluntarily and at one’s own expense. In some regions, immunization policies are implemented for priority groups. In recent years, a number of health economic evaluations on influenza vaccination have been conducted both at home and abroad, especially for key and high-risk populations such as pregnant women, children, elderly people aged ≥60 years old, people suffering from one or more chronic diseases, and health care workers. This paper analyzed the current status of researches on health economic evaluation of influenza vaccination through collating relevant literatures published at home and abroad in recent years, so as to provide a scientific basis for the formulation of influenza vaccination strategies in China. Show
KeyWord：influenza vaccine;influenza;health economic evaluation
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Research advances in receptors related to interaction between SARS-CoV-2 S protein and host cells
• FANG Xiao-min, LIU Xing-jian, ZHANG Rui-gang
•2024,23(10):1326-1332 ,Doi: 10.12138/j.issn.1671-9638.20246284
Abstract:： Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at the end of 2019, its global research has become a hot spot. The tendency of coronavi...Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at the end of 2019, its global research has become a hot spot. The tendency of coronavirus infection mainly depends on the ability of spike protein (S protein) binding to receptors on the cell surface. S protein and its receptor binding domain (S-RBD) not only play a key role in the binding of virus to host cells and the entry of virus into cells, they can also bind to host cell surface receptors such as angiotensin-converting enzyme 2 (ACE2), Toll-like receptor (TLRs), cluster of differentiation (CD)147, and neuropilin 1 (NRP-1), activating different signaling pathways, thus promoting virus to invade host cells and trigger a series of pathogenic processes such as inflammation. Therefore, it is of great significance to study receptors involving in the interaction between S protein and host cells. This article reviews the receptors related to the interaction between S protein and host cells, so as to provide theoretical basis for the prevention and treatment of SARS-CoV-2 infection. Show
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