Abstract:

Novel coronavirus (2019-nCoV) pneumonia(NCP) is an emerging infectious disease. This paper assesses the characteristics of 2019-nCoV, epidemiology and clinical characteristics of NCP, as well as some problems in infection prevention and control. It is suggested that prevention and control of NCP in medical institutions should be strengthened by pre-examination and triage, early identification of patients and timely management of infection sources. It is necessary to implement standard preventive measures; take supplementary preventive measures when contacting suspected and confirmed patients, prevent infection among health care workers; conduct training, monitoring and supervising; adopt environmental and engineering control measures, strengthen discipline construction of infection and infection control.

Abstract:

Pneumonia caused by novel coronavirus infection is an emerging infectious disease, prevention and control of healthcare-associated infection (HAI) is a very important work, because hospitals are places for confirmed and suspected patients. Due to the psychological pressure of sudden epidemic situation and unfamiliarity with the characteristics of new diseases, health care workers are faced with a lot of confusion in the prevention and control of HAI. This paper discusses the the common confusion on the aspects of health care workers protection, hand hygiene, isolation requirements and so on.

Abstract:

In December 2019, multiple cases of novel coronavirus (2019-nCoV) infection occurred in Wuhan, Hubei Province. nCoV is mainly transmitted by close-up droplets and contact, people are generally susceptible to it, in addition, during the special period of Spring Festival travel, the number of confirmed cases, severe cases and suspected cases of nCoV pneumonia rose sharply in a short period of time. The epidemic triggered a large demand for masks by health care workers and the public, there are many kinds of masks on the market, different masks have different scope of application and different standards. The author investigated the application scope and relevant standards of masks in various countries, sorted out the development history, classification, standards and evaluation indicators of masks, so as to provide help for health care workers and the public.

Abstract:

Protective clothing is a very important personal protective equipment for health care workers (HCWs) in fighting against epidemic of infectious diseases, especially in confronting emerging infectious diseases with unknown transmission routes and infectious diseases with a high risk of transmission. Protective clothing can prevent secretion, splash and particle that may carry various pathogens from contacting the human body and protect health of HCWs, it is important protective product against epidemic of novel coronavirus pneumonia. Due to the wide spread of epidemic and large number of infected people, there is a huge demand for protective clothing, medical protective clothing that meets the national standards is in short supply, and some protective clothing that meets the foreign standards are gradually being used. The author consulted and compared the application scope and evaluation indexes of protective clothing in various countries, in order to provide help for HCWs to select protective clothing that meets the requirements.

Abstract:

A large number cases of novel coronavirus pneumonia have emerged in Wuhan and its surrounding areas, more than 10 000 health care workers(HCWs) national wide conduct medical rescue in Hubei Province. HCWs are at high risk of infection, preventing the infection spread in resident of medical team is a main point of the medical team. This paper discusses the management requirements, personal cleaning and disinfection, infection prevention and control in daily life, as well as environmental disinfection and air purification.

Abstract:

Objective To understand the status and influencing factors of drug abuse of human immunodeficiency virus (HIV) negative men who have sex with men (MSM) in Chongqing, and explore the relationship between drug abuse and incidence of sexually transmitted diseases(STD). Methods From June 2018 to June 2019, HIV negative MSM in Chongqing were recruited, social demography, high-risk sexual behavior, STD infection and other information were collected. Univariate and multivariate logistic regression analysis were used to analyze the influencing factors for drug abuse, relationship between drug abuse and occurrence of STD was analyzed by Chi-square test. Results A total of 139 HIV negative MSM were recruited, 34.53% (48/139) of whom had a history of drug abuse in the recent 6 months. Univariate and multivariate logistic regression analysis results showed that obstacle factor for drug abuse was post exposure prophylaxis; the independent risk factor for drug abuse was group intercourse with ≥ 3 men (OR=0.027, 95%CI:0.009-0.085). Incidence of STD in drug abusers was 16.67% (8/48), which was higher than that in non-drug abusers (4.40%,4/91) (P<0.05). Conclusion Drug abuse rate of HIV negative MSM in Chongqing is high, and drug abuse is more likely to lead to high-risk sexual behavior, and incidence of STD is higher.

Abstract:

Objective To systematically assess risk factors for healthcare-associated infection(HAI) with Stenotrophomonas maltophilia (SMA). Methods Literatures about the risk factors for SMA HAI were retrieved from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure(CNKI), Chinese Biology Medicine(CBM) database, Wanfang database (Wanfang), and VIP database from the establishment of database to March of 2019, literatures were screened, extracted, and performed quality evaluation according to inclusion and exclusion criteria by two researchers, Meta-analysis was conducted using RevMan 5.3 software. Results A total of 10 literatures were included in study, 3 in English and 7 in Chinese. Meta-analysis showed that APCHE-II score>20 at admission (OR=3.69, 95%CI:1.58-8.59), length of ICU stay>7 days (OR=2.14, 95%CI:1.55-2.95), length of hospital stay (MD=7.54, 95%CI:6.22-8.86), use glucocorticoid (OR=2.40, 95% CI:1.57-3.68), combined with immunodeficiency disease (OR=2.31, 95%CI:1.64-3.25), mechanical ventilation (OR=7.59, 95%CI:3.40-11.97), tracheal intubation (OR=4.98, 95%CI:3.21-7.73), tracheotomy (OR=4.31, 95%CI:2.80-6.64), central venous catheterization (OR=1.68, 95%CI:1.19-2.38), indwelling nasogastric tube (OR=3.10, 95%CI:1.83-5.26), use carbapenems (OR=2.81, 95%CI:2.24-3.54), use β-lactamase inhibitors (OR=3.52, 95%CI:1.71-7.24), use aminoglycosides (OR=1.93, 95%CI:1.37-2.73), use glycopeptides (OR=3.42, 95%CI:1.13-10.32) and use antimicrobial agents ≥ 3 kinds(OR=2.70, 95%CI:1.75-4.16) were risk factors for SMA HAI (all P<0.05). Conclusion There are many risk factors for SMA HAI, targeted preventive measures should be taken in clinical practice to reduce the risk of infection.

Abstract:

Objective To explore the effect of bundle intervention measures on the prevention of healthcare-associated infection(HAI) in patients with hematological malignancies(HM), and provide basis for formulating HAI preventive measures for patients with hematological malignancies. Methods By using the combination method of retrospective and prospective investigation, patients with HM in the hematology department of a hospital were selected as the research objects, those who received routine intervention from January 1, 2017 to January 31, 2018 were as control group, and those who received bundle intervention from February 1, 2018 to September 20, 2018 were as trial group, changes in incidence and site of HAI between two groups of patients before and after bundle intervention during therapeutic process were compared. Results Incidence of HAI in trial group was lower than control group (8.18%[28/342] vs 17.40%[75/431], P<0.05). Classified analysis results showed that compared with control group, incidence of HAI in patients with lymphoma in trial group decreased most obviously (28.85% vs 9.80%), followed by patients with acute leukemia (24.42% vs 13.27%). Difference in the incidence of HAI between patients with these two kinds of diseases before and after bundle intervention were both significant (both P<0.05); constituent ratios of infection sites in patients with lymphoma and acute leukemia changed significantly, constituent ratios of infection in respiratory system, oral cavity, and soft tissue decreased, while that in bloodstream increased. Conclusion The bundle intervention can reduce the incidence of HAI in patients with HM.

Abstract:

Objective To understand the clinical efficacy and adverse reactions of elbasvir/grazoprevir in the treatment of hepatitis C virus (HCV) 1b infection in dialysis patients. Methods Clinical data of 3 dialysis patients with HCV 1b infection who were treated with elbasvir/grazoprevir were collected retrospectively, related literatures were consulted, analyzed and summarized. Results Two hemodialysis patients and one peritoneal dialysis patient were treated with antiviral therapy of elbasvir/grazoprevir, all of them achieved sustained virological response at 12 weeks (SVR12) and achieved the goal of clinical cure. One patient showed a significant decrease in hemoglobin after 4 weeks of treatment, but released after 12 weeks of treatment. Another patient had fatigue during the treatment,symptom disappeared after treatment. None of the three patients stopped the treatment due to complications. Conclusion Elbasvir/grazoprevir is effective for treating HCV 1b infection in hemodialysis and peritoneal dialysis patients, there is no serious adverse reaction.

Abstract:

Objective To analyze risk factors and internal network path among risk factors for multidrug-resistant organism (MDRO) infection in intensive care unit (ICU), clarify interaction among risk factors, and construct risk model of MDRO infection in ICU. Methods Patients with infection in the general ICU in a tertiary first-class hospital from January to March 2019 were analyzed retrospectively,they were divided into MDRO infection group (patients with MDRO infection judged by clinicians and HAI surveillance and control doctors) and non-MDRO infection group (patients without MDRO infection but with other infection), univariate analysis was used to screen the diffe-rent risk factors between two groups, social network analysis was used to analyze the network path of different risk factors. Results A total of 219 infected patients were included, 80 of whom were with MDRO infection, accounting for 36.5% of all infected patients. The network of risk factors in MDRO infection group was denser than that of non-MDRO infection group, and the interaction between risk factors was stronger. Among them, age, days of fever, times of abnormal procalcitonin and days of postoperative antimicrobial use were the core risk points of MDRO infection, which were in the center of network diagram (P<0.05). Conclusion Rational use of antimicrobial agents after operation, take the elderly, fever patients and patients with abnormal procalcitonin index as the high-risk popu-lation of MDRO infection and pay attention to them can bring prevention forward.

Abstract:

Objective To evaluate application effect of fluorescence labeling method on survey of compliance to high-frequency touched environmental cleaning in medical institutions in ethnic minority areas. Methods High-frequency touched areas of surgical and obstetric and gynecological wards of a county hospital were selected for fluorescence labeling, after cleaned by cleaners, video monitoring and fluorescence labeling were performed to survey compliance to cleaning, fluorescence was labeled in the middle of door handle of wards to be put into use and in the front panel of door locks which were not easy to be touched by hand, effect of volunteers' frequent opening and frequent touch on fluorescence labeling was observed. Results Fluorescence labeling on 202 points showed that compliance rate to cleaning in high-frequency touched area was 66.83%. The sensitivity and specificity of fluorescence labeling for surveying environmental cleaning were 94.96% and 73.49% respectively; after 8 times of direct touch by hands, the removal rate of fluorescence labeling was 93.94%, there was a significant difference in the removal rate of fluorescence labeling between door handle with different touch frequencies(χ²=49.622,P<0.05). Pairwise comparison showed that the removal rate of fluorescent labeling increased with the increase of frequency of direct hand touch. Conclusion Fluorescent labeling method is applicable to the survey of compliance to environmental cleaning of high frequency-touched area in primary medical institutions, but it should avoid the area where the door handle, elevator button and other personnel directly frequently touched area when fluorescence was labeled. It is necessary to further study the method of labeling on high-frequency touched area when people directly touch the door handle, elevator button an so on.

Abstract:

Objective To investigate the mixed placement of medical waste and domestic waste in public area of a large tertiary first-class general hospital. Methods A random questionnaire survey was carried out among patients and their accompanying persons in the public area of medical institutions, mixing placement of medical waste and domestic waste in medical waste bins and domestic waste bins in the public area of medical institutions were checked and recorded. Results A total of 100 questionnaires were distributed, 96 of which were available and 85.42% (82/96) of respondents received at least junior high school education. According to the questionnaire survey, 59.38% of respondents knew that hospital waste were divided into medical waste and domestic waste, 33.33% knew the color of medical waste bin and packaging bag that medical waste and domestic waste should be put into respectively, 29.17% knew that medical waste could be reused after harmless treatment, 77.08% thought that classfied disposal logo of medical waste and domestic waste in their hospitals was not obvious, 9.38% had received education on classified disposal of medical waste and domestic waste, 65.63% were willing to take the initiative to implement classified disposal of medical waste and domestic waste in the future medical treatment process. Through on-site inspection of mixed placement of medical waste and domestic waste in medical waste bins and domestic waste bins in public area, it was found that 41.18% of domestic waste bins were mixed with medical waste, and 83.33% of medical waste bins were mixed with domestic waste. Conclusion The mixed placement of medical waste and domestic waste in public area of medical institutions is serious, it is necessary to implement targeted comprehensive interventions to further guide the classification of medical waste and domestic waste in public area of medical institutions.

Abstract:

Objective To review the hot spots in healthcare-associated infection(HAI) control electronic information service system in China in recent 10 years, and summarize the trend changes of hot spots of HAI management personnel. Methods Based on the python scrapy programming method, this paper captured the content published in the Shanghai International Forum for Infection Control(SIFIC) form April 6, 2007 to December 31, 2017, processed Chinese word segment, and extracted the top 5 available words as hot words for analysis. Results A total of 3 112 840 data from 93 sections of SIFIC from 2007 to 2017 were obtained. According to the annual longitudinal analysis, the top 3 hot words were "disinfection", "monitoring", and "training". In 2009, the global outbreak of novel influenza A (H1N1), "influenza A" became the first hot spot word of the year; in 2017, 10 new regulations for HAI management were officially implemented, and "regulation" became the second hot spot word of the year. From horizontal perspective of key sections, each professional section has its own different focus direction, showing the complexity and diversity of HAI management discipline. Conclusion Through the hot spot analysis on the electronic information service system in the field of HAI control, changing trend of focus in the field of practical work can be understood, the focus on hot issues can be further improved and HAI control ability can be improved.

Abstract:

Objective To explore the drying effect of different drying methods on flexible endoscope and its accessories with lumen, and provide basis for clinical selection of better drying methods. Methods 600 choledochoscopes and accessories with lumen to be dried were selected and randomly divided into three groups with 200 devices in each group:group A:wipping the device surface with 95% ethanol-based lint-free fabric, using syringe to pump 95% ethanol into the lumen of device with opening at both ends, drying water on the surface and lumen of device with a pressure air gun; group B:wiping water on device surface one by one with a dry lint-free fiber, then blew the lumen with a pressure air gun for 3-5 seconds, and put it into a low-temperature vacuum drying cabinet at 50℃ for 20-25 minutes; group C:blow lumen with a pressure air gun for 3-5 seconds, put it in a high-temperature drying cabi-net at 60-65℃ for 10-12 minutes, and then put it in a low-temperature vacuum drying cabinet at 50℃ for 20-25 minutes. Determine the drying effect by visual inspection+air gun blowing+weighing, and evaluate the working efficiency by measuring the drying time. Results The qualified rates of drying device in group A, B and C were 86.00%, 94.00% and 98.00% respectively, difference was statistically significant (P<0.05), the drying effect of group B and C was better than that of group A (P<0.0175), difference between group B and C was not statistically significant (P=0.041). The drying time required for surface drying in group A, B and C were 15, 20 and 12 minutes respectively; the drying time required for lumen in group A, B and C with openings at both ends were 1, 20 and 20 minutes respectively, group A could not handle device with blind end, group B and C needed 25 minutes for blind end. Conclusion For flexible endoscope and accessories with lumen which can not endure high temperature, use pressure air gun to blow the lumen for 3-5 seconds, put into high-temperature drying cabinet at 60-65℃ for 12 minutes, then put into low-temperature vacuum drying cabinet at 50℃ for 20-25 minutes, the drying and disinfection effect is the best, and the working efficiency is the highest.

Abstract:

Objective To explore the risk factors for surgical site infection (SSI) after tension-free mesh inguinal hernia repair(TFMIHR). Methods A 1:4 matched case-control study was conducted, 25 patients with postoperative SSI after class I incision TFMIHR in the general surgery department of Huadong Hospital Affiliated to Fudan University from January 2016 to June 2018 were selected as case group, 100 patients who received class I incision TFMIHR but didn't develop SSI after operation were selected as control group according to matching of age, gender and operation date, SPSS 16.0 software was used for univariate analysis and paired multivariate logistic regression analysis. Results A total of 1 648 patients who underwent class I incision TFMIHR were collected, 25 patients suffered from SSI after operation, incidence of SSI was 1.52%. Risk factors for SSI after TFMIHR were diabetes mellitus, hypertension, respiratory system disease, malignant tumor and long duration of hospital stay before operation, OR value was 12.686 and 3.326 respectively; there was no significant difference in the occurrence of SSI after operation in patients who used perioperative prophylactic antimicrobial agents or not, types of mesh, laparoscopic surgery or not, and smoking history(all P<0.05). Conclusion Patients suffering from underlying diseases such as diabetes mellitus, hypertension, respiratory system disease, malignant tumor can increase the risk of SSI after TFMIHR, shortening of preoperative hospitalization time can reduce the risk of SSI after TFMIHR.

Abstract:

Objective To understand the clinical characteristics and treatment outcome of Streptococcus pneumoniae-associated hemolytic uremic syndrome (SP-HUS) in children. Methods Clinical data of one child with SP-HUS treated by plasma exchange (PE) were analyzed retrospectively, relevant literatures were reviewed and analyzed. Results The male patient, 3 years and 3 months old, was admitted to the hospital due to cough for 10 days, and aggravated fever and chest pain for 3 days, he had the triad of HUS, Streptococcus pneumoniae was found in both alveolar lavage fluid culture and sputum culture, diagnosis of SP-HUS was confirmed, after active anti-infective combined with 3 times of continuous renal replacement therapy (CRRT) and 2 times of PE therapy, patient's condition gradually improved and was discharged from hospital. The literature review found that two cases of SP-HUS reported in China were 1 year old, 6 months old and 3 years old respectively, all originated from pneumonia, after active anti-infective and supportive therapy, they all improved and discharged from hospital. Conclusion For children with Streptococcus pneumoniae infection, more attention should be paid to the prevention of HUS complications, infants and young children are high-risk groups, and comprehensive therapy is the key to successful therapy.

Abstract:

Abstract:

Persister is a subpopulation of bacteria that can tolerate lethal doses of drugs in the bacterial population and survive in other stressful environment,it is ubiquitous in various species of bacteria, and even exists in some eukaryotes. It is phenotypic mutant that does not have genetic mutation and will not be killed by antimicrobial agents, which are considered by some scholars to be an adaptive and evolutionary form of bacteria. Persister resists the adverse stimulation of the external environment through a complex dormancy mechanism, recovery of proliferation after detaching the dormant state leads to the failure of clinical treatment, prolongation and recurrence of multiple infectious diseases, and enhancement of genetic resistance mutation, which poses a great challenge to the diagnosis and treatment of infectious diseases, shows a great threat to human health. This article comprehensively summarizes the characteristics, mechanism and clinical treatment of persister, and provides new ideas and help for future research about persister.

Abstract:

Abstract:

Abstract: