Abstract:Vaccine literacy is an essential health literacy for coping with vaccine-preventable diseases such as coronavirus disease 2019 (COVID -19). In this article, the definition, classification, measurement and research status of vaccine literacy are reviewed, so as to provide theoretical and practical reference for improving vaccine literacy, enhancing vaccination coverage rate of residents, and effectively establishing immune barrier.

Abstract:Objective To understand the current situation and problems of cleaning and disinfection of water-perfused esophageal manometry catheter in China. Methods Cleaning, disinfection and sterilization of water-perfused esophageal manometry catheter in 31 hospitals in China was performed questionnaire survey. Results All 31 hospitals used high-resolution water-perfused esophageal manometry catheter, 22.58% used traditional manometry catheters at the same time. 87.10% of hospitals used 1-2 high-resolution water-perfused esophageal manometry catheter, 54.84% of hospitals used catheter in ≤10 patients per month. 58.06% of hospitals had specially assigned persons to clean and disinfect water-perfused esophageal manometry catheter, nurses in 93.55% of hospitals participated in catheter cleaning and disinfection. The cleaning and disinfection process was mainly "initial washing-enzyme wa-shing-rinsing-disinfection-final washing" (96.77%), most hospitals injected and washed the internal channels of catheter one by one in each step (93.55%), the initial washing time was mainly 3-5 minutes (48.39%); 96.77% of hospitalschose the disinfection method of complete immersion of chemical disinfectant, disinfectant was mainly orthophtha-laldehyde (38.71%), disinfection time was mainly 5-10 minutes (74.19%). Only 29.03% of hospitals sterilized water-perfused esophageal manometry catheter, mainly "one sterilization only used for once" (88.89%) and immersion in glutaraldehyde for 10 hours (66.67%). The sterilized water-perfused esophageal manometry catheter was mainly hung vertically in the gastroscope storage room (51.61%), and 38.71% of hospitals disinfected water-perfused esophageal manometry catheter to be used on that day again. Conclusion There are some deficiencies and differences in the cleaning, disinfection and sterilization of water-perfused esophageal manometry catheter in 31 hospitals, it is suggested that the relevant national standards for cleaning and disinfection of water-perfused esophageal manometry catheter should be formulated as soon as possible, so as to standardize the cleaning and disinfection process of water-perfused esophageal manometry catheter.

Abstract:Objective To investigate the sterilization effect of peracetic acid and ethylene oxide on endoscope used for debridement of walled-off pancreatic necrosis (WON) complicated with multidrug-resistant orgamism (MDRO) infection (percutaneous/transgastric). Methods Endoscopes with auxiliary water delivery function used for patients with WON and MDRO infection (percutaneous/transgastric) who underwent debridement in a tertiary first-class hospital in Jiangxi Province were selected and divided into two groups by random number table method: group A was sterilized with peracetic acid immersion, and group B was sterilized with ethylene oxide at low temperature. Specimens of forceps channel, air/water supply channel and auxiliary water supply channel of endoscopes were collected by filter membrane method for microbial culture. The qualified rate of endoscope sterilization, colony number and detection result of MDROs of two groups of endoscopes were compared. Results 78 auxiliary water supply endoscopes were collected, including 39 in group A and 39 in group B, with a total of 234 specimens. The qualified rates of endoscope sterilization of group A and group B were 61.54% and 100% respectively. Qualified rates of forceps channel, air/water supply channel and auxiliary water supply channel in group A were 82.05%, 89.74% and 74.36% respectively, qualified rates of three sites in group B were all 100%. In group A, the total bacterial colonies of forceps channel, air/water supply channel and auxiliary water supply channel were 0-6 CFU, 0-112 CFU and 0-23 CFU respectively. 36 strains of MDROs were isolated, mainly multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and multidrug-resistant Klebsiella pneumoniae. After 15 unqualified endoscopes in group A were sterilized with ethylene oxide at low temperature, qualified rate of microbiological monitoring reached 100%. Conclusion Low temperature sterilization with ethylene oxide is more effective for endoscopic debridement of WON complicated with MDRO infection (percutaneous/transgastric). Microbiological monitoring of endoscope should not be limited to the monitoring of forceps channel, auxiliary water supply channel of endoscope with the auxiliary water supply function should be monitored, so as to reduce the risk of infection.

Abstract:Objective To analyze the changing trend of disease burden and epidemic situation of hepatitis C in China from 1990 to 2019, and provide scientific basis for promoting the elimination of hepatitis C. Methods Data of the Global Burden of Disease Study 2019 (GBD 2019) were used to analyze the 30-year changing trend and current situation of the occurrence, onset, disability-adjusted life year (DALY) and years of life lost (YLL) of hepatitis C in Chinese population, GraphPad Prism 8.0 was used for mapping. Results In 2019, standardized DALY rate of the total disease burden of hepatitis C in China was about 101/100 000 person-year; the standardized incidence of acute hepatitis C was about 47/100 000; the peak incidence of hepatitis C-related chronic liver disease was in population of 40-44 years old, and standardized morbidity was about 1 247/100 000. From 1990 to 2019, the total standardized incidence and standardized morbidity of hepatitis C dropped to the trough in 2015, and then rose sharply in the following 4 years; standardized DALY rate has been declining for 30 years. Conclusion Hepatitis C-related chronic liver disease is the main disease burden of hepatitis C; due to the short treatment cycle and good efficacy of direct antiviral drugs, it is recommended to strengthen publicity, strengthen hepatitis C screening, and promote the construction of a healthy China.

Abstract:Objective To understand the changes in occurrence and etiology of hand-foot-and-mouth disease (HFMD) before and after enterovirus 71 (EV-71) vaccination in Jining City from 2012 to 2021. Methods Occurrence and etiology of HFMD in Jining City were analyzed by descriptive epidemiological methods. Changes in incidence and pathogens of HFMD before and after EV-71 vaccination were compared. Results From 2012 to 2021, incidence of HFMD among children aged 6 months-5 years in Jining City was 658.93/100 000, the highest incidence was 1 094.63/100 000 in 2018, and the lowest incidence was 247.23/100 000 in 2021. In laboratory diagnosis cases, EV-71, coxsackievirus A16 (CV-A16), and non-EV-71 non-CV-A16 accounted for 27.89%, 34.59%, and 37.52% respectively. Among children aged 6 months to 5 years, the estimated incidence of EV-71 was 131.04/100 000, the highest estimated incidence was in 2017 (322.13/100 000), and the lowest estimated incidence was in 2021 (7.71/100 000). EV-71 was the main type of severe cases, accounting for 76.25%. The estimated vaccination rate of EV-71 vaccine in Jining City from 2016 to 2021 was 7.98% on average. After EV-71 vaccination, the proportion of EV-71 HFMD was lower than that before vaccination, with a decrease of 4.80%. The dominant strain in 2013 and 2017 was EV-71, the proportion of EV-71 began to decrease in 2018, and the lowest was 5.16% in 2021. Conclusion Vaccination rate of EV-71 vaccine in Jining City is relatively low. After inoculation of EV-71 vaccine, the estimated incidence of EV-71 reached the peak in 2017, but then showed a downward trend. The majority of virus strains were CV-A16 and non-EV-71 non-CV-A16, it is necessary to further carry out typing of non-EV-71 non-CV-A16, and develop multivalent HFMD vaccine.

Abstract:Objective To explore the significance of air bacterial monitoring in the maintenance and management of air quality in clean operating department. Methods Static and dynamic air monitoring of sedimentated bacteria was carried out in 45 operating rooms in the clean operating department of a hospital. Static air monitoring was conducted based on Code for architectural design of hospital clean operating department (GB 50333) and dynamic air monitoring was conducted according to Code for control of contamination of hospital clean operating department (DB/11408-2007). Dynamic air monitoring was performed during different time periods of the first operation (at skin incision, 2 hours after the operation or at the end of suture, consecutively occupied operating room-anesthesia-skin disinfection), relevant factors that might affect the indoor air quality during operation was recorded. When qualified rate of dynamic and static air monitoring was low, the causes was found out, and the management mea-sures were formulated and implemented. Results From May 2010 to September 2021, 782 static air specimens of operating rooms were taken, and 763 (97.57%) were qualified. Static air sampling of six room were taken in June 2018, with a qualified rate of 33.33%, the causes for the non-qualified result was analyzed, and measures were taken, qualified rate of static air monitoring from November 2018 to September 2021 was 99.48%. Dynamic air monitoring results show that dynamic air monitoring results of different grades of operating rooms in May 2010 were all unqualified, from June 2010 to June 2011, 103 dynamic air specimens were taken, qualified rates of grade Ⅰ, Ⅱ and Ⅲ operating rooms were 90.00%, 89.80% and 95.45% respectively. Colony number of the return air outlet at different positions in grade Ⅱ and Ⅲ operating rooms was compared, colony number of the return air outlet at the entrance was higher than that of the inner return air outlet, differences were all significant (all P < 0.05). The dynamic air sampling colony numbers of grade Ⅰ, Ⅱ and Ⅲ operating rooms in different periods were compared, differences were all significant (all P < 0.001), and the colony number in all grades of operating rooms increased gradually with the operation progress. Conclusion Static and dynamic air monitoring in clean operating room plays a good role in maintaining and managing the air quality in clean operating room; dynamic air monitoring can timely grasp the operating status and bacterial contamination in operating department.

Abstract:Objective To analyze the effect of bundle management on ventilator-associated pneumonia (VAP) in department of critical care medicine. Methods From January 2015 to December 2019, 964 patients who were admitted in department of critical care medicine of a hospital and received mechanical ventilation (MV) for more than 48 hours were selected and divided into control group (January 2015-December 2016) and intervention group (January 2017-December 2019) according to admission time and nursing mode. Control group took routine nursing mana- gement measures, intervention group took cycle bundle management mode on the basis of control group. Incidence of VAP, mortality during hospitalization, detection rate of multidrug-resistant organism (MDRO) and infection rate of MDRO in department of critical care medicine were compared between two groups of patients. Results Among 665 patients in intervention group, incidence of VAP was 12.95 ‰, mortality during hospitalization was 4.06%; among 299 patients in control group, incidence of VAP was 25.79 ‰, mortality during hospitalization was 10.37%, incidence of VAP and mortality during hospitalization in intervention group were both lower than those in control group (both P < 0.05). Detection rate of MDRO in intervention group was lower than that in control group (12.77% vs 43.94%, P < 0.05); MDRO infection rates in patients in intervention group of department of critical care medicine was lower than that of control group during the same period (0.52% vs 4.78%, P < 0.05). Conclusion Bundle management measures can reduce the incidence and mortality of VAP in department of critical care medicine, and can also reduce the detection rate and infection rate of MDRO in MV patients, which is worthy of clinical promotion and application.

Abstract:Objective To study the impact of neurosurgical central nervous system infection (NCNSI) after neurosurgical operation on post-operative hospitalization expense and length of hospital stay, and provide health economic support for infection prevention and control. Methods Clinical data of patients who underwent neurosurgical operation in a tertiary first-class comprehensive hospital in Shanghai from January 1, 2015 to December 31, 2020 were retrospectively collected. According to whether NCNSI occurred after operation, patients were divided into infection group and non-infection group, database of covariate equilibrium was constructed with 1 ∶1 propensity score matching method, post-operative expenses and length of hospital stay of two groups of matched patients were compared. Results A total of 1 661 patients after neurosurgical operation were included, 83 of whom developed NCNSI, with an incidence of 5.00%, 77 pairs of propensity scores were matched successfully. After matching, the median of total hospitalization expenses in patients in infection group and non-infection group were 96 487 Yuan and 44 691 Yuan respectively, direct economic loss was 51 796 Yuan; the median length of hospital stay was 27 days and 10 days respectively, and infection group was extended for additional 17 days. Conclusion NCNSI in neurosurgery patients prolongs length of hospital stay and increases hospitalization expenses, propensity score matching method can provide more accurate results for the economic burden research.

Abstract:Objective To investigate the clinical characteristics, etiology and prognosis of bacterial meningitis in different pathogenic bacteria-infected premature infants and provide evidence for clinical treatment. Methods Clinical data of bacterial meningitis of premature infants hospitalized in the department of neonatology of a children's hospital in Hunan Province from January 2018 to December 2019 were retrospectively analyzed. According to different pathogens of infection, they were divided into Escherichia coli (E. coli) group, other bacteria group and unknown pathogen group. General data, clinical characteristics, cerebrospinal fluid (CSF) examination results and prognosis of three groups of premature infants were compared. Results 90 cases of bacterial meningitis in premature infants were included. The main initial symptoms were poor reaction (58.89%), fever (53.33%), breast refusal (34.44%) and apnea (35.56%), and were the same in early-onset and late-onset bacterial meningitis in premature infants (P>0.05). Among 90 premature infants, 44 were CSF culture positive and were divided into E. coli group (n=18), other bacteria group (n=26) and unknown pathogen group (n=46). The proportion of fever and complications of premature infants in E. coli group and other bacteria group was higher than that in unknown pathogen group (P < 0.05); children whose mothers with premature rupture of membranes and fever before delivery were more likely to suffer from E. coli meningitis (P < 0.05). In E. coli group, inflammation characteristics of CSF bacterial infection of premature infants were more obvious, blood C-reactive protein (CRP) was higher, the appearance of CSF was turbid, with more white blood cell count, higher protein content and lower sugar content (all P < 0.05); prognosis was poorer, the time required for CSF to return to normal and length of hospital stay were longer, incidence of complications was higher (all P < 0.05). Conclusion Clinical manifestations of bacterial meningitis in premature infants are not typical, especially E. coli meningitis, which has a serious disease condition and poor prognosis, it is necessary to be alerted, early diagnosis and treatment should be given.

Abstract:People infected with human immunodeficiency virus (HIV) have different degrees of immune deficiency, which may lead to the lower vaccination effectiveness of SARS-CoV-2 vaccines than the normal population. HIV-infected person should be the priority group for booster shots of SARS-CoV-2 vaccines. However, at present, there are no reports of HIV-infected people receiving adenovirus vector vaccines for sequential booster immunization at home and abroad after receiving SARS-CoV-2 inactivated vaccines. Therefore, this paper reports a case of HIV-infected person whose HIV was well suppressed and CD4⁺ T cell count was normal after receiving antiretroviral therapy (ART). After receiving two doses of SARS-CoV-2 inactivated vaccines (Beijing Biological Research Institute of Biological Products, Sinopharm China Co., Ltd.), sequential booster immunization was performed through vaccinating adenovirus vector vaccine (CanSino Biologics Inc., Ltd.), which was safe and highly immunogenic, and can guide the population to vaccinate against SARS-CoV-2.

Abstract:To summarize the clinical characteristics of pulmonary nocardiosis complicated with Aspergillus infection and improve the diagnosis and treatment of this disease. Two cases of pulmonary nocardiosis complicated with Aspergillus infection were reported. With the combination of "Nocardia" and "Aspergillus" as the key words, 6 Chinese literatures were retrieved from Wanfang Database and China National Knowledge Infrastructure; 17 foreign literatures were retrieved from PubMed and Web of Science with "nocardiosis" and "aspergillosis". Combined with the previously reported literatures and 2 patients in this report, a total of 27 cases (15 males and 12 females) were analyzed, besides 1 patient after a near-drowning incident, 23 patients had immune impairment and the rest 3 patients had underlying structural pulmonary diseases. Their clinical characteristics and imaging manifestations were nonspecific. After failure in initial anti-infection, pathogenic evidence was obtained timely, most patients had good prognosis after treatment against pulmonary nocardiosis and Aspergillosis. Pulmonary nocardiosis may be associated with Aspergillus infection, which is prone to occur in patients with immune impairment or structural pulmonary diseases, especially among glucocorticoid users. Rapid pathogenic detection to obtain early diagnosis and treatment is of great importance to improve prognosis.

Abstract:Inhaled glucocorticoids (ICS) is widely used in the treatment of patients with chronic obstructive pulmonary disease (COPD), but long-term use of ICS is prone to various infections due to local immunosuppression. Three patients with COPD and pulmonary tuberculosis were admitted in department of respiratory and critical care medicine of a hospital in 2015, 2019 and 2021 respectively. According to medical history and relevant examination, pulmonary tuberculosis might be related to ICS. This article intends to analyze the diagnosis and treatment process of 3 cases of ICS-related pulmonary tuberculosis in this hospital, combined with existing research to discuss the diagnosis and treatment strategy of patients with COPD and ICS-related pulmonary tuberculosis.

Abstract:Intervertebral space infection caused by Neisseria elongata (N. elongata) is very rare. This case is the first time that N. elongata has been isolated from tissue specimen of patient with intervertebral space infection. N. elongata was identified by VITEK MS automatic microbial mass spectrometry system, VITEK 2 Compact automatic microbial analysis system and molecular sequencing technology. Antimicrobial susceptibility test was performed and break point was interpreted according to requirements of Clinical and Laboratory Standard Institute (CLSI), M100 S-31. In combination with the results of bacterial culture and antimicrobial susceptibility testing, patient was treated with cefotaxime/sulbactam for 6 days and piperacillin/tazobactam combined with levofloxacin for 7 days respectively. Patient was obviously improved and discharged from hospital. The diagnosis and treatment process of this case and the biological characteristics of N. elongata are reported, so as to provide guidance basis for the diagnosis and treatment of intervertebral space infection caused by N. elongata.

Abstract:Eikenella corrodens(E. corrodens) is a kind of bacteria colonized on the surface of human mucosa, which often distributs in the oral cavity and upper respiratory tract, and seldom causes disease. When the immunity of human body is low, E. corrodens may cause infection. It was reported in the literatures that E. corrodens usually causes cervical abscess, liver abscess and abdominal cavity infection, while thoracic and pulmonary infections are rare. This article reports that a case of empyema due to infection of E. corrodens was improved after treated with medical thoracoscopy, surgical thoracoscopy and systemic anti-infection, so as to improve the clinical understanding of empyema caused by E. corrodens, achieve early diagnosis and treatment.

Abstract:In recent years, the role of intestinal flora in diseases has attracted more and more attention, and its important role in resisting Candida albicans infection has also been widely recognized. This article explores the role and mechanism of intestinal microbes against Candida albicans invasive infection from three aspects of intestinal probiotics, commensal bacteria, and short-chain fatty acids of intestinal microbial metabolites, so as to provide ideas and theoretical basis for clinical treatment.

Abstract:Mycobacterium marinum (M. marinum) is a kind of non-tuberculous Mycobacterium (NTM) and mainly causes skin and soft tissue infection. In recent years, many cases of M. marinum infection, even local outbreaks, have been reported in China. However, there is still a lack of inadequate understanding of the biological characteristics, general characteristics of genome, pathogenicity and virulence of the strains. Epidemiological and clinicopathological features, diagnosis and treatment of M. marinum, as well as clinical manifestations of skin and soft tissue infection caused by it are different, which bring great challenge to the diagnosis and treatment. This paper reviews the research progress of M. marinum.