Abstract:Since the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)infection has swept the world, bringing great harm to human society and significantly increasing the health burden. Due to stronger infectivity, faster transmission, and higher reinfection rate of the Omicron variant, it has now replaced the Delta variant as the main epidemic strain for both imported and local outbreaks in China. Chinese Diagnosis and treatment protocol for SARS-CoV-2 infection (10th trial version) emphasizes "strengthening the protection of key populations, " which includes the increasing number of immunocompromised population. These people have a high incidence of severe diseases and a high fatality rate after infected with SARS-CoV-2, and belong to the high-risk populations of severe or critical diseases. Moreover, due to underlying diseases, these people take immunosuppressants and other related drugs chronically. The interactions between anti-SARS-CoV-2 infection treatment drugs and original drugs are complicated, thus bring significant challenges to the treatment after the SARS-CoV-2 infection. Currently, there is a lack of guidelines or consensus on the diagnosis and treatment of SARS-CoV-2 infection among immunocompromised population. Therefore, the Guangzhou Institute of Respiratory Health and National Center for Respiratory Medicine organized experts from multiple disciplines (respiratory and critical care medicine, organ transplantation, rheumatology and immunology, hematology, infection, critical care medicine, etc.) in China. After multiple rounds of discussions, 13 items of recommendations are made as the reference for peers based on evidence-based medical evidence, so as to provide a theoretical and practical reference for the diagnosis and treatment strategies of this population.

Abstract:Objective To understand the distribution of frequently isolated pathogenic bacteria from clinical specimens and their antimicrobial resistance changes in Hunan Province from 2012 to 2021, and to provide scientific evidence for the formulation and evaluation of antimicrobial clinical administration policies. Methods Species identification, selection of quality control strains and antimicrobial susceptibility testing agents were conducted according to the technical scheme of the China Antimicrobial Resistance Surveillance System (CARSS). Duplicate strains were excluded based on the principle of counting the first strain in each case. Statistical analysis was performed by WHONET 5.6 software. The the variations in constituent ratio and resistance rate of strains were analyzed with linear trend test, and the magnitude of change was described with Pearson correlation coefficient. Results From 2012 to 2021, the number of clinically isolated bacteria in the analysis increased from 82 759 to 312 914, with Gram-negative bacteria accounting for 69.5%-72.4%. The major Gram-positive bacteria were Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis and Enterococcus faecium, and the major Gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. Isolation rate of Gram-positive bacteria increased yearly (r=0.022, P=0.001). Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased from 34.3% to 24.8%. Isolation rates of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were less than 3% and 2%, respectively, presenting a downward trend. The detection rate of penicillin-resistant Streptococcus pneumoniae (PRSP) decreased from 5.6% to 1.0%. Except cefoperazone sulbactam, resistance rates of Escherichia coli to other tested antimicrobial agents showed decreasing trends (r < 0, P=0.001). Isolation rates of third-generation cephalosporin-resistant Escherichia coli (CTX/CRO-R-EC) and carbapenem-resistant Escherichia coli (CREC) decreased year by year (from 70.5% to 45.3%, and 12.2% to 2.0%, respectively). Resistance rates of Klebsiella pneumo-niae to imipenem and meropenem have increased year by year, reaching 9.1% and 11.0% respectively in 2021, while isolation rate of carbapenem-resistant Pseudomonas aeruginosa (CRPA) decreased from 28.5% to 15.0%. Resistance rates of Acinetobacter baumannii to most antimicrobial agents were 40%-60%, and remained relatively stable. Isolation rate of carbapenem-resistant Acinetobacter baumannii (CRAB) ranged from 39.5% to 59.6%. Conclusion The clinical isolation rates of most important special antimicrobial-resistant bacteria have been decreasing year by year, while the resistance rate of Klebsiella pneumoniae to carbapenem agents gradually increased. Antimicrobial stewardship as well as the prevention and control of healthcare-associated infection on specific antimicrobial-resistant bacteria should continue to be implemented in the future. The coverage and quality of antimicrobial resistance surveillance in Hunan Province should continue to be improved.

Abstract:Objective To understand the distribution and antimicrobial resistance changes of bacteria isolated from pleural and peritoneal effusion in Hunan Province, and provide reference for correct clinical diagnosis and rational antimicrobial use. Methods Data reported by member units of Hunan Provincial Antimicrobial Resistance Survei-llance System from 2012 to 2021 were collected. Bacteria antimicrobial resistance surveillance method was implemented according to technical scheme of China Antimicrobial Resistance Surveillance System (CARSS), and WHONET 5.6 software was used to analyze the data of bacteria isolated from pleural and peritoneal effusion as well as antimicrobial susceptibility testing results. Results From 2012 to 2021, a total of 28 934 bacterial strains were isolated from specimens of pleural and peritoneal effusions from member units of Hunan Provincial Antimicrobial Resistance Surveillance System, with 5 752 strains from pleural effusion and 23 182 from peritoneal effusion. The top five bacteria isolated from pleural effusion were Escherichia coli (n=907, 15.8%), Staphylococcus aureus (n=535, 9.3%), Klebsiella pneumoniae (n=369, 6.4%), Staphylococcus epidermidis (n=452, 7.9%), and Staphylococcus haemolyticus (n=285, 5.0%). The detection rate of methicillin-resistant Staphylococcus aureus (MR-SA) from pleural effusion was 24.3%-39.2%, and that of methicillin-resistant coagulase negative Staphylococcus (MRCNS) was 58.8%-77.1%. The top five bacteria isolated from peritoneal effusion were Escherichia coli (n=8 264, 35.6%), Klebsiella pneumoniae (n=2 074, 9.0%), Enterococcus faecium (n=1 458, 6.3%), Staphylococcus epidermidis (n=1 383, 6.0%), and Pseudomonas aeruginosa (n=1 152, 5.0%). The detection rate of MRSA from peritoneal effusion was 22.1%-52.4%, which presented a decreasing trend (P=0.004). The detection rate of MRCNS was 60.4%-79.4%. The resistance rates of Enterobacterales from peritoneal effusion to cefazolin, cefuroxime, ceftriaxone and cefepime all showed decreasing trends (all P < 0.05). Vancomycin-, linezo-lid-, and teicoplanin-resistant Staphylococcus strains were not found in pleural and peritoneal effusions. The resis-tance rates of Enterococcus faecium to most tested antimicrobial agents were higher than those of Enterococcus faecalis. The resistance rates of Enterobacterales to imipenem and meropenem were ≤ 8.5%. The resistance rates of non-fermentative Gram-negative bacilli to imipenem and meropenem were ≤ 43.3%. Conclusion The data structure of Hunan Antimicrobial Resistance Surveillance System for pleural and peritoneal effusions from 2012 to 2021 is relatively complete. The constituent and antimicrobial susceptibility of isolated pathogenic bacteria vary in different years.

Abstract:Objective To understand the distribution and changes in antimicrobial resistance of clinically isolated Pseudomonas aeruginosa (P. aeruginosa) in the member hospitals of Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021. Methods Antimicrobial susceptibility testing by disk diffusion or automated instrument was performed on clinical isolates. Testing results were determined according to the standards of 2022 edition from American Clinical Laboratory Standards Institute (CLSI). Statistical analysis was performed by WHONET 5.6 software. Data were analyzed by trend test (Cochran-armitage) and Chi-square test with SPSS. Results A total of 176 441 strains of P. aeruginosa were surveilled by Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021. 99.4% of the strains were isolated from hospitalized patients, and about 70% of the strains were isolated from respiratory specimens. 8.4% of P. aeruginosa were from children (0-17 years old), 91.6% were from adults. Antimicrobial susceptibility testing results showed that P. aeruginosa was most sensitive to polymyxin B over 10 years, with a resis-tance rate of less than 6%. Resistance rates to piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, aztreonam, imipenem, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, and polymyxin B all showed downward trends. A total of 29 920 carbapenem-resistant P. aeruginosa (CRPA) strains were detected. The average isolation rate of CRPA in this province was 18.0% over 10 years. CRPA detection rate from adult was 18.5%, higher than that from children (12.3%), and both showing downward trends. Conclusion The resistance rate of clinically isolated P. aeruginosa in Hunan Province to most commonly used antimicrobial agents is decreasing.

Abstract:Objective To understand the epidemiology of clinically isolated Acinetobacter baumannii (A. baumannii) in Hunan Province. Methods Bacterial antimicrobial resistance surveillance was carried out according to the requirements of the technical program of National Antimicrobial Resistance Surveillance System. Clinical data of Acinetobacter spp. reported to Hunan Provincial Antimicrobial Resistance Surveillance System by multiple centers in Hunan Province from 2012 to 2021 were summarized and analyzed with reference to the standards of the American Clinical and Laboratory Standards Institute. Results A total of 169 438 strains of Acinetobacter spp. were detected during the 10-year period, with the detection rate of A. baumannii being the highest (82.74%). 70 923 strains (53.63%) of carbapenem-resistant A. baumannii (CRAB) and 58 149 strains (43.97%) of carbapenem-sensitive A. baumannii (CSAB) were detected respectively. Both CRAB and CSAB were detected most frequently in the age group >70 years, which were 34.44% and 32.02%, respectively. The percentage of CRAB and CSAB detected in the intensive care unit were 34.80% and 11.31%, respectively. CRAB and CSAB were mainly isolated from sputum/bronchoalveolar lavage fluid, followed by pus/secretion, urine, and blood. The resistance rates of CRAB to commonly used antimicrobial agents didn't change much during the 10-year period. Resistance rates of CRAB to ceftazidime and cefepime were both >84%, to ampicillin/sulbactam and piperacillin/tazobactam were both >82%, to aminoglycosides and quinolones were both >59%, to minocycline and polymyxin B were 15.9%-25.0% and 1.3%-6.9%, respectively. CSAB were sensitive to commonly used antimicrobial agents. Conclusion The isolation rate of CRAB is high and there is no significant change in resistance to commonly used antimicrobial agents.

Abstract:Objective To explore the risk factors for the development of pneumonia in patients with systemic lupus erythematosus (SLE) following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods A total of 250 SLE patients who received chest CT examination and were diagnosed with COVID-19 at the Department of Rheumatology and Immunology in the First Affiliated Hospital of Nanchang University from December 2022 to February 2023 were included in analysis. Patient were divided into the control group and the pneumonia group according to chest CT results. Demographic data, clinical data, and laboratory indicators of patients in two groups of patients were collected. Laboratory data of patients before completing the chest CT examination were evaluated. Diagnostic capability of age, C-reactive protein/lymphocyte (CLR), and systemic immune inflammation index/albumin (SII/ALB) in evaluating the development of pneumonia in SLE patients with COVID-19 were determined by calculating the receiver operating characteristic (ROC) curve. Results Among 250 SLE patients with COVID-19, 188 (75.2%) didn't develop pneumonia and were assigned into the control group; 62 (24.8%) developed pneumonia in the pneumonia group. There were statistically significant differences between the two groups in terms of age, COVID-19 vaccination status, complications of renal insufficiency, cardiovascular disease or diabetes, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), systemic immune inflammation index (SII), SII/albumin(SII/ALB) and C-reactive protein to lymphocyte ratio (CLR) (all P < 0.05). Among SLE patients who developed pneumonia after developing COVID-19, the levels of SII/ALB and CLR were higher than those of non-pneumonia patients, with statistically significant differences (both P < 0.05). Multivariate logistic regression analysis showed that age, SII/ALB, and CLR were independent risk factors for pneumonia in SLE patients with COVID-19 (all P < 0.05). ROC curve analysis showed the area under the CLR curve of 0.791, sensitivity of 90.3%, and specificity of 57.4%, with good diagnostic value. Conclusion Age, SII/ALB, and CLR are risk factors for pneumonia in SLE patients with COVID-19. More attention needs to be paid on populations with these characteristics in clinical practice, so as to reduce the occurrence of complications and improve prognosis.

Abstract:Objective To explore the in vitro and in vivo antimicrobial activity of antipsychotic agent pimozide against Staphylococcus aureus (S. aureu). Methods The minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of pimozide were determined by micro-dilution assay. Biofilm was cultured in 96-well cell culture plate, and the anti-biofilm activity of pimozide was detected by turbidimetry. The effect of pimozide on biofilm was further observed through laser confocal microscopy and SYTO9/PI staining. Combined antimicrobial effect of pimozide and other antimicrobial agents was detected by chessboard dilution method, and cytotoxicity of pimozide was detected by CCK-8 assay kit. A model of skin abscess was constructed, in vivo antimicrobial activity and toxicity of pimozide was tested. Results Pimozide showed significant dose-dependent antimicrobial activity against S. aureu, with a MIC of 8-16 μg/mL. It could significantly inhibit the formation of S. aureu biofilm and disperse the formed biofilm. The combination of pimozide and doxycycline has a synergistic antimicrobial effect in vitro, with a synergistic antimicrobial index of 0.5. It can significantly reduce the bacterial load in mouse abscess tissue in vivo, and reduce the live bacterial count from (8.25±0.13) lgarithmic value of CFU/abscess to (3.31±0.81) logarithmic value of CFU/abscess (q=3.74, P < 0.05). The cytotoxicity of pimozide was extremely low, with a half inhibitory concentration of 64 μg/mL on cells. Conclusion Pimozide exhibits significant antimicrobial activity in vitro and in vivo with extremely low toxicity, thus is promising for the treatment of S. aureu-related local infection in psychiatric patients.

Abstract:Objective To explore the risk factors for intracranial infection in patients after neurosurgery, construct and validate a Nomogram prediction model. Methods Data of 978 patients who underwent neurosurgery in a hospital in Nanjing from January 1, 2019 to December 31, 2022 were retrospectively analyzed. Independent risk factors were screened through logistic univariate and multivariate analyses. Modeling variables were screened through Lasso regression. A Nomogram model was constructed and internally validated by logistic regression. Effectiveness of the model was evaluated with receiver operating characteristic (ROC) curve, calibration curve and decision curve. Results Among 978 patients underwent neurosurgery, 293 had postoperative intracranial infection, with an incidence of healthcare-associated infection of 29.96%. There was no significant difference in age, gender, proportion of coronary heart disease, cerebral infarction, diabetes and hypertension between the infected group and the non-infected group (all P>0.05). Multivariate logistic analysis showed that postoperative intracranial hypertension, fever, increased neutrophil percentage in blood routine examination, turbid cerebrospinal fluid, positive Pan's test, decreased glucose concentration, abnormal ratio of cerebrospinal fluid/serum glucose, positive microbial culture, absence of indwelling external ventricular drainage tubes, presence of indwelling lumbar cistern drainage tubes, use of immunosuppressive agents, and long duration of surgery were independent risk factors for postoperative intracranial infection in patients who underwent neurosurgery (all P < 0.05). Fifteen variables were screened out through Lasso regression. Fourteen variables were finally included for modeling after collinear screening, missing data imputation (random forest method) and checking pairwise interaction items. A Nomogram prediction model was constructed, with the area under ROC curve, sensitivity, specificity, and accuracy of 0.885, 0.578, 0.896, and 0.704, respectively. Internal validation of the model was conducted. The modeling and validation groups presented similar effects. The calibration curve and decision curve also indicated that the model had good predictive efficacy. Conclusion The constructed Nomogram prediction model for postoperative intracranial infection after neurosurgery is scientific, and the prediction indicators are easy to obtain. The model presents with high stability, reliability, and application value, thus can provide reference for the assessment of postoperative intracranial infection after neurosurgery.

Abstract:Objective To evaluate the effectiveness of pharyngeal swabs combined with anal swabs as multidrug-resistant organism (MDRO) admission screening for patients in intensive care unit (ICU), and provide reference for healthcare-associated infection (HAI) prevention and control strategies. Methods Patients who underwent MDRO admission screening by pharyngeal swabs combined with anal swabs within 24 hours of admission to an ICU of a hospital in Shanghai from August 1 to December 31, 2022 were included as the experimental group, and those who underwent MDRO admission screening only by pharyngeal swabs from August 1 to December 31, 2021 were as the control group. Positive rate of screening, occurrence and pathogen of HAI between the two groups, as well as the sensitivity and specificity of combined admission screening for MDRO in the experimental group were compared. Results A total of 917 patients were included in the study, with 442 cases in the experimental group and 475 cases in the control group. The positive rates of admission screening for MDRO in the experimental and control groups were 7.40% and 3.37%, respectively. The incidences of HAI with MDRO in the experimental and control groups were 2.71% and 5.68%, respectively. Incidences of digestive system HAI with MDRO in the experimental and control groups were 0.68% and 2.32%, respectively. Differences were all statistically significant (all P < 0.05). The area under the ROC curve of admission screening by pharyngeal swabs combined with anal swabs for predicting HAI with MDRO in patients were 0.897 (P < 0.01, 95%CI: 0.802-0.993). The sensitivity and specificity of admi-ssion screening for MDRO by pharyngeal swabs combined with anal swabs in the experimental group were 72.73% and 97.65%, respectively. Conclusion The combination of pharyngeal swabs and anal swabs can be used as an ICU admission screening method for MDRO, and has an important clinical application value.

Abstract:Objective To explore the clinical characteristics and prognostic factors of elderly patients with community-acquired bloodstream infection (CA-BSI), and provide basis for clinical treatment and prevention. Methods Medical records of elderly patients diagnosed with CA-BSI in a tertiary first-class hospital of Changsha from 2017 to 2021 were collected. Patients were divided into a survival group and a death group according to the prognosis after 30 days hospitalization. The differences in clinical data between two groups of patients were compared, and influencing factors for the prognosis in CA-BSI patients were analyzed. Results A total of 575 elderly CA-BSI patients were included in the analysis, with 535 cases in the survival group and 40 cases in the death group. Univariate ana-lysis results suggested that death of elderly CA-BSI patients was related to gender, age, history of hemodialysis, glucocorticoid usage, indwelling catheter, concomitant heart disease, albumin, creatinine, and sequential organ fai- lure assessment (SOFA) score (all P < 0.05). Multivariate logistic regression analysis results suggested that old age (OR=1.062, 95%CI: 1.016-1.109), high SOFA score (OR=1.161, 95%CI: 1.067-1.262), glucocorticoid usage (OR=6.006, 95%CI: 2.441-14.774) were independent risk factors for the death of elderly CA-BSI patients, while normal albumin (OR=0.942, 95%CI: 0.891-0.995) was a protective factor. Conclusion Elderly CA-BSI patients have high risks of death. It is necessary to improve the immunity of patients as well as use antimicrobial agents and glucocorticoids rationally, so as to reduce the risk of death in patients.

Abstract:Objective To explore the effect of improving cleaning and disinfection methods on the prevention, control and disinfection of carbapenem-resistant Enterobacterales (CRE) in burn plastic surgery ward. Methods 297 patients who admitted to the department of burn plastic surgery in a hospital from February 1 to August 31, 2021 were selected as the control group, and 210 patients who admitted to the hospital from September 1, 2021 to February 28, 2022 after cleaning and disinfection methods improved were selected as the intervention group. Detection rate of CRE from patients, incidence of healthcare-associated infection (HAI) with CRE, and detection rate of environmental CRE before and after intervention were statistically analyzed and compared. Results The incidence of HAI and detection rate of CRE from patients in the intervention group were 0.95% and 0, respectively, lower than 4.04% and 2.02% in the control group (both P < 0.05). Compared to the control group, qualified rates of detection of air and surface microbiology, adenosine triphosphate (ATP) bioflorescence and fluorescence labeling in the intervention group were all higher(χ²=5.52, 13.08, 6.66, and 15.01, respectively, all P < 0.05). Conclusion Improving cleaning and disinfection method can reduce the incidence of HAI and the detection rate of CRE in burn wards, improve the surface cleanliness of environmental objects, as well as the effectiveness of HAI prevention and control.

Abstract:Objective To evaluate the effect of targeted monitoring and multi-modular improvement strategy on the prevention and control of catheter-associated urinary tract infection (CAUTI). Methods Patients with indwe-lling urinary catheter in a tertiary first-class hospital from January 2018 to December 2022 were selected as the research subjects. Targeted monitoring results and distribution of pathogenic bacteria in 5 consecutive years were analyzed, and a multi-modular improvement strategy based on the targeted monitoring results was implemented. The occurrence of CAUTI before and after implementation, status and effectiveness of training in prevention and control measures were compared respectively. Results Before and after the implementation of the multi-modular improvement strategy, health care workers' compliance rate of hand hygiene, awareness rate of prevention and control measures, and implementation rate of prevention and control measures all increased significantly (all P < 0.001). Targeted monitoring results showed that daily test rates of urine culture and routine urine from patients with indwelling catheters have been on the rise in 5 consecutive years (P < 0.05). A total of 397 cases of CAUTI occurred in the past 5 years. Incidences of CAUTI in general intensive care unit(ICU) and surgical ICU showed decreasing trends in 5 consecutive years (all P < 0.05). Incidence of CAUTI in general wards showed no statistically significant difference in 5 years (P=0.088). A total of 431 strains of pathogenic bacteria were detected, mainly Gram-negative bacteria. Daily incidence of multidrug-resistant organism infection in patients with indwelling catheters was 0.12‰. After the implementation of the multi-modular improvement strategy, incidence of CAUTI in all departments reduced significantly (P < 0.05). Conclusion Targeted monitoring can help identify departments with high-risk of CAUTI, multi-modular improvement strategy can raise the quality of prevention and control of CAUTI in all occasions, reduce the incidence of CAUTI, and is worthy of clinical promotion and application.

Abstract:Objective To investigate the bacterial colonization and disinfection effect of infusion connectors in neonatal intensive care unit (NICU), and provide clinical reference for improving the safety management of intravenous infusion in neonates. Methods 59 infusion connectors in NICU were selected as the control group. 52 disinfected infusion connectors during the same period were selected as the observation group A, meanwhile, disinfection time and method used by nurses were observed. After training on disinfection method, 50 disinfected infusion connectors were selected as the observation group B. All infusion connectors were sampled for culture. Results In the control group, bacteria were detected from 53 connectors, with a detection rate of 89.8%. Among them, 39 connectors were isolated 1 bacterial specie respectively, 13 were isolated 2 bacterial species respectively and 1 was isolated 3 bacterial species. Bacteria were detected from 13 connectors in observation group A, and the detection rate was 25.0%. In observation group B, bacteria were detected from 4 connectors, with a detection rate of 8.0%. Diffe-rence in the positive rates of bacterial culture before and after training was statistically significant(χ²=84.418, P < 0.001). Conclusion Infusion connectors in NICU are prone to be contaminated. Effective disinfection can significantly reduce bacterial colonization. Health care workers should be aware of the risks of infusion-associated infection, standardize infusion operation, strengthen the management of infusion devices, and explore more effective disinfection methods.

Abstract:Objective To construct a quantitative evaluation system for professional competency of healthcare-associated infection (HAI) management professionals, and provide scientific basis for the training of professionals through scientific evaluation. Methods Literature and experience summary were adopted to construct evaluation key points. Evaluation key points were selected through expert consultation method, and the weight coefficient of evaluation key points was calculated. The hierarchical evaluation content options for each evaluation key point were designed and assigned score values by expert group. The product of the score of each evaluation key point and its weight was the score for this point, and the total score of the evaluated person was calculated based on the total score of all evaluation points. Results The evaluation system included 25 evaluation key points in 9 dimensions, including "basic conditions" "recognition competency in HAI" "monitoring competency in HAI" "prevention and control technology application competency in HAI " "emergency response competency" "organization and coordination competency" "quality improvement competency" "education and training competency" and "professional scientific research competency in HAI prevention and control". Each evaluation key point contained three hierarchical quantitative score contents. The internal consistency reliability of the expert's questionnaire consultation Cronbach's α coefficient was 0.873, the total scale-level content validity index (S-CVI) was 0.868, and the item-level content validity index (I-CVI) ranged 0.71-1. Conclusion The quantitative evaluation system constructed in this study meets the requirements for reliability and validity. It is scientifically feasible for evaluating the professional competency of HAI management professionals. It can effectively identify weakness in their competency, determine training directions and priorities, and provide a scientific basis for talent development and team building for HAI management profe-ssionals in medical institutions, and promotes high-quality development within hospitals.

Abstract:The group X meningococcal disease is rare in China and developed countries. No related cases have been reported in Human Province. The disease progresses rapidly and leads to critical severity. Serious complications may occur, if not treated actively. Group X Neisseria meningitidis (Nm X) vaccine has not yet obtained permission at present. This paper collects data on the symptoms, signs, auxiliary examinations, and treatment process of the first patient with severe group X meningococcal disease in Hunan Province, reviews relevant literatures, so as to improve clinicians' understanding on group X meningococcal disease, conduct early identification, diagnosis and treatment of the disease.

Abstract:Sepsis is a life-threatening organ dysfunction resulting from dysregulated host responses to infections. Platelet-related indicators are closely related to the prognosis of sepsis, including platelet(PLT) count, mean platelet volume (MPV), platelet distribution width (PDW) and platelet aggregation rate (PAR), which can serve as important evaluation indicators for the occurrence and development of sepsis. This paper elaborates the value of platelet-related indicators in evaluating the prognosis of patients with sepsis, aiming to help clinicians understand the clinical value of monitoring platelet-related indicators in sepsis patients and accurately identify high-risk sepsis patients.

Abstract:Gegen Qinlian Decoction is a classical prescription with the function of relieving exterior and interior syndromes. The formula contains complex chemical components and is prepared into several dosage forms regulating the function of the gut. The review discusses the chemical components, common dosage forms, clinical application and effect on the intestinal barrier of Gegen Qinlian Decoction, so as to provide a basis for its further development and utilization.