Abstract:Hepatitis C virus (HCV) infection is of high prevalence among patients with chronic kidney disease (CKD). There are many unique features in anti-HCV treatment of CKD patients. With the advent of direct-acting antiviral agents (DAAs) and their widely application in clinic practice, the prognosis of CKD patients with HCV infection has been greatly improved. In recent years, rapid progress has been made in HCV treatment, and many DAAs have been approved for marketing in China. Therefore, based on The expert consensus for the diagnosis and treatment of hepatitis C virus infection in patients with chronic kidney disease published in 2019, combined with the domestic and foreign progress of clinical research and the national situation in China at present, a panel of experts specialized in nephrology, infectious disease, hepatology and infection control have updated and issued this guideline, to provide guidance for the standardized diagnosis and treatment of HCV infection in CKD patients.

Abstract:Objective To explore the intervention effect and molecular mechanism of engeletin on the proliferation, inflammatory response, and oxidative stress in mouse RAW264.7 macrophages induced by lipopolysaccharide (LPS). Methods RAW264.7 cells were randomly divided into the control group, the LPS group and the intervention groups with different engeletin concentrations. Cell proliferation was detected by methyl thiazolyl tetrazolium(MTT) assay at different culture times. The concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)and interleukin-1β (IL-1β) in supernatant were detected by enzyme-linked immunosorbent assay (ELISA). The release of cell reactive oxygen species (ROS), superoxide (O₂·^-) and nitric oxide (NO) was detected by corresponding kits. Expression of IκBα, p65 and p-p65 in NF-κB signaling pathway was analyzed by Western blot. Results Compared with the control group, cell proliferation in the LPS group was increased, 100, 200, 400, 600 and 800 μmol/L engeletin could inhibit LPS-induced cell proliferation, and 400 μmol/L engeletin intervention was most effective. TNF-α, IL-6, IL-1β, ROS, O₂·^- and NO produced by cells in the LPS group were higher than those in the control group. 400 μmol/L engeletin could decrease the production of LPS-induced TNF-α, IL-6, IL-1β, ROS, O₂·^- and NO. In the LPS group, protein level of IκBα was down-regulated, and p65 and p-p65 were up-regulated; engeletin could rescue these phenotypes. Conclusion Engeletin may inhibit cell proliferation and the generation of inflammatory factors, ROS/reactive nitrogen species (RNS) in RAW264.7 cells under LPS induction through interfering NF-κB signal pathway. It shows an important anti-inflammatory and antioxidant effect, and provides reference for research of engeletin in the treatment of inflammatory diseases.

Abstract:Objective To explore the relationship among the polymorphisms of CYP2R1 gene at rs10741657, rs10766197, and rs1993116 loci, vitamin D levels and susceptibility to tuberculosis. Methods 174 tuberculosis patients from a hospital in Qinghai Province were selected as the case group and 202 healthy individuals underwent physical examination during the same period were selected as the control group. Polymerase chain reaction (PCR) was used to amplify the rs10741657, rs10766197 and rs1993116 loci, and determine the genotypes. The vitamin D level was determined by enzyme-linked immunosorbent assay (ELISA). Results rs10741657 gene polymorphism was associated with tuberculosis(χ²=6.884, P=0.032), while no association was found between rs10766197, rs1993116 polymorphisms and tuberculosis. Among tuberculosis patients, individuals carrying the GG genotype at the rs10741657 locus had lower vitamin D level than those with the AA genotype (P=0.033) and AG genotype (P=0.034). The genotypes at the rs10766197 and rs1993116 loci were not found to be associated with vitamin D levels. Conclusion Gene polymorphism at the rs10741657 locus is associated with vitamin D levels and the development of tuberculosis.

Abstract:Objective To evaluate the clinical value of procalcitonin/albumin (PCT/ALB) combined with C-reactive protein/albumin (CRP/ALB) in predicting necrotizing pneumonia due to Streptococcus pneumoniae infection in children. Methods Clinical data of children with Streptococcus pneumoniae necrotizing pneumonia (SPNP) or Mycoplasma pneumoniae necrotizing pneumonia (MPNP) admitted to the pediatrics in a hospital between January 2018 and December 2020 were analyzed retrospectively. Baseline data and peripheral blood laboratory indicators between SPNP group and MPNP group were compared. Urine creatinine (UCr), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels of child patients were measured. Results 272 children with SPNP and 280 children with MPNP were included. Children with SPNP had lower average age, longer duration of fever, longer length of hospital stay, and higher incidence of hypoxemia than those with MPNP, with statistically significant differences (all P < 0.05). Serum CRP, PCT levels, as well as PCT/ALB and CRP/ALB ratios of children with SPNP were all higher than those with MPNP, while ALB level was lower. Differences were all statistically significant (all P < 0.001). UCr, AST, and ALT levels of children in SPNP group were higher than MPNP group, difference were all significant (all P < 0.05). Multivariate logistic regression analysis showed that PCT, CRP, PCT/ALB, and CRP/ALB were independent risk factors for SPNP (P < 0.05), while ALB was an independent protective factor (P < 0.05). The area under the curve (AUC) for PCT/ALB and CRP/ALB in predicting SPNP were 0.898 and 0.921, respectively, and the combined AUC was 0.961. Conclusion It should be alert to the development of children SPNP when PCT/ALB >0.15 and CRP/ALB >3.84.

Abstract:Objective To investigate the homology of the multidrug-resistant organisms (MDROs) isolated from patients and environment of intensive care unit (ICU) in a hospital, and provide evidence for clinical prevention and control of MDRO infections. Methods MDROs isolated from patients and environment of ICU in a tertiary first-class hospital from November 17 to December 17, 2021 were collected. Antimicrobial susceptibility test, pulsed-field gel electrophoresis (PFGE) and cluster analysis were conducted on the isolated strains. Results A total of 22 MDROs were collected, including 6 carbapenem-resistant Klebsiella pneumoniae (CRKP) strains, 11 multidrug-resistant Acinetobacter baumannii (MDR-AB) strains and 5 methicillin-resistant Staphylococcus aureus (MRSA) strains. 11 strains each were isolated from clinical patients and environment. Some of the environmental strains were highly homologous to the clinical strains. MDROs were isolated from ICU environment such as the surfaces of objects in the staff's living area, microwave oven buttons, switches, etc. CRKP and MDR-AB were isolated even after disinfection of patient bedside tables and sinks. MRSA identical to that from the stethoscope used by patient was isolated from nurses' hands after hand washing. CRKP was resistant to all commonly used antimicrobial agents (except ceftazidime/avibactam). MDR-AB clinical strains showed a resistance rate of 40.0% to minocycline, and resis-tance rates ≥ 60% to other antimicrobial agents; while environmental strains of MDR-AB had a lower resistance rate than the clinical strains. Conclusion Clinical MDRO strains from ICU are highly homologous to the environmental strains, suggesting the possibility of MDRO transmission and cross-infection through the hospital environment. Therefore, it is necessary to strengthen the implementation of environmental cleaning and disinfection measures, improve hand hygiene compliance, and cut off the transmission of pathogenic bacteria in hospital to reduce the incidence of MDROs.

Abstract:Objective To analyze the isolation and antimicrobial resistance of imipenem-resistant Pseudomonas aeruginosa (IRPA), and provide support for the prevention and control of IRPA infection. Methods Detection rate, department source, specimen source, antimicrobial resistance rate of IRPA and defined daily doses (DDDs) of commonly used antimicrobial agents in Inner Mongolia Autonomous Region People's Hospital from January 2017 to December 2021 were analyzed retrospectively. Relationship between DDDs value of commonly used antimicrobial agents and antimicrobial resistance of Pseudomonas aeruginosa (PA) was analyzed. Results From 2017 to 2021, 1 114 IRPA strains were detected from 4 170 PA strains, with a detection rate of 26.71%. The detection rates of each year were 31.09%, 30.05%, 27.64%, 26.66% and 23.18% respectively, showing a downward trend(χ²=17.347, P < 0.001). IRPA strains were mainly from cadre health care ward, intensive care unit (ICU) and respiratory department, accounting for 54.76%, 11.85% and 8.26%, respectively. The department with the highest IRPA detection rate was ICU (44.30%). IRPA was mainly isolated from sputum, urine and bronchoalveolar lavage fluid, accounting for 80.61%, 5.92% and 5.39%, respectively. Among the detected specimens, pharyngeal swab had the highest IRPA detection rate (54.17%). Resistance rates of IRPA to piperacillin, piperacillin/tazobactam, ceftazidime, amikacin, gentamicin, tobramycin, levofloxacin, meropenem and ciprofloxacin increased first, then decrease. Except meropenem, there was statistically significant difference in the change of antimicrobial resistance rate of other detected antimicrobial agents (all P < 0.05). From 2017 to 2021, IRPA had lower resistance rates to amikacin, gentamicin and tobramycin, and had higher resistance to the other 7 antimicrobial agents, especially to meropenem (above 80%). Total DDDs have been decreasing year by year since 2018. Within 5 years, the DDDs of ceftazidime, levofloxacin and gentamicin ranked among the top 3 commonly used antimicrobial agents in this hospital. There was no linear correlation between IRPA resistance rate and the DDDs of commonly used antimicrobial agents (P>0.05). Conclusion IRPA is mainly distributed in cadre health care ward, and sputum is the main specimen source. There was no linear correlation between IRPA resistance and the DDDs of commonly used antimicrobial agents within 5 years. Although antimicrobial resistance of IRPA has been controlled to a certain extent, it is still serious. Hospitals should strengthen various infection prevention and control measures to effectively control antimicrobial resistance and infection of IRPA.

Abstract:Objective To understand the clinical distribution characteristics and antimicrobial resistance of Staphylococcus aureus (SA), as well as the staphyloccal casette chromosomal mec (SCCmec) typing and panton-valentine leukocdin (PVL) gene expression of methicillin-resistant SA (MRSA) in local pediatric patients, so as to provide evidence for the prevention and treatment of MRSA infection. Methods Clinical distribution and antimicrobial resistance characteristics of SA and MRSA isolated from various clinical specimens of a children's hospital in Suzhou from 2016 to 2021 were analyzed retrospectively. The mecA, SCCmec typing and PVL gene expression of 161 MRSA strains were detected by polymerase chain reaction (PCR). Results A total of 4 967 SA strains were detected in this hospital from 2016 to 2021, of which 1 730 strains (34.83%) were MRSA, detection rate of MRSA in 2018 (39.25%) was the highest. Detection rate of MRSA in 2018 (39.25%) was the highest. MRSA mainly came from sputum (1 091 strains), pus (382 strains), and ear pus (149 strains). Detection rates of MRSA from hospitalized children in different years were significantly different (P < 0.001), while those from outpatient children in different years were not (P=0.885). SA showed a high resistance rate to penicillin, but no strains resistant to vancomycin, teicoplanin or linezolid were detected. The resistance rates of MRSA to macrolides and tetracyclines were higher than those of methicillin-sensitive SA (MSSA) (P < 0.01), but the resistance rates to quinolones, aminoglycosides, and trimethoprim-sulfamethoxazole were lower than those of MSSA (P < 0.01). All of the 161 MRSA strains expressed the mecA gene, but not the PVL gene. SCCmec type Ⅱ (63.98%) was the main type of SCCmec, followed by SCCmec Ⅴ (16.77%) and SCCmec Ⅲ (12.42%). Conclusion Although the detection rate of MRSA in this hospital has decreased in recent years, it is still around 30%. Community-acquired infection is an important source of MRSA. Therefore, in addition to strengthening measures such as antimicrobial management, bacterial antimicrobial resistance monitoring, and healthcare-associated infection control, controlling MRSA in children in Suzhou region also requires strengthening community management to reduce the incidence of MRSA.

Abstract:Objective To evaluate the effect of different enteral nutrition pathways on ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation in intensive care unit (ICU) through network Meta-analysis. Methods Randomized controlled trials on the effect of enteral nutrition on VAP in mechanically ventilated ICU patients were retrieved from the Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP and CBM databases. After literature screening, data extraction and quality evaluation of the included literatures, Bayesian network Meta-analysis was performed using the R4.1.3 Gemtc program package. Results A total of 46 literatures were included in the analysis, involving 3 510 patients and 5 enteral nutrition pathways (nasointestinal tube, nasogastric tube, gastrointestinal double-lumen tube, gastrostomy tube, gastrojejunostomy tube). Network Meta-analysis results showed that in terms of reducing the incidence of VAP, nasointestinal tube, gastrointestinal double-lumen tube, gastrojejunostomy tube and gastrostomy tube were all superior to nasogastric tube (all P < 0.05). Gastrostomy tube was the best, followed by gastrojejunostomy tube and gastrointestinal double-lumen tube. In terms of shortening mechanical ventilation time, nasointestinal tube, gastrointestinal double-lumen tube and gastrostomy tube were all superior to nasogastric tube (all P < 0.05). In terms of shortening the length of stay in ICU, nasointestinal tube and gastrostomy tube were both superior to nasogastric tube (both P < 0.05), In terms of shor-tening duration of mechanical ventilation and length of hospital stay, gastrostomy tube was the best, followed by nasointestinal tube and gastrojejunostomy tube. Conclusion Gastrostomy, gastrojejunostomy and gastrointestinal double-lumen tube have advantages in reducing the incidence of VAP in ICU patients with mechanical ventilation. Gastrostomy tube, nasointestinal tube and gastrojejunostomy tube have advantages in reducing the duration of mechanical ventilation and the length of ICU stay of patients undergoing mechanical ventilation. However, the results should be carefully explained due to the limited number and quality of the included studies.

Abstract:Objective To explore the effect of bundled care on reducing the incidence of pulmonary infection (PI) in patients with acute leukemia receiving chemotherapy. Methods Quasi-experimental research design was adopted, and patients with acute leukemia in the department of hematology in a tertiary first-class hospital from August 2019 to December 2021 were chosen as the study subjects. Ward A was the control group, and Ward B was the intervention group. The intervention group and the control group were matched based on the type of leukemia and age (±5 years). The intervention group received bundled care intervention measures, including systematic health education led by nurses, reducing exposure, enhancing oral care, and pulmonary function exercises driven by respiration trai-ning device. The control group received routine measures. Two groups were continuously observed for two chemotherapy courses, and the differences in PI rates, PI types, and pulmonary function (the percentage of forced expiratory volume in one second[FEV1%]) between two groups of patients were analyzed and compared. Results In the first chemotherapy course, 47 pairs of patients from two groups were matched, and 34 pairs of patients ultimately matched in the second chemotherapy course. Incidence of PI in patients in the intervention group and the control group were 35.80% and 43.21%, respectively, with no statistically significant difference (P>0.05). The incidence of invasive pulmonary fungal infections was 3.70% in patients in the intervention group and 12.35% in the control group, with a statistically significant difference (P < 0.05). Repeated measures analysis of variance showed that the FEV1% value in patients in the intervention group was better than that in the control group (P < 0.05). The incidence of oral mucositis in patients in the intervention group was 11.11%, which was statistically lower than 24.69% in the control group (P < 0.05). Conclusion Bundled care can effectively reduce the incidence of pulmonary fungal infections in patients and improve patients' pulmonary function, while preventing the occurrence of oral mucositis. However, further investigation is needed to explore its effect on reducing the incidence of other types of PI.

Abstract:Objective To systematically evaluate the prediction models of multidrug-resistant organism (MDRO) infection in patients in the intensive care unit (ICU). Methods Literatures related to the prediction models of MDRO infection in ICU patients were retrieved from PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CBM, Wanfang, and China National Knowledge Infrastructure (CNKI) from the establishment of the databases up to June 2022. Two researchers independently screened the literatures, extracted data, and evaluated the risk of bias and applicability. Results A total of 17 literatures were included, and the area under the receiver operating characteristic curve of all 16 models were >0.7 (0.64-0.94). Risk of bias assessment showed high risk of bias in all included models, but the models were all applicable. The most common identified predictive factors in the models included antimicrobial drugs, mechanical ventilation, length of ICU stay, indwelling urinary catheter, gender, underlying diseases, and comorbidities. Conclusion The existing predictive models for MDRO infection in ICU patients are not ideal, as they exhibit bias in the development, design, statistical analysis, and reporting of the models. In the future, attention should be focused on the methodological details of research design and the standardization of reports. Additionally, larger-scale, multicenter studies and model validation and updates should be con-ducted to improve model performance.

Abstract:Objective To explore the subtype distribution and the primary drug resistance (PDR) among human immunodeficiency virus-1(HIV-1) infected individuals in Hunan Province, and provide reference for the prevention and control as well as antiretroviral therapy (ART) of acquired immunodeficiency syndrome. Methods Demographical and epidemiological data of individuals newly diagnosed with HIV-1 infection and without receiving ART in a hospital's HIV clinic in Hunan Province from January 2021 to August 2022 were collected. Patients' serum was taken, ribonucleic acid was extracted, and two rounds of polymerase chain reaction for gene amplification was performed with the In-house method. PCR product was sequenced with Sanger method for analyzing clinical data, HIV-1 subtypes and drug resistance of patients. Results A total of 667 patients were recruited. 20 patients failed the genotypic drug resistance test, thus 647 newly diagnosed HIV-1 infected patients were studied. 53 HIV-1 infected patients had PDR, with a incidence of 8.19%. These patients were mainly male (88.68%), unmarried (71.70%), men who had sex with men (MSM, 60.38%), 21-40 years old group (58.49%), and local residents of Hunan Province (98.11%). A total of 15 subtypes of HIV-1 were detected, and the main subtype were CRF_01AE(35.70%), CRF07_BC (25.19%), B/C (18.86%) and CRF55_01B(7.88%). The differences of PDR incidence in patients with different HIV-1 subtypes were statistically significant (χ²=18.62, P=0.017). Drug resis-tance rates of protease inhibitors (PIs), nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (INSTIs) were 0.15%, 2.78%, 6.65%, and 0.31%, respectively. Conclusion The distribution of HIV-1 subtype in Hunan Province is complex, and the incidence of PDR has exceeded the low-level drug resistance warning line (< 5%) established by the World Health Organization. It is necessary to strengthen the prevention and control of the infection and block the transmission of drug-resistant virus strains.

Abstract:Objective To evaluate the status and risk factors of healthcare-associated infection (HAI) after ente-rostomy in neonates. Methods Basic information, clinical and postoperative HAI data of neonates underwent ente-rostomy from June 2019 to June 2022 in the department of neonatal surgery of a hospital were collected. Neonates were divided into the HAI group and non-HAI group according to whether HAI occurred after operation. The HAI-related risk factors were analyzed by univariate analysis and logistic regression. Results A total of 227 neonates underwent surgery were analyzed, with 71 neonates having 84 episodes of HAI and a HAI incidence of 31.28%. Infection sites were mainly surgical site infection (n=24), gastrointestinal infection (n=24) and bloodstream infection (n=23). 49 pathogenic bacterial strains were detected in HAI cases, mainly Gram-positive bacteria (59.18%). Univariate analysis showed statistically significant differences between two groups in gestational status, gestational age at birth, birth weight, primary disease, fistula location, fistula mode, postoperative ventilator use, and postoperative fasting time(all P < 0.05). Binary logistic multivariate regression analysis showed that low gestational age at birth (OR=0.806, 95%CI[0.676-0.962]) and neonatal necrotizing enterocolitis (NEC) (OR=0.484, 95%CI[0.247-0.948]) were risk factors for the development of HAI after enterostomy in neonates (both P < 0.05). Conclusion Low gestational age at birth and NEC are risk factors for the postoperative HAI in neonates underwent enterostomy. Clinical attention should be paid to these neonates.

Abstract:Objective To analyze the epidemic characteristics and species of brucellosis in patients in Chenzhou City, Hunan Province in 2021, and provide basis for the scientific prevention and control of brucellosis. Methods Clinical and epidemiological data of brucellosis cases in Chenzhou City in 2021 were collected and analyzed. The species of isolated strains were identified by AMOS polymerase chain reaction (AMOS-PCR). Results A total of 32 cases of brucellosis were reported in Chenzhou in 2021, with an incidence of 0.68/100 000. There were 26 males and 6 females, and the average age was (51.13±13.33) years old. The top three counties with the highest incidence were Linwu County (3.72/100 000), Guiyang County (0.99/100 000), and Jiahe County (0.87/100 000). The majority cases (29 in total) were reported between the months from March to September, and the age group most affected was middle-aged and young adults. Clinical manifestations of brucellosis patients were mainly fever, hyperhidrosis, fatigue, lumbago and leg pain. Brucella was isolated from the blood cultures of 14 patients with brucellosis, and identified as Brucella melitensis by AMOS-PCR. Conclusion The onset time of human brucellosis in Chenzhou City in 2021 is mainly concentrated in spring and summer, with more males than females. The onset age is mainly middle-aged and young adults. The isolated strains are mainly Brucella melitensis. The possibility of brucellosis should be considered in patients with fever accompanied by lumbago and leg pain after contact with sheep or cattle.

Abstract:Objective To evaluate the contamination of SARS-CoV-2 on environmental object via SARS-CoV-2 nucleic acid re-positive persons, and provide data support for healthcare-associated infection prevention and control. Methods From June 15 to 30, 2022, 27 nucleic acid re-positive patients admitted to a COVID-19 designated hospital in Shanghai were selected. Basic information of patients were collected. Specimens were taken from the inside and outside of patients' masks wore on the sampling day and high frequently touched object surfaces in patients' ward. SARS-CoV-2 nucleic acid of specimens was tested. SPSS 20.0 was used for analysis. Results Of the 27 re-positive patients, 6 (22.22%) had a Ct value < 35 and 21 (77.78%) had a Ct value ≥ 35 in the first SARS-CoV-2 nucleic acid test after admission. Of the 162 environment-related specimens, 16 (9.88%) were positive for nucleic acid test, including 5 (3.09%) double-gene positive specimens and 11 (6.79%) single-gene positive specimens. Among the different sampling sites, positive rate of mattress+sheet was the highest (18.52%), Ct value of all positive environmental specimens was >35. Whether the Ct value of the first nucleic acid test of patients after admission was < 35 has nothing to do with the positive rate of nucleic acid test result of patient-related environment, difference was not statistically significant (P>0.05). Contamination of different object surfaces was not statistically significant (P>0.05). Conclusion Viral load of SARS-CoV-2 contamination on environment through respiratory tract of SARS-CoV-2 nucleic acid test re-positive patients is low, thus transmission risk through environmental media is low.

Abstract:The establishment of healthcare-associated infection (HAI) prevention and control emergency system for respiratory infectious diseases is the basis for large general hospitals to start emergency mechanisms smoothly and quickly in response to the outbreaks of respiratory infectious diseases, and achieve the "transformation of epidemic prevention" mode, thus can greatly reduce the risk of HAI in general hospitals during the outbreaks of respiratory infectious diseases. Based on the practical experience of the prevention and control of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, relevant standards, norms, guidelines, documents, and combined with risk assessment, this study preliminarily explores and establishes a four-level emergency management system for general hospitals to respond to HAI of respiratory infectious diseases. The emergency system consists of four-level organizational system: the emergency command center, HAI management and collaborative departments, joint inspection teams, department leaders and grid administrators. The hospital leadership is responsible for the overall deployment. The emergency command center is responsible for unified coordination. Responsibilities of each department are clearly defined, and the hospital-wide grid mechanism of the prevention and control is activated. The joint inspection team supervises the implementation of various prevention and control measures, and the hospital quickly converts to the "epidemic prevention and control" emergency status, while ensuring the orderly conduct of daily diagnosis and treatment work.

Abstract:Objective To understand the management effectiveness of the intervention in multidrug-resistant organism (MDRO) infection through quality management tool plan-do-check-act (PDCA), and evaluate the impact in healthcare institutions under the diagnosis-related group/diagnosis-intervention packet (DRG/DIP) charging model. Methods The implementation of the prevention and control measures for MDRO infection in a tertiary first-class hospital from November 1 to December 31, 2021, and the infection-related indicators of the departments with high MDRO infection incidence were collected retrospectively. From March 1 to April 30, 2022, PDCA was adopted for intervention. The implementation rate of the prevention and control measures for MDRO infection, the incidence of healthcare-associated infection (HAI), the average length of hospital stay, and the average expense of hospitalization before and after the intervention were compared. Results The implementation rate of prevention and control measures for MDRO infection before and after PDCA intervention increased from 61.94% to 88.35%. After PDCA intervention, the incidence of MDRO HAI, the average length of hospital stay and the average hospitalization expenses of departments with high incidence of MDRO infection decreased compared with those before the intervention, with statistically significant differences (all P < 0.05). Conclusion The scientific use of PDCA can improve the implementation rate of the prevention and control measures for MDRO infection, and decrease the incidence of HAI and the average hospitalization expenses, as well as shorten the average length of hospital stay, thus avoid medical expense loss in medical institutions under the DRG/DIP charging mode.

Abstract:With constant technological improvements, Da Vinci surgical robot system is favored by doctors and patients due to its clear vision, precise operation, minimal invasion and various functions, however, it costs high, and is complicated and precise in structure as well as operation with high turnover rate. At present, there are some problems in the treatment of Da Vinci surgical robot system in China, including inconsistent monitoring methods, non-standard instrument management, irrational staffing, insufficient handling quality, and imperfect traceability systems. In this study, by inquiring, screening and sorting out domestic and foreign studies related to the cleaning, disinfection and sterilization of Da Vinci surgical robot system in the past five years, and combined with the practice in the referred department, reference solutions are proposed for relevant personnel.

Abstract:Based on the Health Building Note 00-09:Infection Control in the Built Environment published by the Ministry of Health of the United Kingdom (UK), the principles and processes of infection control in healthcare buildings in UK are interpreted. Current situation of infection control in healthcare buildings in China was analyzed, so as to provide references for the future revision of the codes or standards represented by Code for Design of Infectious Diseases Hospital and Code for Design of General Hospital in China. In order to reduce infection risks in healthcare buildings, infection control process in the UK is divided into 9 stages. In each stage, the corresponding time period and the focus of the issues to be considered are different. Compared with the UK, there are certain gaps in infection control in healthcare buildings in China. It is recommended that China puts forward specific requirements and establishes complete procedures for infection control in healthcare buildings according to code or standard; develops consensus and clarifies focus of infection control in healthcare buildings in practice; establishes healthcare buil-ding infection prevention and control teams in the organizational structure and participates in the work of all stages.