Abstract:Objective To investigate the prevalence of qacE, qacE△1, and qacE△1-SUL1 disinfectant-resistant genes and the minimum inhibitory concentrations (MICs) of four commonly used disinfectants for carbapenem-resistant Enterobacterales (CRE), providing reference for the scientific disinfection in hospitals. Methods 93 non-duplicate CRE strains isolated from all clinical specimens in a hospital from October 2021 to March 2022 were collected. The strains were identified and tested for antimicrobial susceptibility. Polymerase chain reaction (PCR) was used to detect the presence of disinfectant-resistant genes qacE, qacE△1, and acE△1-SUL1, and the MICs of glu-taraldehyde, iodophor, "84" disinfectant (chlorine-containing disinfectant) and ethanol to CRE were determined using agar dilution method. Results 93 CRE strains were mainly Klebsiella pneumoniae (52 strains) and Ente-robacter cloacae (25 strains). The resistance rates of CRE strains to most antimicrobial drugs were up to 100%. The prevalence rates of disinfectant-resistant genes qacE, qacE△1, and acE△1-SUL1 were 72.0% (67 strains), 81.7% (76 strains) and 89.2% (83 strains), respectively. The MICs of glutaraldehyde, iodophor, "84" disinfec-tant (effective chlorine concentration) and ethanol to CRE were 500 mg/L, 625-2 500 mg/L, 250-500 mg/L and 75%, respectively. The MICs of iodophor (2 500 mg/L) to 4 CRE strains and "84" disinfectant (effective chlorine concentration 500 mg/L) to 24 CRE strains were higher than the standard strains. Conclusion The prevalence of disinfectant-resistant genes among the CRE strains isolated from this hospital is high. CRE strains are partially resistant to iodophor and "84" disinfectant. Disinfectants should be used scientifically and properly in clinical practice, so as to prevent the spread of drug-resistant bacteria in the hospital.

Abstract:Objective To understand the application of air purification methods in different hospitals. Methods A survey was conducted in hospitals of different levels and types in 7 provinces from 7 regions of China, to investigate the current application status of air purification methods in hospitals after the promulgation of Hospital Air Purification Management Code, including the application of different air purification methods, the combination of air purification methods, and the application of air purification methods in different regions. Results A total of 340 hospitals were surveyed. 38.53% (n=131) of which had negative pressure isolation wards, 81.47% (n=277) had clean operating rooms with cleaning technology, 97.35% (n=331) had air disinfectors. 70.00% (n=238) had two or more air purification methods simultaneously in a certain region. General intensive care unit, infectious disease department and fever clinic adopted three or more air purification methods, accounting for 55.93%, 43.01% and 38.49%, respectively. The most common combination was natural/mechanical ventilation+air disinfectors (83.19%, 198/238). 20.59% (49/238) used ultraviolet lamps additionally for the disinfection in rooms with clean technology. Except for non-clean operating rooms, delivery rooms, catheter rooms and disinfection supply center, over 80% areas had ventilation systems. Conclusion The selection of air purification methods is diverse, and the architectural design pays more attention to ventilation, but the selection of air purification methods is still excessive and non-standardized.

Abstract:Objective To investigate the management status of hydrogen peroxide low temperature plasma sterilization in hospitals of Henan Province, analyze existing weakness and provide effective countermeasures and refe- rences for improving the quality of low temperature sterilization. Methods From July to August 2021, 170 hospitals in Henan Province were conveniently selected. A self-designed questionnaire was adopted to investigate the use status, management system, sterilization operation, sterilization effect monitoring, maintenance, knowledge and skill training of operators of hydrogen peroxide low temperature plasma sterilizer. Results Of the 170 surveyed hospitals, 147(86.47%) have formulated job responsibilities of operators and the maintenance system for sterilizers; 146(85.88%) have established emergency scheme for sterilizer failure; 152(89.41%) have kept a distance of at least 25 mm between load and electrode grid; 167(98.24%) have obtained the sanitary license from National Health Commission (the former Ministry of Health) for the disinfection products for hospital sterilizers, sterilizing agent, and monitored products; 137(80.59%) checked the leakage monitoring indicator and the outer packing before using sterilizing agent; 126(74.12%) blocked ultraviolet light while loading sterilized items; 110(64.71%) checked and confirmed the hydrogen peroxide concentration after sterilization; 71(41.76%) used luminal biological process challenge device (PCD) to monitor luminal instruments; operators in 156(91.76%) hospitals received training and passed the assessment of relevant knowledge before working; operators in 152(89.41%) hospitals could correctly handle common sterilizer failures. Conclusion There are still problems in management of hydrogen peroxide low temperature plasma sterilization in hospital central sterile supply departments in Henan Province, such as nonstandard sterilization operation, inadequate implementation of sterilization effect monitoring, as well as lacking of knowledge and skill training of operators. Central sterile supply departments should establish quality management system for hydrogen peroxide low temperature plasma sterilization, standardize sterilization operations, strictly implement sterilization effect monitoring, refine maintenance contents and strengthen relevant knowledge and skill training, so as to ensure the quality and safety of low temperature sterilization.

Abstract:Objective To analyze the low-temperature disinfection effect of a compound peroxide disinfectant using glycerol and propanol as antifreeze agents. Methods Carrier quantitative germicidal test and object surface simulation on-site disinfection test were performed to analyze the disinfection effect and safety of the compound disinfectant at low temperatures. Results At constant temperatures of -20℃, -10℃ and 20℃, the logarithmic killing values of the compound peroxide disinfectant on Escherichia coli, Staphylococcus aureus and poliovirus on the carriers were >3. In cold storage at -20℃ and 10℃, logarithmic killing values of the compound peroxide disinfectant on both Staphylococcus aureus and Escherichia coli on the carriers at different sites were >3. The safety evaluation test showed that the acute oral toxicity lethal dose(LD₅₀)value of the compound disinfectant in mice was greater than 5 000 mg/kg. It did not cause irritation to rabbit skin, and had no damage on mouse chromosome. Conclusion The compound peroxide disinfectant with glycerol and propanol as antifreeze agents has a strong killing effect on bacterial propagules and viruses at low temperature, and is safe and non-toxic.

Abstract:Objective To investigate the clinical application value of metagenomic next-generation sequencing (mNGS) in the etiological diagnosis of bone and joint infection. Methods Clinical data of patients with suspected bone and joint infection in a hospital in Guangdong Province from January 2021 to June 2022 were retrospectively ana- lyzed. Specimens from infected sites of bone and joint infection of all patients were taken for mNGS detection and microbial culture, infected sites of bone and joint infection were performed CT imaging examination. The efficacy of the three methods in diagnosing bone and joint infection was compared. Results A total of 108 suspected patients with bone and joint infections were included in the study, and 126 specimens were taken from bone and joint infection site. The sensitivity of mNGS detection was 84.38%, higher than that of microbial culture (48.44%) and CT imaging examination (62.50%), with statistically significant difference (P < 0.001). The negative predictive value of mNGS detection was 85.51%, higher than that of microbial culture (64.89%) and CT imaging (68.42%); The specificity of microbial culture was 98.39%, higher than that of mNGS detection (95.16%) and CT imaging (83.87%); the positive predictive value of microbial culture was 96.88%, higher than that of mNGS detection (94.74%) and CT imaging (81.63%), differences were all statistically significant (P < 0.05). Compared with microbial culture, mNGS could detect more pathogens, especially Mycobacterium tuberculosis (9.52% VS 2.38%; χ²=5.742, P < 0.05). The concordance rates between pre- and post-host removal mNGS sequencing results and clinical diagnosis results of 56 specimens with high human background were 87.50% (49/56) and 78.57% (44/56), respectively, with no statistically significant difference (P=0.125). Conclusion The sensitivity of mNGS in diagnosing pathogens of bone and joint infections is high, with a shorter detection period and the ability to detect more pathogens, which has important clinical value.

Abstract:Objective To investigate the current management status of pathogen examination rate before antimicrobial treatment for hospitalized patients in tertiary hospitals, and provide reference to further improve the examination rate. Methods Questionnaire was designed using the "Questionnaire Star" platform. 38 tertiary comprehensive hospitals in Jiangsu Province were selected. The survey included the pathogen examination rate before antimicrobial treatment and management status of hospitalized patients, the pathogen examination rate before treatment with key antimicrobial combination, and the pathogen examination rate related to healthcare-associated infection(HAI) diagnosis. Results Among the 38 tertiary hospitals, 78.95% (n=30) monitored pathogen examination rate by the department of HAI management, 100% implemented standards equal to or higher than the standards for all categories (30%), restricted categories (50%), and special categories (80%) of antimicrobial agents, respectively. More than 50% hospitals included the detection of procalcitonin (PCT), 1, 3-β-D-glucan test (G-test), galactomannan test (GM test), and interleukin-6 (IL-6) in the pathogen examination, with PCT included in 73.68% hospitals. 15.79% (n=6) hospitals did not only capture therapeutic antimicrobial use in terms of medication purpose; 31.58% (n=12) hospitals included local antimicrobial use in terms of medication route; 52.63% (n=20) hospitals captured the time of medical prescription for the use of antimicrobial agents; 31.58% (n=12) hospitals captured the time of medical prescription for the pathogen examination. The average data of pathogen examination rate before antimicrobial treatment met the relevant requirements, while the average data of pathogen examination rate before treatment with key antimicrobial combination and that relevant to HAI diagnosis did not. Differences among hospitals were significant. Conclusion The management of pathogen examination rate before antimicrobial treatment in various hospitals implemented inconsistently in multiple aspects. Each medical institution should further promote the homogeneous monitoring on pathogen examination rate before antimicrobial treatment in strict accordance with the stan-dardized requirements.

Abstract:Objective To explore the distribution pattern of infection pathogens and risk factors for death within one year after kidney transplantation. Methods Post-surgery infection in kidney transplant recipients who underwent allogeneic kidney transplantation in a hospital and were followed up from January 2018 to December 2020 were analyzed retrospectively. The occurrence of infection and distribution of pathogens of patients who developed infection in different periods within one year after surgery were analyzed. According to the prognosis within one year, patients were divided into the survival group and the death group. Clinical data and risk factors for death between two groups of patients were compared. Results Among the 326 kidney transplant patients, 119 had at least once infection within one year after surgery, a total of 145 episodes of infection occurred. A total of 71 bacterial strains, 31 fungal strains, and 26 viral strains were isolated. The main infection type was pulmonary infection (53.1%). Bacterial infection was the main cause (86.1%) at the early stage, while fungal and viral infection increased in the middle and late stages. There were 104 cases in the survival group and 15 cases in the death group. Pulmonary infection and opportunistic infection were the main causes of death caused by infection after kidney transplantation. Compared with the survival group, patients in the death group had higher proportion of delayed recovery of kidney function and acute rejection, lower level of serum albumin level 28 days after surgery, and higher blood drug concentration of FK506, with statistically significant differences(all P < 0.05). Binary logistic regression analysis showed that delayed recovery of the function of transplanted kidney was an independent risk factor for infection-related death (OR=4.479, P < 0.05), while high serum albumin level was a protective factor (OR=0.266, P < 0.05). Conclusion Pulmonary infection and opportunistic infection are the main causes for death after kidney transplantation. Health care workers should pay attention to patients with delayed recovery of kidney function and monitor changes in serum albumin levels after surgery.

Abstract:Objective To compare the effectiveness and cost-effectiveness of the recombinant Mycobacterium tuberculosis fusion protein skin test (EC) and the tuberculin skin test (TST) for detecting latent tuberculosis infection (LTBI), and to explore a more suitable screening method for LTBI in school students. Methods 283 high school freshmen enrolled in September 2021 in Chongqing City were divided into EC group (n=138) and TST group (n=145) by cluster random sampling. Each student was intracutaneously injected with 0.1 mL of either EC or TST into the left forearm, and skin reactions were observed 72 hours after injection. Before skin test, venous blood of all 283 students was collected for in vitro interferon-γ release assay (IGRA). Taking the IGRA test result as the standard, the sensitivity, specificity, misdiagnosis rate, and consistency between EC/TST and IGRA were calculated respectively. Cost-effectiveness of the three methods were compared. Results The sensitivity, specificity, misdiagnosis rate, and consistency rate of EC were 54.55%, 93.70%, 45.45%, and 90.58% respectively, while those of TST were 61.11%, 81.10%, 38.89%, and 78.62% respectively. The detection cost for detecting one tuberculosis infection case using TST, EC, and IGRA were 124.29 Yuan, 492.86 Yuan and 4 879.31 Yuan, respectively. Conclusion The consistency between EC and IGRA is good, and the specificity, consistency and cost-effectiveness of EC are higher than TST. EC is also easy to perform, making it a potential new screening method for LTBI among school students.

Abstract:Objective To systematically evaluate the incidence of high-risk sexual behaviors among human immunodeficiency virus (HIV) infected individuals in China, provide reference for developing targeted interventions to reduce HIV transmission and promote the health of this population. Methods Eight databases including CNKI, Wanfang Database, SinoMed, PubMed, Web of Science, Embase, the Cochrane Library and CINAHL were retrieved with key words of "AIDS", "high-risk sexual behavior", "HIV", and "unsafe sex". The references of included lite-ratures were also traced. Publication date was limited from January 1, 2017 to March 31, 2022. The pooled incidences and 95% confidence intervals of various types of high-risk sexual behaviors were calculated. Subgroup analysis on unprotected sexual behaviors was conducted, and differences among groups were inferred with χ² test. Results A total of 22 Chinese literatures and 8 English literatures were included, with a total sample size of 19 764 individuals, covering 17 provinces (municipalities and autonomous regions) in China. Meta-analysis results showed that the incidences and 95% confidence intervals of various types of high-risk sexual behaviors among HIV-infected individuals in China were 39.7% (33.8%-45.5%) for unprotected sex, 43.3% (24.4%-62.2%) for multiple sexual partners, 27.2% (15.3%-39.1%) for casual sex, and 14.7% (9.1%-20.2%) for commercial sex. Based on the data, subgroup analysis on unprotected sex in this population revealed that the incidences of unprotec-ted sex among different subgroups, including different gender, age, education, marital status, type of sexual beha-vior, region, survey time, antiviral therapy, and infection status of regular sexual partners, were all significantly different (all P < 0.05). Conclusion The incidence of high-risk sexual behaviors among HIV-infected individuals is high. It is necessary to focus on the interventions to those with a high incidence of unprotected sex, including the middle-aged and elderly individuals and individuals without antiviral therapy. Meanwhile, the causes for regional differences should be explored to develop more targeted prevention strategies.

Abstract:Objective To understand the cognition on tuberculosis (TB) and its influencing factors among health care workers (HCWs) in medical institutions (MIs) in Gansu Province, and to provide a basis for improving HCWs' awareness on tuberculosis prevention and control. Methods Questionnaire about HCWs' cognition status on TB in MIs in Gansu Province was designed. HCWs' cognition status on TB in MIs in Gansu Province was surveyed through "Questionnaire Star", and influencing factors for HCWs' cognition on TB was analyzed statistically. Results A total of 60 636 valid questionnaires were collected. Among the surveyed HCWs, women accounted for 78.89%. 39.64% HCWs were aged 30-39 years. Nursing staff accounted for 53.05%. 57 440 (94.73%) HCWs got qualified score on cognition on TB (total score ≥14 points), 3 196 was unqualified (total score ≤13 points), accounting for 5.27%. Univariate analysis results showed that there were statistically significant differences in HCWs' cognitive qualification rate on TB in terms of hospital level and type, whether there were infectious disease department, gender, age, nationality, educational background, professionaity, professional title, years of work experience, and the number of times participating in occupational protection training (all P < 0.05). Conclusion There are multiple factors that influence HCWs' cognition on TB in Gansu Province. HCWs' cognition on TB can be improved by increasing the frequency of TB prevention and control knowledge training, improving HCWs' academic qualification, and strengthening the learning of relevant professional knowledge.

Abstract:Objective To investigate the causes of the outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection in the neurological intensive care unit (ICU), and provide evidence for effective control of multidrug-resistant organism healthcare-associated infection (HAI). Methods An on-site epidemiological investigation and environmental hygiene monitoring were conducted on patients with CRKP infection in the neurological ICU of a hospital from June to July 2021. Control measures were taken, and the effectiveness of prevention and control mea-sures was evaluated. Results There were 7 cases of CRKP HAI cases, with an incidence of 12.28% (7/57), which was significantly different from the incidence during the same period in 2019 and 2020 (P < 0.05). Environmental hygiene monitoring showed that the isolation rate of CRKP from hand specimens was 6.67% (1/15), which was from the hand of a cleaner. Isolation rate of CRKP from environmental object surface was 5.45% (3/55), which were from bedside table and infusion pump of bed-19, as well as personal digital assistant-1(PDA-1). After taking a series of targeted measures such as centralized isolation of CRKP-infected patients, strict restriction on personnel movement, ward cleaning and disinfection, and strengthening hand hygiene supervision, the outbreak has been effectively controlled. Conclusion This event is considered as a suspected outbreak of CRKP HAI. It is speculated that the main causes for this outbreak were the failure to adopt centralized isolation measures for CRKP-infected patients, incomplete environmental disinfection, and poor execution of hand hygiene. Early identification of infection outbreak, investigation of causes, and timely adoption of effective targeted measures are key to controlling infection outbreaks.

Abstract:Objective To analyze the clinical characteristics of patients with pulmonary nocardiosis (PN). Methods Clinical data of patients with PN diagnosed by metagenomic next-generation sequencing (mNGS) in a hospital from September 2019 to December 2022 were retrospectively analyzed, and patients' clinical characteristics were analyzed and summarized. Results Among the 15 patients with PN, 14 were males and 1 was female, aged 36-83 years old. 14 patients had underlying diseases, 3 of whom used immunosuppressants or glucocorticoids chronically. 11 cases were simple PN, and two sites were simutaneously invaded in 4 cases, 2 of whom spread to the blood, 1 case to the liver, and 1 case to the central nervous system on the basis of PN. Cough and expectoration were the most common symptoms (73.33%). The percentage of neutrophils, C-reactive protein and procalcitonin increased, CD4⁺T cell count and albumin decreased. Chest imaging showed that unilateral lung lesions were more common, mostly occurred in the right lung in the form of cavities, patchy shadows, bronchiectasis, nodular shadow, tree-in-bud sign, and consolidation shadow. Among the 15 patients, only 1 was treated with sulfonamides, 12 were treated with sulfonamides combined with other antimicrobial agents, and 2 were treated with other antimicrobial combination. 14 patients improved after treatment, and 1 patient died. Conclusion PN often occurs in patients with underlying diseases and compromised immunity. With atypical clinical characteristics, it is prone to be misdiagnosed. mNGS can diagnose promptly and accurately. Early, adequate, and full-course sulfonamide-based antimicrobial combination treatment generally results in good prognosis.

Abstract:Objective To explore the suspected secondary SARS-CoV-2 infection caused by nucleic acid sampling activities during the epidemic of SARS-CoV-2 infection. Methods A local epidemic of SARS-CoV-2 Delta variant infection broke out in a city in Jiangsu Province from July to August 2021. Based on the detection information in the SARS-CoV-2 nucleic acid testing information system of Jiangsu Province in this period, combined with the epidemiological history and laboratory genetic sequencing results of the patients, suspected cases of secondary infection caused by sampling activities were screened, and the time interval between onset/first positive test of associated cases and single exposure to secondary cases was calculated. Risks of secondary infection under different sampling modes at sampling locations were assessed. Results A total of 8 sampling locations were suspected of secondary infection, involving 42 cases, among which 32 cases had participated in large-scale nucleic acid sampling activities in village-L. Among the 42 cases of secondary SARS-CoV-2 infections, 25 had a clear infection source. Their single exposure with associated cases occurred 3 and 7 days before the onset of associated cases, 0, 1, 3, 4 days before and 1 day after the first positive test of associated cases, respectively. The majority of the single exposure occurred 1 day after the first positive test of associated cases, accounting for 64.0%(16/25). The risk of secondary infection at sampling locations under different sampling modes was: concentrated sampling of large-scale population >sampling based on streets or communities > door-to-door sampling. Conclusion The risk of secondary SARS-CoV-2 infection at centralized sampling location of large-scale population is relatively high, which increases the risk of subsequent transmission and spread of the epidemic. The sampling modes based on streets or communities and door-to-door sampling are preferred, but maintaining order at the sampling location and personal protection are still key measures to avoid secondary SARS-CoV-2 infection at the sampling location.

Abstract:Rapid and precise epidemiological investigation is one of the most important control measures for implementing "scientific and precise, dynamic zero-COVID -19" policy in China. Compared with ordinary locations, medical institutions have a large flow of people and a complex layout, making it difficult to investigate. Moreover, most people involved in the epidemic are patients and health care workers, which puts higher demands on the precision of epidemiological investigation. When local epidemics occur, the resources for epidemiological investigation at disease prevention and control are extremely scarce. How to simultaneously utilize medical institution resources to achieve large-scale and multi-location precise epidemiological investigation is an important issue in epidemic prevention and control. Since the outbreak of COVID -19, the infection control team of West China Hospital has carried out active and in-depth exploration for the epidemiological investigation in medical institutions, and gradually formed a precise epidemiological investigation management mode with distinctive features of West China Hospital. This article combines the experience of infection control team at West China Hospital to elaborate the construction mechanism, ta-lent selection, training system, and assignment of responsibility in medical institution epidemiological investigation team. Meanwhile, it proposes the challenges faced by medical institutions in the construction of professional epidemiological investigation talent team under the current situation, as well as the development direction for the professionalization of infection control talents in the future.

Abstract:Objective To explore the application effect of the "one before and five after" hand hygiene (HH) indicators in HH management of cleaning staff in medical institutions. Methods From December 2021 to January 2022, cleaning staff from a tertiary hospital were selected as the research subjects through convenience sampling method and randomly divided into three groups (control group, experimental group Ⅰ, and experimental group Ⅱ). The control group received training according to the World Health Organization (WHO) "two before and three after" HH indicators, while the experimental group Ⅰ received extensive training according to the "one before and five after" HH indicators, and the experimental group Ⅱ received precision training according to the "one before and five after" HH indicators. HH compliance rate, HH compliance rates for different indicators, and the distribution trend of HH moments among three groups of cleaning staff were compared. Results A total of 26 cleaning staff in the control group, 24 in the experimental group Ⅰ, and 18 in the experimental group Ⅱ were surveyed. HH compliance rates before training in the control group, experimental group Ⅰ, and experimental group Ⅱ were 31.30%, 27.18%, and 30.30%, respectively; and those after training were 43.11%, 59.26%, and 83.62%, respectively. After training, HH compliance rate of cleaning staff in experimental group Ⅱ significantly increased compared to before training, with a growth rate of 53.32% and statistically significant difference (P < 0.05). After training, HH compliance rate in experimental group Ⅱ was the highest (83.62%). The HH moment with the highest HH compliance rate of cleaning staff in experimental group Ⅰ was after unloading personal protective equipment (64.77%), and the lowest was before cleaning and disinfection (54.55%). Except after preparing tools, HH compliance rates of experimental group Ⅱ at other different HH moments after training were all higher than experimental group Ⅰ, differences were statistically significant (all P < 0.05). After training, the HH moment with the highest HH compliance rate of cleaning staff in experimental group Ⅱ was after the disposal of medical waste (90.72%), and the lowest was after the preparation of tools (78.33%). High frequency periods for HH behavior of cleaning staff were 6:00 a.m.-9:00 a.m and 3:00 p.m.-4:00 p.m. Conclusion The "one before and five after" HH indicator is more suitable for monitoring and training on HH compliance of cleaning staff in medical institutions than the "two before and three after" HH indicators. "one before and five after" HH precision training can effectively improve the HH compliance of cleaning staff in medical institutions.

Abstract:Chlamydia pecorum (C. pecorum)is a Gram-negative obligate intracellular pathogen belonging to the Chlamydiaceae family. It can infect a wide range of animals, including sheep, goat, cattle, and wild animals. Human infection with C. pecorum is rare and without specific clinical symptoms. A 75-year-old male patient was diagnosed with severe community-acquired pneumonia, respiratory failure, shock, and acute kidney injury due to abdominal pain, nausea, vomiting, diarrhea, fever, and shortness of breath. The patient had a history of close contact with sheep, and chest CT showed inflammatory exudation, patchy shadows in the right lung, and consolidation in the left lung. C. pecorum was detected from patient's bronchoalveolar lavage fluid through metagenomic next-gene-ration sequencing (mNGS), combined with clinical manifestations and medical history, the patient was confirmed with severe pneumonia caused by C. pecorum and multiple organ failure. Despite targeted anti-infective and comprehensive treatment, the patient's condition didn't improve significantly and he was automatically discharged. This paper reports the diagnosis and treatment processes of this case, aiming to increase clinical awareness on C. pecorum infection, to take targeted treatment at the early stage, and to reduce the risk of mortality.

Abstract:Vibrio vulnificus (V. vulnificus) is a Gram-negative, curved rod-shaped bacterium which exists in warm seawater and belongs to Halophilic vibrio. V. vulnificus can cause necrotizing fasciitis, a rare but fatal clinical emergency that is difficult to diagnose accurately in the early stages. V. vulnificus can be isolated from patient's blood, exudate, blisters and cerebrospinal fluid, which is the gold standard for clinical diagnosis of the infection. The main clinical manifestations of V. vulnificus infection included acute fever, chills, hemorrhagic bullous skin lesions, and septic shock. Appropriate antimicrobial therapy should be conducted immediately and early surgical intervention is necessary. This article reports a case of V. vulnificus infection, aiming to improve the clinical.

Abstract:Ultraviolet(UV) irradiation technology can improve indoor air quality and control microbial contamination in pipelines. This article reviews the mechanism of UV irradiation for killing airborne microorganisms (DNA damage, lipid changes and protein damage), factors affecting the effectiveness of UV removal of microorganisms inside pipelines, calculation models of UV intensity distribution inside pipelines, and theoretical models of UV in killing microorganisms. It also provides an outlook on the future research direction of UV irradiation for removing air-borne microorganisms in pipelines.

Abstract:Adenovirus (AdV) is widely distributed in nature, and infections caused by AdV have been reported in countries or regions all over the world. Since AdV was first isolated in 1953, over 100 serotypes have been identified and classified into mammalian AdV and avian AdV. According to the ability to neutralize AdV in serum, human ade- novirus (HAdV) can be further classified into 71 serotypes, which can be divided into 7 subgroups (A-G) based on biological and immunological characteristics. AdV can infect the upper respiratory tract, lung, conjunctiva, urinary tract and gastrointestinal tract, causing inflammation in the corresponding sites. In some cases, AdV can cause he-patitis, pancreatitis, nephritis, hemorrhagic colitis, hemorrhagic cystitis, and meningoencephalitis. AdV can also cause severe or even fatal infections in immunocompromised patients, posing a significant threat to human health. This article reviews the pathogenicity of HAdV in human body and discusses the various mechanisms by which HAdV causes disease. It also proposes future directions for the researches on the pathogenic mechanism and immune escape of HAdV, and outlines prospects for the development of new drugs against HAdV based on emerging research in this field.