• Jing-bo LI , Tong-yang ZHANG , Yong-qiang LI , Yi-gang TONG
•2023(7):743-750. DOI: 10.12138/j.issn.1671-9638.20233052
Abstract:Objective To explore whether objects and environment contaminated by pathogens can be identified as infection sources, and to analyze the theoretical basis of "object-to-human transmission" for SARS-CoV-2. Methods Differences in the definition of infection sources between Chinese and Western academics are analyzed. Examples of "environment-to-human transmission" and "object-to-human transmission" for viral infectious diseases such as hepatitis A, avian influenza and severe acute respiratory syndrome (SARS) were reviewed. The basic theory and know-ledge of life science were applied to analyze various cases of SARS-CoV-2 transmission via multiple channels such as "imported cold chain" "border trade or port operation" "international mail", etc. encountered in SARS-CoV-2 in-fection prevention and control effort of China. Results It is clarified that the definition about infection sources in China is rigorous, emphasizing the proliferation, and only human and animal infected by pathogens can be recognized as infection source, while the Western definitions are broader, emphasizing infectivity, objects and environment contaminated by pathogens can also be identified as infection source. Through theoretical analysis and various examples, it is confirmed that SARS-CoV-2 can survive in normal temperature environment for several days, extends to several months under cryogenic condition. The objects contaminated by SARS-CoV-2 can cause indirect contact infection. However, the probability of "object-to-human transmission" is relatively lower. Conclusion Definitions about infection sources in China is rigorous, scientific, and practical, and has formed a convention in the prevention and control of infectious diseases. Therefore, there is no need to amend the definition. With popularizing nucleic acid test, the goal of screening for viral infectious diseases such as COVID -19 can be converted from "quickly finding sources of infection" to "quickly seeking sources of the virus", including viruses in environment. Understanding the theoretical basis of "object-to-human transmission", the necessity of positive strategies such as "preventing the transmission from both sources of human and objects" would be fully comprehended.
• Chao LIU , Liu-ming DU , Xin-rong NIE , Shao-jie FANG , Hai-liang NIE
•2023(7):751-757. DOI: 10.12138/j.issn.1671-9638.20234107
Abstract:Objective To analyze the seasonal characteristics and cycle of pulmonary tuberculosis (PTB) in China, make long- and short-term predictions, and provide basis for the formulation of prevention and control measures. Methods The seasonal characteristics of PTB occurrence in China were analyzed by the CensusX-13 seasonal adjustment method. The cycle of PTB occurrence was analyzed by Hodrick-Prescott (HP) filtering method. Long-term prediction was conducted by the linear regression model based on the decomposed long-term trend, and the short-term prediction was made by Holt-Winter seasonal exponential smoothing model. Results The occurrence of PTB in China from 2010 to 2021 exhibited clear seasonal characteristics, with a concentration of reported cases in the se- cond quarter of each year. The peak period for reported cases was from March to July annually. There were approximately 6 cycles, with an average length of 21 months.Overall, there was a declining long-term trend. The short- and long-term prediction results were good. Conclusion Taking into consideration the seasonal characteristics and cycle of PTB, combined with the pathological features of PTB, effective preventive and control measures should be taken before the peak period of the disease.
• Pei-chao CHEN , Qiang HUANG , Yu-hua MAO , Pan SUN , Qian PENG
•2023(7):758-764. DOI: 10.12138/j.issn.1671-9638.20234057
Abstract:Objective To investigate the contamination status and antimicrobial resistance of Staphylococcus aureus (SA) in the environment of a hospital in Jiading District, Shanghai, and explore the detection and antimicrobial resistance characteristics of methicillin-resistant SA (MRSA) in environmental strains. Methods SA strains from environmental specimens from this hospital were isolated and identified, and subjected to antimicrobial resistance test against 15 common antimicrobial agents using the broth dilution method. The presence of the mecA gene in SA strains were detected. Results Among 936 hospital environmental specimens, 60 specimens were positive for SA, with an isolation rate of 6.41%. Among SA strains, the isolation rate of MRSA was 25.00%. The isolation rates of SA from the intensive care unit (ICU) and the respiratory department were 7.35% and 5.94%, respectively, while the isolation rates of MRSA were 3.51% and 0.64%, respectively. The isolation rate of SA from hospital computer mice and keyboards was the highest (17.14%), followed by hospital gowns, pillowcases, and bedside cupboards (all 16.67%). The highest isolation rates of MRSA in environmental specimens were found on soap (dishes) and hand sanitizer bottles, with rates of 7.69% and 6.25%, respectively. SA strains from hospital environmental specimens were all sensitive to 7 antimicrobial agents, including daptomycin, linezolid, furantoin, rifampicin, compound sulfamethoxazole, teicoplanin, and vancomycin. The antimicrobial resistance rates of MRSA to the other 8 antimicrobial agents were all higher than those of methicillin-sensitive SA (MSSA). Conclusion The proportion of MRSA within SA in the general ICU environment is higher than that in the respiratory department of this hospital. The specimens with high MRSA isolation rate and high SA isolation rate in the environmental specimens are inconsistent, and the antimicrobial resistance rate of MRSA is higher than that of MSSA. It is necessary to enhance the disinfection and control of SA and MRSA in the hospital, especially in the ICU, to avoid the increased antimicrobial resistance in SA.
• Xiao-bo WANG , Hong XIA , Xiang WEN , Min DENG , Yu-xia YANG , Shi-gang WANG , Bei JIA
•2023(7):765-774. DOI: 10.12138/j.issn.1671-9638.20233694
Abstract:Objective To explore the relationship between the virulence factors of extended-spectrum β-lactamases-producing uropathogenic Escherichia coli (ESBLs-UPEC) and recurrence of urinary tract infection (UTI). Methods 469 ESBLs-UPEC strains were obtained from patients with UTI in the First Affiliated Hospital of Chongqing Medical University and the People's Hospital of Dazu District from January 2019 to September 2021. Multiple PCR amplification was used to identify virulence factors. All patients were followed up for UTI within 6 months. Results 469 ESBLs-UPEC strains were susceptible to tigecycline, ertapenem and amikacin, while showed high resistance to levofloxacin, cotrimoxazole, and ampicillin. There was no statistically significant difference in antimicrobial susceptibility of ESBLs-UPEC before and after UTI recurrence(P>0.05). 90.4% of the 469 ESBLs-UPEC strains carried the virulence factor fimH, while the detection rate of sfaDE was the lowest (8.3%). There was no obvious correlation between the number and combination of different virulence factors and UTI recurrence (P>0.05). The carria- ge rate of virulence factor iucD in ESBLs-UPEC isolated from UTI was higher in patients group with ≥3 recurrences (P=0.008). There was no statistically significant difference in the carriage rate of virulence factors in ESBLs-UPEC isolated from recurrent and non-recurrent groups of patients of the same gender and age group (P>0.05). Among postmenopausal female patients, the carriage rate of virulence factor kps MT Ⅱ in ESBLs-UPEC isolated from recurrent group was higher than that in the non-recurrent group (61.7% vs 45.6%, P=0.037). Conclusion Antimicrobial resistance of ESBLs-UPEC strains is serious. The virulence factor most commonly carried by ESBLs-UPEC is fimH. The carriage rate of virulence factor iucD in ESBLs-UPEC from patients with ≥3 recurrences of UTI is high. The carriage rate of virulence factor kps MT Ⅱ in ESBLs-UPEC from postmenopausal women with recurrent UTI is high.
• Ying ZHANG , Fa-zhen ZHANG , Yan-qiu LU , Meng-ru YANG , Wen-ling WU , Yao-kai CHEN
•2023(7):775-781. DOI: 10.12138/j.issn.1671-9638.20234171
Abstract:Objective To understand the prevalence of cryptococcal meningitis (CM) associated with acquired immunodeficiency syndrome (AIDS) and the disease burden in different regions in China. Methods Relevant literatures published up to October 10, 2022 were systematically retrieved from PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform. Stata 17.0 software was used for Meta-analysis. Results The random-effects model showed that the overall prevalence of AIDS/CM in China was 2.8% (95%CI: 1.9%-3.8%). The prevalence in southern China (3.3%) was higher than that in northern China (1.8%). The highest prevalence was in Southwest China (3.5%), while the lowest in North China (2.0%). The prevalence of AIDS/CM during the period of extensive antiretroviral therapy (ART) (2.7%) was lower than that during the period of limited ART (2.9%). Conclusion The disease burden of CM/AIDS patients in China is heavy, with higher prevalence in the South compared to the North. The overall prevalence of AIDS/CM has declined after the extensive implementation of ART.
• Hong-yan CUI , Wen-jun HOU , Fei-fei TIAN , Shi-yu ZHANG , Peng-cheng ZHANG , Yao-wen ZHANG , Yan-qing GAO
•2023(7):782-787. DOI: 10.12138/j.issn.1671-9638.20234011
Abstract:Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in schools in Daxing District, Beijing, from 2016 to 2021, and provide scientific evidence for PTB prevention and control in schools within this district. Methods The school-related PTB cases in Daxing District of Beijing were co-llected through the "China Disease Prevention and Control Information System-Surveillance Report Management" and the monthly report table of PTB epidemic surveillance in schools of Daxing District of Beijing from 2016 to 2021. The epidemiological characteristics were analyzed. Results A total of 446 school-related cases were reported, mostly were student cases (n=386, 86.55%). The number of reported cases decreased from 192 in 2016 to 37 in 2021, and both the number of reported cases and the proportion of student cases showed a declining trend. The male to female ratio was 2.72 ∶1, and the incidence peak was mainly distributed in April-May or September-October. The cases in low age schools (kindergartens, primary schools) were mainly teaching staff, accounting for 87.50% and 54.55%, respectively. The cases were mainly distributed in vocational schools and universities, accounting for 78.48%. The proportion of patients with negative pathogenic results was ralatively high (63.90%), but the number of patients with positive pathogenic results increased significantly after 2018. A total of three PTB clustered epidemics and one public health emergency event were reported, with 181 cases involved. Conclusion PTB epidemic in schools in Da-xing District decreased steadily from 2016 to 2021. Teaching staff were the main cases in kindergartens and primary schools, while students in vocational schools and universities were the major population for PTB prevention and control in schools. It is necessary to improve the ability of active monitoring, detect the epidemic as early as possible, so as to effectively prevent the spread of tuberculosis epidemic in schools.
• Xi XIE , Dan-yang YAN , Xiang-jie FU , Ling-jin HUANG , Ning LI , Run YAO
•2023(7):788-795. DOI: 10.12138/j.issn.1671-9638.20233594
Abstract:Objective To explore the risk factors for postoperative pneumonia in patients with acute type A aortic dissection (AAAD) and construct a predictive model for postoperative pneumonia in AAAD patients. Methods Patients who underwent emergency surgery for AAAD at Xiangya Hospital of Central South University from January 2014 to June 2020 were retrospectively selected for the study. Predictive factors were screened by all-subsets regression, and the cut-off values for continuous data were determined by the Youden index. A binary logistic regression model was constructed to predict postoperative pneumonia in AAAD patients. The efficacy of the model was assessed by the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve. Results A total of 210 AAAD patients were included, 53 (25.24%) of whom developed postoperative pneumonia. Six predictive factors were screened through all-subsets regression, and the cut-off values were determined by the Youden index: male patients (OR=2.21, 95%CI: 0.88-5.54), chronic pulmonary disease (OR=2.53, 95%CI: 1.12-5.74), platelet distribution width >17.5% (OR=3.27, 95%CI: 1.57-6.78), surgical duration >9 hours (OR=2.76, 95%CI: 1.25-6.06), mechanical ventilation duration >99 hours (OR=3.87, 95%CI: 1.63-9.18), and red blood cell transfusion >9 units (OR=1.69, 95%CI: 0.80-3.60). The AUC of the constructed predictive model for postoperative pneumonia was 0.789 (95%CI: 0.718-0.860), and the optimal risk threshold was 0.21. The calibration curve and Hosmer-Lemeshow test (P=0.48) demonstrated good calibration of the mo-del. The decision curve showed that patients with a predicted postoperative pneumonia risk of 0-69% could benefit from using this model. Conclusion The predictive model constructed in this study can effectively predict the risk of postoperative pneumonia in AAAD patients. Early intervention can be implemented for high-risk patients in clinical practice.
• Quan-ming WU , Shao-lian WU , Ning LI , Chang-sheng WU , Yu CHEN , Xiu-qing SHEN , Fa-lin CHEN , Dong-jie CHEN
•2023(7):796-801. DOI: 10.12138/j.issn.1671-9638.20233446
Abstract:Objective To provide reference for the rational antimicrobial use for the clinical treatment of Corynebacterium striatum (C. striatum) infection and prevent its nosocomial transmission. Methods 49 strains of clinica-lly isolated C. striatum from a hospital were collected. Clinical data analysis, antimicrobial susceptibility test of 12 antimicrobial agents and detection of carriage of 7 antimicrobial-resistant genes were performed. Results The specimen sources of the 49 C. striatum strains were mostly sputum (63.27%), followed by urine (16.33%). Patients were mainly distributed in the intensive care unit (36.73%), cadre-special clinics (26.53%) and neurology department (16.33%). The resistance rates of C. striatum to ceftriaxone, erythromycin and ciprofloxacin were all 100%, while the resistance rates to penicillin, clindamycin and meropenem were 95.92%, 95.92% and 93.88%, respectively. The resistance rates to gentamicin and rifampicin were both low, which were 12.24% and 8.16%, respectively. No strains were resistant to linezolid or vancomycin. The positive rates of the ermX gene and tetL gene were both 100%, while the positive rates of tetW gene, aph(3'')-Ib gene and aac(6')-Ib gene were 69.39%, 18.37% and 6.12%, respectively. No strains carrying aadA gene and blaIMP gene were detected. Conclusion C. striatum mainly causes respiratory and urinary tract infections in immunocompromised individuals and elderly patients. Antimicrobial resistance of C. striatum is serious, but the resistance rates to gentamicin, rifampicin, linezolid and vancomycin are low, which can be used for the treatment of infections caused by C. striatum.
• Hui WANG , Dan-mei ZHANG , Zhi-yuan ZHANG , Yong-zhen ZHAO , Gang MA , Bao-zhong YANG , Hua-wei KOU , Xiao-jun YANG
•2023(7):802-808. DOI: 10.12138/j.issn.1671-9638.20234134
Abstract:Objective To analyze relevant characteristics and epidemiological features of healthcare-associated infection (HAI) in the general intensive care unit (GICU) for 10 consecutive years, and provide scientific basis for HAI prevention and control management. Methods The targeted monitoring data of HAI in GICU of a tertiary first-class hospital from January 2013 to December 2022 were analyzed with prospectively targeted monitoring method. Results A total of 15 189 patients were monitored. Incidence and case incidence of HAI were 4.27% and 4.73%, respectively. The incidence and case incidence of HAI in GICU for 10 consecutive years were in a downward trend and tended to be stable, with fluctuation ranges of 2.73%-5.55% and 2.83%-6.48%, respectively. The differences were both statistically significant (both P < 0.05). The main infection sites were the respiratory system (71.34%), the blood system (14.46%) and the urinary system (11.96%). 543 cases of device-related infection occurred, accounting for 75.52%. The incidences of catheter-associated urinary tract infection (CAUTI), catheter-related blood stream infection (CRBSI), and ventilator-associated pneumonia (VAP) were 1.198‰, 0.603‰ and 9.266 ‰, respectively. The total incidence of device-related infection in GICU for 10 consecutive years was 3.531‰, with the highest in 2014 (5.572‰) and lowest in 2022 (2.226‰). A total of 622 strains of pathogenic bacteria were isolated from 649 HAI patients, predominantly Gram-negative bacteria (77.82%), with Acinetobacter baumannii being the most commonly detected species (48.39%). A total of 365 multidrug-resistant organism strains were isolated, accounting for 58.68%, with carbapenem-resistant Acinetobacter baumannii (80.27%) being the most prevalent. Conclusion The incidence of HAI in the GICU of the hospital remains at a relatively low level for 10 consecutive years, but the management of device-related infections and multidrug-resistant organism remains the focus for the prevention and control of HAI in GICU.
• Jin-hua HUANG , Yao CHEN , Ying DING , Xu-hui KONG
•2023(7):809-815. DOI: 10.12138/j.issn.1671-9638.20234148
Abstract:Objective To improve the pathogen detection rate through project-based management mode. Methods Hospitalized patients who received therapeutic antimicrobial treatment in a tertiary first-class hospital from January to December 2022 were selected as the research subjects. The control group comprised patients from January to June, while the intervention group consisted of patients from July to December. The intervention group adopted a project-based management mode with five stages, including project initiation, planning, execution, monitoring, and closure. The monitoring indicators related to pathogen detection were compared between the two groups of patients before and after the intervention. Results A total of 35 488 hospitalized patients received therapeutic antimicrobial agents were investigated, with 15 536 patients in the control group and 19 952 in the intervention group. Pathogen detection rate in the intervention group was higher than that in the control group (69.52% vs 44.10%), with a statistically significant difference (P < 0.001). The goal achievement rate was 430.85%, and the improvement rate was 57.64%. There were statistically significant differences (all P < 0.05) between the two groups of patients in terms of the pathogen detection rate before antimicrobial use, antimicrobial use rate, antimicrobial use intensity, and the detection rate of multidrug-resistant organisms (except carbapenem-resistant Enterobacteriaceae and methicillin-resistant Staphylococcus aureus). The detection rate of relevant biomarkers increased after intervention (53.61% vs 25.01%), with a growth rate of 114.35%, higher than the growth rates of microbial culture, microscopy examination, immunological detection, and other detection items. Among the 87 cases underwent procalcitonin (PCT)/interleukin-6 (IL)-6 detection after the intervention, 17.24% were detected >3 days before therapeutic antimicrobial use. Among the 68 cases underwent microbial culture after the intervention, 20.59% were detected >3 days before therapeutic antimicrobial use. Conclusion The application of a project-based management mode can improve the pathogen detection rate in hospitalized patients. However, attention should be paid to the quality management of pathogen detection.
• Zi-huan LI , Cui-qiong FAN , Tian WANG , Guan-wen LIN , Mao-rui LIN
•2023(7):816-821. DOI: 10.12138/j.issn.1671-9638.20234125
Abstract:Objective To explore the impact of multi-department collaboration mode on improving the positive rate of blood culture and reducing the intensity of antimicrobial use. Methods Patients who underwent blood culture in the key internal medicine departments for infection management from January to December 2020 were selected as the research subjects. The blood culture and antimicrobial use were analyzed. Patients from January to June 2020 were the control group, while patients from July to December 2020 were the intervention group. Intervention measures for blood delivering were implemented starting in July 2020. Ten quality control indicators related to blood culture, such as the average delivering time of blood culture specimens, were set up to assess the key departments monthly, and the improvement of the 10 indicators were observed. Blood specimen delivering rate before antimicrobial use, blood culture delivering modes, specimen contamination rate and positive rate, as well as antimicrobial use rate of hospitalized patients before and after the intervention through multi-department collaboration management mode were compared. Results A total of 16 246 blood culture specimens were delivered for detection, including 7 512 in the control group and 8 734 in the intervention group. The delivering rate of two or more sets of blood delivering in the intervention group (24.91%) was higher than that in the control group (15.04%), and the difference was statistically significant (P < 0.001). The average delivering time of the intervention group was 18.56 minutes (reaching the quality control goal), the average machine operation time was 18.83 minutes (reaching the quality control goal), and the average reporting time of positive results to clinical department was 148.28 minutes (not reaching the quality control goal, ≤1 hour). The average delivering time, machine operation time, and reporting time for positive results to clinical departments in the intervention group were all higher than those in the control group, and the differences were all statistically significant (all P < 0.001). The accuracy rate of collection opportunity of blood culture (98.33% vs 74.67%), accuracy rate of blood collection method (82.67% vs 67.67%), and accuracy rate of correct treatment for clinical department with positive blood culture (70.67% vs 62.00%) in the intervention group were all higher than those in the control group, and the differences were statistically significant (all P < 0.05). The positive rate of blood culture in the intervention group was higher than that in the control group (9.43% vs 6.56%); the contamination rate was lower than that in the control group (0.77% vs 1.28%); the unqualified rate was lower than that of the control group (1.19% vs 2.18%), all the differences were statistically significant (all P < 0.05). After the intervention, the antimicrobial use intensity in the intensive care medicine department, hematology department, infectious disease department, and the neurology department decreased by 2.78%, 42.36%, 27.82%, and 39.47%, respectively, while the pulmonary and critical care medicine department increased by 8.10%. Conclusion The multi-department collaboration mode has a good impact on improving the positive rate of blood culture and reducing the intensity of antimicrobial use in the internal medicine departments.
• Yan-chun WAN , Ke GAO , Yan-qiu LIU , Chun HAN
•2023(7):822-827. DOI: 10.12138/j.issn.1671-9638.20234346
Abstract:Objective To explore the intervention measures and effectiveness evaluation for the improvement of the pathogenic detection rate related to healthcare-associated infection (HAI) diagnosis in secondary general hospitals. Methods The reported HAI cases among all hospitalized patients in a secondary general hospital from 2021 to 2022 were selected as the research object, with 2021 as the pre-intervention group and 2022 as the post-intervention group. Indicators of pathogenic detection rates related to HAI diagnosis before and after the implementation of improvement intervention measures were compared. Results Pathogenic detection rate related to HAI diagnosis was 66.07% in 2021. After implementing improvement intervention measures, detection rate reached 91.55% in 2022, meeting the standard requirements of ≥90%. The difference before and after intervention was statistically significant (χ2=12.85, P < 0.01). After implementing improvement intervention measures, differences in the antimicrobial use rate and the constituent ratios of restricted and special-grade antimicrobials among hospitalized patients were all statistically significant (all P < 0.05). Conclusion Implementing effective improvement intervention measures can increase HAI diagnosis-related pathogenic detection rate, but the quality control indicators still needs to be improved and refined.
• Zhen-yu XU , Pei-zhen LI , Yun XU , Li XIONG , Yi SHU , Min YANG , Xiao-wei WANG , Min ZHANG , Ning ZHOU
•2023(7):828-838. DOI: 10.12138/j.issn.1671-9638.20233619
Abstract:Disseminated cryptococcosis is a disease caused by Cryptococcus spp. that affects two or more non-adjacent body parts. The clinical manifestations of the disease are diverse, often leading to diagnostic challenges. A 34-year-old female patient was admitted to a hospital due to abdominal distension, intermittent low fever for 2 months, jaundice for 1 month, and high fever with headache for 11 days. The patient was not immunocompromised. During the disease course, the patient initially presented with abdominal distension, jaundice, and intermittent low fever, followed by high fever and headache. Auxiliary examination revealed thickened bile duct walls and biliary obstruction, pulmonary exudative lesions, endocardium vegetations, multi-lymph node enlargement in mediastinum, hepatic hilum and retroperitoneal space, cerebrospinal fluid pressure >400 mmH2O on lumbar punctures. Meta-genomic next-generation sequencing (mNGS) and culture of cerebrospinal fluid detected Cryptococcus neoformans. Pathological examination of retroperitoneal lymph nodes and liver suggested Cryptococcus infection. The patient was ultimately diagnosed with disseminated cryptococcosis. The case analysis aims to enhance clinical understanding on disseminated cryptococcal infection.
• Juan-juan HU , Yao ZHENG , Wen-yan XIAO , Jin ZHANG , Min YANG
•2023(7):839-844. DOI: 10.12138/j.issn.1671-9638.20233696
Abstract:To explore the clinical characteristics, diagnosis and treatment process of liver abscess and hemolytic anemia caused by Clostridium perfringens (Cp) infection in diabetes patients, and improve the awareness, diagnosis and treatment of patients. Clinical data of a diabetes patient with liver abscess, hemolytic anemia, bloodstream infection and multiple organ failure caused by Cp infection in a hospital in August 2022 were analyzed. Retrospective analysis of the data was conducted in combination with relevant literatures. A total of 19 English literatures were retrieved. Combined with the case in this study, 20 patients were included in the analysis, 10 were males and 10 were females, with an average age of 70.7 years, 12 patients complicated with diabetes. Clinical manifestations of the patients lacked specificity, and all patients had varying degrees of hemolytic anemia. Seventeen patients (85.0%) died, with an average time of 23.84 hours from seeking medical advice to death. Fourteen of them (82.4%) died before a clear pathogenic diagnosis was made, and 11 (64.7%) died within 8 hours of admission due to ineffective rescue efforts. There were only 3 survived patients, all of whom had obtained pathogenic results at the early stage of the disease: two patients underwent liver abscess puncture and drainage at the early stage, while the other patient's liver abscess ruptured into the liver capsule during treatment, and the lump shrank. Cp-infected liver abscess complicated with hemolytic anemia progresses rapidly, and has a high mortality at early stage, making early diagnosis especially important. When Cp infection is suspected, pathogenic diagnosis should be rapidly confirmed through Gram-staining or next-generation sequencing of puncture fluid/blood, so as to alter patient's survival outcome through early adjustment of sensitive antimicrobial agents and clearance of infected lesions.
• Yun LIU , Rui CHENG , Yan GUO , Xiao-guang ZHOU , Jun CHEN , Ai-min QIAN
•2023(7):845-848. DOI: 10.12138/j.issn.1671-9638.20233510
Abstract:Clinical manifestations, laboratory tests, imaging features, as well as treatment and prognosis of two cases of Ureaplasma parvum (U. parvum) meningitis in premature infants in a hospital were retrospectively analyzed, and provide evidence for early diagnosis and treatment. The main clinical symptom of two groups of premature infants was fever, and the efficacy of empirical antimicrobial therapy was not satisfactory. The metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid indicated U. parvum infection. After receiving azithromycin anti-infection therapy, conditions of two premature infants improved. They were followed up to 14 and 18 months old, respectively, and their neurobehavioral development was similar to that of normal children of the same age. The clinical symptoms of U. parvum meningitis in premature infants lack specificity. When conventional anti-infective therapy is ineffective, mNGS of cerebrospinal fluid can identify the pathogen. Azithromycin is effective, and the prognosis of premature infants with U. parvum meningitis is good.
• Sheng-han GAO , Tao LI , Yan-xin FU , Si-yu JI , Jin-yu SHANG , Ya-hu BAI , Kang NING
•2023(7):849-852. DOI: 10.12138/j.issn.1671-9638.20233551
Abstract:Rickettsia felis is a newly emerged pathogen of Rickettsia, which is closely related to Rickettsia prowazekii and Rickettsia mooseri, belonging to the genus Rickettsia. This paper analyzes the clinical data of an elderly patient infected with Rickettsia felis, and further summarizes the detection techniques and methods of Ricke-ttsia felis based on domestic and international literatures, so as to enhance the capabilities of clinical health care workers in the early diagnosis of Rickettsia felis infection.
•2023(7):853-855. DOI: 10.12138/j.issn.1671-9638.20233640
Abstract:With the continuous development and progress of medicine, new medical concepts and terms have emerged, such as preemptive prevention. This paper introduces the concept, connotation and methods of preemptive prevention, and focuses on the application of preemptive prevention in the field of infectious diseases. The diffe-rences and connections among preemptive prevention and other similar terms such as general prevention and targeted prevention are analyzed, providing guidance for the clinical application of this theory to medical personnel.
• Xin-rui DU , Jun-rui WANG , Di ZHOU , Yuan ZUO
•2023(7):856-863. DOI: 10.12138/j.issn.1671-9638.20233180
Abstract:Staphylococcus aureus (SA)is one of the common pathogens that can cause bone and joint infection through secreting toxins, biofilm formation and other ways. Because SA can colonize in the nasal cavity and other sites of the host for a long time, it significantly increases the risk of bone and joint infection in hospitalized patients. Decolonization treatment is proved to decrease the incidence of SA bone and joint infection of hospitalized patients. Although classic decolonization drugs (such as mupirocin) show good efficacy, there is an increasing demand for developing other new alternative medicine in clinical treatment due to drug resistance, allergic reaction and other causes. In this paper, the pathogenic mechanism of SA, the correlation between colonization as well as bone and joint infection, etc. are reviewed, so as to provide reference and evidence for the prevention and treatment of bone and joint infection caused by SA.
•2023(7):864-868. DOI: 10.12138/j.issn.1671-9638.20233381
Abstract:Tuberculosis (TB) imposes a significant disease burden globally, emphasizing the importance of TB prevention and control. In recent years, COVID-19 pandemic has severely disrupted the progress of global TB prevention and control programs, raising concerns about TB prevention and control. Transmission dynamics models have played a crucial role in TB research by providing insights into the patterns and dynamics of TB transmission from both macro and micro perspectives, and evaluating the effectiveness of various intervention measures. This review introduces five TB transmission dynamics models: the compartmental model, the metapopulation model, the agent-based model, the network model, and the phylodynamics model, providing reference and support for the prevention, control and further research of TB.
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