Abstract:Objective To understand the whole genome sequence characteristics of a Coxsackievirus A4 (CVA4) isolated from Yunnan, China in 2022, and explore the phylogenetic characteristics of CVA4. Methods The whole genome sequence of CVA4 isolate 194R3/YN/CHN/2022 was amplified and sequenced, and the phylogenetic tree of CVA4 isolate was constructed by using Mega 7.0, Geneious 9.1.4 and Simplot 3.5.1 softwares. The whole genome sequence characteristics were analyzed. Results The 194R3/YN/CHN/2022 isolate was identified as CVA4, belonging to the C2 gene subtype, which was consistent with the dominant gene subtype in recent years in China. Recombination analysis showed that recombination of CVA4 virus isolate with EVA114 prototype (V13-0285), CVA16 prototype (G-10), and CVA14 prototype (G-14) at the non-structural coding regions of P2 and P3 may have occurred. Conclusion The 194R3/YN/CHN/2022 isolated from Yunnan belongs to the C2 gene subtype, which is the prevalent CVA4 in China, but with certain mutations.

Abstract:Objective To retrieve and extract the best evidence for preventing intracranial infections related to external cerebrospinal fluid (CSF) drainage, and provide evidence-based support for reducing the incidence of intracranial infection caused by external CSF drainage. Methods Evidence-based care issues were determined according to PIPOST, and the best evidence on intracranial infection related to external CSF drainage tube was retrieved from top to bottom. The literature retrieval period was 2013-2023. Quality control of the literatures, as well as extraction and summary of the evidence were carried out by 2 trained graduate students. Results A total of 17 literatures were included in the analysis, including 3 guidelines, 5 expert consensus, 8 systematic reviews, and 1 randomized controlled trial. Management strategies from 3 dimensions (pre-catheterization, in-catheterization and post-catheterization) were obtained, including 20 pieces of evidence for preventing intracranial infection, such as preparation for external CSF drainage tube, precautions during catheterization, and post-catheterization disposal. Conclusion There are differences in the management of external CSF drainage tube in clinical practice. It is necessary to develop unified, standardized, and rational bundle strategies to prevent intracranial infection, so as to reduce the incidence of catheter-related intracranial infection.

Abstract:Objective To explore the in vitro and in vivo antimicrobial activity of pinaverium bromide (PVB)against Staphylococcus epidermidis (S. epidermidis). Methods S. epidermidis isolated from blood specimens of hospitalized patients in a hospital in Changsha from January to December 2022 were collected. Susceptibility test of S. epidermidis to PVB was performed using broth microdilution method and disc diffusion method. The time- and concentration-dependent antimicrobial activity of PVB were determined by time-killing assay. Ultrastructural changes in bacteria after PVB treatment was observed by transmission electron microscope. The inhibitory and clearance effects of PVB on S. epidermidis biofilm were detected by crystal violet staining test. The combined antimicrobial effect of PVB and antimicrobial agents was studied through microdilution checkerboard technique. A skin abscess infection model was constructed to detect the in vivo antimicrobial activity of PVB. Results Antimicrobial susceptibility testing results showed that the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of PVB against the standard strains RP62A and ATCC 12228 were 8 and 16 μg/mL, respectively; The MIC and MBC of clinical strains of S. epidermidis were 4-8 μg/mL and 8-16 μg/mL, respectively. Disc diffusion method results showed that compared with the untreated control group (0.60±0) cm, 0.2 mg PVB treatment showed a significant inhibitory zone (［2.26±0.09］ cm; t=45.34, P<0.001), and the diameter of inhibitory zone increased with the increase of PVB dosage. The time-killing curves indicated PVB had bactericidal activity, which enhanced with increased concentration and action duration. Transmission electron microscope observed that PVB could significantly damage the normal structure of S. epidermidis, leading to bacterial edema and lysis. In addition, at the concentration of 1×MIC, PVB could significantly inhibit the formation of S. epidermidis biofilm, reducing the amount of biofilm formation (A_{570 nm}) from (2.30±0.18) to (0.47±0.11; t=14.85, P<0.001). Meanwhile, PVB at the concentration of 1×MIC could effectively destroy the formed biofilm, reducing the amount of biofilm from (2.64±0.10) to (1.77±0.30; t=4.76, P=0.009). The combination of PVB with amikacin and gentamicin exhibited synergistic antimicrobial activity, with synergistic inhibitory indexes of 0.50 and 0.31, respectively. Animal models showed that 10 mg/kg body weight of PVB could reduce the area of abscesses from (68.83±10.68) mm² to (35.50±10.58) mm² (t=6.52, P<0.001), and reduce the amount of viable bacteria in abscesses from (6.11±0.55) lg (CFU/abscess) to (3.60±0.34) lg (CFU/abscess) (t=3.08, P=0.014). Hematoxylin-eosin staining revealed that the infiltration of inflammatory cells in skin abscesses in the PVB treatment group reduced significantly compared with the control group, tending to be normal. Conclusion PVB exhibits effective in vitro and in vivo antimicrobial effect against S. epidermidis, which can be used as an alternative for the treatment of S. epidermidis-related infections.

Abstract:Objective To retrospectively analyze the distribution and antimicrobial resistance changes of Gram-negative (G^-) bacteria, as well as related clinical characteristics of peritoneal dialysis-related peritonitis (PDRP) in elderly patients, provide reference for clinical diagnosis and treatment. Methods Elderly PDRP patients in three tertiary first-class hospitals in a city from January 2015 to December 2022 were analyzed, distribution and antimicrobial resistance of G^- bacterial PDRP pathogens, as well as incidence, clinical characteristics and prognosis of PDRP were analyzed. Results A total of 247 elderly peritoneal dialysis (PD) patients developed 406 episodes of PDRP. The overall incidence and incidence of Gram-positive (G⁺) bacterial PDRP in elderly PD patients showed a downward trend year by year (both P<0.05), while the incidence of G^- bacterial PDRP showed no significant downward trend (P>0.05). A total of 96 cases (106 episodes) of G^- bacterial PDRP occurred in elderly PD patients, with Escherichia coli being the predominant strain (38.68%). Compared with 2015-2018, there was no significant change in the susceptibility rates of G^- bacteria isolated from elderly PDRP patients to piperacillin/tazobactam, cefo- perazone/sulbactam, imipenem, meropenem, and amikacin in 2019-2022, all of which were highly susceptible. The resistance rate to cefotaxime increased (P=0.033). Multivariate logistic regression analysis showed that high serum C-reactive protein, high white blood cell count in PD fluid on the first day, and long time for white blood cell count in PD fluid to return to normal were risk factors for G^- bacterial PDRP in elderly PD patients (all P<0.05). The cure rate of elderly PDRP patients in G^- bacterial group (83.96%) was lower than that of the G⁺ bacterial group (93.01%), with statistically difference (P<0.05). Conclusion There is no obvious downward trend in the incidence of G^- bacterial PDRP in elderly PD patients, aminoglycosides can be used as the first choice for empirical treatment of G^- bacterial PDRP.

Abstract:Objective To evaluate the in vitro effect of combinations of 5 β-lactam antibiotics with different β-lactamase inhibitors on the activity of multidrug-resistant Mycobacterium tuberculosis (MDR-TB), and identify the most effective combination of β-lactam antibiotics and β-lactamase inhibitors against MDR-TB. Methods MDR-TB strains collected in Henan Province Antimicrobial Resistance Surveillance Project in 2021 were selected. The minimum inhibitory concentrations (MIC) of 5 β-lactam antibiotics or combinations with different β-lactamase inhibitors on clinically isolated MDR-TB strains were measured by MIC detection method, and the blaC mutation of the strains was analyzed by polymerase chain reaction (PCR) and DNA sequencing. Results A total of 105 strains of MDR-TB were included in the analysis. MIC detection results showed that doripenem had the highest antibacterial activity against MDR-TB, with a MIC₅₀ of 16 μg/mL. MIC values of most β-lactam antibiotics decreased significantly after combined with β-lactamase inhibitors. A total of 13.33% (n=14) strains had mutations in blaC gene, mainly 3 nucleotide substitution mutations, namely AGT333AGG, AAC638ACC and ATC786ATT. BlaC proteins Ser111Arg and Asn213Thr enhanced the synergistic effect of clavulanic acid/sulbactam and meropenem on MDR-TB compared with synonymous single-nucleotide mutation. Conclusion The combination of doripenem and sulbactam has the strongest antibacterial activity against MDR-TB. Substitution mutations of BlaC protein Ser111Arg and Asn213Thr enhances the sensitivity of MDR-TB to meropenem through the synergy with clavulanic acid/sulbactam.

Abstract:Objective To study the clinical and pathological characteristics, as well as diagnosis, treatment methods and prognosis of adult patients with chronic active Epstein-Barr virus infection (CAEBVI). Methods Clinical and pathological data of 8 adult patients with CAEBVI admitted to a hospital in Gansu Province from January 2017 to December 2022 were collected retrospectively, clinical and histopathological characteristics, EBV-related test results, as well as treatment and prognosis of patients were analyzed. Results Among 8 CAEBVI patients, 3 were males and 5 were females, with the median age of 21.5 years. The median time from onset to diagnosis of CAEBVI was 7 months. The main manifestations were fever, pancytopenia (involving two or three peripheral blood lines), as well as lymph node enlargement, hepatomegaly and splenomegaly. The quantifications of plasma EBV nucleic acid (DNA) were all >1.0×10³. The sorting results of EBV infected cells showed that 3 cases were T lymphocytes infection, 2 were NK cell infection, and 3 were co-infection of T lymphocytes and NK cells. Bone marrow cytological examination of 8 patients showed no atypical lymphocytes, while 6 patients showed hemophagocytic cells. Flow cytometey (FCM) typing results showed that no abnormal cell population was detected in all the 8 patients, and no myeloid, B lymphocyte, T lymphocyte and NK cell markers were expressed. The positive rate of T cell receptor (TCR) gene rearrangement was 37.5% (n=3). Histopathology showed that most cases (n=6, 75.0%) expressed CD3, partial cases expressed CD4, CD8, CD56, TIA-1, and EBV encoded RNA (EBER), all were positive. The survival rate of patients after treatment was 50.0% (n=4), the follow-up time was 6-51 months, the 1-year survival rate was 85.7%, and the median survival time was 24 months. Conclusion CAEBVI is characterized by variable clinical manifestations that may lead to fatal complications. Early diagnosis and individualized treatment should be performed to reduce mortality of patients.

Abstract:Objective To explore the clinical efficacy and influencing factors of omadacycline (OMC) in the treatment of patients with infectious diseases. Methods Data about hospitalized patients who received OMC monotherapy or combination therapy at Xiangya Hospital of Central South University from January 2022 to December 2023 were analyzed retrospectively. The influencing factors for failure of OMC treatment was analyzed by univariate and multivariate logistic regression analysis. Results A total of 160 patients were included in analysis, with an overall effective treatment rate of 69.4% (n=111). After treatment with OMC, patients in effective group was observed that body temperature improved (［36.83±0.52］℃ vs ［37.85±0.92］℃, P<0.001), white blood cell count (［7.78±4.07］×10⁹/L vs ［10.06±6.49］×10⁹/L, P<0.001), procalcitonin (［0.63±1.19］ ng/mL vs ［4.43±10.14］ ng/mL, P=0.001), C-reactive protein (［35.16±37.82］ mg/L vs ［105.08±99.47］ mg/L, P<0.001), and aspartate aminotransferase (［50.50 ±40.04］ U/L vs ［77.17±91.43］ U/L, P=0.004) all decreased significantly. Only one patient had adverse reactions such as diarrhea, but treatment was not interrupted. Univariate ana-lysis showed that patients in failure treatment group had a higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (17.0 ［9.5-22.0］ vs 12.0 ［9.0-19.0］, P=0.046) and sequential organ failure assessment (SOFA) score (7.0 ［4.5-10.0］ vs 4.0 ［2.0-9.0］, P=0.019). Multivariate analysis showed that end-stage liver disease (OR=77.691, 95%CI: 5.448-1 107.880, P=0.001), mechanical ventilation (OR=6.686, 95%CI: 1.628-27.452, P=0.008) and the combination treatment of vancomycin (OR＝6.432, 95%CI: 1.891-21.874, P＝0.003) were risk factors for the failure of OMC treatment, while the course of OMC treatment (OR=0.905, 95%CI: 0.825-0.994, P=0.037) was a protective factor for the effective treatment. Conclusion OMC can be used as an alternative therapy for refractory severe infection, with fewer adverse reaction. End-stage liver disease, mechanical ventilation and combination treatment of vancomycin are risk factors for failure of OMC treatment in infected patients. Adequate OMC treatment course can improve patients’ clinical outcome, large-scale case studies are needed to confirm the initial conclusion.

Abstract:Objective To explore the pathogen contamination and cost-effectiveness of hospital bed-side curtains under different cleaning frequencies. Methods Fourteen departments in a hospital with relatively higher incidence but smaller fluctuation of incidence of infection from January to June 2023 were selected. Nine wards in each department were selected, and two curtains were selected from each ward. According to the cleaning frequency, wards were divided into low, medium and high frequency groups. The qualified rate of environmental hygienic detection on pathogens on the bed-side curtains and bacterial contamination on the surface of curtains after 6 months were comparted, cost-effectiveness analysis was conducted. Results The qualified rate of environmental hygienic detection of bed-side curtains was the highest in high frequency group, at 88.10%. Bacterial counts on the upper, middle, and lower segments of the bed-side curtains in the high frequency group were all lowest (P<0.05). Within 6 months, the incidence of healthcare-associated infection (HAI) in patients in the high and the medium frequency groups (0.16% and 0.25%, respectively) were both lower than 0.85% in the low frequency group (χ²=5.653, 3.915, respectively, both P<0.05). Cost-effectiveness analysis showed that for every additional unit of qualified rate for the high and medium frequency groups, the costs increase by 124.51 and 44.10 Yuan, respectively. Conclusion The increase of cleaning frequency can effectively reduce bacterial contamination of bed-side curtains, decrease the risk of HAI, and improve the qualified rate of environmental hygiene of bed-side curtains in the wards. Cleaning once every 2 months can achieve better cost-effectiveness.

Abstract:Objective To understand the epidemiological and clinical characteristics of healthcare-associated infection (HAI) in neonates with different gestational ages and birth weights, and provide guidance for personalized cli-nical diagnosis and treatment. Methods According to the inclusion and exclusion criteria, 240 neonates with HAI in the neonatal intensive care unit (NICU) of a hospital in Handan City from January 2018 to December 2022 were selected as the study group, 720 neonates without HAI were selected as the control group based on systematic sampling method with a ratio of 1 ∶3. The incidence of HAI , distribution characteristics of infection site, pathogenic features of HAI, as well as the effect of different delivery modes on HAI in neonates with different gestational ages and birth weights were analyzed. Results Neonates with gestational age <28 weeks and birth weight <1 000 g had the highest incidence of HAI, which were 19.48% and 20.41%, respectively. Among neonates with gestational age <28 weeks, unidentified site infection were the most (37.50%), while in all gestational age groups within 28-36⁺⁶ weeks, bloodstream infection (BSI) and respiratory system infection were predominant. For neonates with gestational age ≥37 weeks, BSI and unidentified site infection occurred frequently. Among neonates in all weight groups, BSI was the most frequent, followed by respiratory system infection. Pathogens from different sites of infections in neonates with different gestational ages and birth weights varied. Among neonates with gestational age of 28-31⁺⁶ weeks and birth weight of 1 000-1 499 g, the constituent of birth modes showed statistically significant difference between neonates with and without HAI (both P<0.05). Conclusion Epidemiological and clinical chara-cteristics of HAI in neonates with different gestational ages and birth weights are different. For the prevention and control of HAI, individualized diagnosis and treatment plans should be developed to achieve precise prevention and control, reduce the incidence of HAI, and improve the overall treatment level of neonates.

Abstract:Objective To analyze the distribution and antimicrobial resistance of pathogens from wounds of burned patients, providing reference for the rational use of antimicrobial agents and healthcare-associated infection (HAI) prevention and control. Methods Clinical data of burned patients admitted to a tertiary first-class hospital from Ja-nuary 2020 to December 2022 were analyzed retrospectively, pathogens in the wound was cultured, identified, and performed antimicrobial susceptibility analysis. Results From 2020 to 2022, a total of 588 burned patients were admitted, 734 strains of pathogens were detected, including 415 strains (56.54%) of Gram-negative bacteria, 306 strains (41.69%) of Gram-positive bacteria, and 13 (1.77%) strains of fungi. The top 5 pathogens were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterobacter cloacae. Staphylococcus aureus had higher resistance rates (93.02%-97.37%) to penicillin G, resistance rate to oxacillin increased from 11.63% to 21.92%. Pseudomonas aeruginosa mainly exhibited resistance to ticarcillin/clavulanic acid, aztreonam, and levofloxacin, resistance rates to imipenem and meropenem were 15.00% -38.10% and 10.00%-33.33%, respectively. Susceptibility of Enterobacterales bacteria to cephalosporins enhanced with the increased of cephalosporin generations, and exhibited higher resistance to commonly used antimicrobial agents. Conclusion Over the past three years, there has been no significant change in the detection of major pathogens and antimicrobial resistance in wounds of burned patients in this hospital. Antimicrobial resistance of Staphylococcus aureus and Enterobacterales is relatively severe, and it is necessary to carry out surveillance on pathogens from burn wounds in corresponding areas.

Abstract:Objective To describe the changing trend and related factors of prevalence rates of healthcare-associa-ted infection (HAI) in a tertiary hospital in the past 10 years, and analyze the influencing factors for HAI. Methods A cross-sectional survey on HAI was conducted for 10 consecutive years from 2013 to 2022 (one day was selected as the survey day each year), data were collected. The distribution and related factors of prevalence rates of HAI were analyzed by trend-χ² test and Pearson correlation coefficient. Multivariate logistic regression and multilayer perceptron (MLP) models were constructed to analyze the independent effect and significance of factors. Results From 2013 to 2022, the prevalence rates of HAI ranged from 4.66% to 8.07% in this hospital, showing a linear upward trend. The proportions of ICU patients and utilization rate of central venous catheters within 2 days before the survey showed linear upward trends, while the proportion of patients with urinary catheters within 2 days before the survey and proportion of patients undergoing surgery within 30 days before the survey decreased. The MLP model revealed that the top 3 important factors for HAI were length of hospital stay >10 days, admission in ICU, and indwelling central venous catheters within 2 days before the survey. Multivariate logistic regression model indicated that length of hospital stay ＞10 days, indwelling central venous catheters or urinary catheters within 2 days before the survey, surgery within 30 days before the survey, and admission in ICU were independent influencing factors for HAI. Conclusion The incidence of HAI in this hospital presents a linear increase in recent 10 years, the causes should be further analyzed and the direction of intervention should be determined through targeted surveillance. Adopting trend test statistical analysis method, logistic regression, MLP multi-factor model can further explore the data value of HAI prevalence survey.

Abstract:Objective To understand the current situation of healthcare-associated infection (HAI) among hospitalized patients in Yunnan area from 2020 to 2022, and provide reference for optimizing corresponding prevention and control measures. Methods Data of HAI prevalence rate survey (cross-sectional survey) in Yunnan area from 2020 to 2022 were collected through Yunnan Provincial HAI Quality Control Center Surveillance System, and su-mmarized. Statistical analysis was performed with SPSS 25.0 software. Results From 2020 to 2022, 117 695, 109 691, and 137 188 patients were surveyed respectively, and the prevalence rates of HAI were 1.58%, 1.47%, and 1.29%, respectively, with statistically significant difference (χ²=36.853, P<0.001). Lower respiratory tract (n=2 526, 43.60%) and urinary tract (n=785, 13.55%) were the major infection sites. General intensive care unit (ICU) had the highest HAI prevalence rate (10.95%-16.47%) in all three prevalence surveys. The main pathogens causing HAI were Gram-negative bacteria, with Escherichia coli being the first, followed by Klebsiella pneumoniae, while the major Gram-positive bacteria was Staphylococcus aureus. Antimicrobial use rates in patients were 30.96%-33.91%, showing an upward trend (χ²＝257.586, P＜0.001). The main purpose of antimicrobial use was for treatment (accounting for 76.46%-78.62%). Antimicrobial use was mainly single use, with a slight increase in combined use of three antimicrobials and above, increasing from 0.66% to 0.98%. The pathogenic detection rate for therapeutic antimicrobial use showed an upward trend (χ²＝94.823, P＜0.001). Surgical site infection rates in patients undergoing class Ⅰ incision surgery were 0.77%-1.22%; the prophylactic antimicrobial use rates in patients undergoing class Ⅰ incision surgery in three years were 19.40%, 19.11%, and 20.93%, respectively, both with statistically significant difference (χ²=94.823, 10.179, both P=0.006). Conclusion The prevalence rate of HAI among hospitalized patients in Yunnan area has decreased, however, the prevention and control of HAI pathogens, as well as the rational use of prophylactic antimicrobial agents for class Ⅰ incision surgical patients are difficult, and represent the focus of future work.

Abstract:Objective To understand the allocation of full-time staff in healthcare-associated infection (HAI) ma-nagement and the ability in HAI information surveillance of medical institutions (MIs) in Hubei Province, and provide a basis for the quality control of HAI management in the province. Methods In July 2023, a survey was issued to the quality control centers of cities, counties and districts of the province by Hubei HAI Management Quality Control Center, and a questionnaire survey was carried out regarding the basic situation, HAI full-time staff and HAI surveillance in secondary- and above level MIs in cities and states of Hubei Province. Results A total of 476 MIs were surveyed, 328 MIs (68.91%) had adequate staff for HAI management, and 214 MIs (44.96%) carried out HAI surveillance through HAI information system. In the survey on the ability in acquiring 13 indicators of HAI quality control, MIs carrying out HAI surveillance through HAI information system was higher than those through manual surveillance. Conclusion The construction of full-time staff of HAI management in Hubei Province needs to be further strengthened, and the ability of HAI information surveillance needs to be further improved. MIs with HAI information surveillance should pay attention to the updating and iteration of HAI surveillance system, and constantly improve the monitoring function.

Abstract:Objective To investigate the current status of cleaning and disinfection of endoscopic ultrasound microprobes in tertiary hospitals in Beijing. Methods 51 tertiary hospitals in Beijing were selected with convenience sampling method, and a questionnaire survey was conducted on head nurses in endoscopy centers, the investigation included pre-treatment, cleaning, disinfection, sterilization, biological testing, disinfection traceability, storage and maintenance of endoscopic ultrasound microprobes. Results Among the 51 tertiary hospitals, 33 were first-class hospitals and 18 were second-class hospitals. 76.47% (n=39) of hospitals performed bed-side pre-cleaning on ultrasound microprobes after use, bed-side pre-treatment methods for endoscopic ultrasound microprobes mainly included enzyme solution wiping (38.47%, 15/39) and ethanol wiping (30.77%, 12/39); 96.08% (n=49) of hospitals performed manual cleaning for ultrasound microprobes, with "enzyme wash-scrub-dry" as the main method (58.82%, n=30); 96.08% (n=49) of hospitals disinfected microprobes after use, with chemical disinfectant immersion as the main methods (65.31%, n=32); 43.14% (n=22) of hospitals sterilized the microprobes, and the main method of sterilization was immersion in 0.2%-0.35% peroxyacetic acid for 10-15 minutes (77.27%, 17/22); 41.18% (n=21) of hospitals regularly conducted biological monitoring on microprobes; 37.25% (n=19) of hospitals traced the cleaning and disinfection process of microprobes; 88.24% (n=45) of hospitals regularly inspected, maintained, and repaired microprobes. Conclusion The pre-treatment, cleaning, disinfection, sterilization, and biological monitoring of endoscopic ultrasound microprobes in 51 tertiary hospitals in Beijing varies significantly, and it is recommended that a relevant expert consensus or guideline be formulated as early as possible, so as to standardize the cleaning and disinfection of endoscopic ultrasound microprobes.

Abstract:Objective To investigate the current status of hand hygiene (HH)compliance with concealed observation method, compare compliance rates of HH of health care workers (HCWs) obtained through concealed observation method, direct observation method and monitoring observation method, provide effective surveillance methods and means for further improving HH compliance. Methods Data about HH compliance and HH products consumption in a hospital obtained through monitoring observation method, concealed observation method, and direct observation method were collected, all observed HCWs have received unified training, the correlation among three me-thods and HH consumption were explored. Results Differences in HH compliance rates obtained by different observation methods were statistically significant (χ²=17.401, P＜0.001). The direct observation method had the highest HH compliance rate at 95.08%, while the concealed observation method had the lowest HH compliance rate at 50.83%. The daily consumption of HH products was highest in department of neonatology, at 119.14 mL/bed-day, and lowest in department of pediatrics, at 10.39 mL/bed-day. The monitoring observation method (r=0.975, P=0.005) and the concealed observation method (r=0.949, P=0.012) had a good correlation with the consumption of HH products. The concealed observation method showed that the department with the highest HH compliance rate was department of neonatology, at 90.00%. Conclusion The actual HH compliance can be indirectly reflected by comprehensive monitoring observation method and the consumption of HH products per bed-day.

Abstract:Objective To investigate a suspected outbreak event of Mycobacterium abscessus (Mab) infection in department of pulmonary and critical care medicine in a hospital, provide basis for the precise prevention and control of healthcare-associated infection (HAI). Methods On-site epidemiological investigation and environmental hygienic detection were carried out in patients with Mab infection following fiberbronchoscopic bronchoalveolar lavage in the department of pulmonary and critical care medicine in this hospital, and targeted intervention measures were proposed. Results From September 7 to October 20, 2022, a total of 344 cases of bronchoalveolar lavage were performed for patients in fiberbronchoscopy room of department of pulmonary and critical care medicine. Mab was detected from bronchoalveolar lavage fluid (BALF) of 10 patients. Through on-site and follow-up investigation, the initial case was defined as community-associated infection, and the other 9 cases were due to the contamination of specimens. A total of 33 environmental hygienic specimens were collected, and no Mab was detected. The event was effectively controlled after standardizing the process of bronchoscope decontamination, strengthening the infection management of ward and bronchoscopy room, and strictly implementing the certificate system of bronchoscopy decontamination personnel. Conclusion This pseudo-outbreak is due to the contamination of fiberbronchoscope by Mab. Timely identifying risk factors as well as taking targeted prevention and control measures can effectively control the spread and prevalence of Mab infection.

Abstract:Objective To evaluate the application value of combined detection of Mycobacterium tuberculosis-specific cytokines interferon-γ (IFN-γ) and interleukin-2 (IL-2) in the differential diagnosis of pulmonary tuberculosis and bacterial pneumonia. Methods A total of 91 hospitalized patients in the respiratory department of Fuyang People’s Hospital from January 2022 to October 2023 were selected. Forty-five patients were diagnosed with pulmonary tuberculosis (pulmonary tuberculosis group), and 46 patients were diagnosed with bacterial pneumonia (pneumonia group). Two-cytokine combined detection were performed on all patients. The effect of two-cytokine combined detection and C-reactive protein (CRP) in the differential diagnosis of pulmonary tuberculosis and bacterial pneumonia was compared. Results The sensitivity and specificity of two-cytokine combined detection for the differential diagnosis of pulmonary tuberculosis and bacterial pneumonia were 86.7% and 84.8%, respectively. The area under the receiver operating characteristic curve was 0.928 (95%CI: 0.870-0.986), which showed significant difference compared with differential diagnostic efficacy of CRP (P<0.05). Conclusion The combined detection of Mycobacterium tuberculosis-specific cytokine IFN-γ and IL-2 in the differential diagnosis of pulmonary tuberculosis and bacterial pneumonia has a high application value, which can provide a basis for the differential diagnosis of pulmonary tuberculosis and bacterial pneumonia.

Abstract:Fungal mycetoma is a chronic granulomatous lesion that persists in the skin and subcutaneous tissue for a long time. It is commonly caused by fungal infection in field workers who are pricked to the subcutaneous tissue by thorns from soil, plants, or bramble. Fungal mycetoma cases is rare in China. This article reports two cases of fungal mycetoma caused by Madurella grisea and Aspergillus flavus infection, which improve after surgical debridement and antifungal drug treatment. This study aims to improve clinicians’ understanding on fungal mycetoma and achieve early diagnosis and treatment.

Abstract:Immmunosuppressants are mainly used to reduce rejection after solid organ transplantation, so as to improve the success rate of organ transplantation. However, long-term use of immunosuppressants can also seriously impair the immune function of patients, thereby increasing the risk of viral infection and postoperative complications, leading to transplant failure. Therefore, patients need to use both immunosuppressants and antiviral agents. If some immunosuppressants with antiviral effects are found, the patient’s burden of taking medicines will be greatly reduced. Currently, the immunosuppressants with antiviral effect have been focused by researchers. The gradual revealing of the antiviral mechanism of these immunosuppressants will help to optimize the treatment plan of postope-rative rehabilitation of organ transplant recipients. Based on the mechanism of rejection of transplanted organ, this paper systematically describes the types of viruses which closely related to infection of organ transplant patients and the molecular mechanism of some immunosuppressants in antiviral aspects, which further provides a new idea for clinical prevention and treatment of viral infection due to organ transplantation.

Abstract:Butyric acid is a type of short chain fatty acid and an important nutrient in intestinal epithelial cells. In addition to its important role in intestinal health, it has application value in anti-tumor, treatment of neuritis and diabetes. At the same time, based on the demand for green development in the livestock industry, its anti-inflammatory effect can avoid the abuse of antimicrobial agents. As a green, pollution-free, and residue-free new feed, butyric acid ensures the sustainable and healthy development of the livestock industry. This article mainly summarizes the production of butyric acid in the intestine, its effects on the balance of gut microbiota, digestion ability, and inflammation in humans and animals, elaborates its application in human health and animal production.