Chinese Journal of Infection Control |
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Editor in Chief:Wu, Anhua ISSN:1671-9638 CN:43-1390/R Sponsor:Ministry of Education of the People's Republic of China Organizer:Central South University, Xiangya Hospital of Central South University Publication cycle:monthly Telephone:0731-84327658 84327237 Email:zggrkz2002@vip.sina.com |
•2025,24(5):577-583 ,Doi: 10.12138/j.issn.1671-9638.20257381
Abstract:: Invasive fungal disease (IFD) is a group of serious infectious diseases caused by fungi. In recent years, its incidence has shown an upward trend. Traditionally, the diagnostic cri...Invasive fungal disease (IFD) is a group of serious infectious diseases caused by fungi. In recent years, its incidence has shown an upward trend. Traditionally, the diagnostic criteria for IFD primarily target patients with neutropenia. However, in clinical practice, more and more IFD patients do not have neutropenia as their underlying disease. Instead, they are non-neutropenic patients with high-risk factors such as chronic obstructive pulmonary di-sease (COPD), severe viral pneumonia, and diabetes, etc. Their clinical features, imaging manifestations, laboratory tests, and diagnostic criteria are significantly different from those of neutropenic patients. This article comprehensively expounds the diagnostic criteria and their evolution for IFD in non-neutropenic patients, especially highligh-ting the differences from neutropenic patients, so as to provide a reference for the correct clinical diagnosis of IFD. Show
KeyWord:invasive fungal disease;neutropenia;non-neutropenia;diagnostic criteria
• NIE Chan, LI Xueyun, TANG Lan, CHEN Liyuan, HE Ling, XU Yan, MU Xia
•2025,24(5):584-590 ,Doi: 10.12138/j.issn.1671-9638.20257194
Abstract:: Objective To analyze the research hotspots and trends of invasive fungal infections (IFIs) in China over the past 24 years, and provide references and suggestions for future...Objective To analyze the research hotspots and trends of invasive fungal infections (IFIs) in China over the past 24 years, and provide references and suggestions for future research. Methods Literatures on IFIs research in China from 2000 to 2024 were retrieved from China National Knowledge Infrastructure (CNKI) and Web of Science (WOS). CiteSpace software was employed to conduct collaboration network analysis on authors’ institutions, and co-occurrence, clustering, and burst analyses were conducted on key words. Results A total of 2 479 li-teratures retrieved from CNKI and 1 149 from WOS were included in the analysis, involving 295 research institutions, with no core research team identified having a intermediary centrality >0.1. Institutions with intermediary centrality >0.1 included Chinese Academy of Sciences, Peking University, Fudan University, Sun Yat-sen University and Zhejiang University. Key words with high centrality included "diagnosis" "risk factor" "voriconazole" and "Candida albicans". Clustering analysis grouped the co-occurrence network of key words into 6 clusters, mainly covering fungal diagnosis, treatment, and susceptible factors. Since 2020, focuses on the safety of antifungal treatment agents and primary prevention have emerged, with hot topics including pharmacokinetics, children, clinical features, and risk factors. Conclusion Currently, research teams are dispersed with insufficient interdisciplinary collaboration. Research topics are relatively simple. It is necessary to strengthen research on fungal resistance and healthcare-associated infection prevention and control. Risk factors and prevention measures for IFIs may be the focus of future research. Show
KeyWord:invasive fungus;risk factor;CiteSpace software;visualization analysis
• LI Sha, XIE Xiaoyan, LIANG Tingting, LIU Jun, HE Yaoqin, FENG Fengquan, HUANG Meizhen, LI Qian
•2025,24(5):591-596 ,Doi: 10.12138/j.issn.1671-9638.20256486
Abstract:: Objective To analyze the clinical characteristics of co-infection of Talaromyces marneffei (TM) and non-tuberculous Mycobacterium (NTM) in human immunodeficiency virus (HIV)...Objective To analyze the clinical characteristics of co-infection of Talaromyces marneffei (TM) and non-tuberculous Mycobacterium (NTM) in human immunodeficiency virus (HIV)-negative patients. Methods Clinical data of 8 HIV-negative patients with co-infection of TM and NTM in a hospital from 2019 to 2022 were co-llected. Clinical manifestations, auxiliary examination, treatment and prognosis were retrospectively analyzed. Results Among the 8 patients, 5 were females and 3 were males, with an average age of (52.25±12.31) years old. All patients presented TM and NTM disseminated infection. The major involved organs were lung (100%), lymph nodes (87.5%), and skin (75.0%). Clinical symptoms mainly included cough and expectoration (87.5%), fatigue (62.5%), joint and lumbosacral pains (62.5%), fever (50.0%), as well as skin and soft tissue abscess (50.0%), etc. Anti-interferon-γ (INF-γ) autoantibodies were detected in 4 patients and the results were positive. All 8 patients (100%) had pulmonary lesions, with chest CT mainly showing spots, patches, and striped shadows in both lungs. Among them, 7 cases (87.5%) had increased and enlarged mediastinal lymph nodes, 4 cases (50.0%) had pleural thickening and pleural effusion, 2 cases each (25.0% for each) were accompanied by pulmonary mass shadows, bronchial stenosis, as well as increased and enlarged hilar lymph nodes. One case each (12.5% for each) had pulmonary cavity formation, bronchiectasis, and pericardial effusion. Conclusion The co-infection of TM and NTM in non-HIV patients presents disseminated infection, with multiple clinical symptoms. Chest imaging shows a wide variety of pulmonary lesions. It is prone to miss diagnosis in clinic, and the effect is not ideal after treatment for single pathogen infection. Show
• FAN Baiyuan, XU Shilan, GAO Shuo, WANG Handong, ZHOU Wanqing
•2025,24(5):597-601 ,Doi: 10.12138/j.issn.1671-9638.20257261
Abstract:: Objective To explore the clinical infection distribution and antifungal resistance characteristics of the Stephanoascus ciferrii (S. ciferrii) complex. Methods Clinic...Objective To explore the clinical infection distribution and antifungal resistance characteristics of the Stephanoascus ciferrii (S. ciferrii) complex. Methods Clinical fungal culture and isolation data from Nanjing Drum Tower Hospital from 2012 to 2023 were retrospectively analyzed. The annual isolation quantity, proportion, and distribution of infection sites of S. ciferrii were statistically analyzed. The minimum inhibitory concentrations (MICs) of isolated strains against common antifungal agents were detected by ATB Fungus 3 fungal susceptibility test kit, and their resistance was analyzed. Results From 2012 to 2023, a total of 26 602 fungal strains were isolated in this hospital, including 79 strains of the S. ciferrii complex. Compared with 2012-2017, the isolation rate of S. ciferrii complex increased from 2018 to 2023 (0.06% vs 0.43%, P<0.001). There were 69 cases of superficial infection, including infection of ear canal (n=67) and skin (n=2). 92.75% (n=64) of the patients were immunocompetent individuals. There were 10 cases of invasive infection, including infection of urinary tract (n=5), respiratory tract (n=2), biliary tract (n=1), pacemaker pouch (n=1), and vagina (n=1). 70.00% of the patients had other underlying diseases, including 3 cases of immunosuppressed patients who died due to combined infection with the S. ciferrii complex. The MICs detection results showed that the MIC50 and MIC90 of fluconazole were 32 μg/mL and 128 μg/mL, respectively; the MIC50 and MIC90 of amphotericin B were 0.5 μg/mL and 2 μg/mL, respectively. Conclusion S. ciferrii complex mainly causes ear canal infection and has the dual pathogenic ability to cause superficial and invasive infection. The isolated strains showed higher MIC values for fluconazole and lower MIC values for amphotericin B. The mortality is high in immunosuppressed patients combined with invasive infection caused by S. ciferrii. Show
KeyWord:Stephanoascus ciferrii complex;clinical characteristics;fungus;drug resistance
• XU Dan, XIONG Jian, HU Zhimin
•2025,24(5):602-608 ,Doi: 10.12138/j.issn.1671-9638.20256914
Abstract:: Objective To investigate Candida albicans (C. auris) colonization in patients and environmental contamination of non-intensive care unit (non-ICU) in a hospital, and evaluat...Objective To investigate Candida albicans (C. auris) colonization in patients and environmental contamination of non-intensive care unit (non-ICU) in a hospital, and evaluate the effectiveness of infection prevention and control measures in non-ICU. Methods In March 2024, a paraplegic patient admitted to the department of rehabilitation medicine was found to have C. auris in bothurinary catheter and urine culture. The patient was immedia-tely isolated in single room, and patient transfer-in/out of non-ICU was suspended. Fungal cultures were performed on specimens from the ward environment, caregivers, doctors, nurses, and co-hospitalized patients. Mass spectrometry and molecular biology techniques were used for strain identification and cluster analysis. Contact isolation was conducted on patient. Prevention and control measures were taken, including strict hand hygiene, 1 000 mg/L chlorine-based (sodium hypochlorite) disinfection, 2% chlorhexidine decolonization, and terminal disinfection of patient-contact items. After discharge, these measures continued with regular C. auris surveillance. Results Five strains of C. auris were isolated from the patient’s urine, urinary catheter, inguinal swab, perianal swab, and bed rail swab. Protein mass spectrometry cluster analysis confirmed clonal relatedness of all isolates. The strain showed resistance to fluconazole and amphotericin B, but susceptibility to echinocandins. No C. auris was detected from healthcare workers’ hand/axillary/groin swabs. After intervention (such as decolonization and environmental disinfection), follow-up cultures were negative for C. auris. Conclusion Based on the characteristics of admitted patients, non-ICU should implement active prevention and control measures including: admission screening, contact precautions, object surface microbiological monitoring, decolonization, environmental disinfection, and community management. Hand hygiene, contact isolation, and terminal disinfection are crucial for preventing C. auris transmission. Show
• CAI Lili, LIN Zhihang, GUO Ruyi, WU Namei, CHEN Qingqing
•2025,24(5):609-617 ,Doi: 10.12138/j.issn.1671-9638.20256700
Abstract:: Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii (T. asahii) bloodstream infection (BSI), and provide reference...Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii (T. asahii) bloodstream infection (BSI), and provide reference for clinical diagnosis and treatment for such disease. Methods Diagnosis and treatment process of a patient with T. asahii BSI were reported. China National Knowledge Infrastructure(CNKI), Wanfang, PubMed, and Web of Science databases were retrieved using keywords: "Trichosporon asahii" and "bloodstream infection". Patients’ age, gender, underlying diseases, immune status, treatment, and clinical outcome as well as antimicrobial susceptibility testing results of T. asahii were analyzed retrospectively. Results The leukemia patient developed T. asahii BSI during chemotherapy, and showed clinical improvement after treatment with fluconazole+flucytosine. A total of 44 cases (43 from literature plus this index case) were analyzed. Among these cases, 28 were males, the median age was 54.5 years old. The underlying diseases were predominantly hematological diseases. Catheter, urinary tract, and skin were identified as concurrent culture-positive sites. Azoles exhibited good antimicrobial activity in vitro, with voriconazole showing the strongest activity and associated with significantly higher survival rates. Under the guidance of antimicrobial susceptibility testing results, patients with fluconazole treatment had a higher survival rate. At minimum inhibitory concentrations (MICs) of 4-8 μg/mL of fluconazole, fluconazole combined with other agents was predominantly required. Amphotericin B demonstrated good in vitro activity, but the overall survival rate of patients was low when amphotericin B was used as monotherapy without azoles. Catheters removal, surgical intervention, and neutrophil recovery were influencing factors for enhanced survival rates. Conclusion BSI caused by T. asahii primarily occurs in patients with hematological diseases, with neutropenia being a high-risk factor. Infection sites at catheter, urinary tract, and skin may be infection sources. Clearing the source of infection and promoting the recovery of neutrophils can help to improve survival rates of patients. For voriconazole-intolerant patients, fluconazole monotherapy or in combination with flucytosine/amphotericin B can be used alternatively based on antimicrobial susceptibility testing results. Show
KeyWord:Trichosporon asahii;bloodstream infection;fluconazole;treatment;literature review
• CHEN Ying, LI Hong, WANG Huiyu, HUANG Guangding, WANG Qiongying, LI Xiaofang
•2025,24(5):618-624 ,Doi: 10.12138/j.issn.1671-9638.20252080
Abstract:: Objective To report the diagnosis and treatment processes of a fungal keratitis case caused by Lasiodiplodia theobromae (L. theobromae), and enhance the diagnosis and treatm...Objective To report the diagnosis and treatment processes of a fungal keratitis case caused by Lasiodiplodia theobromae (L. theobromae), and enhance the diagnosis and treatment experience on fungal keratitis caused by this rare pathogen. Methods Corneal scraping specimen from a patient with fungal keratitis was collec-ted. Gram-staining and fluorescence staining were conducted on specimen, followed with direct microscopic observation and isolation culture. The strain was identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) technology and targeted DNA sequencing. Antimicrobial susceptibility testing was conducted. Literatures were summarized and clinical data on fungal keratitis caused by this pathogen were sorted out. Results Septal fungal hyphae could be seen on the corneal scraping specimen microscopically. The strain was identified as L. theobromae by both MALDI-TOF MS and targeted DNA sequencing after culture. Antimicrobial susceptibility testing (microdilution method) showed that the minimal inhibitory concentrations (MICs) of amphotericin B, vorionazole,itraconazole, posaconazole, fluconazole, 5-fluorocytosine, micafungin, caspofungin, and[LM]anidulafungin against this strain were 1, 0.25, > 8, 0.25, > 256, 8, 16, 2, and 0.25 μg/mL, respectively. Patient recovered well after antifungal treatment plan was adjusted according to antimicrobial susceptibility testing results. Conclusion L. theobromae is a rare pathogen that causes fungal keratitis. Laboratory tests provide rapid microscopic examination results, and take MALDI-TOF MS and targeted DNA sequencing identification techniques as effective means to detect rare pathogen. In vitro antimicrobial susceptibility testing result can provide reference for clinicians to correctly use antifungal agents for treatment of infection due to this pathogen. Show
KeyWord:Lasiodiplodia theobromae;fungal keratitis;case report
• LIN Xiaofeng, LI Yan, CHEN Nuo, ZHOU Weilong, CHENG Fan, TAN Yibin, WANG Ying
•2025,24(5):625-630 ,Doi: 10.12138/j.issn.1671-9638.20257234
Abstract:: Objective To understand the distribution characteristics of fungi on object surface in hospital environment, and provide reference for the scientific and precise formulation...Objective To understand the distribution characteristics of fungi on object surface in hospital environment, and provide reference for the scientific and precise formulation of environment control strategies based on fungal in clinic. Methods From December 7 to 23, 2023, a total of 60 environmental specimens of 19 categories in 6 departments of a large tertiary first-class hospital were collected and divided into water-related environmental specimen group, complete facade environmental specimen group, and sanitary ware environmental specimen group. 18S rRNA sequencing was performed on specimens with fungi detected. Results Fungal detection rate of environmental specimenswas 20.00% (12/60). Sink in the department of endocrinology had the highest fungal colony count (15 CFU/cm2), followed by the air outlet of air disinfection device in the department of thoracic surgery and the internal part of a faucet in the department of endocrinology (both 10 CFU/cm2). The water-related environmental specimen group detected most diverse fungal genera (14 species), with high relative abundances of Aspergillus (100%), Meyerozyma (99.06%), Ophiocordyceps genus (95.63%), and Kodamaea (87.86%). The air outlet of air disinfection device was detected with a high abundance of Chaetomium (44.08%) and Corollospora (39.71%). There was no statistically significant difference in the α-diversity (Shannon and Simpson indices, P values of 0.661 and 0.568, respectively) and β-diversity (P=0.712) among the three environmental specimens. Conclusion Under the routine implementation of basic environmental cleaning and disinfection in medical institutions, fungi are in a low prevalence in the environment. However, moist surfaces and air disinfection device are prone to fungal colonization, and it is necessary to strengthen daily monitoring and take corresponding intervention measures to reduce the risk of infection. Show
• LAN Qingzhan, LYU Xin, HAO Yingying, LU Bingru, LI Boqing
•2025,24(5):631-637 ,Doi: 10.12138/j.issn.1671-9638.20256768
Abstract:: Objective To understand the respiratory pathogen infection of acute fever and respiratory symptoms in a hospital in Jinan City, explore its epidemiological characteristics, ...Objective To understand the respiratory pathogen infection of acute fever and respiratory symptoms in a hospital in Jinan City, explore its epidemiological characteristics, and provide reference for the scientific diagnosis and treatment of acute respiratory infection in this region. Methods Patients who underwent respiratory pathogen IgM antibody detection at Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2018 to June 2024 were selected as the research subjects. IgM antibody detection was performed on 9 common respiratory pathogens by magnetic particle chemiluminescence method. Pathogen detection of patients stratified by genders, age, season, and years was analyzed. Results A total of 19 463 patients were included in the analysis, out of which 6 933 patients were detected with at least one kind of pathogen, accounting for 35.62%. The top three pathogens with high detection rates were Mycoplasma pneumoniae (MP), influenza B virus (FluB), and influenza A virus (FluA), with detection rates of 17.14%, 13.62%, and 4.58%, respectively. The detection rates of single and multiple pathogens were 28.57% and 7.05%, respectively. The detection rate of females was higher than that of males (38.02% vs 33.78%), with statistically significant difference (P<0.001). With the increase of age, the total detection of respiratory pathogens first decreased, then increased. Detection rate of respiratory pathogens was highest in winter (41.59%) and lowest in autumn (31.23%). The total detection rate decreased year by year. Conclusion Respiratory pathogen infection in this region is mainly caused by MP and FluB, with minors being the high-risk population and winter being the peak season. In recent years, the detection rate has been decreasing year by year. Effort should be made to strengthen the prevention and treatment of high-risk populations during the peak season, so as to avoid large-scale regional epidemics. Show
KeyWord:acute respiratory infection;respiratory pathogen;detection rate;IgM antibody
• DI Jiaxin, XIAO Nenqun, PENG Maijiao, TAN Zhoujin
•2025,24(5):638-646 ,Doi: 10.12138/j.issn.1671-9638.20257030
Abstract:: Objective To explore the synergistic therapeutic effect of sodium butyrate and Sishen pill on mice with diarrhea with kidney-yang deficiency syndrome, and provide experiment...Objective To explore the synergistic therapeutic effect of sodium butyrate and Sishen pill on mice with diarrhea with kidney-yang deficiency syndrome, and provide experimental evidence for the contemporary application of classical prescriptions. Methods The diarrhea with kidney-yang deficiency syndrome mouse model was constructed by gavage of adenine combined with Folium sennae. Mice were given 100% Sishen pill decoction, 50 mg/kg sodium butyrate+75% Sishen pill decoction, 100 mg/kg sodium butyrate+50% Sishen pill decoction, 200 mg/kg sodium butyrate+25% Sishen pill decoction, and 300 mg/mL sodium butyrate decoction by intragastric administration, respectively. General condition, food and water intake, anal temperature, body weight, fecal water content, organ index, intestinal microbiota, and enzyme activity of the mice were compared. Results After treatment, the general condition, food and water intake, anal temperature, and fecal water content of the mice gradually recovered. The body weight of mice from the natural recovery group, the 200 mg/kg sodium butyrate+25% Sishen pill group, and the 50 mg/kg sodium butyrate+75% Sishen pill group still showed statistical differences from the normal group (P<0.05). The body weight of mice from the 100 mg/kg sodium butyrate+50% Sishen pill group (34.23±4.93) g increased, close to the body weight of mice from the normal group (35.69±4.78) g. Spleen index of the mice from the 100 mg/kg sodium butyrate+50% Sishen pill group recovered to normal, showing significant difference from mice from the natural recovery group (P<0.05). There were no significant differences in thymus index of mice from different groups (P>0.05). After treatment, the mice intestinal microbiota began to recover, with no significant differences in the number of bacteria among groups (P>0.05). Compared with the natural recovery group, the number of Escherichia coli in mice from each treatment group reduced significantly (P<0.01), and the mice from 100 mg/kg sodium butyrate+50% Sishen pill group had the smallest number of Escherichia coli. The number of Bifidobacteria in mice from the 100 mg/kg sodium butyrate+50% Sishen pill group and the 50 mg/kg sodium butyrate+75% Sishen pill group recovered to the level of the normal group (P>0.05). The mice from 100 mg/kg sodium butyrate+50% Sishen pill group showed a significant effect on the recovery of Lactobacillus number (P<0.05). The amylase, lactase, and protease activities in mice from the natural recovery group were all higher than those from the normal group (all P<0.05), and the enzyme activities in mice from the 100 mg/kg sodium butyrate+50% Sishen pill group were closer to those from the normal group. Compared with the natural recovery group, lactase activity of mice from the 100% Sishen pill group reduced significantly (P<0.01), and the xylanase activity in mice from the 100 mg/kg sodium butyrate+50% Sishen pill group was closest to the normal group. Conclusion The synergistic effect of sodium butyrate enhances the therapeutic efficacy of Sishen pill. 100 mg/kg sodium butyrate+50% Sishen pill group showed significant improvement in mice mental status, diarrhea symptoms, intestinal enzyme activity, and microbial stability compared with other groups using sodium butyrate or Sishen pill alone. Show
• ZHANG Chun, KE Wujian, JIANG Yinbo, TANG Shixing
•2025,24(5):647-656 ,Doi: 10.12138/j.issn.1671-9638.20256619
Abstract:: Objective To study the effect of peripheral blood CD4+T lymphocytes of syphilis patients on human immunodeficiency virus type 1 (HIV-1) infection and replication,...Objective To study the effect of peripheral blood CD4+T lymphocytes of syphilis patients on human immunodeficiency virus type 1 (HIV-1) infection and replication, and explore the molecular mechanism of Treponema pallidum (TP) in facilitating HIV-1 replication. Methods Peripheral blood mononuclear cells (PBMCs) were isolated from syphilis patients and TP-uninfected healthy blood donors, then infected with HIV-1 in vitro. HIV-1 replication level was studied. PBMCs of healthy persons were stimulated with TP and then infected with HIV-1. CD4+T lymphocytes were isolated using flow cytometry, and changes in host gene expression profiles were verified using messenger RNA (mRNA) high-throughput sequencing and real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) methods. Results CD4+T lymphocytes from TP-infected persons and TP-stimulated CD4+T lymphocytes from healthy persons could significantly enhance HIV-1 infection and viral replication levels. The HIV-1 p24 content in the supernatant of cultured cells and intracellular HIV-1 DNA copy number were both higher than those in the control group (both P<0.05). There were significant differences in the mRNA gene expression profiles between the TP stimulation combined with HIV-1 infection group and the HIV-1 infection alone group. Among them, the expression levels of chemokines CXCL5 and CXCL8 were significantly upregulated in the TP stimulation combined with HIV-1 infection group, indicating that chemokines might play an important role in the enhancement of HIV-1 infection and replication by TP. Conclusion TP infection can significantly enhance the susceptibility of peripheral blood CD4+T lymphocytes to HIV-1 and promote virus replication, providing new scientific evidences for TP infection promoting HIV-1 infection. Show
• CHEN Yinzhi, TU Zailan, ZHOU Mingchuan, YE Hemei, ZHONG Zhen, CHENG Yan, LIU Xiaoyan, HOU Zhangmei
•2025,24(5):657-665 ,Doi: 10.12138/j.issn.1671-9638.20255438
Abstract:: Objective To analyze the monitoring of healthcare-associated infection (HAI) in the intensive care unit (ICU) over the past 12 years based on Joinpoint regression model, and...Objective To analyze the monitoring of healthcare-associated infection (HAI) in the intensive care unit (ICU) over the past 12 years based on Joinpoint regression model, and evaluate the trend changes and relevant factors of HAI incidence. Methods ICU patients in a tertiary first-class hospital from January 2012 to December 2023 were selected and performed prospective monitoring. Trend changes of HAI incidence and the correlation with consumption of hand hygiene products as well as HAI management measures were analyzed. Results From 2012 to 2023, 6 929 ICU patients were included in the monitoring, 543 patients had 655 episodes of HAI, with incidence and case incidence of HAI being 7.84% and 9.45%, respectively. The average severity of the disease was 3.62, and the adjusted HAI incidence was 2.17%. The daily incidence of ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI), and central line-associated bloodstream infection (CLABSI) were 6.19‰, 3.45‰, and 1.23‰, respectively. The consumption of hand hygiene products was 122.98 mL/bed-day. The compliance rate and correct rate of hand hygiene were 90.63% and 90.46%, respectively. From 2012 to 2023, incidence of HAI (51.29% vs 4.39%), case incidence of HAI (72.41% vs 4.94%), the adjusted incidence of HAI (15.98% vs 1.04%), daily incidence of VAP (22.50‰ vs 4.33‰), daily incidence of CAUTI (14.23‰ vs 1.64‰), and daily incidence of CLABSI (10.60‰ vs 0.20‰) all decreased significantly (all P<0.05). Both consumption of hand hygiene products (75.16 mL/bed-day vs 147.35 mL/bed-day) and correct rate of hand hygiene (85.00% vs 90.28%) increased significantly (both P<0.05). A total of 1 946 pathogens were detected, with an increase in the proportion of Staphylococcus aureus (1.30% vs 9.57%) and a decrease in the proportion of fungi (11.04% vs 1.74%). The daily consumption of hand hygiene products negatively correlated with the incidence of HAI, the case incidence of HAI, as well as the daily incidence of CAUTI and CLABSI (all P<0.05). Incorporating HAI real-time monitoring system and HAI management into performance assessment could decrease HAI-rela-ted incidence (P<0.05). Conclusion HAI-related incidence presents a downward trend. Scientific and comprehensive HAI prevention and control management measures such as healthcare workers’ hand hygiene management, online HAI real-time monitoring system, and incorporating HAI management into performance assessment can decrease HAI-related incidence and promote the improvement of medical quality. Show
• LIU Jinping, MA Yaoyao, ZHANG Bing, ZHAO Menghan, GUO Ziqing, QI Qi, MAO Yiping
•2025,24(5):666-673 ,Doi: 10.12138/j.issn.1671-9638.20255454
Abstract:: Objective To construct a knowledge graph of healthcare-associated infection (HAI) prevention and control course, and evaluate its usability. Methods Based on the cons...Objective To construct a knowledge graph of healthcare-associated infection (HAI) prevention and control course, and evaluate its usability. Methods Based on the constructivist learning theory and the analyze-design-develop-implement-evaluate (ADDIE) model, knowledge from various sources such as books, guidelines, and literature related to HAI prevention and control were integrated. The knowledge graph of HAI prevention and control course were designed and constructed with the support of knowledge graph technology in Chaoxing Fanya platform. Thirty medical students were selected by convenience sampling method to try out the course knowledge graph. System usability scale and usage effect questionnaire were filled out to evaluate the usability of the knowledge graph. Results The knowledge graph of HAI prevention and control course contained 379 knowledge points asso-ciated with 520 test questions and 56 learning resources. After testing, the total score ([70.50±12.20] points) was obtained for the usability of the knowledge graph. Among the four dimensions of the usage effect agreement questionnaire, satisfaction, learning attitude, learning ability, and learning resource support accounted for 93.33%-96.67%, 90.00%, 93.33%-96.67%, and 83.33%-90.00%, respectively, with a high overall satisfaction rate. Conclusion The knowledge graph of HAI prevention and control course has good usability, which can realize students’ personalized independent learning and improve their learning efficiency. Show
• QIU Sangsang, XU Qinfen, SHAO Junfei, HUANG Qinhong, WU Bo, HU Chunxiao, CHEN Jingyu
•2025,24(5):674-681 ,Doi: 10.12138/j.issn.1671-9638.20256898
Abstract:: Objective To explore the risk factors for healthcare-associated infection (HAI) in lung transplant recipients (LTRs), and construct a predictive nomogram model. MethodsObjective To explore the risk factors for healthcare-associated infection (HAI) in lung transplant recipients (LTRs), and construct a predictive nomogram model. Methods Clinical data of patients who underwent lung transplant in Wuxi People’s Hospital from January 2019 to December 2023 were analyzed retrospectively. The patients were divided into a training set (n=506) and a validation set (n=218). Independent risk factors were screened through LASSO regression, and multivariate logistic regression was included to construct a nomogram prediction model. The discrimination, calibration, and clinical applicability of the model were evaluated using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow goodness-of-fit, and decision curves. Results Among the 506 LTRs, 201 developed HAIs, with an incidence of 39.72%. The major infection site was lower respiratory tract, and the major pathogen were Gram-negative bacilli (Acinetobacter baumannii). Older age, use of extracorporeal membrane oxygenation (ECMO), double-lung transplant, surgery duration >3 hours, long duration of continuous fever, frequent abnormal blood routine examination, and long duration of combined use of antimicrobial agents were identified as independent risk factors for HAI after lung transplant. The ROC curve analysis results showed that the areas under the curve (AUCs) of the training set and the validation set were 0.74 (95%CI: 0.70-0.78) and 0.71 (95%CI: 0.64-0.78), respectively. The Hosmer-Lemeshow test results showed that there was no statistically significant difference between the predictive and actual probability of HAI (P>0.05). The clinical decision curve results indicated that the modelhad clinical benefits at a threshold probability value of 7%-71%. Conclusion The nomogram prediction model constructed in this study can effectively evaluate the risk of postoperative infection in LTRs. The model is stable and has high clinical application value, providing scientific reference for postoperative infection prevention and control. Show
•2025,24(5):682-686 ,Doi: 10.12138/j.issn.1671-9638.20257013
Abstract:: Objective To analyze the clinical data of 48 monkeypox patients in Changsha City, improve the understanding and early diagnosis on monkeypox, and provide scientific basis fo...Objective To analyze the clinical data of 48 monkeypox patients in Changsha City, improve the understanding and early diagnosis on monkeypox, and provide scientific basis for the prevention and control of monkeypox outbreak. Methods Clinical data of 48 monkeypox patients admitted to The First Hospital of Changsha City from June 29, 2023 to September 30, 2024 were collected retrospectively. Epidemiological data, clinical manifestations, diagnosis, and treatment process of patients were analyzed. Results All of the 48 patients were male, with a median age of 33 years old (19-54 years old). 95.83% (n=46) of the patients were men who had sex with men (MSM), and 93.75% (n=45) admitted to having sex with men prior to disease onset. Patients primarily presented with fever (43.75%) and rash (97.92%) as clinical manifestations, 62.50% (n=30) of the patients had concurrent human immunodeficiency virus (HIV) infection, and those with HIV infection had more severe skin rashes. After symptomaticand supportive treatment, most patients had good prognoses, but two HIV-infected patients died. Conclusion MSM are high-risk population for this monkeypox outbreak, and close contact is the main route of transmission. Patients present with fever and rash as major clinical manifestations. Monkeypox patients with concurrent HIV infection have more severe skin rashes. Most monkeypox patients have good prognoses, HIV co-infection and low CD4+T lymphocyte counts may be high-risk factors for death. Epidemic prevention and control should be carried out among high-risk population, and suspected rashes should be detected and treated as early as possible. Show
KeyWord:monkeypox;monkeypox virus;clinical characteristics;epidemiological characteristics
• BIAN Binghao, XU Peng, GUO Xuan, XU Yi, LYU Jingyi, ZHANG Fang, WANG Lili
•2025,24(5):687-693 ,Doi: 10.12138/j.issn.1671-9638.20255448
Abstract:: Objective To investigate the incidence and economic burden of healthcare-associated infection (HAI) in patients after liver transplant. Methods Basic clinical informa...Objective To investigate the incidence and economic burden of healthcare-associated infection (HAI) in patients after liver transplant. Methods Basic clinical information, infection status, and related medical expenses of liver transplant patients in the department of hepatobiliary surgery in a tertiary first-class hospital from November 2012 to December 2023 were investigated retrospectively. A case-control study design was employed, with post-li-ver transplant patients who developed HAI as the infection group and those without HAI during the same period as the control group. The 1∶1 propensity score matching (PSM) method was adopted (caliper value was set at 0.05, employing sampling without replacement). Length of hospital stay and hospitalization expenses between patients in the infection group and the control group were compared using Wilcoxon rank-sum test, and the economic burden due to HAI was calculated. Results A total of 336 liver transplant patients were included in study, out of which 48 had HAI, with an incidence of 14.29%. 44 pairs were successfully matched by PSM. After matching, the median hospitalization expense for patients in the infection group was 334 473.73 Yuan, while that of the control group was 285 824.82 Yuan, with a statistically significant difference (Z=-3.430, P<0.05). The direct economic burden of[LM]HAI in liver transplant patients was 48 648.91 Yuan. After matching, the median length of hospital stay in the infection group (37.0 days) was 12.5 days longer than that in the control group (24.5 days), with statistically significnat difference (Z=-3.630, P<0.001). Conclusion HAI after liver transplant increases patients’ hospitalization expense and prolongs their hospital stay, thus brings huge economic burdens to the patients. Show
• LIU Xinyu, PENG Lihua, LI Meihua
•2025,24(5):694-700 ,Doi: 10.12138/j.issn.1671-9638.20256639
Abstract:: Objective To conduct a large-scale survey on the competence of healthcare workers (HCWs) in stan-dard prevention, assess the current status and training needs, and provide b...Objective To conduct a large-scale survey on the competence of healthcare workers (HCWs) in stan-dard prevention, assess the current status and training needs, and provide basis for the effective implementation of standard prevention. Methods A convenience sampling method was used to conduct an online questionnaire survey among HCWs from various medical institutions across the city. The survey contents included general information, competence questionnaires (basic cognitive and practical competence), as well as training willingness and needs. Results A total of 6 773 HCWs from 62 medical institutions participated in the survey. The average score of their competence in standard prevention was (14.98±2.63) points, with a total scoring rate of 68.07%. The scoring rate of "practical competence" (63.79%) was lower than that of "basic cognition" (73.20%). The highest scoring rate for each dimension was "hand hygiene" (90.90%), and the lowest was "use of protective equipment" (17.25%). Males, technicians, primary medical institutions, college degrees, work experience under 10 years, and emergency/general departments were characteristics of HCWs with lower standard prevention competence. 99.37% of the HCWs were willing to participate in training."once a month" "Monday to Friday afternoon" "15-30 minutes" "online learning" "use protective equipment" "local infection control experts" were the top choices in terms of training needs. Conclusion HCWs’ competence in standard prevention needs to be improved urgently, especially in the aspects of weak practical skills and differences among various groups, HCWs have a strong willingness to participate in standard prevention training. Future efforts should focus on overlooked population in HAI management, increase their training opportunities and diversity, and enhance practice implementation. Show
KeyWord:healthcare worker;standard prevention;current situation survey;training need
• WU Xiaoping, SUN Xiaowei, LI Jiantao
•2025,24(5):701-704 ,Doi: 10.12138/j.issn.1671-9638.20256869
Abstract:: This article reports thediagnosis and treatment process of a case with secondary infective femoral artery pseudoaneurysm after intervention surgery for cerebral infarction, who imp...This article reports thediagnosis and treatment process of a case with secondary infective femoral artery pseudoaneurysm after intervention surgery for cerebral infarction, who improved after anti-infection and surgical treatment and was discharged. The patient was a 52-year-old female who underwent percutaneous balloon dilatation of basilar artery due to basilar artery stenosis. After surgery, she developed secondary methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection and infective femoral artery pseudoaneurysm. After treatment with vancomycin and linezolid, femoral artery pseudoaneurysm resection, and autovascular replacement, the patient recovered well after the surgery and discharged from hospital. CT angiography (CTA) re-examination showed artificial blood vessel patency. This study is expected to provide experience for the diagnosis and treatment of such patients in clinical work. Show
KeyWord:pseudoaneurysm;infection;femoral artery;cerebral infarction
• QIAN Xianzhe, ZHANG Shuwen, LI Chunhui, XIANG Tianxin
•2025,24(5):705-711 ,Doi: 10.12138/j.issn.1671-9638.20257091
Abstract:: Fungal infection is an increasingly serious clinical problem, especially in immunocompromised patients. Fungi, such as Candida albicans, Aspergillus, and Cryptococcus, can form bio...Fungal infection is an increasingly serious clinical problem, especially in immunocompromised patients. Fungi, such as Candida albicans, Aspergillus, and Cryptococcus, can form biofilm, which enhance their drug resistance and immune evasion ability, thus become major obstacles to the treatment of infection. Biofilm formation is not limited to human body, it can also form on the surface of medical devices, leading to chronic and recurrent infection. This article elaborates the biofilm formation mechanisms and hazards caused by different fungi such as Candida albicans and Aspergillus, emphasizes immune suppression, chronic diseases, and medical devices as high-risk factors for biofilm formation. Fungi can form biofilm through multiple stages such as adhesion, proliferation, extracellular matrix (ECM) construction, and cell dispersion, and enhance drug resistance based on physical barriers and gene regulation. Although existing antifungal agents are effective in infection caused by planktonic fungi, their treatment efficacy on fungal biofilm is limited. Therefore, the article explores new treatment strategies, including non-pharmacological therapies such as photodynamic therapy and electric field therapy, as well as targeted gene editing and the application of new biomaterials. It is necessary to strengthen the combination of basic research and clinical applications, develop efficient and low toxicity treatment scheme to improve the successful treatment rate for patients. Show
KeyWord:biofilm;fungal infection;antifungal agent;drug resistance of fungus;immunocompromised host
• ZHANG Jiaxue, WANG Xiaoping, LIU Li, MA Qinmei, DENG Guangcun, WU Xiaoling
•2025,24(5):712-720 ,Doi: 10.12138/j.issn.1671-9638.20256620
Abstract:: Tuberculosis, as a chronic infectious disease caused by Mycobacterium tuberculosis (MTB) infection, presenting a serious threat to human and animal health. When human body is infec...Tuberculosis, as a chronic infectious disease caused by Mycobacterium tuberculosis (MTB) infection, presenting a serious threat to human and animal health. When human body is infected by MTB, it quickly initiates an immune response, in which T lymphocyte-mediated cellular immunity plays a key role, as it can effectively recognize and eliminate MTB, serving as an important defense line for the body against MTB. However, during MTB infection process, myeloid-derived suppressor cells (MDSCs) undergo amplification and activation, which exhibit inhibitory effect on the immune function of T lymphocytes and interfere the normal immune response of the body, making MTB easier to survive and reproduce in the body. This article discusses the role of MDSCs in the occu-rrence, development and prognosis of tuberculosis from two different perspectives, expects to provide new perspectives and ideas for the immunotherapy of tuberculosis as well as the research and development of targeted drugs, so as to open up a new way for the prevention and treatment of tuberculosis. Show
KeyWord:Mycobacterium tuberculosis;myeloid-derived suppressor cell;immunosuppression
•2025,24(5):721-732 ,Doi: 10.12138/j.issn.1671-9638.20257382
Abstract:: Show
KeyWord:infectious disease;law of prevention and control;prevention;treatment
• Doi: 10.3969/j.issn.1671-9638.2014.06.007
• Doi: 10.3969/j.issn.1671-9638.2013.
• DU Jing1,LONG Ji chuan1, LI Chun hui2
• Doi: 10.3969/j.issn.1671-9638.2015.07.009
• LEI Xin yun, JIN Zheng jiang
• Doi: 10.3969/j.issn.1671-9638.2015.07.004
•YU Hong,YANG Hui ying,LIU Yin mei
• Doi: 10.3969/j.issn.1671-9638.2015.06.017
• ZHANG Shu min, RAN Su ping, ZHOU Wen jing, HE Yu, CUI Huan huan,LIU Lan rong, JIA Xi
• Doi: 10.3969/j.issn.1671-9638.2014.09.007
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CN 43-1301/R;ISSN 1008-8830
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