Chinese Journal of Infection Control |
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Editor in Chief：Wu, Anhua ISSN：2096-9244(Online) ISSN：1671-9638(Pring) 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 |
Ranking list
- 01 Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare associated infection6565
- 02 Molecular epidemiological study of methicillin resistant Staphylococcus aureus FREE5639
- 03 Homology analysis on ICU multidrug resistant Acinetobacter baumannii nosocomial infection FREE4835
- 04 A new glycopeptide antibiotic——dalbavancin4718
- 05 Distribution and change of microbial population of clinical isolated bacteria from a hospital between 1999 and 2008 FREE4533
- 06 Colonization and drug resistance of multidrug resistant bacteria in intensive care unit FREE4472
- 07 A case control study on risk factors for nosocomial infection of Acinetobacter baumannii in internal medicine intensive care units FREE4231
- 08 Antimicrobial activity of linezolid and other antimicrobial agents against Enterococci spp. in vitro FREE4214
- 09 Change in drug resistance of Pseudomonas aeruginosa to β lactam antibiotics FREE4024
- 10 Catheter associated nosocomial infection in surgical intensive care unit :a 5 year data analysis3883
- 01 Epidemiological and clinical analysis on bacillary dysentery in 175 children in three years252790
- 02 Comparison of the effectiveness of different disinfectants on blood donors before donation127748
- 03 National healthcare associated infection surveillance system point prevalence survey of antimicrobial use in 740 Chinese hospitals in 2010124036
- 04 Study on resistant mechanism of two clinical strains of Enterobacter aerogenes to ertapenem122074
- 05 Distribution and antimicrobial resistance of major gram negative bacilli in ICU and non ICU wards in a grass roots hospital120001
- 06 Adverse drug reactions of ganciclovir in treating infants with cytomegalovirus hepatitis115255
- 07 Drug resistance and disinfectant resistant genes of Staphylococcus aureus from neonates at a neonatal ward114583
- 08 Monitoring on occupational exposure of health care workers at a general tertiary hospital110484
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Construction and performance of DeepSeek-based artificial intelligence judgement system for healthcare-associated infection
• FAN Pengchao, GAO Huacong, WANG Qian, LIU Xinyi, LIU Wenzhi
•2026,25(5):631-637 ,Doi: 10.12138/j.issn.1671-9638.20262906
Abstract:： Objective To construct an artificial intelligence (AI) judgement system for healthcare-associated infection (HAI) based on the DeepSeek large language model, evaluate its pe...Objective To construct an artificial intelligence (AI) judgement system for healthcare-associated infection (HAI) based on the DeepSeek large language model, evaluate its performance differences from traditional individual-based manual review. Methods A single-center retrospective study was conducted, medical records of discharged patients from the Second Hospital of Dalian Medical University between January and June 2025 were included for analysis, the blinded consensus of 5 senior infection control experts was used as the gold standard to judge HAI, the differences in sensitivity, specificity, accuracy, area under the curve (AUC), and Kappa values of the AI system and individual review were compared, subgroup analysis based on infection sites and error type categorization was also performed. Results According to the expert gold standard judgement, 136 cases were positive and 184 cases were negative for HAI in this study. The performance comparison showed that the AI system outperformed individual judgement in various performance indicators: sensitivity (92.6% vs 84.6%), accuracy (93.8% vs 89.1%), AUC (0.976 vs 0.897), and Kappa value (0.869 vs 0.776), with differences being statistically signi-ficant (all P<0.05). The sensitivity of the AI system to different infection sites remained above 94%, especially in bloodstream infection, which was significantly superior to manual review (94.7% vs 73.7%, P=0.044). Analysis of error types revealed that AI misjudgements were mainly caused by atypical clinical manifestations, while manual underreporting was often caused by negligence in reading medical records. Conclusion The DeepSeek-based AI judgement system for HAI demonstrates high judgement performance and stability, and can significantly improve the sensitivity and standardization of HAI recognition. The human-AI collaborative model of "AI initial screening-manual final review" can serve as an intelligent solution for HAI prevention and control. Show
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Application and effect of artificial intelligence technology in the management of surgical hand disinfection
• LYU Guiping, ZHANG Zixian, DENG Xueqin
•2026,25(5):638-644 ,Doi: 10.12138/j.issn.1671-9638.20263158
Abstract:： Objective To evaluate the application effect of artificial intelligence (AI) surgical hand disinfection monitoring system in healthcare workers (HCWs) in the operating room....Objective To evaluate the application effect of artificial intelligence (AI) surgical hand disinfection monitoring system in healthcare workers (HCWs) in the operating room. Methods 120 HCWs from the operating room of a tertiary first-class hospital in Zhejiang Province were selected as the research subjects,out of which 60 HCWs who adopted conventional surgical rinsing-free hand disinfection method from January to December 2023 were the control group, and implementation of surgical hand disinfection was monitored by on-site observation or video monitoring. Other 60 HCWs who adopted AI surgical hand disinfection process monitoring system from January to December 2024 served as the intervention group, AI was adopted for real-time monitoring and feedback. Hand bacterial colony forming unit (CFU), surgical hand disinfection status, and satisfaction between two groups of HCWs were compared. Results Bacterial CFU on the hands of both groups of HCWs met the national standard (≤ 5 CFU/cm2), intervention group was lower than control group, and the difference was statistically significant (P<0.05). The total correct rate of surgical hand disinfection process for HCWs in the intervention group was (97.69±2.46)%, which was higher than (91.94±5.92)% of control group, and the difference was statistically significant (P<0.05). The surgical hand disinfection time of intervention group was (232.42±29.89) seconds, which was longer than (158.12±47.43) seconds of control group. The qualified rate of surgical hand disinfection time of intervention group (98.33%) was higher than control group (76.67%); the satisfaction rate of HCWs towards surgical hand disinfection process in intervention group (98.33%) was higher than control group (86.67%); differences were all statistically significant (all P<0.05). Conclusion The AI surgical hand disinfection monitoring system can improve the efficiency of surgical hand disinfection management and the satisfaction of HCWs, and is an effective intelligent healthcare-associated infection control method. Show
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Application and evaluation of a large language model in the prevention and control of multidrug-resistant organism infection
• YU Han, WANG Lihua, YANG Ying, ZHENG Yi, HE Shuai, DIAO Yizhuo
•2026,25(5):645-651 ,Doi: 10.12138/j.issn.1671-9638.20263074
Abstract:： Objective To evaluate the knowledge capability of the large language model (LLM) ChatGPT-4o in the field of multidrug-resistant organism infection prevention and control, an...Objective To evaluate the knowledge capability of the large language model (LLM) ChatGPT-4o in the field of multidrug-resistant organism infection prevention and control, and explore its potential applications in healthcare-associated infection (HAI)control. Methods A professional knowledge question-and-answer dataset covering 5 categories (basic concept, transmission risk identification, infection control practice, antimicrobial stewardship, surveillance evaluation) was constructed based on guidelines and expert consensus. The dataset was input into ChatGPT-4o to generate responses. Four experts in the HAI management field evaluated the model’s output results using a 5-point Likert scale. The accuracy, completeness, and usability of LLM in the field of multidrug-resistant organism infection prevention and control were compared and analyzed. Results Among the 50 questions, ChatGPT-4o achieved an overall accuracy rate of 58.0%, a partially accuracy rate of 40.0%, and an inaccuracy rate of 2.0%. ChatGPT-4o performed best on "basic concept" questions, with an accuracy rate of 86.0%, and worst on "antimicrobial stewardship" questions, with an accuracy rate of 40.0%. The average scores for accuracy, completeness, and usability were 4.63, 4.70, and 4.57 points, respectively. Conclusion ChatGPT-4o demonstrates an excellent response capability for basic knowledge in the field of multidrug-resistant organism infection prevention and control. Although it has limitations such as content generalization and insufficient decision support ability in complex infection control situations, LLM in the field of HAI control has broad application prospects in the future. Show
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Effect of perioperative antimicrobial prophylaxis >48 hours on postoperative healthcare-associated infection in patients undergoing colorectal resection
• YANG Yujuan, BAO Zhenjie, ZHENG Shufang
•2026,25(5):652-664 ,Doi: 10.12138/j.issn.1671-9638.20262956
Abstract:： Objective To investigate the effect of perioperative antimicrobial prophylaxis (PAP)>48 hours on the incidence of surgical site infection (SSI) and other healthcare-associat...Objective To investigate the effect of perioperative antimicrobial prophylaxis (PAP)>48 hours on the incidence of surgical site infection (SSI) and other healthcare-associated infection (HAI) in patients undergoing colorectal resection. Methods A retrospective cohort study was adopted, patients who underwent colorectal resection in a hospital from March 1, 2023 to February 28, 2025 were included in analysis. According to whether PAP exceeded 48 hours, patients were divided into a ≤48 hour group and a >48 hour group. The main outcome was the incidence of SSI, and the secondary outcome was the incidence of other HAI. Multivariate logistic regre-ssion analysis was adopted to evaluate the association between prolonged antimicrobial use and infection outcome, and potential confounding factors were adjusted. Results A total of 1 904 patients were included in analysis. There were 1 260 cases in PAP≤48 hour group and 644 cases in PAP>48 hour group; 163 patients had SSI, the overall incidence of SSI was 8.56% (n=163). There was no significant difference in the incidence of SSI between patients in PAP>48 hour group and PAP≤48 hour group (8.70% vs 8.49%), without statistically significant difference (P>0.05). The incidence of other HAI in patients in PAP≤48 hour group was higher than that in PAP>48 hour group (10.63% vs 7.76%), with a statistically significant difference (P<0.05). Multivariate logistic regression analysis showed that after adjusting age, sex, history of diabetes, history of hypertension, anemia and hypoproteinemia, PAP>48 hours was not an influencing factor for SSI (OR=1.15, 95%CI: 0.81-1.62, P=0.438) and other HAI (OR=0.83, 95%CI: 0.58-1.17, P=0.283). After further adjusting all confounding factors, the results still showed that PAP>48 hours was not an influencing factor for SSI (OR=1.35, 95%CI: 0.77-2.34, P=0.292) and other HAI (OR=1.73, 95%CI: 0.98-3.08, P=0.060). Conclusion PAP>48 hours of colorectal resection has limited effect on reducing the incidence of SSI and other HAI, so prolonging PAP to reduce the risk of HAI after colorectal resection is not supported. Show
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Epidemiological and clinical characteristics of hospitalized patients with co-infection of HIV and non-tuberculous Mycobacteria in Kashgar: a retrospective analysis
• ZULIPIYA·Moming, ABUDUWALI·Shayipu, WU Jing
•2026,25(5):665-674 ,Doi: 10.12138/j.issn.1671-9638.20262977
Abstract:： Objective To investigate non-tuberculous mycobacterial (NTM) infection in hospitalized patients with human immunodeficiency virus (HIV) infection in Kashgar region, providin...Objective To investigate non-tuberculous mycobacterial (NTM) infection in hospitalized patients with human immunodeficiency virus (HIV) infection in Kashgar region, providing evidence for early identification and treatment. Methods Data on HIV-infected and non-HIV-infected hospitalized patients with suspected pulmonary tuberculosis and admitted to the First People’s Hospital of Kashi during the same period from January 2020 to June 2025 were analyzed retrospectively. Based on infection types, patients were divided into several groups: HIV co-infected with Mycobacterium tuberculosis (MTB) (HIV/MTB group), HIV co-infected with NTM (HIV/NTM group), non-HIV-infected individuals co-infected with MTB (non-HIV/MTB group), and non-HIV-infected individuals co-infected with NTM (non-HIV/NTM group). Respiratory specimen detection results, clinical symptoms and signs, imaging and laboratory examination indicators, as well as the all-cause mortality during the follow-up period among different groups of patients were compared. The data were analyzed using statistical software SPSS 26.0 and GraphPad Prism 9.0. Results A total of 944 HIV-infected patients were included in the analysis. Respiratory specimens from 152 cases were positive for Mycobacteria, including 141 cases of MTB (92.76%) and 11 cases of NTM (7.24%). Among the 800 non-HIV-infected hospitalized patients with suspected pulmonary tuberculosis during the same period, 440 respiratory specimens were positive for Mycobacteria, including 427 cases (97.05%) of MTB and 13 cases (2.95%) of NTM. NTM positive rate in HIV-infected patients was higher than that in non-HIV-infected patients (P<0.05). Compared with patients in the HIV/MTB group, those in the HIV/NTM group exhibited more cough (81.82% vs 47.52%, P=0.03) and lymphadenopathy (81.82% vs 35.46%, P<0.01), lower CD4+T lymphocyte counts (65.00 cells/μL vs 171.00 cells/μL, P=0.04), lower CD4+/CD8+ratios (0.13 vs 0.37, P<0.01), higher serum albumin (38.10 g/L vs 32.00 g/L, P<0.01), higher nodule rate (72.73% vs 22.70%, P<0.01), and more emphysema (36.36% vs 11.35%, P=0.01). Conclusion In Kashgar region, NTM positive rate among hospitalized HIV-infected patients is higher than that in non-HIV-infected patients. HIV patients co-infected with NTM exhibit more severe immune dysfunction, with higher incidences of cough, lymphadenopathy, emphysema, and pulmonary nodules, as well as elevated all-cause mortality. These clinical features can serve as early identification reference indicators for HIV/NTM co-infection. Show
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Effect of fluorescence labelling combined with comprehensive intervention measures on the cleaning of high-touch object surfaces in key departments
• HUANG Shuai, DUAN Hongjian, YANG Jianxiu, LI Xuping
•2026,25(5):675-681 ,Doi: 10.12138/j.issn.1671-9638.20263144
Abstract:： Objective To evaluate the effect of fluorescence labelling combined with comprehensive intervention measures such as training and supervision on the cleaning of high-touch o...Objective To evaluate the effect of fluorescence labelling combined with comprehensive intervention measures such as training and supervision on the cleaning of high-touch object surfaces in key departments, and explore its effectiveness in the prevention and control of healthcare-associated infection (HAI) and multidrug-resistant organism (MDRO) infection. Methods A before-and-after controlled study was conducted on eight key departments (intensive care unit[ICU], operating room, hemodialysis unit, neonatal ward, stomatology department, neurosurgery ICU, cardiovascular surgery ICU, and cardiac intensive care unit[CCU])in Laizhou City People’s Hospital from March to November 2024. Before intervention (March-May, 2024), 644 high-touch object surfaces were labelled with fluorescence by a single-blind method, the clearance rate of fluorescence labelling was detected. During the intervention period (June-August, 2024), comprehensive measures, including staff training, optimizing cleaning procedures, and enhancing supervision, were implemented. After intervention (September-November, 2024), 826 object surfaces were re-detected, and data on the incidence rates of HAI and MDRO HAI were collected from the HAI surveillance system for comparative analysis. Results After intervention, the overall clearance rate of fluorescence labelling increased from 55.59% (358/644) to 77.48% (640/826), and the difference was statistically significant (χ2=79.56, P<0.001). The clearance rates of fluorescence labelling in various departments and most object surfaces improved significantly. The incidence rates of HAI before and after the intervention were 2.53% and 1.87%, respectively, with no statistically significant difference (χ2=1.20, P>0.05), only the incidence rate of HAI in CCU decreased from 2.23% to 0.54%, and the difference was statistically significant (P<0.05). The incidence of MDRO HAI in departments with high MDRO detection rates (such as ICU and neurosurgery ICU) did not show significant changes (P>0.05). Conclusion The combination of fluorescence labelling and comprehensive intervention measures can objectively evaluate and significantly improve the quality of environmental cleanliness, but the prevention and control effect on HAI and MDRO HAI is not obvious. Integration of bundle management strategies (including MDRO active screening, contact isolation, hand hygiene, and rational use of antimicrobial agents) is suggested for achieving precise infection prevention and control. Show
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Construction of surgical site infection risk prediction model and its application effect in perioperative infection prevention and control
• TAN Fengling, LI Yuejuan, ZHANG Bei, WANG Shuqi, GUO Zhening, ZHANG Mingxia, ZHAO Kui
•2026,25(5):682-690 ,Doi: 10.12138/j.issn.1671-9638.20263169
Abstract:： Objective To explore the application effect of constructing a surgical site infection (SSI) prediction model in perioperative infection prevention and control management in ...Objective To explore the application effect of constructing a surgical site infection (SSI) prediction model in perioperative infection prevention and control management in a tertiary general hospital. Methods A two-stage research design was adopted. Stage 1 (retrospectively constructing model): 50 021 hospitalized patients who underwent surgery from January 2019 to December 2022 were included to establish SSI risk prediction model. Stage 2 (prospectively evaluating intervention): 49 260 patients who underwent surgery from January to December 2023 were selected as the pre-intervention group, and 56 463 patients who underwent surgery from January to December 2024 were selected as the post-intervention group, effect of perioperative infection control intervention was evaluated. Statistical analysis of SSI relevant indicators before and after intervention was conducted. Results Among 50 021 cases in the modeling group, the incidence of SSI was 0.48% (n=242). Multivariate logistic regression analysis showed that surgical duration ≥60 minutes, preoperative length of hospital stay ≥7 days, incision type (class II, III), ASA grading (class III/IV), and preoperative peripheral white blood cell count>10×109/L were all independent risk factors for SSI (all P<0.05). The area under the receiver operating characteristic curve (AUC) of this prediction model was 0.783 (95%CI: 0.712-0.854), and its predictive performance was significantly better than any single variable. After the intervention, the overall SSI incidence and SSI incidence of patients with selective surgery, class III incision, and aged≥ 60 years were all lower than those before the intervention, differences were all statistically significant (all P<0.05). The qualified rates of preoperative hospitalization days, 0.5-1 hours preoperative antimicrobial administration, preoperative hand-washing, intraoperative heat preservation, sterile operation of postoperative dressing change, as well as object surface cleaning and disinfection after intervention were all higher than those before intervention, and the differences were all statistically significant (all P<0.05). Conclusion The application of prediction model can identify high-risk surgical patients early, improve the implementation rate of core infection control measures, and effectively reduce the incidence of SSI. Show
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Inhibition of proliferation of Candida by Escherichia coli ΔtbpA mutant strain and its mechanism
• HAN Zibing, MAO Jiayi, MAO Shanshan, ZHANG Yu, XIA Chuan, CHEN Feipeng, CUI Huiyue, LI Ying
•2026,25(5):691-699 ,Doi: 10.12138/j.issn.1671-9638.20262237
Abstract:： Objective This study aimed to evaluate the antifungal efficacy and mechanism of Escherichia coli (E. coli) ΔtbpA mutant strain, providing experimental support for its use as...Objective This study aimed to evaluate the antifungal efficacy and mechanism of Escherichia coli (E. coli) ΔtbpA mutant strain, providing experimental support for its use as a novel antifungal treatment strategy. Methods E. coli ΔtbpA was cultured, and its cell-free supernatant (CFS) was collected and filtered. Effect of CFS on Candida was analyzed through time-growth curve. The proliferation of Candida during co-culture with E. coli ΔtbpA was detected by plate counting. The adhesion ability of E. coli ΔtbpA and its tolerance to artificial gastric and intestinal fluids were detected, and its probiotic properties were explored. Its in vivo antifungal effect was evaluated by Caenorhabditis elegans-Candida albicans (C. albicans) infection model. The antifungal active ingredients in CFS were explored through Transwell chamber assay as well as enzyme/heat treatment experiments.Results The time-growth curve and co-culture experiment results indicated that E. coli ΔtbpA could significantly inhibit the proliferation of Candida. The survival time of C. albicans-infected Caenorhabditis prolonged significantly after feeding with E. coli ΔtbpA. E. coli ΔtbpA could tolerate artificial gastrointestinal fluid environment. Transwell chamber assay and enzyme/heat treatment results showed that its antifungal effect depended on the secreted protease-sensitive and heat-resistant substances. Conclusion E. coli ΔtbpA mutant strain inhibits Candida proliferation by secreting protein-like active substances, and has good adhesion ability and tolerance to artificial gastrointestinal fluid. It is expected to be used as a probiotic for the treatment of Candida infection. Show
KeyWord：Candida albicans;Escherichia coli;ΔtbpA mutation;antifungal activity;adhesion
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Exploring infection prevention and control based on HFMEA: reflections based on a hemodialysis patient with HIV antibody seroconversion
• JIANG Zhengyang, LIU Ting, GONG Yanyan, JIANG Ting
•2026,25(5):700-704 ,Doi: 10.12138/j.issn.1671-9638.20267407
Abstract:： Objective To analyze and rectify the potential risk points in each stage of hemodialysis operation process through healthcare failure mode and effect analysis (HFMEA), and v...Objective To analyze and rectify the potential risk points in each stage of hemodialysis operation process through healthcare failure mode and effect analysis (HFMEA), and verify the effectiveness of its application. Methods Based on the infection risk of hemodialysis exposed to a patient who had human immunodeficiency virus antibody (HIV antibody) seroconversion after hemodialysis, potential failure points in the process of connecting and disconnecting the dialyzer of hemodialysis operation were assessed with HFMEA, the causes were analyzed, and improvement measures were implemented. The compliance rate of hand hygiene before and after the implementation of measures, the incidence of blood splashing during arteriovenous fistula puncture, incidence of blood splashing during unloading of hemoperfusion devices, and the rate of non-standard wiping for machines before and after implementation of measures were compared. Results The compliance rate of hand hygiene increased from 58.25% before implementation to 90.82%, the incidence of blood splashing during arteriovenous fistula puncture decreased from 13.22% to 0.81%, the incidence of blood splashing during unloading of hemoperfusion devices decreased from 93.00% to 0, and the rate of non-standard wiping for machine surfaces decreased from 36.92% to 4.07%, and all differences were statistically significant (all P<0.05). Conclusion The improvement measures based on the risk points identified by HFMEA are highly targeted and remarkably effective, and can significantly reduce the risk of infection in hemodialysis operations. Show
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Changing trend of temporal and spatial distribution of AIDS incidence rates in China from 2002 to 2022 and prediction analysis based on ARIMA model
• ZHANG Junchao, LAN Yi, WANG Hanwei, LEI Chunyan, LUAN Zemin
•2026,25(5):705-715 ,Doi: 10.12138/j.issn.1671-9638.20263080
Abstract:： Objective To analyze the incidence trend and temporal and spatial distribution characteristics of acquired immunodeficiency syndrome (AIDS) in 31 provinces (autonomous regio...Objective To analyze the incidence trend and temporal and spatial distribution characteristics of acquired immunodeficiency syndrome (AIDS) in 31 provinces (autonomous regions, municipalities) in China, and to predict the incidence rates of AIDS from 2023 to 2030, thereby providing a theoretical basis for AIDS prevention and control. Methods Based on the data of AIDS incidence rates of 31 provinces (autonomous regions, municipalities) in China from 2002 to 2022, the temporal distribution characteristics were analyzed by Joinpoint software. Global and local spatial autocorrelation analysis was conducted with ArcGIS software to identify the characteristics of epidemic clustering, temporal and spatial scanning analysis was conducted with SaTScan 10.2.5 software to clarify the temporal and spatial distribution clustering of AIDS epidemic. The ARIMA model was constructed through SPSS software to predict the incidence rates of AIDS from 2023 to 2030. Results The incidence rates of AIDS in China presented an increasing trend year by year from 2002 to 2019, but decreased from 2020 to 2022. The incidence rates of AIDS randomly distributed from 2002 to 2006, but were clustered from 2007 to 2022. The high-incidence areas were mainly concentrated in southwest China, such as Yunnan Province, Guangxi Zhuang Autonomous Region, and Guizhou Province. From 2013 to 2022, Yunnan Province, Guizhou Province, Sichuan Province, Guangxi Zhuang Autonomous Region and Chongqing City were the first clustering areas of AIDS. The ARIMA model prediction based on the national incidence data from 2002 to 2022 showed that the incidence rates from 2023 to 2030 would be 3.86/100 000, 4.02/100 000, 4.19/100 000, 4.35/100 000, 4.52/100 000, 4.68/100 000, 4.85/100 000, and 5.01/10 000, respectively. In the first-class clustering area, the incidence rates in Yunnan Province, Guizhou Province, Guangxi Zhuang Autonomous Region and Chongqing City increased year by year, Sichuan Province showed a fluctuating upward trend, the incidence of AIDS in Sichuan Province was expected to reach 27.89/100 000 by 2030. Conclusion The incidence rates of AIDS in China generally present an increasing trend year by year, and the incidence pattern has changed from sporadic to cluster distribution, southwest China presents high cluster distribution area, which may expand outward year by year. ARIMA model has certain reference value for the prediction of AIDS epidemic trend. It is suggested that future prevention and control work should focus on strengthening medical resource investment in clustering areas and surrounding provinces, and enhancing intervention measures for high-risk populations. Show
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Application of failure mode and effect analysis combined with multidrug-resistant organism active screening in the prevention and control of healthcare-associated infection in neurology intensive care unit
• LI Fengrong, YAN Xiaoli, LU Sijia, ZHAO Jiazhe, LIU Qiong
•2026,25(5):716-723 ,Doi: 10.12138/j.issn.1671-9638.20263005
Abstract:： Objective To explore the application effectiveness of failure mode and effect analysis (FMEA) combined with multidrug-resistant organism (MDRO) active screening in healthcar...Objective To explore the application effectiveness of failure mode and effect analysis (FMEA) combined with multidrug-resistant organism (MDRO) active screening in healthcare-associated infection (HAI) control in the neurology intensive care unit (ICU). Methods Combined with the actual clinical situation of neurology ICU, risk priority events were identified by FMEA risk assessment method, and continuous improvement measures were formulated. Combined with MDRO active screening, effectiveness of HAI prevention and control before and after the implementation of FMEA risk assessment as well as before and after combining active screening was compared. Results After the implementation of the FMEA risk assessment, hand hygiene compliance rate increased from 68.78% to 85.02%, detection rate of MDRO decreased from 39.47% to 25.51%, both with statistically significant difference (both P<0.001). The case incidence of HAI, incidence of ventilator-associated pneumonia, and case incidence of MDRO HAI all decreased, but the differences were not statistically significant (all P>0.05). After combining MDRO active screening, MDRO detection rate presented a decreasing trend, with statistically significant differences (P<0.001). Conclusion The combination of FMEA risk assessment and MDRO active screening can effectively reduce the case incidence of HAI and case incidence of MDRO HAI in the neurology ICU. Show
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Correlation between biofilm formation, expression of outer membrane protein OmpA/CarO and carbapenem resistance of Acinetobacter baumannii
• DONG Yao, GUAN Lina, WANG Chaoli, FENG Li, XIE Yongen
•2026,25(5):724-729 ,Doi: 10.12138/j.issn.1671-9638.20263221
Abstract:： Objective To investigate the biofilm formation and expression of outer membrane proteins OmpA and CarO of Acinetobacter baumannii (A. baumannii), as well as their correlatio...Objective To investigate the biofilm formation and expression of outer membrane proteins OmpA and CarO of Acinetobacter baumannii (A. baumannii), as well as their correlation with resistance to carbapenem antibiotics. Methods The crystal violet staining method was used for qualitative and quantitative detection of biofilm forming ability of clinically isolated A. baumannii. The minimum inhibitory concentration (MIC) and minimum biofilm inhibitory concentration (MBIC) of imipenem against the strains were determined by the microdilution broth method. MBIC/MIC values were calculated, difference in drug resistance of bacterial strains in planktonic and biofilm conditions was compared. Total RNA was extracted from imipenem-resistant strains in two conditions, the relative expression levels of outer membrane protein OmpA and CarO genes were detected with fluorescence quantitative polymerase chain reaction (qPCR), and their potential impact on carbapenem resistance of A. baumannii was analyzed. Results Among the 108 A. baumannii strains, the detection rate of imipenem-resistant strains was 61.1%, detection rate of biofilm-positive strains was 93.5%, out of which 44 (43.6%), 45 (44.5%) and 12 (11.9%) strains showed weak, moderate and strong biofilm positivity, respectively. MBIC/MIC value analysis revealed that, regardless of whether the strains were resistant or sensitive, their resistance all increased after forming biofilm: for imipenem-resistant strains, most showed a 4- to 8-fold increase in resistance, while sensitive strains exhibited a 2- to 4-fold increase. Fluorescence qPCR showed that compared with the planktonic condition, the expression of outer membrane protein OmpA in A. baumannii increased significantly under biofilm condition (t=5.385, P<0.001), the expression of outer membrane porin protein CarO decreased significantly (t=-4.359, P<0.001).Conclusion The formation of biofilm can increase the carbapenem resistance of A. baumannii. The up-regulation of OmpA expression and down-regulation of CarO expression may be one of the key mechanisms of the increase of resistance. Show
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Exploration and practice of the whole-course management model for hepatitis C based on a multidisciplinary collaboration and an anti-HCV antibody-positive early warning platform
• WU Shasha, ZHONG Qianmei, GAN Haoyue, XIE Junhua, CHEN Xi, DU Ningli, KOU Guoxian, DAI Xiaoyu
•2026,25(5):730-737 ,Doi: 10.12138/j.issn.1671-9638.20263204
Abstract:： Objective To explore a multidisciplinary collaborative whole-course management model for hepatitis C based on an anti-hepatitis C virus (anti-HCV) antibody-positive early wa...Objective To explore a multidisciplinary collaborative whole-course management model for hepatitis C based on an anti-hepatitis C virus (anti-HCV) antibody-positive early warning platform, and provide reference for formulating strategies to eliminate the public health hazards of HCV. Methods The relevant data of patients who received HCV screening in a tertiary first-class general hospital from January 2023 to December 2024 were analyzed retrospectively. The 2023 data was the baseline data, and the 2024 data were data from the full-course management model. The HCV-related screening, diagnosis, treatment, and follow-up data were analyzed. HCV RNA detection rate, referral rate, antiviral treatment rate, follow-up rate, and cure rate were used as evaluation indicators. Results After the implementation of whole-course management, HCV RNA detection rate (90.67% vs 78.74%) and referral rate (80.39% vs 58.00%) improved, with statistically significant differences (both P<0.05). Antiviral treatment rate remained relatively stable (84.62% vs 78.57%), with no statistically significant difference (P=0.332). After implementing the whole-course management model, the differences in the 4-week follow-up rate (80.30% vs 56.06%), 12-week follow-up rate (90.91% vs 59.09%), and 24-week follow-up rate (89.39% vs 51.52%) after treatment all enhanced (all P<0.05). The cure rate remained above 95%. Conclusion This study relies on the anti-HCV antibody-positive early warning platform and multidisciplinary collaboration mechanism to implement a whole-course management model covering "screening-diagnosis-treatment-following-up" for hepatitis C, explores the closed-loop management of hepatitis C cases from discovery to cure, effectively enhanced the HCV RNA detection rate, referral rate, and follow-up rate, stabilized the antiviral treatment rate and cure rate, and has promotional value. Show
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Evaluation of the detection performance of fluorescent PCR-melting curve method in detecting the resistance of Mycobacterium tuberculosis complex to isoniazid and fluoroquinolones
• WAN Xiaojie, GUO Jingwei, WANG Jue, DUAN Jie, ZHONG Biao, LIU Binbin
•2026,25(5):738-743 ,Doi: 10.12138/j.issn.1671-9638.20262972
Abstract:： Objective To evaluate the application value of a novel fluorescent polymerase chain reaction (PCR)-melting curve method (referred to as "melting curve method") in detecting ...Objective To evaluate the application value of a novel fluorescent polymerase chain reaction (PCR)-melting curve method (referred to as "melting curve method") in detecting the resistance of Mycobacterium tuberculosis complex (MTBC) to isoniazid (INH) and fluoroquinolones (FQS). Methods Sputum specimens from hospitalized patients with pulmonary tuberculosis in Hunan Chest Hospital from April to October 2024 were collected prospectively. According to inclusion and exclusion criteria, 231 pathogenic positive specimens from tuberculosis patients were selected for Sanger sequencing, BACTEC MGIT 960 (referred to as "MGIT 960") liquid culture and phenotypic drug susceptibility testing, INH and FQS resistance-related gene mutations were detected with melting curve method, 28 specimens with negative melting curve results were excluded. A total of 203 MTBC-positive specimens were finally included in the analysis. Sanger sequencing and phenotype drug susceptibility results were taken as reference standards, respectively, the sensitivity, specificity, positive predictive value, and negative predictive value of the melting curve method for detecting INH and FQS resistance were calculated, consistency of the two was analyzed (kappa test). Results Taking Sanger sequencing as a reference standard, the sensitivity of the melting curve method in detecting MTBC resistance to INH and FQS was 97.92% (95%CI: 89.11%-99.63%) and 100% (95%CI: 88.97%-100%), respectively, the specificity was 100% (95%CI: 97.47%-100%) and 100% (95%CI: 97.72%-100%), respectively. The two methods showed high consistency (kappa values were 0.986 and 1.000, respectively). Taking phenotype drug susceptibility testing as a reference standard, the sensitivity of the melting curve method in detecting MTBC resistance to INH and FQS was 96.67% (95%CI: 83.33%-99.41%) and 94.44% (95%CI: 74.24%-99.01%), respectively, the specificity was 98.55% (95%CI: 92.24%-99.74%) and 97.53% (95%CI: 91.44%-99.32%), respectively. The two methods showed high consistency (kappa values were 0.952 and 0.900, respectively). Conclusion The melting curve method has high sensitivity and specificity in detecting INH and FQS drug-resistant mutations, which is of great value for the early and rapid diagnosis of drug-resistant tuberculosis. Show
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Impact of healthcare-associated infection on the medical expenses of inpatients in the neurology department: an empirical study based on propensity score matching
• ZHANG Cheng, WANG Keke, QIU Lijun, JIANG Liangzhi, ZHANG Yun
•2026,25(5):744-749 ,Doi: 10.12138/j.issn.1671-9638.20267405
Abstract:： Objective To explore the impact of healthcare-associated infection(HAI) on the medical expenses of inpatients in the neurology department, and provide scientific basis for o...Objective To explore the impact of healthcare-associated infection(HAI) on the medical expenses of inpatients in the neurology department, and provide scientific basis for optimizing infection prevention and control strategies. Methods A total of 23 541 inpatients in the neurology department of a tertiary hospital in Shanghai from January 2017 to December 2024 were selected as the research subjects. According to whether HAI occurred, patients were divided into HAI group (n=643) and control group (n=22 898). Propensity score matching (PSM) method was adopted for 1∶1 matching, differences in total hospitalization expenses and each category of expenses between two groups after matching were analyzed. Results Among 23 541 inpatients in the neurology department, 643 (2.73%) had HAI. The main infection site was respiratory tract (n=488, accounting for 75.89%). Before matching, the average total hospitalization expense for the infection group was 50 587.14 Yuan (median of 28 550.67 Yuan), while the control group was 21 597.51 Yuan (median of 15 928.10 Yuan). After matching, the medians of expenses of total hospitalization, nursing, antimicrobial use, hospitalization drug use, and hospitalization consumables in the infection group were all higher than those in the control group, and the differences were all statistically significant (all P<0.001). Conclusion HAI significantly increase the medical expenses of inpatients in the neurology department. Targeted infection prevention and control measures should be adopted to reduce the disease burden. Show
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A case-control study on the relationship between use of proton pump inhi-bitors and healthcare-associated infection
• DUAN Kaiyue, ZHANG Xiaoliang, YAO Chenghong, LIANG Yan, LI Lin, YAO Zi-yan, FENG Yujuan, ZHANG Haojun
•2026,25(5):750-755 ,Doi: 10.12138/j.issn.1671-9638.20267403
Abstract:： Objective To evaluate the relationship between the use of proton pump inhibitors (PPIs) and the occurrence of healthcare-associated infection (HAI)in hospitalized patients, ...Objective To evaluate the relationship between the use of proton pump inhibitors (PPIs) and the occurrence of healthcare-associated infection (HAI)in hospitalized patients, providing a theoretical basis for the prevention and control of HAI. Methods HAI cases reported from 3 public hospitals of different classes in Gansu Province between January 2023 and December 2024 were selected as the case group. The stratified random sampling method was adopted, the case group was divided into four levels based on the Charlson comorbidity index (CCI). An equal number of cases without HAI during the same period were selected as control group through CCI stratification, and a retrospective case-control study was conducted. The risk factors for HAI as well as the dose-response relationship between duration of PPI use and HAI occurrence were explored. Results The use rate of PPIs in patients in the case group was higher than that in the control group (45.36% vs 29.57%), with a statistically significant difference (P<0.001, OR=1.98). Multivariate logistic regression results indicated that the adjusted OR value for use of PPIs was 1.78 (P<0.001), its infection risk was comparable to that of invasive procedures such as urinary catheterization. The median duration of PPI use in patients in the case group was 9 days, which was longer than the 8 days in the control group (P<0.001). An extension of duration of PPI use and increasing of infection risk presented a dose-response relationship (OR=4.59 when the duration of PPI use exceeded 14 days). Additionally, the proportion of oral combined with intravenous administration in patients in the case group was higher than that in the control group, and urinary catheterization and central venous catheterization also increased the risk of HAI (all P<0.05). Conclusion The use of PPIs in hospitalized patients can increase the risk of HAI, and this risk rises with prolonged medication duration. Factors such as administration method, length of hospital stay, as well as urinary catheterization and central venous catheterization also impact the occurrence of HAI. Show
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Distribution and antimicrobial resistance of pathogens causing bloodstream infection in Lhasa City
• CIREN Yangjin, LIU Zhijuan, GASONG Zhuoga, PU Yuxi, BIAN Zhen, YIXI Jinba, WANG Jingyi
•2026,25(5):756-762 ,Doi: 10.12138/j.issn.1671-9638.20262953
Abstract:： Objective To understand the distribution and antimicrobial resistance of pathogens from patients with bloodstream infection (BSI) in Lhasa City, and to provide basis for ant...Objective To understand the distribution and antimicrobial resistance of pathogens from patients with bloodstream infection (BSI) in Lhasa City, and to provide basis for antimicrobial use in clinical practice. Methods The distribution and antimicrobial resistance results of pathogens isolated from blood culture specimens from the Tibet Autonomous Region People’s Hospital from July 2019 to October 2024 were analyzed retrospectively. Results A total of 24 597 blood specimens were cultured and identified, 1 097 strains of pathogens were isolated, with an overall positive rate of 4.5%. Gram-positive bacteria, Gram-negative bacteria, and fungi were 626, 442, and 29 strains, respectively, accounting for 57.1%, 40.3%, and 2.6%. The detection rates of methicillin-resistant Staphyloco-ccus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) were 45.1% and 83.5%, respectively. Among the isolated Staphylococcus aureus and coagulase-negative Staphylococcus (CNS), there were no vancomycin- and linezolid-resistant strains. Among Escherichia coli and Klebsiella pneumoniae, detection rates of extended-spectrum β-lactamases (ESBLs)-producing strains were 59.3% and 35.0%, respectively. The detection rate of carbapenem-resistant Enterobacterales was low, with a detection rate of 2.4%. Conclusion Antimicrobial spectrum of pathogens detected from blood culture is broad, and there are significant differences in antimicrobial resistance among different pathogens. Surveillance should be strengthened, and antimicrobial use should be standardized. Show
KeyWord：bloodstream infection;pathogen;antimicrobial resistance;Lhasa
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Two cases of pulmonary nocardiosis secondary to influenza A
• LIU Wei, PAN Sufei, WANG Chuanhai
•2026,25(5):763-766 ,Doi: 10.12138/j.issn.1671-9638.20263031
Abstract:： Pulmonary nocardiosis is a pulmonary infectious disease caused by Nocardia, it is commonly occurred in immunocompromised hosts and patients with structural pulmonary diseases, the ...Pulmonary nocardiosis is a pulmonary infectious disease caused by Nocardia, it is commonly occurred in immunocompromised hosts and patients with structural pulmonary diseases, the clinical manifestations are similar to those of pneumonia caused by other pathogens, and a confirmed diagnosis requires pathogenic evidence. Influenza can affect the lower respiratory tract and cause secondary bacterial pneumonia, but secondary pulmonary nocardiosis has rarely been reported. This paper reports the clinical data of two patients with pulmonary nocardiosis secondary to influenza, summarizes the clinical manifestations, diagnosis and treatment process, and prognosis, with the aim to enhance clinicians’ understanding on this disease. Show
KeyWord：influenza;pulmonary nocardiosis;targeted high-throughput sequencing
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Subdural hematoma caused by Mycoplasma hominis infection: a rare case report
• MA Guomei, JI Ye, WANG Yali, HAN Jingzhe
•2026,25(5):767-769 ,Doi: 10.12138/j.issn.1671-9638.20263040
Abstract:： Mycoplasma hominis (M. hominis) central nervous system (CNS) infection is mainly manifested clinically as encephalitis, meningitis or brain abscess, but the manifestation of subdur...Mycoplasma hominis (M. hominis) central nervous system (CNS) infection is mainly manifested clinically as encephalitis, meningitis or brain abscess, but the manifestation of subdural hematoma is rare, which can be easily misdiagnosed. This paper reports a case of a 32-year-old female who developed fever, headache, and hemiplegia after cesarean section. Imaging examination revealed both subdural hematoma and meningoencephalitis. The diagnosis was confirmed through detection of M. hominis by metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF). After targeted anti-infective treatment, the patient recovered. This case suggests that for infection cases presenting with subdural hematoma without obvious trauma, M. hominis should be as an important differential pathogen, and mNGS is a key technique for clarifying such diagnosis. Show
KeyWord：M. hominis;central nervous system infection;subdural hematoma;mNGS
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Advances in the application of artificial intelligence in AIDS prevention
• SHADIYEMU·Tuerxun, YUAN Su'e, WU Mingzhe, ZHAI Mimi, LEI Xianyang, LI Yamin, LIU Yiting, LI Yunxia
•2026,25(5):770-776 ,Doi: 10.12138/j.issn.1671-9638.20263357
Abstract:： Acquired immunodeficiency syndrome (AIDS) is one of the major public health challenges in China, and the current prevention and control efforts have shifted towards the "prevention...Acquired immunodeficiency syndrome (AIDS) is one of the major public health challenges in China, and the current prevention and control efforts have shifted towards the "prevention first" precision intervention. Artificial intelligence (AI) offers new opportunities to reform traditional prevention modes. This paper summarizes the advances in the application of AI in AIDS prevention, focuses on analyzing the current situation of technologies, including machine learning and deep learning, in research and development of tools for risk prediction and intelligent intervention, explores the existing challenges such as interpretability, data privacy, and algorithm fairness, looks forward to the future direction, with a view to providing reference for promoting the deep integration of AI and AIDS prevention field. Show
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Research progress on algorithm-driven personalized intervention in HIV prevention and management
• LI Ting, CHEN Siyi, HE Jiaxin, HAO Qin, WANG Shanshan, HOU Yuyang, SU Xinyi
•2026,25(5):777-784 ,Doi: 10.12138/j.issn.1671-9638.20264252
Abstract:： Algorithm-driven personalized intervention, capable of being precisely tailored to individual needs and offering the advantage of scalable implementation, has emerged as an importa...Algorithm-driven personalized intervention, capable of being precisely tailored to individual needs and offering the advantage of scalable implementation, has emerged as an important research direction in the field of human immunodeficiency virus (HIV) prevention and treatment. This paper systematically reviews the application progress of this intervention model in the field of HIV prevention and management, elaborates on the development process, design framework, and typical application scenarios of three major models: computer-tailored intervention, just-in-time adaptive intervention, and artificial intelligence (AI)-driven personalized intervention. Concurrently, it explores existing practical challenges and future trends, aiming to provide references for relevant theoretical research and localized applications in China. Show
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Research advances in the integration and optimization of multimodal diagnostic strategies for periprosthetic joint infection following joint arthroplasty
• ZHAI Jianhui, ZHANG Yumin, WANG Tao, LIU Rui
•2026,25(5):785-792 ,Doi: 10.12138/j.issn.1671-9638.20262805
Abstract:： Periprosthetic joint infection (PJI) is a serious complication following joint arthroplasty, posing cha-llenges to early diagnosis due to atypical clinical manifestations and biofi...Periprosthetic joint infection (PJI) is a serious complication following joint arthroplasty, posing cha-llenges to early diagnosis due to atypical clinical manifestations and biofilm formation. This paper systematically reviews advances in the integration and optimization of multimodal diagnostic strategies for PJI. In terms of pathogen detection, the key factors for improving pathogen detection rate include optimizing sampling methods, standardizing antimicrobial use, as well as enhancing specimen processing techniques (such as sonication and dithiothreitol treatment) and optimizing cultivation conditions. In terms of biomarkers, the specificity of conventional inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) is limited, while interleukin-6(IL-6) in synovial fluid demonstrates higher diagnostic value and often requires combined detection with D-dimer. The diagnostic accuracy of α-defensin and D-dimer in arthroplasty still needs further verification; The clinical value of procalcitonin (PCT) and D-lactate needs further research support. In terms of imaging, ultrasonography (US), X-ray and computed tomography (CT) have lower costs but their diagnostic efficacy is limited; MRI has high soft-tissue resolution, but is susceptible to metal artifacts; Positron emission tomography/CT(PET/CT) has excellent diagnostic performance, but the cost is high. In terms of molecular biology techniques, polymerase chain reaction (PCR) enables rapid detection, but its sensitivity is insufficient; metagenomic next-generation sequencing (mNGS) shows significant advantages in complex infections, but high cost remains a barrier to widespread promotion. Future research should focus on standardizing processes for pathogen detection, exploring novel biomarkers, establishing multi-indicator combination models, improving imaging techniques, controlling costs of molecular diagnosis, and establishing a multidisciplinary integrated diagnostic system, so as to achieve early and accurate diagnosis of PJI. Show
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• ZHANG Shu min, RAN Su ping, ZHOU Wen jing, HE Yu, CUI Huan huan，LIU Lan rong, JIA Xi
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competent authorities：Ministry of Education of the People's Republic of China
Unit：Central South University, Xiangya Hospital of Central South University
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