Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central ne...Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.展开更多
Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcu...Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcus,it is often overlooked in clinical practice.[1]However,in recent years,the incidence of mucormycosis has increased worldwide,potentially correlating with the growing population of diabetic patients.展开更多
Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative ...Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.展开更多
BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological ...BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.展开更多
BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
This study focuses on the detection of infection sources in dynamic networks,which is very important for network analysis,cybersecurity,and public health.We aim to improve source detection in complex networks using da...This study focuses on the detection of infection sources in dynamic networks,which is very important for network analysis,cybersecurity,and public health.We aim to improve source detection in complex networks using data,computational advances,and machine learning to improve epidemic response and public health protection.We explore dynamic network analysis and recent algorithms for infection source detection,emphasizing data integration and machine learning.Our approach involves reviewing existing research,identifying gaps,and proposing dynamic network-based infectious disease source detection strategies.Our study highlights evolving infection source detection methods and underscores the potential of machine learning and artificial intelligence.We acknowledge ongoing challenges due to network complexity and outline promising research directions.Detecting infection sources in dynamic networks is vital.This study emphasizes the need for improved techniques and technology integration to address complexities effectively.Advancements will empower us to identify and mitigate epidemics,reducing their societal and public health impacts.展开更多
Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous revie...Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous reviews,the department of acupuncture is a potential place where nosocomial infection might occur.Objectives To investigate the common pathogens and possible risk factors for nosocomial infection,figure out the measures and strategies for control and prevention,and provide general reporting guideline for future cases.Methods A systematic literature search of 6 libraries(EMBASE,CINAHL,PubMed,VIP,CNKI,SinoMed)was carried out on nosocomial infection(NIs)after acupuncture and its related therapies(e.g.,moxibustion,cupping,massage,dry needling)published from January 1,2012 to August 31,2023.Studies providing primary data were included;reviews,comments,and non-primary data studies were excluded to prevent duplicate case analysis.Data on bibliographic details,study characteristics,and clinical information were extracted.Results were synthesized through tabulation and categorized by therapy type,country income level,symptoms/diagnoses,pathogens,risk factors,treatments,and outcomes.Conclusion Nosocomial infections after acupuncture and its related therapies are possible but preventable.Prevention measures can be carried out in terms of the risk factors listed above.Future case reports are suggested to provide specific details of infection,including the setting,qualification,treatment,disinfection,and causal evidence.展开更多
Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance....Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.展开更多
Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria...Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.展开更多
BACKGROUND The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative ...BACKGROUND The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative infection rate,improving post-operative biochemical markers,and enhancing postoperative recovery outcomes.AIM To explore the effectiveness of perioperative disinfection and isolation measures in controlling postoperative infection following gastrointestinal surgery.It also sought to compare infection rates and biochemical markers between the obser-vation and control groups and evaluate the impact of disinfection and isolation measures on reducing postoperative complications.METHODS A retrospective analysis was conducted.Ninety-six patients who underwent gastrointestinal surgery between January 2022 and December 2023 were selected and divided into an observation group and a control group,with 48 cases in each.The observation group received disinfection and isolation measures during the perioperative period,whereas the control group received standard nursing care.The incidence of infection,white blood cell count,C-reactive protein levels,hemoglobin levels,and liver function markers(alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen)were monitored postoperatively in both groups.RESULTS The postoperative infection rate in the observation group was significantly lower than that in the control group(P<0.05).White blood cell and C-reactive protein levels decreased significantly after surgery in the observation group and were significantly lower than those in the control group(P<0.05).Alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen levels in the observation group were lower than those in the control group on postoperative days 1 and 3,showing a significant difference(P<0.05).CONCLUSION Perioperative disinfection and isolation measures effectively reduce postoperative infection rates in gastrointestinal surgery patients and improve biochemical markers,thereby enhancing recovery outcomes.This study provides a valuable basis for postoperative infection control and has significant clinical applications.展开更多
This editorial critically evaluated the recent study by Wang et al,which systematically investigated the efficacy of perioperative disinfection and isolation measures(including preoperative povidone-iodine disinfectio...This editorial critically evaluated the recent study by Wang et al,which systematically investigated the efficacy of perioperative disinfection and isolation measures(including preoperative povidone-iodine disinfection,intraoperative sterile barrier techniques,and postoperative intensive care)in reducing infection rates.The study further incorporated the surgical site infection risk prediction model(constructed via the least absolute shrinkage and selection operator al-gorithm,integrating patients'baseline characteristics,surgical indicators,and regional antibiotic-resistant bacterial data),and proposed a dynamic prevention and control system termed“disinfection protocols-predictive models–real-time monitoring”.The article highlighted that preoperative risk stratification,intraoperative personalized antibiotic selection,and postoperative multidimensional monitoring(encompassing inflammatory biomarkers,imaging,and microbiological testing)enabled the precise identification of high-risk patients and optimized intervention thresholds.Future research is deemed necessary to validate the synergistic effects of disinfection protocols and predictive models through large-scale multicenter studies,combined with advanced intraoperative rapid microbial detection technologies.This approach aims to establish standardized infection control protocols tailored for precision medicine and regional adaptability.Future research should prioritize validating the synergistic effects of disinfection protocols and predictive models via multi-center studies,while incorporating advanced rapid intraoperative microbial detection technologies to develop standardized infection prevention and control procedures.Such efforts will enhance the implementation of precise and regionally adaptive infection control strategies.展开更多
As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center direc...As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center directly impacts medical safety and infection control effectiveness.Professional protective training for personnel is crucial to ensure operational quality in this department.Systematic training enhances staff awareness of occupational exposure risks,standardizes protective measures in procedures,reduces cross-infection risks caused by improper operations,and ultimately lowers infection transmission risks.This paper analyzes the core content,implementation approaches,and practical role of professional protective training for disinfection supply center personnel in infection control.It aims to clarify the significant value of such training,providing references for medical institutions to optimize disinfection center management and strengthen infection control systems,thereby contributing to improved overall medical safety standards.展开更多
In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Boju...In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.展开更多
AIM To report the results of the International Nosocomial Infection Control Consortium(INICC)study conducted in Quito,Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI)prospective surveillance st...AIM To report the results of the International Nosocomial Infection Control Consortium(INICC)study conducted in Quito,Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI)prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs)from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN)definitions and INICC methods.RESULTS We followed 776 ICU patients for 4818 bed-days.The central line-associated bloodstream infection(CLABSI)rate was 6.5 per 1000 central line(CL)-days,the ventilator-associated pneumonia(VAP)rate was 44.3 per 1000 mechanical ventilator(MV)-days,and the catheterassociated urinary tract infection(CAUTI)rate was 5.7 per 1000 urinary catheter(UC)-days.CLABSI and CAUTI rates in our ICUs were similar to INICC rates[4.9(CLABSI)and 5.3(CAUTI)]and higher than NHSN rates[0.8(CLABSI)and 1.3(CAUTI)]-although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios.By contrast,despite the VAP rate was higher than INICC(16.5)and NHSN's rates(1.1),MV DUR was lower in our ICUs.Resistance of A.baumannii to imipenem and meropenem was 75.0%,and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%,all them higher than CDC/NHSN rates.Excess length of stay was 7.4 d for patients with CLABSI,4.8 for patients with VAP and 9.2 for patients CAUTI.Excess crude mortality in ICUs was 30.9%for CLABSI,14.5%for VAP and 17.6%for CAUTI.CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.展开更多
In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given t...In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.展开更多
BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatm...BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.展开更多
BACKGROUND Transfusion transmissible infections(TTIs)are illnesses spread through contaminated blood or blood products.In India,screening for TTIs such as hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodefi...BACKGROUND Transfusion transmissible infections(TTIs)are illnesses spread through contaminated blood or blood products.In India,screening for TTIs such as hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodeficiency virus(HIV)-I/II,malaria,and syphilis is mandatory before blood transfusions.Worldwide,HCV,HBV,and HIV are the leading viruses causing mortality,affecting millions of people globally,including those with co-infections of HIV/HCV and HIV/HBV.Studies highlight the impact of TTIs on life expectancy and health risks,such as liver cirrhosis,cancer,and other diseases in individuals with chronic HBV.Globally,millions of blood donations take place annually,emphasizing the importance of maintaining blood safety.AIM To study the prevalence of TTIs,viz.,HBV,HCV,HIV I/II,syphilis,and malaria parasite(MP),among different blood donor groups.METHODS The study assessed the prevalence of TTIs among different blood donor groups in Delhi,India.Groups included total donors,in-house donors,total camp donors,institutional camp donors,and community camp donors.Tests for HIV,HBV,and HCV were done using enzyme-linked immunosorbent assay,while syphilis was tested with rapid plasma reagins and MP rapid card methods.The prevalence of HBV,HCV,HIV,and syphilis,expressed as percentages.Differences in infection rates between the groups were analyzed usingχ²tests and P-values(less than 0.05).RESULTS The study evaluated TTIs among 42158 blood donors in Delhi.The overall cumulative frequency of TTIs in total blood donors was 2.071%,and the frequencies of HBV,HCV,HIV-I/II,venereal disease research laboratory,and MP were 1.048%,0.425%,0.221%,0.377%,and 0.0024%,respectively.In-house donors,representing 37656 donors,had the highest transfusion transmissible infection(TTI)prevalence at 2.167%.Among total camp donors(4502 donors),TTIs were identified in 1.266%of donors,while community camp donors(2439 donors)exhibited a prevalence of 1.558%.Institutional camp donors(2063 donors)had the lowest TTI prevalence at 0.921%.Statistical analysis revealed significant differences in overall TTI prevalence,with total and in-house donors exhibiting higher rates compared to camp donors.CONCLUSION Ongoing monitoring and effective screening programs are essential for minimizing TTIs.Customizing blood safety measures for different donor groups and studying socio-economic-health factors is essential to improving blood safety.展开更多
BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postope...BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.展开更多
This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parame...This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parameters.These pathogens included Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,Pseudomonas aeruginosa,and Staphylococcus aureus.A total of 1951 men of infertile couples were recruited between 23 March 2023,and 17 May 2023,at the Department of Reproductive Medicine of The First People’s Hospital of Yunnan Province(Kunming,China).Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping.Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs.The overall prevalence of HPV infection was 12.4%.The top five prevalent HPV subtypes were types 56,52,43,16,and 53 among those tested positive for HPV.Other common infections with high prevalence rates were Ureaplasma urealyticum(28.3%),Ureaplasma parvum(20.4%),and Enterococcus faecalis(9.5%).The prevalence rates of HPV coinfection with Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,and Staphylococcus aureus were 24.8%,25.4%,10.6%,6.4%,2.4%,7.9%,5.9%,0.9%,and 1.3%,respectively.The semen volume and total sperm count were greatly decreased by HPV infection alone.Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability.Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters,emphasizing the necessity of semen screening for STIs.展开更多
BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdia...BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdiagnosis and missed diagnosis.Additionally,this disease is difficult to treat,often requiring months or even years of antibacterial therapy,and can be fatal in patients with underlying conditions.CASE SUMMARY A 93-year-old male patient with chronic renal insufficiency sustained a skin injury at the tip of his right thumb.As a result of an initial misdiagnosis and inadequate treatment,the infection progressed,resulting in multiple rashes on his right upper limb.Local incision and drainage of pus,combined with oral antibiotics administered at a different hospital,yielded no significant improvement.Upon hospitalization,the patient’s immune function was assessed,and further local incision and drainage were performed.Cultures of the pus identified Nocardia brasiliensis.Treatment involved intravenous infusion of piperacillin-tazobactam sodium and oral administration of sulfamethoxazole-trimethoprim,leading to the patient’s recovery.After discharge,the patient continued to take sulfamethoxazole tablets for 6 months,with complete healing of the skin lesions and no recurrence.CONCLUSION Nocardiosis should be considered in patients with underlying conditions and compromised immunity.Prompt and accurate diagnosis is crucial.展开更多
基金supported by funds from the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico do Brasil(CNPq)(312286/2023-6,307201/2023-6,and Instituto Nacional Saude Cerebral INSC,No.406020/2022-1)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior(CAPES)Fundacao de Amparo a Pesquisa do Estado do Rio de Janeiro-FAPERJ(E-26/010.002260/2019,E-26/010.001652/2019,E-26/010.101036/2018,E-26/202.774/2018,E-26/210.240/2020,E-26/211.138/2021,26/210.823/2021,E-26/211.325/2021,E-26/210.779/2021,E-26/201.086/2022,E-26/210.312/2022,E-26/203.262/2023,E-26/200.195/2023)(to LEBS)。
文摘Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.
基金supported by the National Natural Science Foundation(82372206)the Project of Jiangsu Provincial Health Commission(H2023107)the Project of Basic and Clinical Research on Cardiac Arrest in the Emergency and Critical Care Department of the Second Affiliated Hospital of Soochow University(XKTJ-XK202408-2).
文摘Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcus,it is often overlooked in clinical practice.[1]However,in recent years,the incidence of mucormycosis has increased worldwide,potentially correlating with the growing population of diabetic patients.
文摘Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.
基金Supported by Beijing Ditan Hospital Affiliated to Capital Medical University“Sailing Plan”,No.DTQH-202405.
文摘BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
文摘This study focuses on the detection of infection sources in dynamic networks,which is very important for network analysis,cybersecurity,and public health.We aim to improve source detection in complex networks using data,computational advances,and machine learning to improve epidemic response and public health protection.We explore dynamic network analysis and recent algorithms for infection source detection,emphasizing data integration and machine learning.Our approach involves reviewing existing research,identifying gaps,and proposing dynamic network-based infectious disease source detection strategies.Our study highlights evolving infection source detection methods and underscores the potential of machine learning and artificial intelligence.We acknowledge ongoing challenges due to network complexity and outline promising research directions.Detecting infection sources in dynamic networks is vital.This study emphasizes the need for improved techniques and technology integration to address complexities effectively.Advancements will empower us to identify and mitigate epidemics,reducing their societal and public health impacts.
基金Supported by grants from Shanghai Municipal Health Commission for the Inheritance and Innovation of Traditional Chinese Medicine:ZY (2021-2023)-0204。
文摘Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous reviews,the department of acupuncture is a potential place where nosocomial infection might occur.Objectives To investigate the common pathogens and possible risk factors for nosocomial infection,figure out the measures and strategies for control and prevention,and provide general reporting guideline for future cases.Methods A systematic literature search of 6 libraries(EMBASE,CINAHL,PubMed,VIP,CNKI,SinoMed)was carried out on nosocomial infection(NIs)after acupuncture and its related therapies(e.g.,moxibustion,cupping,massage,dry needling)published from January 1,2012 to August 31,2023.Studies providing primary data were included;reviews,comments,and non-primary data studies were excluded to prevent duplicate case analysis.Data on bibliographic details,study characteristics,and clinical information were extracted.Results were synthesized through tabulation and categorized by therapy type,country income level,symptoms/diagnoses,pathogens,risk factors,treatments,and outcomes.Conclusion Nosocomial infections after acupuncture and its related therapies are possible but preventable.Prevention measures can be carried out in terms of the risk factors listed above.Future case reports are suggested to provide specific details of infection,including the setting,qualification,treatment,disinfection,and causal evidence.
基金Supported by the Ministry of Health of the Czech Republic,Grant/Award Number:NU22-05-00475 and NV19-05-00214。
文摘Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.
基金supported by the Beijing Science and Technology Planning Project of the Beijing Science and Technology Commission(Z241100009024047)the High-Level Public Health Technical Talent Training Plan(lingjunrencai-01-02).
文摘Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.
文摘BACKGROUND The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative infection rate,improving post-operative biochemical markers,and enhancing postoperative recovery outcomes.AIM To explore the effectiveness of perioperative disinfection and isolation measures in controlling postoperative infection following gastrointestinal surgery.It also sought to compare infection rates and biochemical markers between the obser-vation and control groups and evaluate the impact of disinfection and isolation measures on reducing postoperative complications.METHODS A retrospective analysis was conducted.Ninety-six patients who underwent gastrointestinal surgery between January 2022 and December 2023 were selected and divided into an observation group and a control group,with 48 cases in each.The observation group received disinfection and isolation measures during the perioperative period,whereas the control group received standard nursing care.The incidence of infection,white blood cell count,C-reactive protein levels,hemoglobin levels,and liver function markers(alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen)were monitored postoperatively in both groups.RESULTS The postoperative infection rate in the observation group was significantly lower than that in the control group(P<0.05).White blood cell and C-reactive protein levels decreased significantly after surgery in the observation group and were significantly lower than those in the control group(P<0.05).Alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen levels in the observation group were lower than those in the control group on postoperative days 1 and 3,showing a significant difference(P<0.05).CONCLUSION Perioperative disinfection and isolation measures effectively reduce postoperative infection rates in gastrointestinal surgery patients and improve biochemical markers,thereby enhancing recovery outcomes.This study provides a valuable basis for postoperative infection control and has significant clinical applications.
文摘This editorial critically evaluated the recent study by Wang et al,which systematically investigated the efficacy of perioperative disinfection and isolation measures(including preoperative povidone-iodine disinfection,intraoperative sterile barrier techniques,and postoperative intensive care)in reducing infection rates.The study further incorporated the surgical site infection risk prediction model(constructed via the least absolute shrinkage and selection operator al-gorithm,integrating patients'baseline characteristics,surgical indicators,and regional antibiotic-resistant bacterial data),and proposed a dynamic prevention and control system termed“disinfection protocols-predictive models–real-time monitoring”.The article highlighted that preoperative risk stratification,intraoperative personalized antibiotic selection,and postoperative multidimensional monitoring(encompassing inflammatory biomarkers,imaging,and microbiological testing)enabled the precise identification of high-risk patients and optimized intervention thresholds.Future research is deemed necessary to validate the synergistic effects of disinfection protocols and predictive models through large-scale multicenter studies,combined with advanced intraoperative rapid microbial detection technologies.This approach aims to establish standardized infection control protocols tailored for precision medicine and regional adaptability.Future research should prioritize validating the synergistic effects of disinfection protocols and predictive models via multi-center studies,while incorporating advanced rapid intraoperative microbial detection technologies to develop standardized infection prevention and control procedures.Such efforts will enhance the implementation of precise and regionally adaptive infection control strategies.
文摘As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center directly impacts medical safety and infection control effectiveness.Professional protective training for personnel is crucial to ensure operational quality in this department.Systematic training enhances staff awareness of occupational exposure risks,standardizes protective measures in procedures,reduces cross-infection risks caused by improper operations,and ultimately lowers infection transmission risks.This paper analyzes the core content,implementation approaches,and practical role of professional protective training for disinfection supply center personnel in infection control.It aims to clarify the significant value of such training,providing references for medical institutions to optimize disinfection center management and strengthen infection control systems,thereby contributing to improved overall medical safety standards.
文摘In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.
文摘AIM To report the results of the International Nosocomial Infection Control Consortium(INICC)study conducted in Quito,Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI)prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs)from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN)definitions and INICC methods.RESULTS We followed 776 ICU patients for 4818 bed-days.The central line-associated bloodstream infection(CLABSI)rate was 6.5 per 1000 central line(CL)-days,the ventilator-associated pneumonia(VAP)rate was 44.3 per 1000 mechanical ventilator(MV)-days,and the catheterassociated urinary tract infection(CAUTI)rate was 5.7 per 1000 urinary catheter(UC)-days.CLABSI and CAUTI rates in our ICUs were similar to INICC rates[4.9(CLABSI)and 5.3(CAUTI)]and higher than NHSN rates[0.8(CLABSI)and 1.3(CAUTI)]-although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios.By contrast,despite the VAP rate was higher than INICC(16.5)and NHSN's rates(1.1),MV DUR was lower in our ICUs.Resistance of A.baumannii to imipenem and meropenem was 75.0%,and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%,all them higher than CDC/NHSN rates.Excess length of stay was 7.4 d for patients with CLABSI,4.8 for patients with VAP and 9.2 for patients CAUTI.Excess crude mortality in ICUs was 30.9%for CLABSI,14.5%for VAP and 17.6%for CAUTI.CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.
基金Supported by Scientific Research Foundation of Shanghai Municipal Health Commission of Changning District,No.20234Y038.
文摘In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.
文摘BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.
文摘BACKGROUND Transfusion transmissible infections(TTIs)are illnesses spread through contaminated blood or blood products.In India,screening for TTIs such as hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodeficiency virus(HIV)-I/II,malaria,and syphilis is mandatory before blood transfusions.Worldwide,HCV,HBV,and HIV are the leading viruses causing mortality,affecting millions of people globally,including those with co-infections of HIV/HCV and HIV/HBV.Studies highlight the impact of TTIs on life expectancy and health risks,such as liver cirrhosis,cancer,and other diseases in individuals with chronic HBV.Globally,millions of blood donations take place annually,emphasizing the importance of maintaining blood safety.AIM To study the prevalence of TTIs,viz.,HBV,HCV,HIV I/II,syphilis,and malaria parasite(MP),among different blood donor groups.METHODS The study assessed the prevalence of TTIs among different blood donor groups in Delhi,India.Groups included total donors,in-house donors,total camp donors,institutional camp donors,and community camp donors.Tests for HIV,HBV,and HCV were done using enzyme-linked immunosorbent assay,while syphilis was tested with rapid plasma reagins and MP rapid card methods.The prevalence of HBV,HCV,HIV,and syphilis,expressed as percentages.Differences in infection rates between the groups were analyzed usingχ²tests and P-values(less than 0.05).RESULTS The study evaluated TTIs among 42158 blood donors in Delhi.The overall cumulative frequency of TTIs in total blood donors was 2.071%,and the frequencies of HBV,HCV,HIV-I/II,venereal disease research laboratory,and MP were 1.048%,0.425%,0.221%,0.377%,and 0.0024%,respectively.In-house donors,representing 37656 donors,had the highest transfusion transmissible infection(TTI)prevalence at 2.167%.Among total camp donors(4502 donors),TTIs were identified in 1.266%of donors,while community camp donors(2439 donors)exhibited a prevalence of 1.558%.Institutional camp donors(2063 donors)had the lowest TTI prevalence at 0.921%.Statistical analysis revealed significant differences in overall TTI prevalence,with total and in-house donors exhibiting higher rates compared to camp donors.CONCLUSION Ongoing monitoring and effective screening programs are essential for minimizing TTIs.Customizing blood safety measures for different donor groups and studying socio-economic-health factors is essential to improving blood safety.
文摘BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.
基金supported by the Yunnan Provincial Key Laboratory of Clinical Virology(No.202002AG070062)the Key Projects of Yunnan Province Science and Technology Department(No.202302AA310044)the National Natural Science Foundation of China(No.82060664).
文摘This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parameters.These pathogens included Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,Pseudomonas aeruginosa,and Staphylococcus aureus.A total of 1951 men of infertile couples were recruited between 23 March 2023,and 17 May 2023,at the Department of Reproductive Medicine of The First People’s Hospital of Yunnan Province(Kunming,China).Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping.Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs.The overall prevalence of HPV infection was 12.4%.The top five prevalent HPV subtypes were types 56,52,43,16,and 53 among those tested positive for HPV.Other common infections with high prevalence rates were Ureaplasma urealyticum(28.3%),Ureaplasma parvum(20.4%),and Enterococcus faecalis(9.5%).The prevalence rates of HPV coinfection with Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,and Staphylococcus aureus were 24.8%,25.4%,10.6%,6.4%,2.4%,7.9%,5.9%,0.9%,and 1.3%,respectively.The semen volume and total sperm count were greatly decreased by HPV infection alone.Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability.Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters,emphasizing the necessity of semen screening for STIs.
基金Supported by Zhejiang Provincial Traditional Chinese Medicine Science and Technology Program,No.2023ZF075.
文摘BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdiagnosis and missed diagnosis.Additionally,this disease is difficult to treat,often requiring months or even years of antibacterial therapy,and can be fatal in patients with underlying conditions.CASE SUMMARY A 93-year-old male patient with chronic renal insufficiency sustained a skin injury at the tip of his right thumb.As a result of an initial misdiagnosis and inadequate treatment,the infection progressed,resulting in multiple rashes on his right upper limb.Local incision and drainage of pus,combined with oral antibiotics administered at a different hospital,yielded no significant improvement.Upon hospitalization,the patient’s immune function was assessed,and further local incision and drainage were performed.Cultures of the pus identified Nocardia brasiliensis.Treatment involved intravenous infusion of piperacillin-tazobactam sodium and oral administration of sulfamethoxazole-trimethoprim,leading to the patient’s recovery.After discharge,the patient continued to take sulfamethoxazole tablets for 6 months,with complete healing of the skin lesions and no recurrence.CONCLUSION Nocardiosis should be considered in patients with underlying conditions and compromised immunity.Prompt and accurate diagnosis is crucial.
