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
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
Objective:To explore the trend of detection and antimicrobial resistance of Serratia marcescens with different infection types for 7 consecutive years,to provide a reference for future studies for the control of S.mar...Objective:To explore the trend of detection and antimicrobial resistance of Serratia marcescens with different infection types for 7 consecutive years,to provide a reference for future studies for the control of S.marcescens infections and a rational selection of antibiotics.Methods:S.marcescens isolates were collected from 2014 to 2020,and the trend of detection and antimicrobial resistance were analyzed according to different types of infection.Results:For 7 consecutive years,the data showed that patients with S.marcescens infections were mainly from the intensive care unit(ICU)(384 isolates,40.98%),and the isolates recovered were mainly from sputum samples(743 isolates,79.30%).The number of isolated strains increased every year,and the average rate of detection ranged from 0.60%to 0.80%.The detection rate of S.marcescens with hospital-acquired infections(HAI)showed a downward trend and that of S.marcescens with colonization showed an upward trend.The detection rate of multidrug-resistant S.marcescens fluctuated between 8.33%–16.89%.The resistance rate of S.marcescens to piperacillin was 17.0%–29.06%and the resistance rate to piperacillin tazobactam was 2.95%–13.13%.For cephalosporin antibiotics,the resistance rates of S.marcescens to cefuroxime and cefazolin were>99%and the resistance rates to ceftazidime and cefepime were<13%.The resistance rate of S.marcescens to aminoglycoside antibiotics,especially amikacin,was the lowest.The resistance rate of S.marcescens with community-acquired infections(CAI)to carbapenems was higher than that with HAI and colonization.Conclusion:The different infection types of S.marcescens have different detection and epidemic trends.In addition,resistance to carbapenems is different across the strains.展开更多
BACKGROUND Clostridium difficile(C.difficile)infection(CDI)is a common healthcare-associated infection.Older adult hospitalized patients with pressure ulcers are more sus-ceptible because of low immunity and disordere...BACKGROUND Clostridium difficile(C.difficile)infection(CDI)is a common healthcare-associated infection.Older adult hospitalized patients with pressure ulcers are more sus-ceptible because of low immunity and disordered flora,but their specific risk factors are unknown.This study hypothesizes that the use of antibiotics for more than 2 weeks,the use of proton pump inhibitors(PPIs),and the use ofβ-lactam antibiotics are independent risk factors for CDI in this population.METHODS A total of 120 older adults hospitalized with pressure ulcers from 2020 to 2023 were enrolled in the wound repair ward of the hospital.Stool samples were collected for anaerobic culture,C.difficile glutamate dehydrogenase(GDH)anti-gen and toxin detection,and multivariate logistic regression was used to analyze risk factors.RESULTS Among 120 older adults hospitalized patients with pressure ulcers,39 tested po-sitive for C.difficile,with an incidence rate of 32.5%.Thirty-nine patients(32.5%)were positive for GDH antigen.Twelve patients(10.0%)were positive for toxin A/B.Multivariate analysis shows that the use of antibiotics for more than 2 weeks,the use of proton pump inhibitors,and the use ofβ-lactam antibiotics are independent risk factors for CDI(all P values<0.05).CONCLUSION From 2020 to 2023,the incidence of CDI in 120 hospitalized older adult patients with pressure ulcers was 32.5%,and three independent risk factors were identified.展开更多
Objective:To determine the surgical site infection(SSI)rate and related factors in patients undergoing colectomy at the University Medical Center Ho Chi Minh City.Methods:A cross-sectional study was conducted on 298 p...Objective:To determine the surgical site infection(SSI)rate and related factors in patients undergoing colectomy at the University Medical Center Ho Chi Minh City.Methods:A cross-sectional study was conducted on 298 patients,aged 18 years or older,who underwent colectomy at the University Medical Center Ho Chi Minh City from January to October 2023.Demographic,general characteristics,and surgical characteristics data were collected from medical records using a structured questionnaire.SSIs were diagnosed within 30 days after surgery based on CDC criteria.Multivariate logistic regression analysis was used to identify factors influencing infection rates,with significance set at P<0.05.Results:A total of 298 patients underwent colectomy,with a median age of 64 years,54.4%of them were male,and 47.3%had a normal BMI.The SSI rate was 12.1%and Klebsiella pneumoniae was the most frequent pathogen.Key characteristics of SSI included abscess formation(83.3%)and the presence of pus or exudate(100%).The risk factors for SSI included preoperative hospital stay(OR 1.13,95%CI 1.03-1.22;P=0.008),surgical approach(OR 0.32,95%CI 0.14-0.76;P=0.01),and surgical incision classified as infected(OR 3.21,95%CI 1.22-8.45;P=0.018).Conclusions:SSI after colectomy is relatively common.Patient health status and surgery-related factors,which independently influence the 30-day risk of SSI,should be carefully considered before surgery.展开更多
With the rapid development of the medical industry,ensuring patient safety and improving medical quality have led to the development of a very important aspect:hospital infection control.This paper intends to evaluate...With the rapid development of the medical industry,ensuring patient safety and improving medical quality have led to the development of a very important aspect:hospital infection control.This paper intends to evaluate the job competencies of infection prevention and control personnel in Chinese medicine hospitals through an analysis of the necessity of such competencies,the establishment of criteria for evaluation,and the exploration of methods for implementation.This paper proposes an effective evaluation system on the basis of recent research findings and some recommendations for how to improve infection management in these hospitals.This study provides suggestions for the training and management of staff in infection prevention and control through a review of the relevant literature within the context of Chinese medicine hospitals.展开更多
The purpose of this article is to review the evidence regarding transmission of infection during gastrointestinal endoscopy, factors important in endoscope reprocessing and infection control, areas to focus on to impr...The purpose of this article is to review the evidence regarding transmission of infection during gastrointestinal endoscopy, factors important in endoscope reprocessing and infection control, areas to focus on to improve compliance, and recent developments and advances in the field.展开更多
Respiratory syncytial virus(RSV)is one of the most common viruses leading to lower respiratory tract infections(LRTIs)in children and elderly individuals worldwide.Although significant progress in the prevention and t...Respiratory syncytial virus(RSV)is one of the most common viruses leading to lower respiratory tract infections(LRTIs)in children and elderly individuals worldwide.Although significant progress in the prevention and treatment of RSV infection was made in 2023,with two anti-RSV vaccines and one monoclonal antibody approved by the FDA,there is still a lack of postinfection therapeutic drugs in clinical practice,especially for the pediatric population.In recent years,with an increasing understanding of the pathogenic mechanisms of RSV,drugs and drug candidates,have shown great potential for clinical application.In this review,we categorize and discuss promising anti-RSV drug candidates that have been in preclinical or clinical development over the last five years.展开更多
Human herpesvirus,a specific group within the herpesvirus family,is responsible for a variety of human diseases.These viruses can infect humans and other vertebrates,primarily targeting the skin,mucous membranes,and n...Human herpesvirus,a specific group within the herpesvirus family,is responsible for a variety of human diseases.These viruses can infect humans and other vertebrates,primarily targeting the skin,mucous membranes,and neural tissues,thereby signifi-cantly impacting the health of both humans and animals.Animal models are crucial for studying virus pathogenesis,vaccine development,and drug testing.Despite several vaccine candidates being in preclinical and clinical stages,no vaccines are current available to prevent lifelong infections caused by these human herpesviruses,except for varicella-zoster virus(VZV)vaccine.However,the strict host tropism of herpes-viruses and other limitations mean that no single animal model can fully replicate all key features of human herpesvirus-associated diseases.This makes it challeng-ing to evaluate vaccines and antivirals against human herpesvirus comprehensively.Herein,we summarize the current animal models used to study the human herpesvi-ruses includingα-herpesviruses(herpes simplex virus type 1(HSV-1),HSV-2,VZV),β-herpesviruses(human cytomegalovirus(HCMV),γ-herpesviruses(Epstein-Barr virus(EBV))and Kaposi's sarcoma herpesvirus(KSHV)).By providing concise information and detailed analysis of the potential,limitations and applications of various models,such as non-human primates,mice,rabbits,guinea pigs,and tree shrews,this sum-mary aims to help researchers efficiently select the most appropriate animal model,offering practical guidance for studying human herpesvirus.展开更多
Background:Vaccinia virus(VACV)and mpox virus(MPXV)belong to the orthopoxvirus genus and share high genetic similarity,making VACV widely used in the mpox pandemic.CAST/EiJ mice have been widely used for studying orth...Background:Vaccinia virus(VACV)and mpox virus(MPXV)belong to the orthopoxvirus genus and share high genetic similarity,making VACV widely used in the mpox pandemic.CAST/EiJ mice have been widely used for studying orthopoxvirus infection.However,the histopathological features of CAST/EiJ mice with mpox virus(MPXV)and vaccinia virus(VACV)infections have not been fully elucidated.Methods:Four group of CAST/EiJ mice were challenged with low-dose VACV(103 PFU,VACV-L),high-dose VACV(106 PFU,VACV-H),MPXV(106 PFU)or PBS via intraperitoneal route,and the disease signs and body weight were monitored daily.Subsequently,viral loads and titers in the blood and spleen of CAST/EiJ mice were analyzed via qPCR and TCID 50 assay.Finally,the spleen samples were analyzed for histopathological,immunohistochemical and RNA-seq.Results:Herein,we found that VACV-L and MPXV caused splenomegaly via the intraperitoneal route,whereas VACV-H caused rapid lethality with limited splenomegaly.Transcriptome analysis from spleen revealed significant differences in gene expression between VACV-L and VACV-H groups,but the differentially expressed genes induced by splenomegaly between VACV-L and MPXV groups were highly similar.Furthermore,pathway enrichment analysis demonstrated that the VACV-L,VACV-H,and MPXV groups were all associated with the calcium,MAPK,and PI3K-Akt signaling pathway.Compared to the lethal infection observed in VACV-H group,the splenomegaly in the VACV-L and MPXV groups was characterized by extramedullary hematopoiesis and increased macrophages infiltration in the red pulp.Transcriptome analysis of the spleen demonstrated that the Wnt,tumor necrosis factor(TNF),and transforming growth factorβ(TGF-β)signaling pathways may promote splenomegaly by modulating granulocyte infiltration and inflammatory responses.Compared to VACV-L group,the limited splenomegaly but lethality in VACV-H-infected mice might be associated with extensive splenic necrosis,diffuse congestion,and hemorrhage in the red pulp,as well as changes in the cGMP-PKG,Ras signaling,and Fc gamma Rmediated phagocytosis pathways.Conclusions:Our findings systematically compared the pathogenicity of VACV and MPXV in CAST/EiJ mice,incorporating splenic transcriptome analysis to provide insights into the potential molecular mechanism behind orthopoxvirus-induced splenomegaly in CAST/EiJ mice.展开更多
BACKGROUND Infection at the pin tract is a frequent and feared complication of external fixators(EF).The type of pin material and coatings have been regarded as possibly influencing infection rates.Over the last 20 ye...BACKGROUND Infection at the pin tract is a frequent and feared complication of external fixators(EF).The type of pin material and coatings have been regarded as possibly influencing infection rates.Over the last 20 years,few prospective clinical studies and systematic reviews addressed the role of coated pins on the rate of pin site infection in human clinical studies.AIM To assess the EF literature over the past 20 years on the clinical benefits of pins manufactured from varied materials and coating systems and their possible role in pin tract infection rates.METHODS We performed a systematic review according to the PRISMA and PICOS guidelines using four scientific platforms:PubMed,LiLacs,SciELO,and Cochrane.We searched the literature for related publications over the past 20 years.RESULTS A literature search yielded 29 articles,among which seven met the inclusion criteria.These studies compared stainless-steel pins and pins coated with hydroxyapatite(HA),titanium and silver.The pin tract infection definitions were arbitrary and not standardized among studies.Most studies included a low number of patients in the analysis and used a short follow-up time.Three metaanalyses were carried out,comparing stainless steel vs silver pins,stainless steel vs HA-coated pins,and titanium vs HA-coated pins.None of this analysis resulted in statistically significant differences in pin tract infection rates.CONCLUSION Currently,no clinical evidence supports the advantage of EF pins manufactured with materials other than stainless steel or coated over uncoated pins in reducing the rates of pin tract infections.A standardized definition of pin tract infection in external fixation is still lacking.展开更多
BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complic...BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic presents a significant challenge to the medical profession,increasing in the presence of microbial coinfection.Bacterial and Fungal co-infections increase the ...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic presents a significant challenge to the medical profession,increasing in the presence of microbial coinfection.Bacterial and Fungal co-infections increase the risk of morbidity and mortality in patients with COVID-19.AIM To study the bacterial profile in patients with COVID-19 who needed admission to receive treatment in the main centres concerned with managing COVID-19 disease in the Kingdom of Bahrain.METHODS The study was a retrospective observational analysis of the bacterial profile and the bacterial resistance in patients with confirmed COVID-19 disease who needed admission to receive treatment in the main centres assigned to manage patients with COVID-19 disease in the Kingdom of Bahrain from February to October 2020.We used the electronic patients’records and the microbiology laboratory data to identify patients’demographics,clinical data,microbial profile,hospital or community-acquired,and the outcomes.RESULTS The study included 1380 patients admitted with confirmed COVID-19 disease during the study period.51%were admitted from February to June,and 49%were admitted from July to October 2020,with a recurrence rate was 0.36%.There was a significant increase in bacterial and fungal co-infection in the second period compared to the first period.The most common isolated organisms were the gram-negative bacteria(mainly Klebsiella pneumoniae,Pseudomonas aeruginosa,multi-drug resistant Acinetobacter baumannii,and Escherichia coli),the grampositive bacteria(mainly coagulase negative Staphylococci,Enterococcus faecium,Enterococcus faecalis,Staphylococcus aureus)and fungaemia(Candida galabrata,Candida tropicalis,Candida albicans,Aspergillus fumigatus,Candida parapsilosis,Aspergillus niger).The hospital-acquired infection formed 73.8%,61.6%,100%gram-negative,gram-positive and fungaemia.Most of the hospital-acquired infection occurred in the second period with a higher death rate than communityacquired infections.CONCLUSION Bacterial and fungal co-infections in patients admitted with confirmed COVID-19 disease pose higher morbidity and mortality risks than those without coinfections.We should perform every effort to minimize these risks.展开更多
In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally grow.Therefore,in order to counteract this trend more rigid ...In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally grow.Therefore,in order to counteract this trend more rigid rules and a stricter implementation of effective preventive strategies is of highest importance.In the absence of a"miracle weapon"priorities should lie in evidence-based measures including preoperative optimization of patients at higher infection risks,the fulfilment of strict hygiene rules in the operating theatre and an effective antibiotic prophylaxis regimen.Instead of a"one size fits all"philosophy,it has been proposed to adjust the antibiotic prophylaxis protocol to major infection risks taking into account important patient-and procedure-related risk factors.A stronger focus on the local application mode via use of high dose dual antibioticloaded bone cement in such risk situations may have its advantages and is easy to apply in the theatre.The more potent antimicrobial growth inhibition in vitro and the strong reduction of the prosthetic joint infection rate in risk for infection patients with aid of dual antibiotic-loaded bone cement in clinical studies align with this hypothesis.展开更多
BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test k...BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC practices.METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.RESULTS A total of 1333 nurses from 13 countries completed the survey.The average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ICUs.Statistically,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of ICUs.Working in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among respondents.CONCLUSION There is considerable variation in knowledge among nurses working in ICU.Factors like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.展开更多
Dear Editor,Zika virus (ZIKV) is a mosquito-borne virus that belongs to the Flavivirus family along with dengue virus (DENV),yellow fever virus, West Nile virus, and Japanese encephalitis virus (Ming et al. 2016). ZIK...Dear Editor,Zika virus (ZIKV) is a mosquito-borne virus that belongs to the Flavivirus family along with dengue virus (DENV),yellow fever virus, West Nile virus, and Japanese encephalitis virus (Ming et al. 2016). ZIKV is a singlestranded positive-sense RNA virus encoding three structural proteins, including nucleocapsid protein C, prM/M,envelope glycoprotein E, and seven non-structural proteins.Since 2015.展开更多
Background: Co-infections may represent substantial diagnostic and treatment challenges. Aim: To the better of our knowledge, we describe the first case in the literature of congenital Cytomegalovirus (CMV) infection ...Background: Co-infections may represent substantial diagnostic and treatment challenges. Aim: To the better of our knowledge, we describe the first case in the literature of congenital Cytomegalovirus (CMV) infection following maternal CMV non primary infection contemporary to varicella during pregnancy. Case Presentation: A pregnant woman had a varicella during her pregnancy. Congenital CMV infection was fortuitously discovered in the neonate owing to a universal CMV screening. Retrospective analysis of maternal serums during pregnancy showed CMV reactivation. We aim to highlight that CMV reactivation could be due to varicella and discuss if it could facilitate the transplacental transmission of CMV. Conclusion: This case report emphasizes neonatal CMV screening, and warns against dual maternal infection especially because this may be at particular risk of transmission to the fetus.展开更多
Human respiratory syncytial virus(RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a mol...Human respiratory syncytial virus(RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a molecular epidemiological study during 2015–2019. A total of 964 RSV-positive specimens were identified from 5529 enrolled patients during a multi-center study. RSV subgroup A(RSV-A) was the predominant subgroup during this research period except in2016. Totally, 535 sequences of the second hypervariable region(HVR-2) of the G gene were obtained. Combined with182 Chinese sequences from GenBank, phylogenetic trees showed that 521 RSV-A sequences fell in genotypes ON1(512),NA1(6) and GA5(3), respectively;while 196 RSV-B sequences fell in BA9(193) and SAB4(3). ON1 and BA9 were the only genotypes after December 2015. Genotypes ON1 and BA9 can be separated into 10 and 7 lineages, respectively. The HVR-2 of genotype ON1 had six amino acid changes with a frequency more than 10%, while two substitutions H258 Q and H266 L were co-occurrences. The HVR-2 of genotype BA9 had nine amino acid substitutions with a frequency more than10%, while the sequences with T290 I and T312 I were all from 2018 to 2019. One N-glycosylation site at 237 was identified among ON1 sequences, while two N-glycosylation sites(296 and 310) were identified in the 60-nucleotide duplication region of BA9. To conclusion, ON1 and BA9 were the predominant genotypes in China during 2015–2019. For the genotypes ON1 and BA9, the G gene exhibited relatively high diversity and evolved continuously.展开更多
In many traditional Chinese medicine （TCM） hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections （nBSIs） are an important cause of morbidity and mortality. A retrospective s...In many traditional Chinese medicine （TCM） hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections （nBSIs） are an important cause of morbidity and mortality. A retrospective sur- veillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions Escherichia coli （25.5%） was the most common Gram-negative and coagulase-negative staphylococcus （CONS） （14.1%） was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsie/la pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glyco- peptide were the most frequently used for nBSI therapy. Only about one-third of patients （157/482） received appro- priate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score 〉4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.展开更多
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Hospital Management Innovation Program of Jiangsu Hospital Association in 2021(Project No.:JSYGY-3-2021-511)。
文摘Objective:To explore the trend of detection and antimicrobial resistance of Serratia marcescens with different infection types for 7 consecutive years,to provide a reference for future studies for the control of S.marcescens infections and a rational selection of antibiotics.Methods:S.marcescens isolates were collected from 2014 to 2020,and the trend of detection and antimicrobial resistance were analyzed according to different types of infection.Results:For 7 consecutive years,the data showed that patients with S.marcescens infections were mainly from the intensive care unit(ICU)(384 isolates,40.98%),and the isolates recovered were mainly from sputum samples(743 isolates,79.30%).The number of isolated strains increased every year,and the average rate of detection ranged from 0.60%to 0.80%.The detection rate of S.marcescens with hospital-acquired infections(HAI)showed a downward trend and that of S.marcescens with colonization showed an upward trend.The detection rate of multidrug-resistant S.marcescens fluctuated between 8.33%–16.89%.The resistance rate of S.marcescens to piperacillin was 17.0%–29.06%and the resistance rate to piperacillin tazobactam was 2.95%–13.13%.For cephalosporin antibiotics,the resistance rates of S.marcescens to cefuroxime and cefazolin were>99%and the resistance rates to ceftazidime and cefepime were<13%.The resistance rate of S.marcescens to aminoglycoside antibiotics,especially amikacin,was the lowest.The resistance rate of S.marcescens with community-acquired infections(CAI)to carbapenems was higher than that with HAI and colonization.Conclusion:The different infection types of S.marcescens have different detection and epidemic trends.In addition,resistance to carbapenems is different across the strains.
基金Supported by the Zhejiang Province Medical and Health Science and Technology Plan Project,No.2018KY644 and No.2020KY234。
文摘BACKGROUND Clostridium difficile(C.difficile)infection(CDI)is a common healthcare-associated infection.Older adult hospitalized patients with pressure ulcers are more sus-ceptible because of low immunity and disordered flora,but their specific risk factors are unknown.This study hypothesizes that the use of antibiotics for more than 2 weeks,the use of proton pump inhibitors(PPIs),and the use ofβ-lactam antibiotics are independent risk factors for CDI in this population.METHODS A total of 120 older adults hospitalized with pressure ulcers from 2020 to 2023 were enrolled in the wound repair ward of the hospital.Stool samples were collected for anaerobic culture,C.difficile glutamate dehydrogenase(GDH)anti-gen and toxin detection,and multivariate logistic regression was used to analyze risk factors.RESULTS Among 120 older adults hospitalized patients with pressure ulcers,39 tested po-sitive for C.difficile,with an incidence rate of 32.5%.Thirty-nine patients(32.5%)were positive for GDH antigen.Twelve patients(10.0%)were positive for toxin A/B.Multivariate analysis shows that the use of antibiotics for more than 2 weeks,the use of proton pump inhibitors,and the use ofβ-lactam antibiotics are independent risk factors for CDI(all P values<0.05).CONCLUSION From 2020 to 2023,the incidence of CDI in 120 hospitalized older adult patients with pressure ulcers was 32.5%,and three independent risk factors were identified.
基金funded by the University of Medicine and Pharmacy at Ho Chi Minh City under contract number 136/2024/HĐ-ĐHYD,dated 17/04/2024.
文摘Objective:To determine the surgical site infection(SSI)rate and related factors in patients undergoing colectomy at the University Medical Center Ho Chi Minh City.Methods:A cross-sectional study was conducted on 298 patients,aged 18 years or older,who underwent colectomy at the University Medical Center Ho Chi Minh City from January to October 2023.Demographic,general characteristics,and surgical characteristics data were collected from medical records using a structured questionnaire.SSIs were diagnosed within 30 days after surgery based on CDC criteria.Multivariate logistic regression analysis was used to identify factors influencing infection rates,with significance set at P<0.05.Results:A total of 298 patients underwent colectomy,with a median age of 64 years,54.4%of them were male,and 47.3%had a normal BMI.The SSI rate was 12.1%and Klebsiella pneumoniae was the most frequent pathogen.Key characteristics of SSI included abscess formation(83.3%)and the presence of pus or exudate(100%).The risk factors for SSI included preoperative hospital stay(OR 1.13,95%CI 1.03-1.22;P=0.008),surgical approach(OR 0.32,95%CI 0.14-0.76;P=0.01),and surgical incision classified as infected(OR 3.21,95%CI 1.22-8.45;P=0.018).Conclusions:SSI after colectomy is relatively common.Patient health status and surgery-related factors,which independently influence the 30-day risk of SSI,should be carefully considered before surgery.
基金supported by Weifang Science and Technology Development Plan Project(Soft Science,2022RKX054)Shenzhen Elite Talent Project(JY2024-2).
文摘With the rapid development of the medical industry,ensuring patient safety and improving medical quality have led to the development of a very important aspect:hospital infection control.This paper intends to evaluate the job competencies of infection prevention and control personnel in Chinese medicine hospitals through an analysis of the necessity of such competencies,the establishment of criteria for evaluation,and the exploration of methods for implementation.This paper proposes an effective evaluation system on the basis of recent research findings and some recommendations for how to improve infection management in these hospitals.This study provides suggestions for the training and management of staff in infection prevention and control through a review of the relevant literature within the context of Chinese medicine hospitals.
文摘The purpose of this article is to review the evidence regarding transmission of infection during gastrointestinal endoscopy, factors important in endoscope reprocessing and infection control, areas to focus on to improve compliance, and recent developments and advances in the field.
基金funded by the Beijing Natural Science Foundation(5242007,L222076,L246011)the High-level Public Health Technical Talents Project by the Beijing Municipal Commission of Health(Key discipline personnel-02-05)+1 种基金the CAMS Innovation Fund for Medical Sciences(CIFMS,2019-12M-5-026,2022-I2M-CoV19-006)the Reform and Development of the Beijing Municipal Health Commission,and the Respiratory Research Project of the National Clinical Research Center for Respiratory Diseases(HXZX-202106).
文摘Respiratory syncytial virus(RSV)is one of the most common viruses leading to lower respiratory tract infections(LRTIs)in children and elderly individuals worldwide.Although significant progress in the prevention and treatment of RSV infection was made in 2023,with two anti-RSV vaccines and one monoclonal antibody approved by the FDA,there is still a lack of postinfection therapeutic drugs in clinical practice,especially for the pediatric population.In recent years,with an increasing understanding of the pathogenic mechanisms of RSV,drugs and drug candidates,have shown great potential for clinical application.In this review,we categorize and discuss promising anti-RSV drug candidates that have been in preclinical or clinical development over the last five years.
基金National Natural Science Foundation of China,Grant/Award Number:82222041 and 82241068CAMS Innovation Fund for Medical Sciences,Grant/Award Number:2021-I2M-1-037 and 2023-I2M-2-001+1 种基金National Key Research and Development Project of China,Grant/Award Number:2023YFC2309000Beijing Natural Science Foundation,Grant/Award Number:Z220018。
文摘Human herpesvirus,a specific group within the herpesvirus family,is responsible for a variety of human diseases.These viruses can infect humans and other vertebrates,primarily targeting the skin,mucous membranes,and neural tissues,thereby signifi-cantly impacting the health of both humans and animals.Animal models are crucial for studying virus pathogenesis,vaccine development,and drug testing.Despite several vaccine candidates being in preclinical and clinical stages,no vaccines are current available to prevent lifelong infections caused by these human herpesviruses,except for varicella-zoster virus(VZV)vaccine.However,the strict host tropism of herpes-viruses and other limitations mean that no single animal model can fully replicate all key features of human herpesvirus-associated diseases.This makes it challeng-ing to evaluate vaccines and antivirals against human herpesvirus comprehensively.Herein,we summarize the current animal models used to study the human herpesvi-ruses includingα-herpesviruses(herpes simplex virus type 1(HSV-1),HSV-2,VZV),β-herpesviruses(human cytomegalovirus(HCMV),γ-herpesviruses(Epstein-Barr virus(EBV))and Kaposi's sarcoma herpesvirus(KSHV)).By providing concise information and detailed analysis of the potential,limitations and applications of various models,such as non-human primates,mice,rabbits,guinea pigs,and tree shrews,this sum-mary aims to help researchers efficiently select the most appropriate animal model,offering practical guidance for studying human herpesvirus.
基金Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences,Grant/Award Number:2023-I2M-2-001National Key Research and Development Project of China,Grant/Award Number:2022YFC2304100 and 2023YFC2309000+1 种基金National Natural Science Foundation of China,Grant/Award Number:82241068 and 82222041Beijing Natural Science Foundation,Grant/Award Number:Z220018。
文摘Background:Vaccinia virus(VACV)and mpox virus(MPXV)belong to the orthopoxvirus genus and share high genetic similarity,making VACV widely used in the mpox pandemic.CAST/EiJ mice have been widely used for studying orthopoxvirus infection.However,the histopathological features of CAST/EiJ mice with mpox virus(MPXV)and vaccinia virus(VACV)infections have not been fully elucidated.Methods:Four group of CAST/EiJ mice were challenged with low-dose VACV(103 PFU,VACV-L),high-dose VACV(106 PFU,VACV-H),MPXV(106 PFU)or PBS via intraperitoneal route,and the disease signs and body weight were monitored daily.Subsequently,viral loads and titers in the blood and spleen of CAST/EiJ mice were analyzed via qPCR and TCID 50 assay.Finally,the spleen samples were analyzed for histopathological,immunohistochemical and RNA-seq.Results:Herein,we found that VACV-L and MPXV caused splenomegaly via the intraperitoneal route,whereas VACV-H caused rapid lethality with limited splenomegaly.Transcriptome analysis from spleen revealed significant differences in gene expression between VACV-L and VACV-H groups,but the differentially expressed genes induced by splenomegaly between VACV-L and MPXV groups were highly similar.Furthermore,pathway enrichment analysis demonstrated that the VACV-L,VACV-H,and MPXV groups were all associated with the calcium,MAPK,and PI3K-Akt signaling pathway.Compared to the lethal infection observed in VACV-H group,the splenomegaly in the VACV-L and MPXV groups was characterized by extramedullary hematopoiesis and increased macrophages infiltration in the red pulp.Transcriptome analysis of the spleen demonstrated that the Wnt,tumor necrosis factor(TNF),and transforming growth factorβ(TGF-β)signaling pathways may promote splenomegaly by modulating granulocyte infiltration and inflammatory responses.Compared to VACV-L group,the limited splenomegaly but lethality in VACV-H-infected mice might be associated with extensive splenic necrosis,diffuse congestion,and hemorrhage in the red pulp,as well as changes in the cGMP-PKG,Ras signaling,and Fc gamma Rmediated phagocytosis pathways.Conclusions:Our findings systematically compared the pathogenicity of VACV and MPXV in CAST/EiJ mice,incorporating splenic transcriptome analysis to provide insights into the potential molecular mechanism behind orthopoxvirus-induced splenomegaly in CAST/EiJ mice.
文摘BACKGROUND Infection at the pin tract is a frequent and feared complication of external fixators(EF).The type of pin material and coatings have been regarded as possibly influencing infection rates.Over the last 20 years,few prospective clinical studies and systematic reviews addressed the role of coated pins on the rate of pin site infection in human clinical studies.AIM To assess the EF literature over the past 20 years on the clinical benefits of pins manufactured from varied materials and coating systems and their possible role in pin tract infection rates.METHODS We performed a systematic review according to the PRISMA and PICOS guidelines using four scientific platforms:PubMed,LiLacs,SciELO,and Cochrane.We searched the literature for related publications over the past 20 years.RESULTS A literature search yielded 29 articles,among which seven met the inclusion criteria.These studies compared stainless-steel pins and pins coated with hydroxyapatite(HA),titanium and silver.The pin tract infection definitions were arbitrary and not standardized among studies.Most studies included a low number of patients in the analysis and used a short follow-up time.Three metaanalyses were carried out,comparing stainless steel vs silver pins,stainless steel vs HA-coated pins,and titanium vs HA-coated pins.None of this analysis resulted in statistically significant differences in pin tract infection rates.CONCLUSION Currently,no clinical evidence supports the advantage of EF pins manufactured with materials other than stainless steel or coated over uncoated pins in reducing the rates of pin tract infections.A standardized definition of pin tract infection in external fixation is still lacking.
基金Supported by the Zhejiang Provincial Natural Science Foundation of China,No.LQ20H260002.
文摘BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic presents a significant challenge to the medical profession,increasing in the presence of microbial coinfection.Bacterial and Fungal co-infections increase the risk of morbidity and mortality in patients with COVID-19.AIM To study the bacterial profile in patients with COVID-19 who needed admission to receive treatment in the main centres concerned with managing COVID-19 disease in the Kingdom of Bahrain.METHODS The study was a retrospective observational analysis of the bacterial profile and the bacterial resistance in patients with confirmed COVID-19 disease who needed admission to receive treatment in the main centres assigned to manage patients with COVID-19 disease in the Kingdom of Bahrain from February to October 2020.We used the electronic patients’records and the microbiology laboratory data to identify patients’demographics,clinical data,microbial profile,hospital or community-acquired,and the outcomes.RESULTS The study included 1380 patients admitted with confirmed COVID-19 disease during the study period.51%were admitted from February to June,and 49%were admitted from July to October 2020,with a recurrence rate was 0.36%.There was a significant increase in bacterial and fungal co-infection in the second period compared to the first period.The most common isolated organisms were the gram-negative bacteria(mainly Klebsiella pneumoniae,Pseudomonas aeruginosa,multi-drug resistant Acinetobacter baumannii,and Escherichia coli),the grampositive bacteria(mainly coagulase negative Staphylococci,Enterococcus faecium,Enterococcus faecalis,Staphylococcus aureus)and fungaemia(Candida galabrata,Candida tropicalis,Candida albicans,Aspergillus fumigatus,Candida parapsilosis,Aspergillus niger).The hospital-acquired infection formed 73.8%,61.6%,100%gram-negative,gram-positive and fungaemia.Most of the hospital-acquired infection occurred in the second period with a higher death rate than communityacquired infections.CONCLUSION Bacterial and fungal co-infections in patients admitted with confirmed COVID-19 disease pose higher morbidity and mortality risks than those without coinfections.We should perform every effort to minimize these risks.
文摘In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally grow.Therefore,in order to counteract this trend more rigid rules and a stricter implementation of effective preventive strategies is of highest importance.In the absence of a"miracle weapon"priorities should lie in evidence-based measures including preoperative optimization of patients at higher infection risks,the fulfilment of strict hygiene rules in the operating theatre and an effective antibiotic prophylaxis regimen.Instead of a"one size fits all"philosophy,it has been proposed to adjust the antibiotic prophylaxis protocol to major infection risks taking into account important patient-and procedure-related risk factors.A stronger focus on the local application mode via use of high dose dual antibioticloaded bone cement in such risk situations may have its advantages and is easy to apply in the theatre.The more potent antimicrobial growth inhibition in vitro and the strong reduction of the prosthetic joint infection rate in risk for infection patients with aid of dual antibiotic-loaded bone cement in clinical studies align with this hypothesis.
文摘BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC practices.METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.RESULTS A total of 1333 nurses from 13 countries completed the survey.The average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ICUs.Statistically,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of ICUs.Working in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among respondents.CONCLUSION There is considerable variation in knowledge among nurses working in ICU.Factors like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.
基金supported by the National Natural Science Foundation of China (31470848, 31470880, 31670898, and 31870867)Open Research Fund Program of the State Key Laboratory of Virology of China (2017IOV003)Jiangsu Provincial Innovative Research Team
文摘Dear Editor,Zika virus (ZIKV) is a mosquito-borne virus that belongs to the Flavivirus family along with dengue virus (DENV),yellow fever virus, West Nile virus, and Japanese encephalitis virus (Ming et al. 2016). ZIKV is a singlestranded positive-sense RNA virus encoding three structural proteins, including nucleocapsid protein C, prM/M,envelope glycoprotein E, and seven non-structural proteins.Since 2015.
文摘Background: Co-infections may represent substantial diagnostic and treatment challenges. Aim: To the better of our knowledge, we describe the first case in the literature of congenital Cytomegalovirus (CMV) infection following maternal CMV non primary infection contemporary to varicella during pregnancy. Case Presentation: A pregnant woman had a varicella during her pregnancy. Congenital CMV infection was fortuitously discovered in the neonate owing to a universal CMV screening. Retrospective analysis of maternal serums during pregnancy showed CMV reactivation. We aim to highlight that CMV reactivation could be due to varicella and discuss if it could facilitate the transplacental transmission of CMV. Conclusion: This case report emphasizes neonatal CMV screening, and warns against dual maternal infection especially because this may be at particular risk of transmission to the fetus.
基金This work was supported by the National Science and Technology Major Projects(Grant Number 2017ZX10104001-005-010,2017ZX10103004-004)the CAMS Innovation Fund for Medical Sciences(CIFMS)(Grant Number 2019-I2M-5-026)。
文摘Human respiratory syncytial virus(RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a molecular epidemiological study during 2015–2019. A total of 964 RSV-positive specimens were identified from 5529 enrolled patients during a multi-center study. RSV subgroup A(RSV-A) was the predominant subgroup during this research period except in2016. Totally, 535 sequences of the second hypervariable region(HVR-2) of the G gene were obtained. Combined with182 Chinese sequences from GenBank, phylogenetic trees showed that 521 RSV-A sequences fell in genotypes ON1(512),NA1(6) and GA5(3), respectively;while 196 RSV-B sequences fell in BA9(193) and SAB4(3). ON1 and BA9 were the only genotypes after December 2015. Genotypes ON1 and BA9 can be separated into 10 and 7 lineages, respectively. The HVR-2 of genotype ON1 had six amino acid changes with a frequency more than 10%, while two substitutions H258 Q and H266 L were co-occurrences. The HVR-2 of genotype BA9 had nine amino acid substitutions with a frequency more than10%, while the sequences with T290 I and T312 I were all from 2018 to 2019. One N-glycosylation site at 237 was identified among ON1 sequences, while two N-glycosylation sites(296 and 310) were identified in the 60-nucleotide duplication region of BA9. To conclusion, ON1 and BA9 were the predominant genotypes in China during 2015–2019. For the genotypes ON1 and BA9, the G gene exhibited relatively high diversity and evolved continuously.
基金supported by the Projects of Zhejiang Province Non-profit Technology Research(No.2013C33180),China
文摘In many traditional Chinese medicine （TCM） hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections （nBSIs） are an important cause of morbidity and mortality. A retrospective sur- veillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions Escherichia coli （25.5%） was the most common Gram-negative and coagulase-negative staphylococcus （CONS） （14.1%） was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsie/la pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glyco- peptide were the most frequently used for nBSI therapy. Only about one-third of patients （157/482） received appro- priate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score 〉4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.
