Abstract:The prevalence of antimicrobial resistance (AMR) remains a critical global health threat. The World Health Organization (WHO) released the Global Antibiotic Resistance Surveillance Report 2025, this report evaluates the resistance landscape of 8 priority pathogens and 22 antimicrobial agents across four categories of clinical infections. Utilizing data from over 23 million bacteriologically confirmed infections across 104 countries, the report employs a Bayesian hierarchical model for assessment and introduces a surveillance system maturity scoring framework to address data disparities. Findings indicate a persistent upward trend in resistance in key pathogens, particularly among Gram-negative bacteria, posing increasingly severe challenges to first-line treatments for bloodstream, urinary tract, and gastrointestinal infections. Low-income countries face heightened AMR risks due to deficiencies in surveillance and diagnostic capacities. This interpretative summary outlines the core findings of the report, providing an evidence-based foundation for precision prevention and control strategies, as well as the optimization of empirical antimicrobial therapy.

Abstract:Objective To investigate the feasibility of safe injection measures in clinical practice, provide basis for the formulation of industry standards for "Standard for safe injection", improve standards, and further strengthen the safe injection-related work of healthcare workers (HCWs). Methods Based on the contents of the "Standard for safe injection", a self-designed questionnaire was formulated. From July 13, 2023 to August 13, 2023, conve-nience sampling method was conducted to survey voluntarily participated doctors, nurses, anesthesiologists, pharmacists, technicians, rehabilitation therapists, and administrative personnel from various provinces across the country. Results A total of 28 924 valid questionnaires were collected from 29 provinces/municipalities/autonomous regions. 17 524 persons (60.59%) answered correctly regarding the definition of safe injection. The correct answering rates of HCWs of different regions, hospital levels, occupational titles, ages, years of service, and positions all showed statistically significant differences (all P<0.05). Among the 47 survey items, HCWs’ selection for "completely achievable" was as follows: more than 90% selected 20 items, 80%-89% selected 22 items, and less than 80% selected 5 items, mainly including hand hygiene, surface cleaning of items and equipment, use of protective equipment, and use of blood glucose meters. There were all statistically significant difference in the proportion of HCWs in different positions who judged these 5 items as "completely achievable"(all P<0.05). Conclusion HCWs understand on the definititon of safe injection to some extent, and generally believe that safe injection measures are highly feasible. However, based on the actual situation of clinical practice nationwide, the implementation of safety injection measures still needs to be further standardized and improved.

Abstract:Objective To explore the main clinical characteristics, diagnosis and treatment process, as well as prognostic factors of invasive mucormycosis complicated with thrombotic diseases. Methods Five cases of invasive mucormycosis complicated with thrombotic diseases and admitted to a hospital from January 2021 to January 2025 were analyzed retrospectively. Furthermor, such cases reported both domestically and internationally were summarized. Results A total of 33 patients were included in the analysis (14 males and 19 females), with 21 deaths and 12 survivors, yielding a mortality of 63.64%. 31 patients had one or more underlying diseases, while only 2 had no history of underlying diseases. The clinical manifestations of all patients showed varying degrees of infection and poisoning symptoms (such as fever, cough, shortness of breath, swelling, pain and bleeding of lesions, and shock, etc.) or thrombotic diseases-induced manifestations, such as disturbance of consciousness, sensory and motor disorders, organ function damage, etc. Pathogenicity results showed that 7 cases were positive for direct smearing in microscopic examination, 11 cases were positive for fungal culture, 9 cases were positive for molecular biology detection, 20 cases were positive for pathological biopsy, and 4 cases were positive for autopsy, only 17 cases were identified with specific genera of Mucor. Thrombosis was diagnosed through imaging examination (including ultrasound, arterial vascular imaging, angiography, etc.). In routine blood tests, thrombus indicators like D-dimer, fibrin degradation products (FDP), thrombin-antithrombin complex (TAT), and plasmin-α2-plasmin inhibitor complex (PIC) presented abnormality in all 5 patients in this hospital. Among the 33 cases, 29 cases (87.88%) were treated with a regimen containing amphotericin B, and 14 cases (42.42%) underwent lesion resection or debridement treatment. The survival rates of patients treated with different methods were statistically different (P<0.05). Among the 12 patients survived, 83.33% received amphotericin B combined with other antifungal treatment. Conclusion Mucormycosis combined with thrombotic diseases has poor therapeutic efficacy, high mortality, and often occurs in immunocompromised patients complicated with underlying diseases. Examination methods include microscopy, fungal culture, pathological diagnosis, and molecular biology detection. Imaging diagnosis is crucial in the clinical diagnosis of thrombotic diseases, and antifungal treatment scheme significantly affects the prognosis of patients.

Abstract:Objective To explore the temporal characteristics and independent risk factors of secondary infection after carbapenem-resistant Enterobacterales (CRE) intestinal colonization in patients in the intensive care unit (ICU), and provide basis for clinical prevention and control. Methods Patients who admitted to the respiratory/surgical ICU of a tertiary first-class hospital from January 2023 to June 2025 were analyzed retrospectively. Colonization was determined through active rectal swab/fecal screening, infection was diagnosed according to the "Diagnostic criteria for healthcare-associated infection". Patients were divided into infection group and colonization group based on secondary infection after CRE intestinal colonization. Clinical data of two groups of patients were collected for group comparison, risk factors for secondary infection after CRE intestinal colonization in ICU patients were analyzed by univariate and multivariate logistic regression. Results A total of 1 288 patients were included in analysis, out of which 132 had CRE intestinal colonization, with a colonization rate of 10.25%. Among patients with colonization, 43.94% (n=58) had secondary infection, with respiratory tract being the main infection site (64.62%), followed by blood (24.62%). The duration for secondary infection in patients with hospital-acquired colonization was 5 (2,7) days, which was shorter than that of patients with colonization at admission (12 [4,14] days; Z=-2.97, P=0.003). Univariate and multivariate logistic analysis showed that mechanical ventilation (OR=3.94, 95%CI: 1.60-9.66) and use of carbapenems (OR=7.93, 95%CI: 2.63-20.27) were independent risk factors for secondary infection after CRE intestinal colonization in ICU patients. Conclusion ICU patients have a higher risk of secondary infection after CRE colonization, and those with hospital-acquired colonization have faster progression of infection. Attention should be paid to patients with mechanical ventilation and those exposed to carbapenems, active screening and intervention should be strengthened to effectively control the occurrence of infection.

Abstract:Objective To evaluate the disinfection effect of silver-stabilized hydrogen peroxide disinfectant on common dental impressions and model materials, explore its impact on material volume stability, and provide scientific basis for the disinfection of dental impressions and models in primary medical institutions. Methods Alginate, silicone rubber, polyether, and dental baseplate wax were selected as impression materials, while ordinary gypsum and superhard gypsum were used as model materials to prepare a 1 cm×1 cm square carrier with a thickness of 1-2 mm. Silver-stabilized hydrogen peroxide disinfectant containing 2.8% H₂O₂ and 10.58 mg/L Ag⁺ were adopted. Escherichia coli 8099 was used as the test strain for carrier quantitative bactericidal test. Specimens were taken at 5, 10, and 15 minutes, and the killing logarithm was calculated. The dimensional data of each material before and after disinfection were recorded with 3D scanning technology, and the dimensional changes were analyzed by Geomagic Control X (2020.1) software. Deformation rate was calculated, and the flexural strength of gypsum was measured by universal testing machine. Results Silver-stabilized hydrogen peroxide disinfectant achieved a 99.9% bactericidal effect on all impressions and model materials within 10 minutes, with a killing logarithm value >3.00. In terms of volume stability before and after disinfection, the deformation rate of alginate was 0.736%, while the deformation rates of silicone rubber, polyether, and wax were 0.575%, 0.206%, and 0.156%, respectively. The deformation rates of ordinary gypsum and superhard gypsum were 0.037% and 0.032%, respectively. There is no statistically significant difference in the change of flexural strength of gypsum material before and after disinfection. Conclusion Silver-stabilized hydrogen peroxide disinfectant shows a good disinfection effect on common dental impressions and model materials within a 10 minute disinfection time. It has little effect on the dimensional stability of the materials and does not significantly affect the flexural strength of gypsum materials, and can be used as a disinfectant for such materials.

Abstract:Objective To investigate the usage status of trunk protective isolation products and wearing feeling of isolation gowns made of different materials in tertiary dental hospitals, and provide evidence for optimizing the usage of isolation gowns. Methods A questionnaire survey was conducted to collect data on the usage of isolation gowns and white coats (including type, replacement frequency, cleaning costs, etc.) from 16 tertiary stomatological specialty hospitals. The wearing feeling on three types of isolation gowns (disposable, self-made reusable, and commercial reusable) of healthcare workers (HCWs) in 4 outpatient departments of a hospital was evaluated. Results All institutions used both white coats and isolation gowns, with 81.25% using both one-piece and two-piece white coats, and 75.00% of the institutions used both disposable and reusable isolation gowns. During splashing procedures, 87.50% of the institutions adopted the practice of wearing scrubs underneath isolation gowns. Isolation gowns were mostly replaced daily(75.00%), white coats 1-2 times weekly(43.75%), and scrubs varied in replacement frequency. 87.50% of the institutions outsourced reusable textiles for cleaning. For reusable isolation gowns, the maximum monthly usage reached 21 346 pieces, the median monthly usage per dental unit and per HCW were close to the numbers of white coats. For white coats, the median monthly usage was the highest (2 537 pieces), and the median cleaning cost per piece was also the highest (￥3.50). The highest purchasing cost was from reusable isolation gowns (￥85.00) and the lowest was from disposable ones (￥12.50). Disposable gowns received poor subjective evaluation for breathability, stretchability, and odor during use; self-made reusable gowns received poor evaluation in weight and effective blocking of blood and body fluid; commercial reusable gowns received poor evaluation for being "too short in length". Key improvement suggestions on three isolation gowns focused on breathability, weight, and protective coverage. Conclusion Isolation gowns are recommended during dental splash procedures. The overall cost of purchasing as well as monthly cleaning and disinfection is relatively high. The design of isolation gowns should balance protective performance and comfort based on clinical needs in dental practice.

Abstract:Objective To explore the disease burden and impacting factors of postoperative pneumonia (POP) in patients undergoing coronary artery bypass grafting (CABG), provide basis for the prevention and control of POP. Methods Clinical data of 5 566 patients who underwent CABG from January 1, 2020 to November 30, 2024 and met the study criteria were retrospectively collected. Independent risk factors for severe POP and postoperative 90-day mortality were analyzed, and differences in medical cost-related indicators among subgroups were compared. Results Among 5 566 CABG patients, 627 had POP,with an incidence of 11.3%, out of which 1.4% (n=76) were severe POP. Risk of postoperative 90-day mortality in POP patients was higher than non-POP patients (HR=4.16, 95%CI: 2.39-7.26). Univariate and multivariate Cox regression analysis showed that duration of surgery, red blood cell transfusion, multidrug-resistant organism (MDRO) infection, and mixed bacterial infection were associated with the occurrence of severe POP; Mixed bacterial infection and duration of controlled mechanical ventilation were independent risk factors for postoperative 90-day mortality. The median length of hospital stay, median length of intensive care unit (ICU) stay, and median hospitalization cost for POP patients were all higher than non-POP patients, with the increases of 25.0% (15.0 days vs 12.0 days), 100% (8.0 days vs 4.0 days), and 26.1% (183 911.6 Yuan vs 145 851.6 Yuan), respectively. Among POP patients, those with severe POP, mixed bacterial infection and MDRO infection further increased the length of hospital stay and cost: compared with the common POP group, the above three indicators in severe POP group increased by 63.3%, 83.3%, and 57.9%, respectively; Compared with non-mixed infection, the above three indicators in patients with mixed infection increase by 40.0%, 46.7%, and 57.7%, respectively; Compared with patients with sensitive bacterial infection and pathogen-negative, length of postoperative hospital stay in MDRO-infected patients both increased by 14.3%, length of ICU stay increased by 66.7% and 150.0% respectively, hospitalization cost increased by 11.7% and 21.5%, respectively; The above differences were all statistically significant (all P<0.001). Conclusion Duration of surgery, red blood cell transfusion, MDRO infection, and mixed bacterial infection are independent risk factors for severe POP after CABG, and mixed bacterial infection can further increase the risk of postoperative 90-day mortality. POP can significantly increase the consumption of medical resources, and its impacting extent exhibits heterogeneity depending on the severity of disease condition and characteristics of infection.

Abstract:Objective To analyze the direct economic burden of elderly patients with healthcare-associated infection (HAI) caused by multidrug-resistant ogranism (MDRO), and provide evidence-based support for constructing precise prevention and control strategies. Methods Data of elderly patients with MDRO HAI from January 2023 to December 2024 in a tertiary first-class hospital were collected. After using propensity score matching (PSM) to balance confounding factors among groups, differences in length of hospital stay and total expense between MDRO group and non-MDRO group were compared. Results A total of 234 patients were included in analysis, with 75 in MDRO group and 75 in non-MDRO group after PSM. Univariate analysis showed that MDRO group were all higher than non-MDRO group in terms of mechanical ventilation, histories of recent medical exposure, antimicrobial exposure, and invasive procedure history, as well as antimicrobial resistance rate (all P<0.05). In terms of economic burden, length of hospital stay in MDRO group was longer than non-MDRO group (25 vs 22 days; U=2 249.5, P=0.034), and the median of total expense was also higher (37 779.0 vs 15 075.7 Yuan; U=1 832.5, P＜0.001). Except for self-paid hospitalization expense and surgical treatment expense, other expense in MDRO group were all higher than non-MDRO group (all P<0.05). In terms of infection site, MDRO group had higher economic burden on respiratory tract and urinary tract infections than non-MDRO group (both P<0.05). Gamma regression analysis showed that MDRO infection (OR=1.76, 95%CI: 1.10-2.89), Acinetobacter baumannii infection (OR=1.53, 95%CI: 1.04-2.28), length of hospital stay (OR=1.02, 95%CI: 1.01-1.04), and admission to intensive care unit (ICU) (OR=1.76, 95%CI: 1.13-2.74) were all independent factors affecting medical expense (all P<0.05). Quantile regression revealed that MDRO infection presented positive effect at the low and middle percentile (τ=0.25, β=14 409.75; τ=0.50, β=17 436.48). Length of hospital stay (τ=0.50, β=1 423.15; τ=0.75, β=1 176.13) and admission to ICU (τ=0.50, β=25 762.75; τ=0.75, β=51 689.76) increased the expense at the middle and high percentile (both P<0.05). Conclusion MDRO HAI bring about heavy economic burden on elderly patients. Medical institutions should establish an integrated system that integrates antimicrobial management, early diagnosis, and key prevention and control, so as to effectively control medical expense through multidisciplinary quality improvement.

Abstract:Objective To study the economic losses of hospitalized patients and hospitals due to healthcare-associated infection (HAI) under the diagnosis intervention packet (DIP) medical insurance payment mode, and provide support from the perspectives of warning for high-risk infection in patients, hospital cost operation, and reverse control by medical insurance departments. Methods The length of hospital stay and hospitalization expenses of HAI patients in mixed group (including cases of self-payment, medical insurance payment [8 DIPs and those without included in DIPs]) in a hospital from 2022 to 2023 was analyzed retrospectively, and compared with non-HAI patients with the same type of disease during the same period. Length of hospital stay and hospitalization expenses due to HAI in patients with DIP payment, as well as direct economic losses of hospital resulting from HAI after DIP settlement but before medical insurance sharing expense were analyzed using the same method, and compared with non-HAI patients of the same DIP disease during the same period. Results From 2022 to 2023, the average length of hospital stay and hospitalization expenses due to HAI in patients in the mixed group and those with DIP payment were higher than non-HAI patients with the same types of disease during the same period, differences were all statistically significant (all P<0.05). In 2022-2023, the direct economic losses of hospital after DIP settlement but before medical insurance shared expense for HAI patients were higher than those of non-HAI patients with the same DIP disease type during the same period, differences were both statistically significant (both P<0.05). According to the analysis of different HAI sites, the highest hospitalization expense for patients in 2022 and 2023 were due to bloodstream infection (39 644.03 Yuan and 33 289.34 Yuan, respectively). The HAI sites with the highest direct economic losses in 2022 and 2023 were lower respiratory tract (6 617.25 Yuan) and surgical sites (9 853.40 Yuan). The infection site with the highest actual economic losses caused by HAI in 2022 and 2023 was surgical site (9 831.30 and 13 132.54 Yuan, respectively). Conclusion HAI significantly increases the economic losses of hospitalized patients, but the DIP medical insurance payment model can limit the length of hospital stay and hospitalization expenses of HAI patients. The highest economic losses for hospitalized patients and hospitals vary in different infection sites. It is necessary to comprehensively judge and determine the priority of projects for risk prevention and control in hospital, develop a high-risk infection patient model for the project to reduce HAI risk, and assist the medical insurance department in reducing hospital economic losses.

Abstract:Objective To evaluate the health and economic burden from the perspective of hospitals after implementing pre-isolation based on the "Standard for infection prevention and control of carbapenem-resistant Entero-bacterales" (WS/T 826-2023). Methods Patients from 4 internal medicine intensive care units (ICUs) in 2 tertiary first-class hospitals in Urumqi were selected as research subjects. Data of patients from February 1, 2023 to February 1, 2024 (control group) and from February 2, 2024 to February 1, 2025 (intervention group) were collected retrospectively. Pre-isolation measures recommended by WS/T 826-2023 were implemented in the intervention group, while not in the control group. Compared with patients without Enterobacterales infection, the mortality risk, extra length of hospital stay, and additional hospitalization costs of patients infected with carbape-nem-sensitive Enterobacterales (CSE) and carbapenem-resistant Enterobacterales (CRE) were calculated with Cox proportional hazards regression model and multi-state model. Results A total of 5 286 ICU patients were included in the analysis, with 2 806 in the control group and 2 480 in the intervention group. The detection rate of CRE in the intervention group was lower than in the control group (2.82% vs 4.88%), and the mortality also decreased obviously in the intervention group (7.38% vs 13.44%), differences were both statistically significant (both P<0.05). In the intervention group, there was no statistically significant difference in the mortality risk between patients with CRE infection and those without Enterobacterales infection (P>0.05). The intervention group had an increase in extra length of hospital stay of 2.03 days per case and an increase in additional hospitalization cost of 11 581.35 Yuan per case due to CRE infection. Conclusion After implementing pre-isolation based on "Standard for infection prevention and control of carbapenem-resistant Enterobacterales" (WS/T 826-2023), the extra length of hospital stay and economic burden in CRE-infected patients increased. However, the detection rate of CRE and the mortality of patients also decreased.

Abstract:Objective To investigate the dynamic impact of diagnosis-related group (DRG) payments reform and multidisciplinary team (MDT) management on the antimicrobial usage density (AUD) in intensive care unit (ICU), and construct an interrupted time series prediction model calibrated by the case-mix index (CMI), so as to break through the static limitations of traditional cross-sectional studies. Methods Data from ICU of a tertiary hospital from January 2021 to December 2024 were analyzed by the double interrupted time series (DITS) approach combined with an autoregressive integrated moving average (ARIMA) model. The implementation of DRG in October 2022 and the implementation of MDT management in August 2023 were identified as the key intervention points. Residual-calibrated sequences were constructed via CMI linear regression to control case complexity confounding, and model performance and predictive capability were assessed. Results The AUD exhibited a downward trend (β₁=-1.70) after the implementation of DRG, while the trend reversed to an upward direction (γ₁= 3.38) after the implementation of MDT management, though with no statistical significance. After adjusting case complexity confounders via the CMI linear regression residual method, MDT management demonstrated a significant positive impact on the trend in antimicrobial usage. The ARIMA constructed based on the calibrated sequence demonstrated robust predictive performance. Conclusion The CMI-calibrated time-series model can effectively control confounding and analyze the dynamic heterogeneity of policy interventions. The "confounding control-dynamic prediction" integrated framework constructed in this study provides a data-driven decision support tool for the refined management of antimicrobial agents.

Abstract:Objective To evaluate the medical resource consumption due to healthcare-associated infection (HAI) in patients with cerebrovascular diseases based on disease diagnosis-related group (DRG). Methods Clinical data of patients with cerebrovascular disease DRGs in a hospital from 2022 to 2023 were retrospectively analyzed. The differences in average length of hospital stay and average hospitalization expense between HAI group (infection group) and non-HAI group (non-infection group) were compared, the resource consumption of different infection sites and DRGs were analyzed. Results A total of 160 cases of HAI occurred among 10 546 patients with cerebrovascular diseases in this hospital, with an incidence of 1.52%. The median length of hospital stay of patients in infection group and non-infection group were 23 and 7 days, respectively, the median total hospitalization expense were 71 400 and 12 200 Yuan, respectively. The average length of hospital stay and average hospitalization expense in infection group were both higher than non-infection group, differences were both statistically significant (both P<0.001), bloodstream infection had the highest resource consumption. 160 HAI patients were distributed among 19 DRGs, and 10 386 non-HAI patients were distributed among 25 DRGs. The DGR with the highest number of HAI cases was BR21 (cerebral ischemic disease with important complications and comorbidities), accounting for 25.00% (40/160); The DGR with the highest HAI incidence was AH19 (tracheotomy with ventilator support≥96 hours or ECMO [extracorporeal membrane oxygenation]), accounting for 28.00% (14/50); The DRG with the largest difference in average length of hospital stay and average hospitalization expense was BK19 (neurological diagnosis with ventilator support). Conclusion HAI significantly increases the consumption of medical resources of patients with cerebrovascular diseases. It is suggested that DRGs with high infection risk be paid attention through refined DRG analysis as well as precise prevention and control measures, so as to reduce the incidence of HAI as much as possible.

Abstract:Objective To evaluate the economic burden of healthcare-associated infection (HAI) in hospitalized patients in the general intensive care unit (ICU) by using the disease diagnosis-related group (DRG) method, and provide basis for optimizing HAI management strategies. Methods Clinical data of hospitalized patients in the general ICU of a tertiary first-class hospital from January 1, 2022 to December 31, 2024 were collected retrospectively, patients were divided into HAI group and non-HAI group based on whether they had HAI. The case mix index (CMI), hospitalization expense, and length of hospital stay between two groups of patients were compared and analyzed with DRG system. Results A total of 2 874 hospitalized patients in general ICU were included in analysis, out of which 201 had HAI, with HAI incidence of 6.99%. The CMI value of HAI group was higher than that of non-HAI group (6.48 vs 1.78), difference was statistically significant (P<0.001). The median hospitalization expense of HAI group (108 999.91 Yuan) increased by 65 329.05 Yuan compared with non-HAI group (43 670.86 Yuan), and the median length of hospital stay was extended by 19.00 days (29.00 vs 10.00 days), both with statistically significant differences (both P<0.001). Among the top ten DRGs with the highest incidence of HAI, FP1 (heart failure, shock with manipulation treatment) had the longest length of hospital stay and the largest increase in expense, which were 45.50 days and 511 539.67 Yuan, respectively. Bacteremia, catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP) had a long length of hospital stay and expense consumption index, with length of hospitalization extension≥15 days and hospitalization expense increase>42 996 Yuan. MDRO infection brought about significant economic burden, patients in carbapenem-resistant Enterobacterales (CRE) HAI group had an extension of 25.00 day of hospital stay and an increase of 59 873.84 Yuan of expense. Hospitalized expense of patients with carbapenem-resistant Pseudomonas aeruginosa (CRPA) in HAI group was 2.25 times of non-HAI group. Conclusion There are significant differences in the economic burden caused by different DRGs, different infection types, and different MDRO infection. Based on DRG evaluation, the economic losses caused by HAI can be accurately quantified, which provide evidence-based support for prioritizing key prevention and control measures and optimizing resource investment.

Abstract:Objective To identify the priority disease diagnosis-related groups (DRGs) of healthcare-associated infection (HAI) prevention and control among orthopedic patients aged≥15 years old, and provide an evaluation framework and evidence-based basis for precise prevention. Methods Based on DRG-related methods and indicators, this study evaluated various DRGs of the discharged patients from orthopedic department in a tertiary first-class hospital in 2024 from three dimensions (quality and safety, service capability, and service efficiency) through DRG stratification, case-mix index (CMI) standardization, and additional cost algorithms methods, high-priority populations for HAI prevention and control were then identified. Results A total of 36 084 patients were included in the study, with an overall HAI incidence of 0.46% (n=165). HAI concentrated in 22.76% (33/145) of DRGs. The main infection sites were surgical sites (n=58, 32.95%), respiratory system (n=51, 28.99%), and urinary system (n=25,14.20%), accounting for 76.14% (134/176) of the total HAI cases. From the quality and safety dimension, the top three DRGs with the highest standardized incidences of infection were identified as ZC11(1.48%), ZJ11(0.63%), and ZJ15(0.61%). From the service capability dimension, the vulnerable groups with lower technical difficulty but higher incidences of infection were identified (ZJ15[0.61%], IE21[0.53%], IE39[0.45%]). From the service efficiency dimension, the groups with the heaviest time and economic burden caused by HAI were both identified as IB19 (8 days and 24 200 Yuan). Conclusion It is recommended to incorporate key DRGs into targeted surveillance and conduct precise prevention and control. Based on DRG multidimensional evaluation, key populations for orthopedic infection prevention and control can be accurately identified, which provide scientific basis for resource allocation and optimization of prevention measures.

Abstract:Objective To explore the effect of systematic health education on the incidence of catheter-related infection (CRI)in hemodialysis outpatients. Methods Patients who underwent vascular catheter dialysis at the outpatient hemodialysis center of a tertiary first-class hospital were selected with prospective surveillance method. Patients from the second quarter of 2023 to the first quarter of 2024 were as the control group, and those from the second quarter of 2024 to the first quarter of 2025 were as the intervention group. Systematic health education was implemented to intervene patients in the intervention group, and the incidence of vascular CRI was compared between two groups of patients. Results 61 cases (catheterization No.=75 ) in the intervention group and 63 cases (catheterization No.=70) in the control group were selected for analysis. In the intervention group, 15 cases of dialysis CRI occurred, with case incidence of 24.59%. sAmong them, there were 9 cases of local infection and 6 cases of vascular access-related bloodstream infection (BSI) (including 1 case of BSI caused by pulmonary infection). In the control group, 31 cases of dialysis CRI occurred, with an incidence of 49.21%. Among them, there were 25 cases of local infection and 6 cases of vascular access-related BSI. The incidence of dialysis CRI in patients in the intervention group was lower than the control group, difference was statistically significant (P=0.005). The incidence of local infection in patients in the intervention group was lower than in the control group (P=0.002). The incidences of infection in patients of three types of catheterization before and after intervention all decreased, with a statistically significant difference in the tunneled internal jugular venous catheterization (P=0.003). Among patients without infection, those in the intervention group had longer catheterization days compared with the control group ([201.49±11.48] days vs [119.10±17.21] days, P<0.001). After implementing systematic health education, patients in the intervention group showed a significant improvement in the qualified rate of cognition on six dimensions of catheter home management ability (catheterization during exercise and daily life, daily observation on catheter, information acquisition, catheter abnormality handling, and maintenance compliance), differences were all statistically significant (all P<0.05). Conclusion Adopting systematic health education can effectively reduce the incidence of CRI in hemodialysis outpatient.

Abstract:Objective To evaluate the risk factors and transmission routes of a cluster of surgical site infection (SSI) in the department of thyroid surgery in a hospital, and provide reference and basis for formulating prevention and control strategies. Methods An epidemiological investigation on SSI cases in the wards of thyroid disease from April to May 2025 was conducted. High-risk factors for infection were analyzed using the case-control method. Environmental hygiene detection was conducted. Intervention measures were implemented and their effectiveness was evaluated. Results Staphylococcus aureus with identical drug susceptibility profiles were detected from wound secretion or drainage fluids of 4 SSI patients. Tracing survey revealed that multiple healthcare workers (e.g., B2, B3) and frequently touched environmental surfaces carried highly consistent methicillin-resistance Staphylococcus aureus (MRSA) strains. It was thus inferred that the transmission was due to healthcare workers carrying MRSA, which contaminated the environment and led to infection through contact transmission. By adjusting the decolonization strategies and performing effective decolonization for colonized patients using mupirocin ointment, along with a series of measures such as strict environmental disinfection and hand hygiene, there was no new SSI cases occurred in the ward, indicating the effectiveness of the infection control measures. Conclusion The colonization with Staphylococcus aureus in healthcare workers can increase the risk of SSI in patients. Therefore, it is recommended to conduct regular active screening and decolonization interventions for surgeons involved in specific surgeries to reduce the incidence of SSI.

Abstract:Objective To investigate and analyze a public health emergency caused by Vibrio cholerae O1 infection in Beijing in 2022, and provide scientific basis for the prevention and control of cholera epidemic. Methods On-site epidemiological and traceability investigation were carried out according to the "Work plan for cholera surveillance and epidemic disposal in Beijing (2016 edition)", and various epidemic disposal measures were strictly implemented. Results A total of 1 confirmed case, 3 asymptomatic carriers, and 1 suspected case of cholera were reported in this epidemic, all of whom had exposure history at the same restaurant. Culture results after isolation and purification of specimens from 4 cases and 1 toilet swab specimen from the asymptomatic carrier Zhao’s home showed positive results of Vibrio cholerae O1 serotype Ogawa and oxidase test. Three restaurant environment swab specimens showed positive results for the rfb gene of Vibrio cholerae O1 by polymerase chain reaction (PCR) detection. The epidemic was effectively controlled after implementing relevant prevention and control measures, without second-generation infection or death case. Conclusion This epidemic is speculated to have been caused by the consumption of food contaminated by Vibrio cholerae O1, which suggests that daily surveillance and supervision of the catering industry should be strengthened, and promotion of knowledge about intestinal infectious diseases should be carried out actively to reduce the risk of epidemic occurrence.

Abstract:Objective To explore the risk factors for bloodstream infection related to non-cuffed catheter (NCC) of hemodialysis, and provide basis for the prevention and control of catheter-related bloodstream infection (CRBSI) in hemodialysis patients. Methods A total of 127 hospitalized patients who underwent NCC hemodialysis and developed CRBSI in the department of nephrology of a hospital from January 2015 to December 2024 were selected as the case group. According to a matching ratio of 1∶2, and with gender, renal failure type, and NCC catheterization time ±30 days as matching conditions, 254 hospitalized patients who underwent NCC hemodialysis but did not develop CRBSI were selected as the control group. Data on general information, underlying diseases, nutritional status, treatment methods of two groups of patients were collected. Univariate and multivariate conditional logistic regression analyses were conducted using SAS 9.4 software. Results Among 381 patients, 261 (68.50%) were male and 120 (31.50%) were female. Gram-positive bacteria were the main pathogens of NCC-related CRBSI. Patients’ body mass index (BMI), education level, combined cardiovascular disease, combined diabetes, treatment history of end-stage renal disease, length of hospital stay before catheterization, and blood transfusion therapy during hemodialysis period were potential risk factors for CRBSI in NCC hemodialysis patients. Multivariate conditional logistic analysis showed that patients’ high BMI (OR=1.103, 95% CI: 1.036-1.175), combined cardiovascular disease (OR=1.810, 95% CI: 1.073-3.054), previous treatment history for end-stage renal disease (OR=1.737, 95% CI: 1.047-2.884), length of hospital stay before catheterization (OR=1.065, 95% CI: 1.018-1.113), and blood transfusion during hemodialysis (OR=2.866, 95% CI: 1.611-5.100) all increased the risk of developing CRBSI in NCC hemodialysis patients. Conclusion Controlling patients’ weight, strengthening screening of high-risk patients, selecting appropriate timing for hemodialysis, and standardizing hemodialysis techniques can effectively reduce the risk of CRBSI in NCC hemodialysis patients.

Abstract:This study reports a case of bloodstream infection (BSI) caused by Wohlfahrtiimonas chitiniclastica (W. chitiniclastica) in China for the first time. A single M1 strain was isolated from two blood cultures of the patient, confirming its independent pathogenicity without coinfection. The automated microbial identification system and mass spectrometry failed to accurately identify strain M1. Whole genome sequencing successfully classified it as W. chitiniclastica. Antimicrobial susceptibility testing revealed that M1 was sensitive to ticarcillin/clavulanic acid, cefepime, ceftazidime, imipenem, meropenem, tobramycin, amikacin, ciprofloxacin, and levofloxacin, while resistance to piperacillin/tazobactam. Phylogenetic analysis demonstrated that the M1 strain had the highest affinity with the German strain, suggesting the risk of intercontinental transmission. In addition, there was a close evolutionary relationship between isolates from different hosts, providing strong evidence for their cross-species transmission.

Abstract:Patients with acquired immunodeficiency syndrome (AIDS) are susceptible to various opportunistic infection due to their low immunity. This paper reports a rare case of AIDS patient with simultaneous infections of Talaromyces marneffei (TM) and severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), analyzes clinical diagnosis and treatment processes. The patient belongs to the high-risk group of AIDS complicated with fungal infection, large dose use of glucocorticoid during the treatment process further damaged his immune function, creating opportunities for reactivation and hematogenous dissemination of latent TM. After actively administering amphotericin B combined with fluconazole for antifungal clinical treatment, the patient’s symptoms (such as fever) improved significantly.During subsequent follow-up, combined anti-infective treatment was continued to control the viral load below the detection level, and the condition improved significantly.

Abstract:Due to the impairment of immune function and long-term exposure to high-risk infection environment, patients in the intensive care unit (ICU) have a significantly higher prevalence of multidrug-resistant organism (MDRO) infection than those in other departments, MDRO can prolong hospital stay, decrease antimicrobial efficacy, increase medical cost and mortality, threaten medical quality and patient safety, cause multidimensional economic loss, and affect hospital operational efficiency. The risk factors for MDRO infection include patient-related factors and medical-related factors. The surveillance results of antimicrobial resistance in China in 2024 showed that MDRO in ICU was mainly Gram-negative bacteria, with common bacterial strains having a resistance rate of over 50% to commonly used antimicrobial agents. The detection rate remains high and the resistance spectrum continues to evolve, posing a severe situation for prevention and control. There is an urgent need to establish a multidimensional prevention and control system, including strengthening prevention and control through visual sign management, adenosine triphosphate (ATP) bioluminescence detection, and anhydrous care plans. Meanwhile, case trac-king method and multidisciplinary team collaboration are utilized to enhance efficiency. The core strategy focuses on implementing graded management of antimicrobial agents and developing non-antimicrobial therapy, and based on these, promoting precise prevention and control, standardizing clinical medication, and enhancing public awareness, so as to effectively reduce the risk of MDRO infection. This paper systematically reviews the research progress on risk factors as well as prevention and control strategies for MDRO infection in ICU, and suggests strengthening prevention and control of the heavy economic burden caused by MDRO infection, standardizing antimicrobial use, and enhancing public awareness on infection risks.

Abstract:Tuberculosis (TB) is a zoonotic infectious disease caused by Mycobacterium tuberculosis (Mtb) infection. After Mtb invades the host, innate immune cells such as macrophages activate T cells and trigger the host’s adaptive immune response through processing and presenting the antigens of Mtb to T cells. T cells play important roles in fighting against Mtb infection, which not only can secrete a variety of cytokines to enhance the immune response of the host, but also directly kill the target cells infected by Mtb, thereby inhibiting the survival of Mtb. However, Mtb can also evades host immune clearance by interfering the activation process of T cells, leading to persistent infection of host. This paper systematically elucidates the sources, subgroups, and activation mechanisms of T cells, summarizes the main factors by which Mtb promotes T cell activation, provides detailed introduction of how Mtb achieves immune evasion by inhibiting the activation of CD4⁺T and CD8⁺T cells, summarizes and envisions the important role of T cell activation in resisting Mtb infection, aiming to offer new perspective for a deeper exploration of the role and mechanisms of T cell activation in the process of Mtb infection.