Chinese Journal of Infection Control |
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Editor in Chief：Wu, Anhua ISSN：2096-9244(Online) ISSN：1671-9638(Pring) CN：43-1390/R Sponsor：Ministry of Education of the People's Republic of China Organizer：Central South University, Xiangya Hospital of Central South University Publication cycle：monthly Telephone：0731-84327658 84327237 Email：zggrkz2002@vip.sina.com |
Ranking list
- 01 Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare associated infection6932
- 02 Molecular epidemiological study of methicillin resistant Staphylococcus aureus FREE5737
- 03 Homology analysis on ICU multidrug resistant Acinetobacter baumannii nosocomial infection FREE4906
- 04 A new glycopeptide antibiotic——dalbavancin4821
- 05 Distribution and change of microbial population of clinical isolated bacteria from a hospital between 1999 and 2008 FREE4640
- 06 Colonization and drug resistance of multidrug resistant bacteria in intensive care unit FREE4556
- 07 A case control study on risk factors for nosocomial infection of Acinetobacter baumannii in internal medicine intensive care units FREE4312
- 08 Antimicrobial activity of linezolid and other antimicrobial agents against Enterococci spp. in vitro FREE4296
- 09 Change in drug resistance of Pseudomonas aeruginosa to β lactam antibiotics FREE4134
- 10 Catheter associated nosocomial infection in surgical intensive care unit :a 5 year data analysis3958
- 01 Epidemiological and clinical analysis on bacillary dysentery in 175 children in three years252800
- 02 Comparison of the effectiveness of different disinfectants on blood donors before donation127752
- 03 National healthcare associated infection surveillance system point prevalence survey of antimicrobial use in 740 Chinese hospitals in 2010124046
- 04 Study on resistant mechanism of two clinical strains of Enterobacter aerogenes to ertapenem122075
- 05 Distribution and antimicrobial resistance of major gram negative bacilli in ICU and non ICU wards in a grass roots hospital120004
- 06 Adverse drug reactions of ganciclovir in treating infants with cytomegalovirus hepatitis115264
- 07 Drug resistance and disinfectant resistant genes of Staphylococcus aureus from neonates at a neonatal ward114592
- 08 Monitoring on occupational exposure of health care workers at a general tertiary hospital110486
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Resistance mechanisms and molecular characteristics of carbapenem-resistant Enterobacterales in urinary tract infection: a study based on whole-genome sequencing
• FENG Xiaoqian, WAN Juan, LI Xiaoju, HAO Yangyang, LIU Peng, TAO Zhibo, GUO Yongcen, LIU Yang, WEI Dandan
•2026,25(7):945-953 ,Doi: 10.12138/j.issn.1671-9638.20263370
Abstract:： Objective To analyze the resistance mechanisms and molecular epidemiological characteristics of carbapenem-resistant Enterobacterales (CRE) from urine, and to provide scient...Objective To analyze the resistance mechanisms and molecular epidemiological characteristics of carbapenem-resistant Enterobacterales (CRE) from urine, and to provide scientific basis for the prevention, control, and treatment of CRE-associated urinary tract infection. Methods A total of 97 CRE strains isolated from urine specimens from the First Affiliated Hospital of Nanchang University from 2021 to 2024 were collected, and antimicrobial susceptibility testing was performed with VITEK 2 Compact automatic microbial identification and antimicrobial susceptibility analysis system. The resistance genes, plasmid types, and molecular epidemiological characteristics of strains were analyzed by whole-genome sequencing technique. Results Among the sequenced 97 CRE strains, Klebsiella pneumoniae (n=75, 77.32%) was predominant, followed by Escherichia coli (n=9, 9.28%) and Enterobacter cloacae (n=9, 9.28%). Most strains were mainly from the department of rehabilitation medicine (n=37, 38.15%). Antimicrobial susceptibility testing revealed that the resistance rate of CRE to most commonly used antimicrobial agents exceeded 90%; 92.78% (90/97) of CRE carried carbapenemase genes, with only two genotypes (blaKPC and blaNDM) being detected, primarily the blaKPC-2 and blaNDM-5 subtypes. The plasmid types carried by CRE exhibited high diversity, with the number of plasmid replicons ranging from 1 to 11. 94.85% of the strains harbored three or more plasmid replicons, with IncFII, IncR, and IncHI1B being the most prevalent. Multilocus sequence typing (MLST) results showed that ST11-KL64 and ST11-KL25 were the predominant clones of carbapenem-resistant Klebsiella pneumoniae (CRKP), while carbapenem-resistant Escherichia coli (CREC) and carbapenem-resistant Enterobacter cloacae (CRECL) exhibited significant clonal diversity. Conclusion CRE resis-tance in urinary tract infection in this region is severe, with CRE mainly carrying blaKPC-2 and blaNDM-5 genes, with highly diverse plasmid types. In addition, the ST11-KL64 and ST11-KL25 types are the dominant clones of CRKP, while other CREs exhibit significant clonal diversity, monitoring and prevention should be enhanced. Show
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Antimicrobial resistance and carbapenemase resistance genes of Pseudomonas aeruginosa in Anqing area
• LIU Kang, ZHENG Zhi, WANG Wanjun, WU Zhenzhen, LI Xiaoyue
•2026,25(7):954-960 ,Doi: 10.12138/j.issn.1671-9638.20264208
Abstract:： Objective To understand the resistance of Pseudomonas aeruginosa (PA) and carbapenem-resistant PA (CRPA) to commonly used antimicrobial agents in Anqing area, analyze their ...Objective To understand the resistance of Pseudomonas aeruginosa (PA) and carbapenem-resistant PA (CRPA) to commonly used antimicrobial agents in Anqing area, analyze their enzyme phenotype and resistance gene characteristics, and provide theoretical basis for clinical anti-infective treatment. Methods A total of 114 strains of clinically isolated PA in a hospital in Anhui Province from January 2024 to January 2026 were collected. The strains were identified by mass spectrometry, antimicrobial susceptibility testing results were obtained by VITEK 2 Compact automatic microbial identification and antimicrobial susceptibility analysis system, enzyme production phenotypes of CRPA strains were detected by carbapenem inhibition enhancement assay, enzyme types were identified by colloidal gold method, and genotypes were identified by polymerase chain reaction (PCR) method. Results From January 2024 to January 2026, 114 strains of PA were detected from this hospital, including 34 strains of CRPA. PA was mainly distributed in the intensive care unit (ICU), department of neurosurgery and department of rehabilitation medicine, accounting for 24.5% (n=28), 17.5% (n=20), and 10.5% (n=12), respectively; the proportions of CRPA in the above departments were 47.1% (n=16), 29.5% (n=10), and 14.7% (n=5), respectively. The main sources of PA specimens were sputum (63.1%), secretion (26.3%), and mid-stream urine (7.9%), while CRPA specimens were mainly sputum (85.3%). The resistance rates of PA to imipenem and meropenem were 27.2% and 26.3%, respectively. CRPA had higher resistance to commonly used antimicrobial agents, with resistance rates of 88.2%, 85.3%, and 14.7% to imipenem, meropenem, and amikacin, respectively. Among 34 CRPA strains, 15 strains (44.1%) produced class-B enzymes; the colloidal gold method result showed that 9 strains (26.5%) carried IMP enzymes and 6 strains (17.6%) carried NDM enzymes. PCR detection results were consistent with that of the colloidal gold method. Sequencing analysis showed that blaIMP gene was mainly blaIMP-4 subtype, while blaNDM gene was mainly blaNDM-1 subtype. Conclusion PA in Anqing area has resistance to commonly used antimicrobial agents, and CRPA mainly carries blaIMP-4 and blaNDM-1 gene subtypes, detecting enzyme phenotypes and resistance genes can help guide rational anti-infective treatment in clinical practice. Show
KeyWord：Pseudomonas aeruginosa;antimicrobial resistance;enzyme phenotype test;antimicrobial resistance gene
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Characteristics of serotypes, drug resistance, and virulence genes of Salmonella from patients with diarrhea: an analysis based on whole-genome sequencing
• SUN Min, LI Shuangshu, MA Jian, WEI Mingyue, FAN Mengying, ZHANG Xianfeng, LIU Pei, LI Bingbing, CHEN Dawei
•2026,25(7):961-970 ,Doi: 10.12138/j.issn.1671-9638.20262764
Abstract:： Objective To analyze the serotype distribution, drug resistance, molecular typing, and virulence factor carriage characteristics of Salmonella strains from patients with dia...Objective To analyze the serotype distribution, drug resistance, molecular typing, and virulence factor carriage characteristics of Salmonella strains from patients with diarrhea. Methods Salmonella isolated and cultured from fecal specimens of clinical patients diagnosed with diarrhea in a region from 2021 to 2024 were collected. Serotypes were identified with the serum slide agglutination method, antimicrobial susceptibility testing was performed with microbroth dilution method; core genome multilocus sequence typing (cgMLST) as well as carriage of resistance and virulence genes were analyzed by whole-genome sequencing technique, the distribution of Salmonella ST, drug resistance characteristics, and virulence features were explored. Results A total of 30 non-repetitive Salmonella strains were detected, belonging to 13 serotypes and 12 sequence types (STs), with the dominant serotypes being Salmonella enteritidis (ST11) and Salmonella typhimurium (ST19). Antimicrobial susceptibility testing results showed that the detected Salmonella exhibited the highest resistance rate to streptomycin (80.00% ［n=24 strains］), followed by ampicillin (66.67%), nalidixic acid (56.67%), and tetracycline (53.33%). A total of 20 (66.67%) multidrug-resistant strains were detected, out of which 11 strains (36.67%) exhibited resistance to at least 5 types of antimicrobial agents, 1 variant strain of Salmonella typhimurium and 1 strain of Salmonella thompson showed resistance to all 9 tested antimicrobial agents. Antimicrobial resistance gene testing revealed that the genes with higher carriage rates were aac(6')-Iaa, sul2, blaTEM-1B, aph(3″)-Ib and aph(6)-Id. Virulence gene analysis revealed that all isolates carried 4 types of virulence factors, including secretion system-related factors, non-pili adhesion-related factors, magnesium ion transport-related factors, and pili adhesion-related factors. Conclusion Salmonella isolated from patients with diarrhea in this region exhibited diverse serotypes, with severe multidrug resistance and widespread carriage of multiple virulence factors. Active surveillance on Salmonella resistance and virulence factors should be continuously strengthened, so as to provide scientific basis for clinical antimicrobial therapy and public health prevention strategies. Show
KeyWord：Salmonella spp.;serotype;whole-genome sequencing;antimicrobial resistance;virulence factor
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Epidemic of antimicrobial resistance genes and transmission mode of clone-plasmid complex in clinically isolated Enterobacterales in Jiamusi City
• MENG Qingmin, FU Yu, OUYANG Fengju, YAN Jun, XUE Chengyu, MENG Minzhi, SU Mingming, XING Hui, MA Yongjuan, WANG Bin, BAO Mingjia
•2026,25(7):971-977 ,Doi: 10.12138/j.issn.1671-9638.20263378
Abstract:： Objective To understand the epidemiological characteristics of antimicrobial resistance genes in clinically isolated Enterobacterales in a region, and to analyze the model o...Objective To understand the epidemiological characteristics of antimicrobial resistance genes in clinically isolated Enterobacterales in a region, and to analyze the model of clonal transmission and horizontal transfer of antimicrobial resistance genes in resistant strains. Methods 133 clinical isolates of Enterobacterales from blood and fecal specimens from a sentinal hospital in Jiamusi from March 2023 to October 2024 were collected for antimicrobial susceptibility testing and whole genome sequencing. Analyses of resistance gene and plasmid replicon, multilocus sequence typing (MLST), and phylogenetic analysis were conducted based on genomic data. Horizontal transfer ability of resistant plasmids was evaluated through conjugation transfer test. Results In Klebsiella pneumoniae, blaSHV (93.68%), oqxAB (97.89%), and fosA (86.32%) were the most frequently detected resistance genes, while ST23 was the dominant epidemic type (30.53%), with a percentage of 61.7% in the IncH (pNDM-MAR) plasmid. In diarrheal Escherichia coli DEC, blaCTX-M (57.69%), blaTEM (61.54%), and qnr (38.46%) were the main resistance genes. IncF plasmids were widely present (92.31%), and 80.00% of donor strains exhibited the ability to conjugate and transfer resistant plasmids. Conclusion The transmission of Enterobacterales in this region may be driven by two modes: ST23 IncH (pNDM-MAR) complex clone expansion and IncF plasmid horizontal transfer. Strengthening molecular monitoring of high-risk clone-plasmid complex is crucial for controlling the transmission of healthcare-associated infection. Show
KeyWord：Enterobacterales;antimicrobial resistance gene;plasmid;multilocus sequence typing;clone transmission
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Relationship between medical waste and economic development: evidence from 9 cities in the Pearl River Delta
• YANG Ting, CAO Min, DING Ling, TIAN Zheng
•2026,25(7):978-986 ,Doi: 10.12138/j.issn.1671-9638.20264104
Abstract:： Objective To test whether the generation of medical waste conforms to the environmental Kuznets curve (EKC), and to explore the impact of factors such as education level, ur...Objective To test whether the generation of medical waste conforms to the environmental Kuznets curve (EKC), and to explore the impact of factors such as education level, urbanization level, medical service capacity, and public health level on the amount of medical waste generation (MWG). Methods The EKC was adopted to analyze the direct impact of economic development on MWG. Combined with the spatial Durbin model (SDM) and mediation effect model, the indirect impact of economic development on MWG was further investigated. Results The linear and cubic coefficients of economic development were positive (both P<0.01), while the binomial coefficient was negative (P<0.01), demonstrating a N-shaped curve relationship between MWG and economic development in 9 main cities in the Pearl River Delta. The results of the mediation effect model test showed that the coefficients of hospital discharge volume and economic development level of medical institutions were both positive (both P<0.01), indicating the existence of the mediation effect; the SDM model test results showed that the spatial lag coefficients of economic development level and population size were negative (both P<0.05), indicating the existence of spatial spillover effect. Conclusion The generation of medical waste does not conform to the EKC hypothesis, economic development not only directly promotes the generation of medical waste, but also indirectly drives its growth through the discharge volume of medical institutions. Economic development and population agglomeration of neighboring cities have a significant impact on the MWG of this city. Show
KeyWord：medical waste;economic development;spatial econometric model;Pearl River Delta region
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Epidemiological characteristics of epidemics and genotyping of norovirus in Xicheng District of Beijing for 6 consecutive years
• HUANG Yanhong, CHU Yanhui, LIU Xiaoxiao, YANG Xiong, SUN Jingyi, KONG Qingzheng, JI Yanli, LI Weihong
•2026,25(7):987-993 ,Doi: 10.12138/j.issn.1671-9638.20264399
Abstract:： Objective To analyze the epidemiological characteristics and genotype distribution of norovirus (NoV) gastroenteritis epidemics in Xicheng District of Beijing, and to provid...Objective To analyze the epidemiological characteristics and genotype distribution of norovirus (NoV) gastroenteritis epidemics in Xicheng District of Beijing, and to provide scientific basis for the prevention and control of NoV gastroenteritis epidemics. Methods Descriptive epidemiological method was adopted to analyze the data of NoV gastroenteritis epidemics in Xicheng District of Beijing from July 2019 to June 2025. Reverse transcription polymerase chain reaction (RT-PCR) was used for GⅠ and GⅡ NoV nucleic acid testing. Nucleic acid positive specimens were submitted to the Beijing Center for Disease Prevention and Control for sequencing and genotyping identification. Results A total of 179 NoV gastroenteritis epidemics were reported, including 168 clustered epidemics (93.85%) and 11 outbreaks (6.15%), involving 1 744 cases, with an overall attack rate of 11.04%. The epidemics presented an overall fluctuating trend, characterized by biennial peak. Annual peak of the epidemic concentrated in October-December following the start of autumn semester and in March-May following the start of spring semester, with distinct seasonality. Primary schools were the most common settings where the epidemic occurred (n=85, 47.48%), followed by preschool institutions (n=61, 34.08%). GⅡ NoV was the main pathogen causing the epidemics (accounting for 85.47% of the total epidemics). Genotyping showed that GII. 2 ［P16］ was the dominant genotype from July 2019 to June 2021; only 1 epidemic was successfully identified from July 2021 to June 2022; there was a multi-genotype co-epidemic with no obvious dominant type from July 2022 to June 2024; GII.17 ［P17］ emerged as a new dominant genotype from July 2024 to June 2025. Conclusion NoV gastroenteritis epidemics in Xicheng District of Beijing are mainly concentrated in primary schools and preschool institutions, with high incidence in autumn, winter and spring. It is suggested to strengthen various prevention and control measures during the school opening seasons, continuously conducting pathogen monitoring of the epidemics and sporadic cases, closely tracking the dynamics of virus mutation, and providing scientific basis for precise epidemic prevention and control. Show
KeyWord：norovirus;acute gastroenteritis;epidemiology;genotype
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Impact of combined oral-nasal cavity and skin decolonization on postope-rative pulmonary infection in heart transplant patients
• YANG Xiaohong, LI Na, LIU Ruohan
•2026,25(7):994-1001 ,Doi: 10.12138/j.issn.1671-9638.20264152
Abstract:： Objective To explore the impact of combined oral-nasal cavity and skin decolonization on postoperative pulmonary infection in heart transplant patients. Methods A tot...Objective To explore the impact of combined oral-nasal cavity and skin decolonization on postoperative pulmonary infection in heart transplant patients. Methods A total of 85 patients who underwent heart transplant surgery at the First Affiliated Hospital of Xi’an Jiaotong University from September 2023 to October 2025 were selected as the study subjects. They were randomly divided into an intervention group (n=42) and a control group (n=43) using a random number table method. The control group received routine nursing measures, while the intervention group received combined oral-nasal cavity and skin decolonization intervention. The incidence of pulmonary infection, laboratory test results, duration of mechanical ventilation, and intensive care unit (ICU) stay between two groups of patients were compared. Patients underwent a 3-month follow-up after surgery to compare pulmonary infection and survival status. Results The incidence of pulmonary infection in intervention group was 23.8% (10/42), which was lower than 44.2% (19/43) of control group, and difference was statistically significant (P=0.048). In terms of infection types, patients in the intervention group were mainly infected with single bacteria (80.0%), while those in the control group were mostly infected with mixed bacteria (68.4%), with statistically significant diffe-rence (P=0.021). In terms of pathogen distribution, for patients in the control group, Gram-positive bacteria (mainly Staphylococcus aureus) infection accounted for 52.6%, while the intervention group was predominantly infected with Gram-negative bacteria (90.0%), with Gram-positive bacteria accounting for only 10.0%. Difference between the two groups was statistically significant (P=0.044). In terms of laboratory indicators, there were no statistically significant differences in white blood cell count, absolute neutrophil count, lymphocyte count, and C-reactive protein level between the two groups of patients before the initial intervention (all P>0.05). After 5 days of continuous intervention and 5 days after the end of the intervention, the white blood cell count, absolute neutrophil count, and C-reactive protein level in patients in the intervention group were all lower than those in the control group (all P<0.05), while the lymphocyte count was higher than that in the control group (all P<0.05). The duration of mechanical ventilation and ICU stay in patients in the intervention group were both shorter than those in the control group (both P<0.05). The 3-month follow-up results showed that the incidence of pulmonary infection in patients in the intervention group was 11.9% (5/42), which was lower than 32.6% (14/43) in the control group, and the difference was statistically significant (P=0.022). There was no statistically significant difference in survival rate between the two groups of patients (P=0.676). Conclusion Combined oral-nasal cavity and skin decolonization can reduce the incidence of postoperative pulmonary infection in heart transplant patients, decrease mixed infection, as well as shorten duration of mechanical ventilation and length of ICU stay in heart transplant patients. Show
KeyWord：decolonization;oral-nasal cavity;skin;pulmonary infection;heart transplant;postoperative infection
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Meta-analysis on pre-treatment drug resistance rate and its influencing factors in HIV-infected individuals in China from 2016 to 2025
• LI Le, JIANG Yunlan, LIU Lixin, WANG Yuelin, CHEN Hong, WANG Jing, BAI Xiaoyu, ZHANG Mengjie, WU Senlin, RAO Ying
•2026,25(7):1002-1013 ,Doi: 10.12138/j.issn.1671-9638.20264176
Abstract:： Objective To systematically evaluate the rate of pre-treatment drug resistance (PDR)and its influencing factors in human immunodeficiency virus (HIV)-infected individuals in...Objective To systematically evaluate the rate of pre-treatment drug resistance (PDR)and its influencing factors in human immunodeficiency virus (HIV)-infected individuals in China from 2016 to 2025. Methods PubMed, Web of Science, Embase, the Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database were retrieved, with a retrieval period from the establishment of the databases to November 1, 2025. Two researchers independently screened literature, extracted data, and evaluated quality of the studies. Meta-analysis was performed with Stata 18.0 software. Results A total of 50 literatures were included in analysis, involving 28 662 infected individuals. There was significant heterogeneity among the studies (I2=93.2%, P<0.001). Meta-analysis results showed that from 2016 to 2025, the rate of PDR in HIV-infected individuals in China was 10%, with a resistance rate of 7% to non-nucleoside reverse transcriptase inhibitors (NNRTIs), 2% to nucleoside reverse transcriptase inhibitors (NRTIs), and 1% to protease inhibitors (PIs). CD4+ cell count < 200 cells/μL (OR=1.60, 95%CI: 1.24-2.06), drug injection (OR=2.52, 95%CI: 1.73-3.66), female (OR=2.11, 95%CI: 1.22-3.64), genotype CRF07_BC (OR=0.63, 95%CI: 0.49-0.83), genotype CRF55_01B (OR=6.90, 95%CI: 3.99-11.94), and genotype B (OR=3.35, 95%CI: 2.31-4.85) were all influencing factors of PDR in HIV-infected individuals (all P<0.05). Conclusion The rate of PDR in HIV-infected individuals in China is relatively high. It is necessary to strengthen the surveillance of PDR among HIV-infected individuals, take targeted measures, and improve the supervision system, so as to reduce the spread of drug-resistant strains. The heterogeneity of drug resistance rate among studies is high, and subgroup analysis failed to reduce its heterogeneity, which may be related to differences in HIV prevention and control resources, urban education development levels, and HIV gene subtype distribution in different regions. Show
KeyWord：HIV;pre-treatment drug resistance;China;influencing factor;Meta-analysis
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Efficacy of debridement via unilateral intervertebral foraminal approach in the treatment of thoracolumbar intervertebral infection
• ZHU Jinghui, WU Jianhuang, WU Tianding
•2026,25(7):1014-1020 ,Doi: 10.12138/j.issn.1671-9638.20263386
Abstract:： Objective To evaluate the clinical efficacy and safety of debridement via unilateral intervertebral foraminal approach combined with single-segment fixation of the diseased ...Objective To evaluate the clinical efficacy and safety of debridement via unilateral intervertebral foraminal approach combined with single-segment fixation of the diseased spines in treating thoracolumbar intervertebral infection. Methods Clinical data of 116 patients who received treatment for thoracolumbar intervertebral infection from January 2013 to January 2022 were analyzed retrospectively. Patients were divided into two groups based on the surgical approach. Group A (n=49) underwent debridement via unilateral intervertebral foraminal approach combined with single-segment fixation of the diseased vertebra, while group B (n=67) underwent debridement via posterior total laminectomy and bone graft fusion combined with internal fixation. Clinical and imaging results of two groups of patients were compared. Results No significant differences were found between the two groups in sex, age, body mass index, affected segment, and pathogenic distribution (all P>0.05). Group A had shorter operative duration, less intraoperative blood loss, shorter postoperative hospital stay, and lower hospitalization costs than group B (all P<0.05). There was no statistically significant difference in intervertebral fusion time between the two groups of patients (P>0.05). Repeated-measures analysis of variance showed significant time effect for visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score, and Oswestry disability index (ODI) (all P<0.001), indicating postoperative pain and functional status in both groups of patients improved markedly compared with preoperative status. The group effect and group × time interaction effect for these scores were not statistically significant (all P>0.05), suggesting the differences in overall efficacy and changing trend over time between the two groups were not significant. There was no statistically significant diffe-rence in American Spinal Injury Association (ASIA) grading and neurological function improvement between the two groups of patients (both P>0.05). Conclusion For patients with thoracolumbar intervertebral infection who meet the surgical indications, debridement via unilateral intervertebral foraminal approach combined with single-segment fixation of the diseased vertebra can achieve similar clinical efficacy and safety to debridement via posterior total laminectomy and bone graft fusion combined with internal fixation. At the same time, it has the advantages of shorter surgical duration, less intraoperative blood loss, shorter postoperative hospital stay, and lower hospitalization costs, and may serve as a less invasive posterior surgical approach. Show
KeyWord：spinal infection;intervertebral infection;debridement;thoracolumbar spine;internal fixation
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Application of DRG payment method in infection control monitoring and medical resource consumption
• JING Zhaofeng, CHEN Meili, HUANG Hetian, CHENG Lei, GENG Cui, GAO Jia, LYU Yufeng, MENG Mei, QU Bo, HUANG Hepeng, CAI Wei, CHEN Dongmei, LANG Qinghua, ZHANG Jianying, CHEN Xiaoyu, JIANG Shiyan, MEI Kui
•2026,25(7):1021-1029 ,Doi: 10.12138/j.issn.1671-9638.20263262
Abstract:： Objective To explore the application of disease diagnosis-related group (DRG) payment method in healthcare-associated infection (HAI) monitoring and its impact on medical re...Objective To explore the application of disease diagnosis-related group (DRG) payment method in healthcare-associated infection (HAI) monitoring and its impact on medical resource consumption. Methods The basic information and settlement list information of hospitalized patients in a hospital in Liupanshui City from 2020 to 2023 were analyzed retrospectively. DRG grouping was carried out based on CN-DRG Grouping Scheme (2023), research objects in the same DRG group were divided into HAI group and non-HAI group, and case mix index (CMI) was used to correct the cases incidence rate of HAI. Difference in indexes, such as time consumption index, expense consumption index, length of hospital stay, total hospitalization expense, and each detailed expense between HAI group and non-HAI group were compared. Results A total of 143 652 cases were enrolled, the median length of hospital stay in patients in HAI group prolonged by 13 days compared with that of non-HAI patients within the same DRG, the median total hospitalization expense increased by 23 800-28 300 Yuan (both P<0.05). After the adjustment of CMI value in 2023, the case incidence rates of HAI in the department of neurosurgery intensive care unit and the department of critical care medicine declined, with the largest decline in the neurosurgery intensive care unit (15.00%). In the internal medicine DRG, surgical DRG, and procedural DRG, the time consumption index and expense consumption index of HAI group were both higher than those of non-HAI group (both P<0.05). The top 5 DRGs with the highest HAI case incidence rates were AH29 (invasive ventilator support ≥96 hours, 23.05%), GB39 (major surgery of small intestine and large intestine ［including rectum］, 12.00%), ZJ11 (other surgical procedures related to multiple injuries, with serious comorbidity or complications, 8.06%), IE39 (lower limb bone surgery except femur, 3.64%), ES31 (respiratory system infection/inflammation, with serious comorbidity or complications, 0.70%). For DRGs AH29, ES31 and RN25 (targeted therapy and immunotherapy for malignant and proliferative diseases, without serious comorbidity or complications), patients in HAI group had longer hospitalization days, higher total hospitalization expense, and each detailed expense than those of non-HAI group (all P<0.05). Bloodstream infection, skin and soft tissue infection, and surgical site infection had significant impact on the time consumption index; bloodstream infection and urinary tract infection had significant impact on the expense consumption index. Conclusion Under the DRG payment method, HAI significantly increases the consumption of medical resources. Adjusting CMI values can improve the accuracy of assessing the level of infection prevention and control in departments. It is speculated that implementing targeted prevention and control for patients in high-risk infection DRGs and high consumption infection sites can effectively reduce resource waste and promote the synergistic improvement of medical quality and economic benefits under the DRG payment system. Show
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Construction and validation of risk predicting model for carbapenem-resistant Acinetobacter baumannii infection in ICU patients
• XIAN Jiangyan, LI Duo, WU Xunlian, GAN Changyu
•2026,25(7):1030-1041 ,Doi: 10.12138/j.issn.1671-9638.20264287
Abstract:： Objective To explore the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) infection in patients in intensive care unit (ICU), and to construct and valida...Objective To explore the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) infection in patients in intensive care unit (ICU), and to construct and validate a nomogram risk prediction model. Methods Clinical data of ICU patients in a tertiary first-class hospital from June 1, 2022 to May 31, 2025 were collected retrospectively, and randomly divided into a modeling group and a validation group at a 7∶3 ratio. Based on data from the modeling group, univariate analysis and Lasso regression were used to screen characteristic variables, multivariate logistic regression analysis was adopted to determine independent risk factors for CRAB infection in ICU patients, and a nomogram prediction model was established. Internal validation of the model was conducted with data from validation group, and model performance was evaluated by receiver operating characteristic (ROC) curve, calibration curve, and decision curve. Results Among the 2 256 ICU patients, 194 developed CRAB infection, with an infection rate of 8.60%. Multivariate logistic regression analysis showed that the use of glucocorticoids or immunosuppressants (OR=3.21, 95%CI: 1.55-6.65), hypoalbuminemia (OR=10.20, 95%CI: 5.12-20.34), combination therapy with antimicrobial agents≥2 types before CRAB infection (OR=2.55, 95%CI: 0.99-6.51), duration of ventilator use≥7 days (OR=4.09, 95%CI: 2.56-6.53), previous infection before CRAB infection (OR=6.31, 95%CI: 3.80-10.49), and use of carbapenem antibiotics before CRAB infection (OR=9.93, 95%CI: 3.61-27.31) were independent risk factors for CRAB infection in ICU patients. Based on the above 6 independent risk factors, a nomogram model for predicting CRAB infection in ICU patients was established. The internal validation results showed that the area under ROC curve (AUC) values of the modeling group and the validation group were 0.909 (95%CI: 0.883-0.936) and 0.901 (95%CI: 0.862-0.939), respectively, indicating that the model had high predictive accuracy. The Hosmer-Lemeshow test had P-values of 0.991 and 0.521, respectively, indicating a good fit of the model. Conclusion The risk prediction model for CRAB infection in ICU patients constructed in this study has good discrimination and calibration, which can assist in identifying high-risk patients with CRAB infection and provide early warning references for accurate prevention and control. Show
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Investigation and intervention effectiveness in a standard-exceeding event of microbial monitoring of pediatric ultrathin flexible bronchoscopes
• ZHANG Xiang, FU Lu, GUO Yan, JIN Lin, XU Jue, CHEN Wensen
•2026,25(7):1042-1048 ,Doi: 10.12138/j.issn.1671-9638.20263070
Abstract:： Objective To investigate and intervene in a standard-exceeding event of microbial monitoring of pediatric ultrathin flexible bronchoscopes in a tertiary first-class maternit...Objective To investigate and intervene in a standard-exceeding event of microbial monitoring of pediatric ultrathin flexible bronchoscopes in a tertiary first-class maternity and child health care hospital, and to provide a basis for improving the cleaning and disinfection quality of flexible bronchoscopes and reducing healthcare-associated infection (HAI) caused by contamination of flexible bronchoscopes. Methods Flexible bronchoscopes with microbial contamination were recalled through contacting the manufacturer. The internal channels of the flexible bronchoscopes were examined using borescope, and leakage was tested. On-site sampling of the final rinse water system was conducted. The usage and disposal procedures of flexible bronchoscopes implemented by staff were investigated through on-site survey. Intervention measures were developed. Results The main problems were: 1 There were visible scratches and epidermal lifting on the tube surface of flexible bronchoscopes, with leakage testing indicating minor leakage. 2 Microbial detection of the final rinse water exceeded standards. 3 Some flexible bronchoscopes handling personnel lacked standardized pre-service training and assessment, leading to inadequate drying time and rough brushing of the bronchoscopes. In response to the existing problems, the manufacturer replaced the flexible bronchoscopes outer sheath and the filter for the rinse water generator, and installed a filter at the outlet of the final rinse water. After the hospital strengthened training, assessment, and supervision of the personnel handling flexible bronchoscopes, the re-inspection results were qualified. Conclusion The microbial count exceeding the standard for flexible bronchoscopes may be attributed to biofilm formation resulting from surface damage, contamination of final rinse water, and improper personnel handling. To prevent HAI related to flexible bronchoscopes, medical institutions should regularly inspect the lumens of in-use flexible bronchoscopes and test leakage, promptly repair those with significant damage. In addition, it is necessary to pay attention to the quality of rinse water, disinfection of water supply lines, as well as training and assessment of disposal personnel. Show
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Difference in epidemiological characteristics and prognostic factors of central line-associated bloodstream infection in children in intensive care units and non-intensive care units
• LI Wenwen, ZHAO Danyang, GUO Qiaozhi, SUN Huimin, CHEN Junlan, HE Tongjie, CHEN Xiuchun, CAI Xian
•2026,25(7):1049-1056 ,Doi: 10.12138/j.issn.1671-9638.20264212
Abstract:： Objective To compare the differences in epidemiological characteristics, pathogen distribution, and prognosis of central line-associated bloodstream infection (CLABSI) betwe...Objective To compare the differences in epidemiological characteristics, pathogen distribution, and prognosis of central line-associated bloodstream infection (CLABSI) between children in intensive care units (ICUs) and in non-ICUs, identify key influencing factors, and provide basis for developing individualized prevention and control strategies. Methods 391 children with CLABSI in a tertiary children’s hospital in Guangzhou City between January 1, 2022 and June 30, 2025 were retrospectively enrolled in the analysis. Children were divided into an ICU group (n=134) and a non-ICU group (n=257) based on their hospitalization wards. Basic information, catheter-related information, infection-related information, and prognostic indicators of children were collected. SPSS 26.0 was adopted to conduct statistical analysis, categorical data were analyzed by χ2 test and quantitative data were compared using non-parametric test. After univariate analysis of factors influencing the risk of 30-day all-cause mortality was performed using χ2 test and non-parametric test, factors with P≤0.05 were included in a multivariate logistic regression model for further analysis. Results During the study period, the incidence of CLABSI in ICUs (1.06%-1.53%) remained stable with minor fluctuations, while that in the hematology-oncology ward (1.54‰-2.58‰) increased and was higher than that in ICUs; the incidence in other general wards was 1.45‰. Pathogens in ICUs and hematology-oncology ward were mainly Gram-negative bacteria (accounting for 48.96% and 57.56%, respectively), whereas Gram-positive bacteria were the main pathogens in other general wards (66.67%). The overall mortality of children was 5.37%(21/391), with mortality of 10.45% (14/134) in ICUs and 3.76% (7/186) in the hematology-oncology ward. Multivariate analysis revealed that the longer the hospitalization stay after infection, the lower the risk of all-cause mortality within 30 days (OR=0.884, 95%CI: 0.812-0.963). Anemia (OR=6.357, 95%CI: 1.246-32.429) and pneumonia (OR=5.264, 95%CI: 1.035-26.766) were independent risk factors for mortality in children in hematology-oncology ward. Conclusion The incidence of CLABSI is high in children from the hematology-oncology ward, with common pathogen spectra across different wards. Skin-derived bacteria (e.g. Staphylococcus epidermidis) account for a relatively high proportion in other general wards. Infection control measures targeting specific pathogens should be strengthened, with particular attention to children with anemia and pneumonia in the hematology-oncology ward. Show
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Consumption of antimicrobial agents in public hospitals in Hong Kong, China, 2014-2023
•2026,25(7):1057-1065 ,Doi: 10.12138/j.issn.1671-9638.20263273
Abstract:： Objective To analyze the consumption of antimicrobial agents in public hospitals in Hong Kong Region, China from 2014 to 2023. Methods With the defined daily dose (DD...Objective To analyze the consumption of antimicrobial agents in public hospitals in Hong Kong Region, China from 2014 to 2023. Methods With the defined daily dose (DDD) recommended by the World Health Organization (WHO) as a measuring unit, the categories, varieties, AWaRe classification, consumption of orally administered antimicrobial agents in inpatient department, and antimicrobial use density (AUD) of public hospitals in Hong Kong Region from 2014 to 2023 were statistically analyzed. Results From 2014 to 2023, a total of 70 varieties of antimicrobial agents across 24 categories were used in public hospitals in Hong Kong Region, with a total consumption of 75.014 7 million DDDs. The top proportions of categories, varieties, and AWaRe classification consumption of antimicrobial agents were penicillin/β-lactamase inhibitors (50.25%), amoxicillin/clavulanic acid (44.77%), and access group varieties (68.13%), respectively. The consumption of orally administered antimicrobial agents in inpatient department accounted for 64.15% of the total consumption of inpatient department, with an AUD of 78.63 DDDs. During the same period, 14 varieties of antifungal agents across 4 categories were used in public hospitals in Hong Kong Region, with a total consumption of 4.381 7 million DDDs; the consumption of orally administered antifungal agents in inpatient department accounted for 85.25% of the total consumption of antifungal agents in inpatient department, with the antifungal use density of 4.18 DDDs. Conclusion The categories and varieties of antimicrobial agents with the highest consumption in public hospitals in Hong Kong Region from 2014 to 2023 were penicillin/β-lactamase inhibitors and amoxicillin/clavulanic acid. The consumption of access group varieties has approached the 2030 target requirements set by the United Nations and WHO. Show
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Optimal method and duration for drying lumens of phacoemulsification surgical instruments
• ZHOU Fangfang, LIU Wei, TAN Rong, FENG Jiali, ZHOU Chunyan
•2026,25(7):1066-1071 ,Doi: 10.12138/j.issn.1671-9638.20263159
Abstract:： Objective To explore the effective drying method and drying duration for the lumen of phacoemulsification-specific surgical instruments. Methods 360 phacoemulsificati...Objective To explore the effective drying method and drying duration for the lumen of phacoemulsification-specific surgical instruments. Methods 360 phacoemulsification handpieces and 420 irrigation/aspiration handpieces collected from a hospital within 60 minutes after use between March 2025 and June 2025 were randomly divided into 6 groups (60 pieces per group) and 7 groups (60 pieces per group), respectively. After all handpieces were cleaned and disinfected using a medical vacuum automatic cleaning machine, the control group was directly dried in a 60 ℃ medical vacuum drying cabinet for 20 minutes. In the test group, the irrigation and aspiration lumens were first pre-dried through continuously blowing air with a pressure air gun for 30 seconds, then all were uniformly placed in a medical vacuum drying cabinet at 60 ℃ for drying. The drying durations were as follows: 1, 2, 3, 4, and 5 minutes for phacoemulsification handpiece group, and 1, 2, 3, 4, 5, and 6 minutes for irrigation/aspiration handpiece group. At the end of each drying time, cobalt chloride strip test was used to evaluate the drying effect on the lumens. Results There were statistically significant differences in the qualified rate of lumen drying between phacoemulsification handpiece and irrigation/aspiration handpieces of different groups (both P<0.05). In control group, the qualified drying rates of phacoemulsification and irrigation/aspiration handpieces were 23.33%(14/60) and 16.67%(10/60), respectively. In test group, the qualified drying rates were both 100% for the lumens of phacoemulsification handpiece after continuous blowing with a pressure air gun for 30 seconds+vacuum drying for 5 minutes and for the lumens of irrigation/aspiration handpieces after continuous blowing with a pressure air gun for 30 seconds+vacuum drying for 6 minutes. The qualified rate of lumen drying in each test group showed an upward trend with the increase of drying time (all P<0.05). Conclusion After the lumens of the phacoemulsification handpiece and the irrigation/aspiration handpiece were mechanically cleaned and disinfected, each lumen was first pre-dried manually by continuously blowing with a pressure air gun for 30 seconds, then placed in a medical vacuum drying cabinet at 60℃ for drying. Drying for 5 minutes for the phacoemulsification handpiece and 6 minutes for the irrigation/aspiration handpiece can ensure the effectiveness of lumen drying for phacoemulsification-specific surgical instruments. Show
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Current status and influencing factors for pinworm infection among preschool children in Ninghai County in 2025
• YU Yijiang, YE Qiong, YING Qinqin, MA Bingcun, WANG Bin
•2026,25(7):1072-1077 ,Doi: 10.12138/j.issn.1671-9638.20264118
Abstract:： Objective To comprehensively understand the current status of pinworm infection among kindergarten children in Ninghai County, explore the influencing factors, and provide s...Objective To comprehensively understand the current status of pinworm infection among kindergarten children in Ninghai County, explore the influencing factors, and provide scientific basis for further adjusting and promoting the prevention and control strategies of pinworm disease in children. Methods According to geographical orientation, one township from each of the east, west, south, north, and middle area was randomly selected, cluster sampling was conducted on 2 kindergartens from each township (1 village level/private kindergarten and 1 township kindergarten). From May to June, 2025, transparent adhesive tape was applied to the perianal area of children for two consecutive days. Pinworm infection was examined by microscopy. Questionnaire survey on demographic characteristics and related hygiene habits of children and their parents was conducted, and statistical analysis was performed on the collected questionnaires. Results A total of 3 077 preschool children were monitored, and 13 were found to be infected with pinworm, with an overall infection rate of 0.42%. Multivariate logistic regression analysis showed that being in large classes and having guardians with low education levels were risk factors for pinworm disease in preschool children, while washing hands before meals was a protective factor. Conclusion Pinworm infection in preschool children in Ninghai County is at low prevalence. It is still necessary to continue to strengthen health education and carry out monitoring, so as to promote the prevention and control of pinworm disease in children. Show
KeyWord：pinworm;infection;child;parasitic disease;influencing factor
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Relationship of core competence, professional identity, and job perfor-mance in infection control link nurses
• BAI Ge, ANDREAS Efstathiades
•2026,25(7):1078-1085 ,Doi: 10.12138/j.issn.1671-9638.20263276
Abstract:： Objective To establish and validate the relationship of core competence, professional identity, and job performance in infection control link nurses (ICLNs), and to examine ...Objective To establish and validate the relationship of core competence, professional identity, and job performance in infection control link nurses (ICLNs), and to examine the applicability of the mediating mechanism of professional identity among ICLNs with different years of work experience. Methods A questionnaire survey was conducted on 404 ICLNs from 14 general hospitals. Structural equation model was adopted to validate the path relationships and mediating effect among core competence, professional identity, and job performance. Based on years of work experience, a multi-group structural equation model was further adopted to validate the applicability of the path model. Results Core competence had a direct positive correlation with job performance (β=0.42, P<0.001) and was indirectly correlated with job performance through the partial mediating role of professional identity (β=0.15, P<0.001), with a total effect of 0.57. Multi-group analysis showed that there were no statistically significant differences between the measurement weights model and the baseline model (△χ2= 4.84, P=0.938) as well as between the structural weights model and the measurement weights model (△χ2=6.86, P=0.075), respectively, indicating that the path model in this study was applicable to ICLNs with different years of work experience. Conclusion There is a positive correlation between the core competence of ICLNs and their job performance, and professional identity plays a partial mediating role between the two. The mechanism of this effect does not differ with different years of work experience. Hospital managers should attach importance to the development of professional competence and role value recognition among ICLNs, so as to promote overall performance. Show
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A severe case of Angiostrongylus cantonensis meningitis in child
• WEI Xuemei, YANG Xiaoxiang, LI Juan, CHEN Yuyi
•2026,25(7):1086-1088 ,Doi: 10.12138/j.issn.1671-9638.20264324
Abstract:： This paper reports a case of severe meningitis caused by Angiostrongylus cantonensis in a child. The child presented with fever and vomiting as initial symptoms, with elevated eosi...This paper reports a case of severe meningitis caused by Angiostrongylus cantonensis in a child. The child presented with fever and vomiting as initial symptoms, with elevated eosinophil counts in peripheral blood and cerebrospinal fluid. Head magnetic resonance imaging (MRI) revealed progressive encephalitis changes, and meta-genomic next-generation sequencing (mNGS) of cerebrospinal fluid detected specific sequences of Angiostrongylus cantonensis. After multidisciplinary comprehensive treatment, the child’s condition continued to deteriorate, ultimately leading to death. Therefore, for young children with meningitis complicated with elevated eosinophil counts of unknown cause, the possibility of Angiostrongylus cantonensis infection should be considered as early as possible in clinical practice, and relevant pathogen-related examinations should be performed promptly. Show
KeyWord：Angiostrongylus cantonensis;meningitis;severe type;child;metagenomic next-generation sequencing
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Pulmonary anthrax diagnosed by bronchoalveolar lavage and metagenomic next-generation sequencing: a case report
• YU Yanyan, WANG Tingting, XIAO Jitao
•2026,25(7):1089-1091 ,Doi: 10.12138/j.issn.1671-9638.20263272
Abstract:： Anthrax is a zoonotic disease caused by infection with Bacillus anthracis. Pulmonary anthrax is the most lethal form, with a mortality of over 85%. As an emerging pathogen diagnost...Anthrax is a zoonotic disease caused by infection with Bacillus anthracis. Pulmonary anthrax is the most lethal form, with a mortality of over 85%. As an emerging pathogen diagnostic technique, metagenomic next-generation sequencing (mNGS) has the advantages of detecting a wide range of specimens, covering a broad range of pathogen types, and having a short detection cycle. This paper reports a successfully treated patient who was diagnosed with pulmonary anthrax by mNGS testing of bronchoalveolar lavage fluid specimens. The patient, who had been engaged in processing raw wool for more than 20 years, was admitted to the hospital due to chest tightness, shortness of breath, and low fever for 3 days. Chest CT showed a possible tumor in the right lung and bilateral pneumonia. On the third day after admission, the patient’s breathing difficulty worsened and he was transferred to the intensive care unit. Considering the rapid progression of the condition and the unsatisfactory effect of empirical anti-infective treatment, mNGS testing of bronchoalveolar lavage fluid was performed, confirming the diagnosis of pulmonary anthrax. Combined with literature review and the clinical characteristics of pulmonary anthrax, this case suggests that mNGS has important value in the early diagnosis of complex infections and infectious diseases, which helps to facilitate timely targeted treatment in clinical practice. Show
KeyWord：pulmonary anthrax;metagenomic next-generation sequencing;bronchoalveolar lavage;pathogenic diagnosis
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Research progress and multidisciplinary approach on systematic design of infection prevention and control in hand hygiene facilities
• XIE Hao, LI Yang, LI Sui, ZHANG Qi
•2026,25(7):1092-1099 ,Doi: 10.12138/j.issn.1671-9638.20263136
Abstract:： Hand hygiene (HH) can effectively reduce the risk of healthcare-associated infection (HAI). The design of HH facilities is crucial for infection prevention and control in medical b...Hand hygiene (HH) can effectively reduce the risk of healthcare-associated infection (HAI). The design of HH facilities is crucial for infection prevention and control in medical buildings, and must balance functional and safety requirements. This paper systematically explores the key design elements of HH facilities in medical buildings, as well as the current status and shortcomings of design in this field in China. The design of HH facilities cannot rely solely on local improvements, but must be systematically optimized to meet higher standards for infection prevention and control requirements. The design of future HH facilities should adhere to a multidisciplinary approach, be guided systematically, prioritize user experience, utilize simulation technology, and enhance the application of antimicrobial materials. It is suggested that the regulatory authorities in the medical industry in China develop specialized guidelines for the design of HH facilities in medical buildings, establish a standardized system for HH facility design and products, and provide comprehensive solutions for HH in medical buildings. Show
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Advances in the diagnosis and treatment of acute leukemia complicated with gastrointestinal mucormycosis
• DENG Yudu, WAN Zhaohui, CHEN Sihui, LIU Fang, WEN Chuan, LIU Tao
•2026,25(7):1100-1108 ,Doi: 10.12138/j.issn.1671-9638.20263139
Abstract:： Gastrointestinal mucormycosis is one of the rare but serious complications in patients with acute leukemia. Due to the lack of specificity in clinical manifestations, it often lead...Gastrointestinal mucormycosis is one of the rare but serious complications in patients with acute leukemia. Due to the lack of specificity in clinical manifestations, it often leads to delayed diagnosis or misdiagnosis, resulting in persistently high mortality. This paper reviews the current status, high-risk factors, pathogenesis, diagnosis, treatment, as well as advances in the prevention of acute leukemia complicated with gastrointestinal mucormycosis, aiming to provide reference for clinical diagnosis and treatment. Patients with clinically suspected gastrointestinal mucormycosis should undergo imaging, pathological, and molecular biological examinations as early as possible, so as to achieve early diagnosis and early treatment, thereby improving clinical outcomes and prognosis. Show
KeyWord：gastrointestinal mucormycosis;leukemia;diagnosis;treatment
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