Chinese Journal of Infection Control |
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Editor in Chief：Wu, Anhua ISSN：1671-9638 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 Molecular epidemiological study of methicillin resistant Staphylococcus aureus FREE4976
- 02 Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare associated infection4356
- 03 Homology analysis on ICU multidrug resistant Acinetobacter baumannii nosocomial infection FREE4086
- 04 Distribution and change of microbial population of clinical isolated bacteria from a hospital between 1999 and 2008 FREE3952
- 05 Colonization and drug resistance of multidrug resistant bacteria in intensive care unit FREE3824
- 06 A new glycopeptide antibiotic——dalbavancin3796
- 07 A case control study on risk factors for nosocomial infection of Acinetobacter baumannii in internal medicine intensive care units FREE3532
- 08 Antimicrobial activity of linezolid and other antimicrobial agents against Enterococci spp. in vitro FREE3482
- 09 Change in drug resistance of Pseudomonas aeruginosa to β lactam antibiotics FREE3470
- 10 Catheter associated nosocomial infection in surgical intensive care unit :a 5 year data analysis3375
- 01 Epidemiological and clinical analysis on bacillary dysentery in 175 children in three years250303
- 02 Comparison of the effectiveness of different disinfectants on blood donors before donation125022
- 03 National healthcare associated infection surveillance system point prevalence survey of antimicrobial use in 740 Chinese hospitals in 2010121522
- 04 Study on resistant mechanism of two clinical strains of Enterobacter aerogenes to ertapenem119516
- 05 Distribution and antimicrobial resistance of major gram negative bacilli in ICU and non ICU wards in a grass roots hospital117630
- 06 Adverse drug reactions of ganciclovir in treating infants with cytomegalovirus hepatitis112390
- 07 Drug resistance and disinfectant resistant genes of Staphylococcus aureus from neonates at a neonatal ward111826
- 08 Monitoring on occupational exposure of health care workers at a general tertiary hospital108214
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Expert consensus on infection prevention and control of Creutzfeldt-Jakob disease in medical institutions
• GE Tianxiang, JIA Yangyang, LI Chunhui, HUANG Jianrong, MENG Xiujuan, GAO Xiaodong, ZHANG Jingping, QIAO Fu, XIONG Lijuan, LIANG Hui, LI Wei, LOU Haiyan, WU Wenjuan, XIANG Tianxin, CHEN Jiansen, ZHU Biao, XU Kaijin, ZHOU Zhihui, CAI Hongliu, YU Meihong, ZHANG Yan, SHANGGUAN Yanwan, FENG Haiting, YAO Hangping, GUO Lei, GAN Tieer, ZHANG Weihong, SUN Jimin, LU Ye, LU Qun, CAI Meng, SHEN Jin, YU Yunsong, WU Anhua, LI Liu-yi, QU Tingting
•2025,24(4):437-450 ,Doi: 10.12138/j.issn.1671-9638.20252027
Abstract:： Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and fatal neurodegenerative disorder caused by prions, with certain infectivity and iatrogenic transmission risks. With the...Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and fatal neurodegenerative disorder caused by prions, with certain infectivity and iatrogenic transmission risks. With the rapid progress and application of new dia-gnostic biomarkers and detection methods, as well as the construction and improvement of surveillance and reporting systems, the detection of CJD in patients domestically and internationally has shown an increasing trend year by year. Due to its long incubation period and heterogeneity of early symptoms, early identification and diagnosis of the disease is difficult, increasing the risk of transmission within medical institutions. Currently, there is a lack of consensus on the infection prevention and control of CJD. In order to timely identify and diagnose CJD as well as effectively block its transmission in medical institutions, this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence, as well as combines with clinical practice, aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions. Show
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Development and clinical diagnostic efficacy of a novel LAMP method targeting the tcdC gene in Clostridioides difficile
• XIAO Yuanyuan, DUAN Juping, ZHOU Jingxiang, HUANG Qin, QING Yan, WANG Haibo, WU Anhua, LI Chunhui
•2025,24(4):451-459 ,Doi: 10.12138/j.issn.1671-9638.20255458
Abstract:： Objective To develop a method for rapidly identifying Clostridioides difficile (C. difficile) and determining high-producing toxin strains, conduct clinical evaluation. M...Objective To develop a method for rapidly identifying Clostridioides difficile (C. difficile) and determining high-producing toxin strains, conduct clinical evaluation. Methods The loop-mediated isothermal amplification (LAMP) method was used to identify C. difficile based on the tcdC, tcdA, and tcdB genes. The sensitivity, specificity, and overall consistency of the detection method were evaluated. Results Feces specimens from 499 hospitalized patients suspected of C. difficile-associated diarrhea were detected, with C.difficile detection rate of 12.8% (64/499), out of which the detection rate of toxin-producing C. difficile was 10.8% (54/499). The sensitivity, specificity, positive predictive value, and negative predictive value of the detection method for tcdA were 87.2%, 98.9%, 89.1%, and 98.6%, respectively, and 88.2%, 99.6%, 90.0%, and 98.73% for tcdB , respectively. The total toxin levels of different strains were different, but the average toxin production level of A+B+ strains (1.79 μg/mL) was higher than those of A-B+ strains (0.72 μg/mL) and A-B- strains (<0.10 μg/mL). Conclusion The portable high-throughput LAMP detection method can rapidly and efficiently identify C. difficile and determine high-producing toxin strains. Show
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Dynamic changes and influencing factors of Mycobacterium tuberculosis infection among senior high school students
• WEI Jingru, CHEN Hui, LI Tao, ZHANG Guoqin, YU Yanming, ZHANG Canyou, CHENG Jun, ZHANG Fan
•2025,24(4):460-468 ,Doi: 10.12138/j.issn.1671-9638.20257216
Abstract:： Objective To analyze the dynamic changes and influencing factors of Mycobacterium tuberculosis (TB) infection in grade-1 students in senior high school at the time of enroll...Objective To analyze the dynamic changes and influencing factors of Mycobacterium tuberculosis (TB) infection in grade-1 students in senior high school at the time of enrollment and one year after enrollment. Methods In 2022, TB screening was carried out among grade-2 students in 4 senior high schools in Binhai and Xiqing Districts of Tianjin. Basic information of students was collected, and TB infection detection results of grade-1 students in senior high school at the time of enrollment were collected retrospectively. Positive rate, strong positive rate and positive conversion rate from tuberculin skin test (TST) results of students were compared. Univariate and multivariate logistic regression models were used to analyze the relevant influencing factors for positive conversion of TST results. Results The overall positive rate of 1 839 students one year after enrollment was higher than that at the enrollment (46.82% vs 33.12%), while strong positive rate was lower (12.51% vs 13.00%), both with statistically significant differences (both P<0.001). One year after enrollment, 64 out of 1 230 students who were originally negative for TST in their first year of senior high school turned positive, with a positive conversion rate of 5.20% (95%CI: 3.93%-6.48%). One year after enrollment, TST results showed that the average diameter of induration was 5 (2, 8) mm, diameter was 2 (0, 5) mm at the enrollment of the first year of senior high school, but the difference was not statistically significant (P=0.478). The difference range of average diameter of induration was ±21 mm, 39.70% of students being within ±2 mm. Students with increased and decreased average diameter of induration accounted for 65.09% and 28.49%, respectively. Multivariate logistic regression analysis result showed that students in boarding school had a higher risk of positive conversion compared with non-boarding school students (OR=4.842, 95%CI: 2.794-8.392). Conclusion The screening of TB infection among grade-2 students in senior high school should be strengthened, with a focus on boarding school students. Early detection of tuberculosis patients and newly infected individuals can provide reference for implementing precise prevention and control. Show
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Status of latent tuberculosis infection with Mycobacterium tuberculosis and risk factors for its activation in patients with ANCA-associated vasculitis
• XIE Yangmei, ZHONG Yong, CHEN Jinbiao, ZHANG Heping
•2025,24(4):469-477 ,Doi: 10.12138/j.issn.1671-9638.20257199
Abstract:： Objective To evaluate the status of latent tuberculosis infection (LTBI) with Mycobacterium tuberculosis and the risk of LTBI activation after glucocorticoid therapy in pati...Objective To evaluate the status of latent tuberculosis infection (LTBI) with Mycobacterium tuberculosis and the risk of LTBI activation after glucocorticoid therapy in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods Clinical data of AAV patients who visited Xiangya Hospital of Central South University from May 2018 to May 2023 were retrospectively analyzed. According to the results of interferon-γ release assay (IGRA), they were divided into a LTBI group and a non-LTBI group. The LTBI group was subdivided into an active TB group (ATB group) and a non-ATB group according to the presence of ATB. General conditions and biochemical indicator characteristics of the two groups were compared. The COX regression model was used to analyze the risk factors for LTBI activation in AAV patients. Results A total of 302 AAV patients were included in this study, with an age of 64.0 (53.0, 71.0) years old, 169 male cases (55.96%), and an IGRA positive rate of 24.17% (n=73). The proportion of patients with renal insufficiency in the LTBI group was higher than that in the non-LTBI group (79.45% vs 60.70%), with statistically significant difference (P<0.05). In the LTBI group, the age of patients was 62.0 (53.5, 72.0) years old, 44 cases were male (60.27%), out of which 11 cases (15.07%) had ATB. In the non-LTBI group, 4 male cases (1.75%) had ATB. In the LTBI group, there were statistically significant differences between the ATB group and the non-ATB group in terms of daily average glucocorticoid levels, age, renal dysfunction, neutrophils, and blood creatinine (all P<0.05). COX univariate regression analysis showed that statistically significant differences existed among the groups in terms of daily average glucocorticoid levels, daily average glucocorticoid levels >11.75 mg/day, age, age >65 years old, and blood crea-tinine levels ≥150 μmol/L (all P<0.05). COX multivariate regression analysis showed that daily average glucocorticoid levels >11.75 mg/day (OR=0.14, 95%CI: 1.30-79.01) and age >65 years (OR=0.08, 95%CI: 0.01-0.85) were independent influencing factors for LTBI activation. Conclusion AAV patients have a high rate of LTBI, and daily average glucocorticoid levels >11.75 mg/day is an independent risk factor for LTBI activation in AAV patients. Age >65 years may benefit from receiving lower doses of immunosuppressive therapy, but it is necessary to expand sample size for further study. Show
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Characteristics of molnupiravir in anti-H1N1 influenza virus infection in vitro and in vivo
• FENG Xili, WANG Jinqian, YANG Xuanye, HU Xinyan, DING Yulin, MA Xiaoxia
•2025,24(4):478-485 ,Doi: 10.12138/j.issn.1671-9638.20256193
Abstract:： Objective To analyze the antiviral effect of molnupiravir against influenza virus in vitro and in vivo. Methods The antiviral ability of molnupiravir against influenz...Objective To analyze the antiviral effect of molnupiravir against influenza virus in vitro and in vivo. Methods The antiviral ability of molnupiravir against influenza virus strain H1N1 PR8 was detected in vitro and in vivo. Human non-small cell lung cancer cell line (A549 cells) was used as an in vitro model of PR8 infection. The antiviral effects of molnupiravir on virus replication, protein synthesis, and viral particle formation were analyzed using real-time fluorescence quantitative polymerase chain reaction (qRT-PCR), Western blot (WB) assay, and plaque assay. PR8 nose-dripping infected C57BL/6 female mice were used as an in vivo infection model. The antiviral ability of molnupiravir was evaluated by detecting viral load, pathological changes, and immunohistochemistry in the control group, administration group, inoculation group, and inoculation-administration group. Results In vitro test results showed that molnupiravir had no significant inhibitory effect on influenza virus replication, protein synthesis, and virus particle formation (all P>0.05). In vivo test results showed that compared with mice infected with H1N1 alone, the viral load in the lung tissue of mice treated with molnupiravir declined significantly, and the extent of pathological changes was milder. Immunohistochemical detection showed a significant weakening in nuclear protein (NP) antigen signal, and the expression levels of interferon (IFN)-α, interleukin (IL)-4, and IL-6 in the lungs were lower (all P<0.01). Conclusion As a precursor with antiviral activity, molnupiravir can not exert antiviral activity in lung-derived cells cultured in vitro, but can be transformed into an active form in the host, which significantly decreases the ability of H1N1 influenza virus to proliferate in the lungs and thereby alleviates the da-mage of virus to lung tissue. Show
KeyWord：molnupiravir;influenza;antivirus;infection model;pathological change;H1N1
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Risk assessment of respiratory infectious diseases based on healthcare workers’ actual behaviors: an example from otolaryngology outpatient clinics
•2025,24(4):486-491 ,Doi: 10.12138/j.issn.1671-9638.20256638
Abstract:： Objective To construct a risk assessment model based on healthcare workers’ (HCWs) real behavioral data, and precisely quantify virus exposure dynamics and infection risks o...Objective To construct a risk assessment model based on healthcare workers’ (HCWs) real behavioral data, and precisely quantify virus exposure dynamics and infection risks of HCWs during routine clinical practice. Methods HCWs and patients from otolaryngology outpatient clinics at a general tertiary first-class hospital in Beijing were selected as the research subjects. Behavior information of relevant individuals including relative position, interpersonal distance, facial orientation, and contact frequency, were recorded and stored using depth cameras, laptops, portable power supplies, tripod stands, and removable hard drives. Behavior data were processed by semi-supervised machine learning algorithms. A mathematical model was finally constructed to assess real-time viral exposure and infection risks during HCWs’ procedure. Results A total of 161 917 behavioral datasets were captured in this study, including external auditory canal irrigation, nasal/laryngeal/otoscopic endoscopies. After inspection and exclusion, 103 788 behavioral datasets remained. HCWs in otolaryngology outpatient spent 90.61% of clinical time in close contact on average, predominantly in face-to-side (F-S) orientation. Nasal endoscopy generated peak viral RNA loads, ranging from 0.543 to 0.745 viral RNA loads/s, with an overall infection risk of 42.74%. Infection risks could be reduced to 2.44%, 14.20%, and 36.05% when wearing N95, medical surgical, and cotton masks, respectively. Conclusion HCWs in otolaryngology outpatient clinics face high risks of occupational exposure in their daily work. Personal protective equipment should be used strictly, and appropriate interpersonal distance and optimal face orientation should be maintained. Show
KeyWord：respiratory infectious disease;healthcare worker;behavior;exposure load;infection risk
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Histological chorioamnionitis, meconium-stained amniotic fluid, and adverse pregnancy outcomes in neonates: a correlation analysis
• YANG Kun, QIU Lei, ZHANG Lili
•2025,24(4):492-498 ,Doi: 10.12138/j.issn.1671-9638.20256833
Abstract:： Objective To investigate the association of histological chorioamnionitis (HCA) and meconium-stained amniotic fluid (MSAF) with adverse pregnancy outcomes in neonates. Me...Objective To investigate the association of histological chorioamnionitis (HCA) and meconium-stained amniotic fluid (MSAF) with adverse pregnancy outcomes in neonates. Methods Neonates and their mothers who delivered from May 2021 to January 2024 in the department of neonatology in a hospital were selected as the research subjects. According to placenta pathological diagnosis, participants were divided into the HCA group and the non-HCA group. Clinical data, MSAF incidence, and adverse pregnancy outcomes among neonates with different MSAF levels were compared between two groups. The relationship between HCA and adverse pregnancy outcomes in neonates with different MSAF severity levels was analyzed using logistic regression analysis model, and the impact of the interaction between HCA and MSAF on adverse pregnancy outcomes in neonates was evaluated. Results A total of 300 neonates and their mothers were included in the analysis, with 113 in the HCA group and 187 in the non-HCA group. There was a statistical difference in the occurrence of MSAF with different severity between two groups of neonates (χ2=25.39, P<0.05). The incidence of HCA increased with the increased severity of MSAF. The incidences of neonatal pneumonia, intraventricular hemorrhage, early-onset septicemia and bronchopulmonary dysplasia were all statistically different under different MSAF levels (all P<0.05). As MSAF severity increased, the risk of neonates developing the above-mentioned diseases also increased gradually. HCA was found to be independently associated with neonatal pneumonia, intraventricular hemorrhage, early-onset sepsis, and bronchopulmonary dysplasia under different MSAF levels. Interaction analysis revealed that when HCA and MSAF co-occurred, there was a remarkable increase in the risk of adverse pregnancy outcomes in neonates (OR=6.30; 95%CI: 2.53-10.20). Conclusion MSAF and HCA are both independent risk factors for adverse pregnancy outcomes in neonates, and the coexistence of MSAF and HCA significantly increases this risk. Show
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Construction and application of an intelligent system for recognition, prevention, and control of infectious diseases and multidrug-resistant orga-nism infections
• LI Chenguang, PAN Zetao, ZHU Haozhi, JU Xu, HE Zhonglian, LI Chaofeng, LI Huan
•2025,24(4):499-505 ,Doi: 10.12138/j.issn.1671-9638.20255451
Abstract:： Objective To construct an intelligent recognition, prevention, and control system for infectious diseases and multidrug-resistant organism infections, aiming at improving th...Objective To construct an intelligent recognition, prevention, and control system for infectious diseases and multidrug-resistant organism infections, aiming at improving the efficacy of full-process management, and to evaluate its application effects. Methods Based on personalized logic parsing rules that accurately reflect the infection status and transmission risks in real-time, an intelligent recognition, prevention, and control system with functions of automatic recognition, dynamic labeling, real-time sharing, early warning, and visual guidance was established. Patients undergoing invasive diagnostic and therapeutic procedures in two departments of a tertiary first-class hospital from October 2023 to May 2024 were selected as the research subjects. The differences in recognition, prevention, and control efficacy before and after the application of the system were compared using a self-controlled method, with traditional manual management as the control group and intelligent system management as the experimental group. Results A total of 2 146 patients were included in the analysis. The recognition, prevention, and control rate and the accuracy rate of recognizing infected individuals using the intelligent system were enhanced significantly compared with those using manual mode (improved from 5.3% and 72.4% to 100%, respectively), with statistical significance (both P<0.001). The median early warning time for infection information reached 85.20 days, with 100% early warning achieved. The average time spent by medical staff on infection information recognition and management was reduced by 4.71 hours per day. Conclusion The intelligent system constructed in this study significantly improves the effectiveness of full-process management in recognition, prevention, and control of infectious diseases and multidrug-resistant organism infection, effectively reduces the risk of cross-infection, and enhances the efficiency of diagnostic and therapeutic services. Show
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Clinical distribution characteristics and changing trend of postoperative pneumonia, 2014-2023
•2025,24(4):506-511 ,Doi: 10.12138/j.issn.1671-9638.20255457
Abstract:： Objective To analyze the clinical distribution characteristics and changing trend of postoperative pneumonia (POP), and provide basis for further monitoring and management o...Objective To analyze the clinical distribution characteristics and changing trend of postoperative pneumonia (POP), and provide basis for further monitoring and management of POP. Methods Clinical data of POP patients in the First Affiliated Hospital with Nanjing Medical University from 2014-2023 were collected. The incidence of POP, the changing trend of proportion of ventilator-associated pneumonia (VAP), the occurrence time, pathogen distribution, and incidence of POP in various departments were analyzed retrospectively. Results From 2014 to 2023, a total of 653 609 patients in the hospital received surgery, with 676 245 times of operations, out of which 2 934 cases had POP, and the incidence of POP was 0.43%. The average age of POP patients was (59.76±16.53) years old, with 68.58% being male. The incidence of POP decreased from 2.00% in 2014 to 0.10% in 2023, and the proportion of VAP increased from 9.92% in 2014 to 99.10% in 2023, with statistically significant differences (all P<0.001). POP occurred within 7, 10, and 30 days after surgery accounted for 65.81%, 78.80%, and 95.64%, respectively. The top three departments with the highest incidences were cardiovascular surgery (5.277%), neurosurgery (2.114%), and thoracic surgery (1.130%). The main pathogen of infection was Gram-negative bacteria (77.58%). Conclusion The incidence of POP shows a downward trend. VAP patients should be the focus of follow-up improvement work. Departments of cardiovascular surgery, neurosurgery, and thoracic surgery are the key departments of POP, and 10 days after surgery should be the critical period of POP. Show
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Incidence of postoperative pneumonia in a tertiary first-class general hospital in Shanghai from 2017 to 2023
• ZHU Dan, WANG Dan, WANG Xiaoying, ZOU Ni
•2025,24(4):512-517 ,Doi: 10.12138/j.issn.1671-9638.20255461
Abstract:： Objective To analyze the occurrence of postoperative pneumonia (POP) in a tertiary general first-class hospital in Shanghai, and provide basis for strengthening the implemen...Objective To analyze the occurrence of postoperative pneumonia (POP) in a tertiary general first-class hospital in Shanghai, and provide basis for strengthening the implementation of POP prevention and control measures for the target population. Methods The real-time monitoring data of healthcare-associated infection (HAI) from 2017 to 2023 were retrospectively surveyed. The occurrence of POP in all surgical patients (including minimally invasive interventional surgery) were analyzed. Results A total of 701 postoperative patients had POP. The incidence of POP was 0.30%. Incidence of POP was higher in male patients than in female patients(0.48% vs 0.15%), in 65-year-old-population than in <65-year-old-population(0.58% vs 0.17%), and in elective surgery than in emergency surgery (0.35% vs 0.27%), differences were statistically significant (all P<0.05). The interval from postoperative time to POP occurrence in 701 POP patients was 6 (4, 10) days, with emergency surgery patients developing POP later than elective surgery (7［4,11］ days vs 6［3,10］ days), and difference was statistically significant (P<0.05). The top five departments with higher incidences of POP were neurosurgery (5.84%), cardiac surgery (4.01%), thoracic surgery (1.92%), abdominal surgery (0.74%), and minimally invasive intervention (0.17%). Incidence of POP in emergency neurosurgery was higher than that in elective neurosurgery (9.71% vs 2.14%), while incidences of POP in elective cardiac surgery and thoracic surgery were both higher than emergency surgery (5.09% vs 2.93%, 2.46% vs 0.58%, respectively), differences were all statistically significant (all P<0.05). A total of 675 strains of pathogens were detected from 701 POP patients, with Gram-negative bacteria being the major pathogens (n=520,77.04%). The predominant detected pathogens were Acinetobacter baumannii (n=119), Pseudomonas aeruginosa (n=116), Staphylococcus aureus (n=108), Klebsiella pneumoniae (n=104), and Stenotrophomonas maltophilia (n=47). Conclusion In the prevention and control of perioperative infection, the key populations for POP prevention and control should be males and those aged ≥65 years old, and the key departments should be neurosurgery, cardiac/thoracic surgery, and abdominal surgery. Minimal invasive surgery also has the risk of POP, which should be paid more attention. Show
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Economic losses due to healthcare-associated infection after Da Vinci robotic thoracic surgery: a retrospective study based on propensity score matching
• ZHANG Liwei, DI Jia, TAO Yuan, FENG Chengyi, ZHU Lili, JIN Dan, JIANG Shufang
•2025,24(4):518-525 ,Doi: 10.12138/j.issn.1671-9638.20256480
Abstract:： Objective To understand the economic losses due to healthcare-associated infection (HAI) in patients after Da Vinci robotic thoracic surgery, and provide basis for preventin...Objective To understand the economic losses due to healthcare-associated infection (HAI) in patients after Da Vinci robotic thoracic surgery, and provide basis for preventing and controlling HAI after robotic surgery. Methods Patients who underwent Da Vinci robotic surgery from April 2019 to April 2023 were retrospective stu-died. Patients were divided into HAI group and non-HAI group based on the occurrence of postoperative infection. Through 1 ∶1 propensity score matching (PSM), 31 cases were included in each group, economic losses of two groups of patients were compared. Results A total of 921 patients who underwent Da Vinci robotic thoracic surgery were included in the study, 51 cases with HAI (HAI group) and 870 without HAI (non-HAI group). After 1 ∶1 PSM, 31 cases were included in each group. Four covariates were compared between two groups of patients before PSM, namely gender, age, comorbidities, and the American Society of Anesthesiologists (ASA) grading, all with statistically significant differences (all P<0.05). After PSM, distribution of the above covariates reached equilib-rium between the two groups (both P>0.05). The median total expense for HAI group before PSM during hospitalization was 88 711.72 Yuan, while 78 509.46 Yuan for the non-HAI group. The direct economic losses caused by HAI after Da Vinci robot surgery was 10 202.26 Yuan, mainly increased by expense of medicine, nursing, laboratory diagnosis, etc. Difference in western medicine expense was the highest (8 839.12 Yuan), out of which expense of antimicrobial agents accounted for the highest proportion ( 73.55%). Difference in daily hospitalization expense between HAI-group and non-HAI group was 502.38 Yuan. Length of hospital stay of patients in HAI group and non-HAI group were (21.59±10.62) and (13.92±9.21) days, respectively, with statistical differences (all P<0.05). Conclusion The occurrence of HAI in patients undergoing Da Vinci robotic thoracic surgery leads to direct economic losses, with obvious increases in expenses of nursing, laboratory diagnosis, western medicine (mainly antimicrobial agents). Length of hospital stay of patients also prolongs. Show
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Direct economic burden of healthcare-associated infections in patients undergoing radical pancreatoduodenectomy
•2025,24(4):526-531 ,Doi: 10.12138/j.issn.1671-9638.20256858
Abstract:： Objective To investigate the incidence of healthcare-associated infection (HAI) in patients undergoing radical pancreatoduodenectomy (RPD), assess the economic burden caused...Objective To investigate the incidence of healthcare-associated infection (HAI) in patients undergoing radical pancreatoduodenectomy (RPD), assess the economic burden caused by HAIs in these patients, and provide health and economic support for infection prevention and control. Methods Clinical data of patients who underwent RPD in a general surgery ward of a tertiary teaching hospital in Shandong Province from January 2020 to December 2022 were collected retrospectively. The incidences of HAIs in these patients were investigated. Patients were divided into the infection group and the non-infection group based on whether they developed postoperative HAI. A 1 ∶1 propensity score matching method was adopted to construct a covariate balanced database. The hospitalization expenses and length of hospital stay were compared between the two groups of patients, and the economic burden caused by HAIs was calculated. Results A total of 287 patients undergoing RPD were included in the analysis, of whom 35 developed HAI, with a HAI incidence of 12.20%. Propensity score matching method successfully matched 33 pairs. After matching, the median total hospitalization expenses for patients in the infection and non-infection groups were 120 722.0 Yuan and 100 367.0 Yuan, respectively, with the infection group incurring an additional total hospitalization expenses of 20 355.0 Yuan (P<0.05); the median length of hospital stay were 28 and 19 days, respectively, and the infection group had an extended length of hospital stay of 9 days (P<0.05). The analysis of individual costs for the two groups showed that, except for the expenses of surgical costs and hygiene mate-rials costs, all other medical expenditures were significantly higher in the infection group than in the non-infection group (all P<0.05). The economic burden caused by Western medicine costs was the highest, reaching 11 427.0 Yuan, followed by treatment costs (3 228.0 Yuan) and examination costs (2 304.0 Yuan). Except for the expenses of surgery and hygiene material costs, the constituent ratio of all other costs increased in the infection group, with the largest increase being in Western medicine costs, which rose by 2.66 %. Conclusion HAIs in patients under-going RPD can increase hospitalization expenses and prolong length of hospital stay. Prevention of postoperative HAIs is beneficial for reducing the economic burden on patients and hospitals. Show
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Pathogenic bacteria from children with vulvovaginitis and their antimicrobial resistance
• ZHAO Jun, DONG Fang, LYU Zhiyong, XU Xin
•2025,24(4):532-538 ,Doi: 10.12138/j.issn.1671-9638.20256525
Abstract:： Objective To understand the pathogenic bacteria from children with vulvovaginitis and their antimicrobial resistance. Methods Clinical data of children with vulvovagi...Objective To understand the pathogenic bacteria from children with vulvovaginitis and their antimicrobial resistance. Methods Clinical data of children with vulvovaginitis and positive bacterial culture of vaginal secretion from Beijing Children’s Hospital from January 1, 2016 to December 31, 2023 were analyzed retrospectively. Results Among 3 249 children with vulvovaginitis, a total of 3 389 pathogenic bacteria strains were detected, including 1 730 strains of Gram-negative bacteria and 1 659 strains of Gram-positive bacteria, accounting for 51.05% and 48.95%, respectively. The top 5 detected pathogens were Haemophilus influenzae (n=1 201, 35.44%), Streptococcus pyogenes (Group A) (n=694, 20.48%), Staphylococcus aureus (n=375, 11.06%), Streptococcus agalactiae (Group B) (n=183, 5.40%), and Haemophilus parainfluenzae (n=179, 5.28%). Among the isolated pathogens in pediatric patients across different age groups, Haemophilus influenzae accounted for 46.18% in children < 7 years old, Streptococcus pyogenes (Group A) and Haemophilus influenzae accounted for 27.08% and 25.86% respectively in children aged 7-11 years old, Streptococcus agalactiae (Group B) and Staphylococcus aureus accounted for 31.50% and 18.11% respectively in children >11-18 years old. The pathogens detected varied in different seasons. Among Gram-positive bacteria, Streptococcus pyogenes (Group A) had higher resistance rates to erythromycin and clindamycin, which were 93.52% and 92.94%, respectively. Among Gram-negative bacteria, Haemophilus influenzae had higher resistance rates to ampicillin, compound sulfamethoxazole, cefaclor, and cefuroxime (all >34% ). 648 Haemophilus influenzae strains (53.96%) and 40 Haemophilus parainfluenzae strains (22.35%) produced β-lactamase. Conclusion The common pathogenic bacteria causing infectious vulvovaginitis in children are Haemophilus influenzae, Streptococcus pyogenes (Group A), and Staphylococcus aureus. The detection rate of β-lactamase in Haemophilus influenzae is high. Understanding the pathogen detection and antimicrobial resistance status in hospitals can provide basis for clinician’s empirical and rational selection of antimicrobial agents. Show
KeyWord：bacterial infection;vulvovaginitis;child;antimicrobial resistance
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Current status of healthcare-associated infection management in 62 primary medical institutions in Jiangsu Province
• ZHAO Menghan, QI Qi, GUO Ziqing, LIU Jinping, MA Yaoyao, MAO Yiping
•2025,24(4):539-544 ,Doi: 10.12138/j.issn.1671-9638.20256908
Abstract:： Objective To understand the application of healthcare-associated infection (HAI) quality control indicators and current status of HAI management in primary medical instituti...Objective To understand the application of healthcare-associated infection (HAI) quality control indicators and current status of HAI management in primary medical institutions in Jiangsu Province, and provide refe-rence and basis for primary medical institutions to improve HAI management quality and for health administrative departments to formulate HAI management relevant policies. Methods Data on HAI quality control indicators co-llected by Jiangsu Provincial Primary Healthcare Professional Quality Control Center from the first batch of 62 primary sentinel medical institutions in the province were analyzed. Results of on-site inspections and assessments of 20 institutions were summarized and analyzed. Results From July 2023 to May 2024, a total of 145 814 inpatients were monitored, 219 patients had 220 episodes of HAI. The incidence and case incidence of HAI were both 0.15%, and the main HAI site was upper respiratory tract (40.45%). The compliance rate and correct rate of hand hygiene were 81.34% (14.29%-100%) and 87.90% (18.46%-100%), respectively. The removal rate of surface pollutant from environmental objects was 77.24% (20.00%-100%), and the qualified rate of cleaning of device, appliances, and articles was 98.76% (10.00%-100%). The monitoring data records of quality control indicators in most primary healthcare institutions during on-site inspections didn’t match the monthly data reported to the Jiangsu Provincial Primary Healthcare Professional Quality Control Center. Most healthcare workers in primary healthcare institutions lacked sufficient awareness and knowledge in infection prevention and control. Multiple HAI-related safety hazards existed in key departments of most primary medical institutions. Conclusion After nearly a year of continuous monitoring on HAI, the primary sentinel medical institutions have established their own data on the incidence of HAI. The compliance rate and correct rate of hand hygiene, as well as the removal rate of surface pollutants from environmental objects are still relatively low in some medical medical institutions, and there is much room for improvement. There is still a significant gap in terms of HAI prevention and control in some primary medical institutions when referring to the standards. Show
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Factors affecting the assessment and correct answering rate of healthcare-associated infection training for medical interns
• LU Zhenling, FU Jianguo, ZHANG Xiaoluo
•2025,24(4):545-550 ,Doi: 10.12138/j.issn.1671-9638.20255463
Abstract:： Objective To analyze the correct answering rate and factors affecting healthcare-associated infection (HAI) test questions among medical interns, and provide reference for f...Objective To analyze the correct answering rate and factors affecting healthcare-associated infection (HAI) test questions among medical interns, and provide reference for formulating teaching plans. Methods All medical interns who participated in pre-job training and testing on HAI in a hospital from October 2020 to February 2024 were selected. Pre-internship training and in-class testing on HAI were conducted. After the internship ended, a class of students was randomly selected each year to directly take the written test using the same set of questions. The impact of test content, question types, majors, educational background, and the epidemic on the correct answering rate of pre-internship test was analyzed, and correct answering rate for tests before and after internships was compared. Results A total of 1 163 interns were assessed, out of which 48.75% obtained a correct answering rate of 90%-100% for test questions before the internship. Among the 10 test contents, the correct answering rates for questions about multidrug-resistant organism infection prevention and control were the lowest (［67.13±34.35］ %), among 3 types of questions, the correct answering rate for indefinite-choice questions was the lowest (［79.80±19.31］ %). The correct answering rates of interns majoring in clinical medicine (［90.49±12.32］ %) and nursing (［87.54±10.73］ %) were higher than those of other majors (［82.80±12.24］ %). The correct answering rate of undergraduate students (［89.05±11.29］ %) was higher than that of junior college student (［83.77±12.26］ %). The correct answering rate of interns during the epidemic period (［87.51±11.48］ %) was higher than that after the epidemic (［79.85±13.98］ %), and the correct answering rate after the internship (［81.89±14.78］ %) decreased compared with that before the internship (［92.99±10.48］ %). Differences were all statistically significant (all P<0.005). Conclusion Teachers can carry out targeted teaching plan reforms based on the factors affecting the correct answering rate (such as different majors, teaching content, and internship periods) to improve teaching quality. Show
KeyWord：healthcare-associated infection;medical intern;medical education;training;correct answering rate
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An outbreak of neonatal Pseudomonas aeruginosa infection caused by water contamination
• LIAO Dan, WEI Yanni, LIAO Guiyi, LIANG Wenting, MA Zhangjie, LIANG Ying
•2025,24(4):551-556 ,Doi: 10.12138/j.issn.1671-9638.20256959
Abstract:： Objective To analyze the causes and intervention measure efficacy of an outbreak of neonatal Pseudomonas aeruginosa (P. aeruginosa) infection in a medical institution. Me...Objective To analyze the causes and intervention measure efficacy of an outbreak of neonatal Pseudomonas aeruginosa (P. aeruginosa) infection in a medical institution. Methods The epidemiological investigation was conducted on 5 neonates who had P. aeruginosa infection in the neonatal intensive care unit (NICU) of this medical institution from May 26 to June 10, 2024. Specimens were taken from potentially contaminated environments to infer the cause of P. aeruginosa transmission in the NICU, infection control measures were also taken, and the efficacy of the control measures was continuously monitored. Results Among the 5 infected neonates, 3 had lower respiratory tract infection and 2 had lower respiratory tract combined with bloodstream infection. Seven strains of P. aeruginosa were detected with a consistent antimicrobial resistance spectrum. Infected neonates were in the same ward and had spatial and temporal clustering. Through environmental hygiene monitoring, P. aeruginosa with consistent antimicrobial resistance spectrum of neonatal infection was isolated from the NICU handwashing sink and water-related environment (suction connection pipe, bedside isolation gowns). Infection was controlled after improving sink disinfection methods and enhancing contact isolation measures, and no further P. aeruginosa was detected in the environment. Conclusion The outbreak of neonatal HAI in the NICU is inferred to be caused by contamination of ward handwashing sink by P. aeruginosa, then further contaminated the suction connection tube, thereby leading to the transmission of neonatal infection through suction procedures. Healthcare-associated infection surveillance and control professionals need to fully understand the characteristics of outbreak pathogens and take targeted measures to curb the transmission of neonatal infection. Show
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Elizabethkingia anopheles-associated sepsis or meningitis: a case report and literature review
• XU Changjing, WANG Guojun, WANG Shurong, TANG Hui, YANG Xuping, HUANG Yilan
•2025,24(4):557-562 ,Doi: 10.12138/j.issn.1671-9638.20256990
Abstract:： Objective To report a case of Elizabethkingia anopheles (E. anopheles)-associated sepsis and meningitis, review the relevant literatures, and provide reference for the diagn...Objective To report a case of Elizabethkingia anopheles (E. anopheles)-associated sepsis and meningitis, review the relevant literatures, and provide reference for the diagnosis and treatment of this infection. Methods Treatment process of a pediatric patient aged 11-year-7-month old who developed post-neurosurgery E. anopheles-associated sepsis and meningitis was analyzed retrospectively. Relevant literature was reviewed to summarize clinical characteristics of patients with E. anopheles-associated sepsis or meningitis. Results The main clinical manifestations of this pediatric patient were fever and abnormal cerebrospinal fluid routine. The cerebrospinal fluid and blood cultures showed E. anopheles. Patient recovered after vancomycin treatment. Including this case, a total of 33 cases were analyzed, with 16 males and 1 unreported gender. The median age of patients was 49 years old (range: 1 day-84 years). Most cases were healthcare-associated infections (62.5%, n=20) with underlying diseases, and 24 cases were cured. Conclusion E. anopheles-associated infections are rare in clinic, but can cause severe infections such as sepsis and meningitis, warranting clinical attention. Show
KeyWord：Elizabethkingia anopheles;sepsis;meningitis;literature review;treatment strategy
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Trichoderma longibrachiatum bloodstream infection: a case report and literature review
• WANG Lu, WANG Lin, QU Yuanqing, LIU Yuan
•2025,24(4):563-567 ,Doi: 10.12138/j.issn.1671-9638.20256561
Abstract:： Objective To identify the pathogen causing bloodstream infection (BSI) in an elderly patient and to describe its pathogenic characteristics. This study also reviews recent r...Objective To identify the pathogen causing bloodstream infection (BSI) in an elderly patient and to describe its pathogenic characteristics. This study also reviews recent relevant literatures on Trichoderma longibrachiatum (T. longibrachiatum) infections. Methods Blood specimens from central and peripheral veins were co-llected for blood culture. The morphological characteristics and drug susceptibility of the isolated filamentous fungus were analyzed. The sequences of the isolated strains were detected using the internal transcribed spacer (ITS) region, and then analyzed using MEGA software. Results Both morphological observation and ITS sequencing su-ggested that the pathogen was T. longibrachiatum. The minimum inhibitory concentration (MIC) against the strain detected in accordance with the M38-A2 Guideline for the Drug Susceptibility of Filamentous Fungi issued by the Clinical and Laboratory Standards Institute (CLSI) of the United States showed that the MICs of micafungin, caspofungin, 5-fluorocytosine, posaconazole, voriconazole, itraconazole, fluconazole, anidulafungin and amphotericin were 8, 8, 64, 2, 0.5, 2, 64, 8 and 4 μg/mL respectively. The patient recovered well after anti-fungal treatment with voriconazole. A total of 15 cases of T. longibrachiatum infection were reported in the literature. The main underlying disease was transplantation (n=5), and the main clinical manifestation was pulmonary infection (n=5). Of these, 9 cases survived, 3 died, and 3 had an unknown prognosis. Conclusion T. longibrachiatum infection is more common in patients with low immunity and more underlying diseases, with a high fatality rate, lack standardized clinical treatment guidelines, lack break points in drug sensitivity results, and is resistant to common antifungal drugs. It is of guiding significance to isolate and identify pathogens in time and provide corresponding drug sensitivity testing results for clinical drug use. Show
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A case of fungal bloodstream infection caused by Trichosporon dohaense in a pediatric patient with acute myeloid leukemia
•2025,24(4):568-570 ,Doi: 10.12138/j.issn.1671-9638.20256838
Abstract:： This paper reports a pediatric patient with acute myeloid leukemia (AML) who developed bloodstream infection (BSI) caused by Trichosporon dohaense (T. dohaense). The pathogen in th...This paper reports a pediatric patient with acute myeloid leukemia (AML) who developed bloodstream infection (BSI) caused by Trichosporon dohaense (T. dohaense). The pathogen in the blood culture of this case could not be identified by VITEK MS mass spectrometer; it was mistakenly identified as T.asahii by the VITEK Ⅱ YST system, and was ultimately accurately identified as T. dohaense through molecular sequencing. The (1-3)-β-D-glucan test (G test) result for this pediatric patient was within the normal range. The patient recovered and was discharged after active clinical antifungal treatment. Therefore, for T. dohaense BSI patients with granulocytopenia, it is necessary to actively administer antifungal treatment in clinical practice, carefully interpret G test results, and further strengthen the understanding of this rare fungus. Show
KeyWord：Trichosporon dohaense;acute myeloid leukemia;fungal bloodstream infection;antifungal treatment
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Advances in assessment methods for mask leakage rates
• SHI Ying, GONG Guozhuo, JIN Shubin, CHEN Zhuowei, HU Wencheng, WANG Tong
•2025,24(4):571-576 ,Doi: 10.12138/j.issn.1671-9638.20256793
Abstract:： Leakage rate is a critical metric for evaluating protective efficacy of masks. This paper reviews the current status of experimental methods and numerical simulation studies for as...Leakage rate is a critical metric for evaluating protective efficacy of masks. This paper reviews the current status of experimental methods and numerical simulation studies for assessing the leakage rates of masks, and reveals that leakage rates are related to multiple factors. The inward and outward leakage rates of masks are further compared and analyzed, and the importance of developing a standardized test method for outward leakage rate is emphasized. Finally, future development direction of mask leakage rate assessment is proposed, aiming to realize the scientific and comprehensive assessment on mask leakage rate and provide guidance for formulating public health policies. Show
KeyWord：mask leakage rate;COVID-19;testing method;numerical simulation
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