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Objective To understand the current status of healthcare-associated infections (HAI) among inpatients in medical institutions of Wuhan, and to provide a scientific basis for improving the management of healthcare-associated infections. Methods A combined method of bedside investigation and case review of the patients’ medical records were used to investigate all hospitalized patients in 31 hospitals. Results A total of 42 429 inpatients were investigated, of whom 938 had HAI (2.21%), and 7 561 had community-associated infection (CAI, 17.82%). The top three departments with the highest prevalence rate of HAI were ICU (17.95%), hematology (8.49%), and neurosurgery (6.57%), while the top three departments with the highest prevalence rate of CAI were burns (75.00%), pediatric non-neonatal group (70.26%) and respiratory department (67.53%). Both healthcare-associated infections and community infections were mainly in the lower respiratory tract, which accounted for 47.33% and 53.00%, respectively. The main pathogens of both HAI and CAI were Gram-negative bacteria, which accounted for 65.03% and 57.73%, respectively. The use rate of antimicrobial drugs was 31.74%, and the detection rate of pathogenic bacteria before antimicrobial treatment was 55.77%. The three departments with the highest rates of the use of antibacterial drugs were the pediatric non-neonatal group (78.20%), the department of burns (75.00%) and the department of urology (73.24%). Conclusion ICU, hematology department, and neurosurgery department were high-risk departments for healthcare-associated infections. Pediatrics, burns, and urology departments were the departments with high use of antibacterial drugs. The pathogenic bacterial detection rate has declined, which needs to be strengthened.
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Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.
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Objective To investigate the prevalence rates of healthcare-associated infection(HAI) and community-associated infection(CAI) in hospitalized patients in Wuhan City, and provide a scientific basis for the prevention and control of HAI.Methods Convenience sampling method was used to select 33 hospitals in Wuhan City, all hospitalized patients were surveyed by bedside investigation and medical record reviewing, SPSS 16.0 software was used for data analysis.Results A total of 36 222 hospitalized patients were investigated, of whom 1 116 (3.08%) had HAI, 6 968 (19.24%) had CAI.The prevalence rate of HAI was highest in hospitals with ≥900 beds(3.40%), and the prevalence rate of CAI was highest in hospitals with<300 beds (43.70%).Of departments, general intensive care unit had the highest prevalence rate of HAI(32.88%), department of respiratory diseases had the highest prevalence rate of CAI (78.34%).A total of 699 pathogens were isolated from patients with HAI, the top three were Pseudomonas aeruginosa (18.03%), Acinetobacter baumannii (16.31%) and Staphylococcus aureus (12.88%), a total of 1 149 pathogens were isolated from patients with CAI, the top three were Escherichia coli (14.45%), Pseudomonas aeruginosa (11.23%), and Mycoplasma (10.01%).The main infected sites of both HAI and CAI were the lower respiratory tract, accounting for 48.24% and 45.15% respectively.Conclusion HAI and CAI have different characteristics, it is necessary to take targeted measures according to key departments and key sites, so as to reduce the occurrence of HAI effectively.
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Objective ToestimatetheprevalenceofPanton-Valentineleukocidin (PVL)genes and antimicrobial resistance in methicillin-sensitive Staphylococcus aureus (MSSA)isolateds from outpatients with skin and soft-tissue infections (SSTIs)in Wuhan city. Methods A total of 182 MSSA isolates were collected from outpatients with SSTIs in 5 different hospitals in Wuhan city between 2011 and 2013. The Kirby-Bauer′s disk diffusion method was used to evaluate antimicrobial susceptibility of the MSSA isolates, and multiplex PCR was performed to detect mecA and PVL genes in these isolates. Results Of the 182 MSSA isolates, 65 (35.71%)carried PVL genes. The positive rate of PVL genes was significantly different among patients with different diseases (χ2 = 49.76, P = 0.00), and relatively higher in patients with furuncles/carbuncles(7/7), folliculitis(3/3), abscesses(55.53%, 30/57)or impetigo(2/4). The age of patients with PVL-positive MSSA infection was significantly younger than that with PVL-negative MSSA infection (35.40 ± 19.31 years vs. 43.21 ± 20.75 years,t = 2.50, P = 0.01). Among 65 PVL-positive MSSA isolates, the rate of resistance to clindamycin was highest (87.69%), followed by that to penicillin(53.85%)and erythromycin(41.54%). The frequency of resistance to clindamycin was highest in 117 PVL-negative MSSA isolates, followed by that to penicillin (20.51%)and ampicillin (12.82%). Furthermore, there was a significant increase in the rate of resistance to penicillin(χ2 = 21.19), ampicillin(χ2 = 97.97), doxycycline(χ2 =11.61), ciprofloxacin(χ 2 = 8.07), erythromycin(χ 2 = 25.04)and gentamicin(χ 2 = 10.86)in PVL-positive MSSA isolates compared with PVL-negative MSSA isolates (all P < 0.05). Conclusions MSSA isolates from outpatients with SSTIs in Wuhan city are resistant to most β-lactam antibiotics. Flucloxacillin, compound sulfamethoxazole tablets or doxycycline is recommended for empirical treatment of PVL-positive MSSA infections.
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Rice stripe virus (RSV) infects rice and is transmitted in a propagative manner by the small brown planthopper.How RSV enters an insect cell to initiate the infection cycle is poorly understood.Sequence analysis revealed that the RSV NSvc2 protein was similar to the membrane glycoproteins of several members in the family Bunyaviridae and might induce cell membrane fusion.To conveniently study the membrane fusion activity of NSvc2,we constructed cell surface display vectors for expressing Nsvc2 on the insect cell surface as the membrane glycoproteins of the enveloped viruses.Our results showed that NSvc2 was successfully expressed and displayed on the surface of insect Sf9 cells.When induced by low pH,the membrane fusion was not observed in the cells that expressed NSvc2.Additionally,the membrane fusion was also not detected when co-expressing Nsvc2 and the viral capsid protein on insect cell surface.Thus,RSV NSvc2 is probably different from the phlebovirus counterparts,which could suggest different functions.RSV might enter insect cells other than by fusion with plasma or endosome membrane.
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Objective To analyze the causes and preventions of the perioperative complications of micro-laparoscopic hernioplasty in infants and children with indirect inguinal hernia.Methods From January 1997 to January 2007,4500 infants or children with indirect inguinal hernia,including 702 cases who were complicated with hydrocele testis,were treated by micro-laparoscopic hernioplasty in our hospital.By laparoscopy,the endocycle was sutured circularly under the peritoneum using a self-designed needle.Then,only the peritoneum was ligated.Results No organ injury or complication occurred during the operation.The mean operation time was 9 min(5-13 min).Among the patients,4250 received a follow-up of 7-36 months(mean,25 months).Postoperative complications were found in 132 patients(3.1%),included scrotal gas in 10(0.24%),scrotal hydrocele in 16(0.38%),umbilical hernia in 27(0.64%),extraperitoneal emphysema in 20(0.47%),abdominal wall hematoma at the burr hole in 15(0.35%),foreign body sensation at the suture sites in 30(0.71%),scrotal hematoma in 8(0.19%),and iatrogenic cryptorchism in 6(0.14%).Thirty-five patients had recurrence(0.82%).Conclusions Micro-laparoscopic hernioplasty is a safe and reliable method for indirect inguinal hernia in infants and children.It is important to be familiar with the anatomy of the hernia under a laparoscope and to perform the operation carefully so that to avoid or decrease the perioperative complications.
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Objective To explore the clinical effects of laparoscopic hernioplasty in patient over 70 years old. Methods We utilized the modified laparoscopic intraperitoneal onlay mesh (IPOM) to treat the inguinal hernia in 69 elderly patients. Results The laparoscopic operations were completed in all the 69 patients. The operative time was 20～30 min (mean, 25 min). No operative complications took place and the intraoperative blood loss was hardly seen. The duration of hospitalization was 5～7 days. The patients recovered smoothly, without wound infection or scrotum hematoma. Follow-up observations for 6～24 months in the 69 patients found no recurrence. Conclusions Modified laparoscopic IPOM treating inguinal hernia in elderly patients is feasible, on the premise of proper perioperative management.
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Objective To evaluate the efficacy of mini-laparoscopic hernioplasty with Mesh strengthening in the treatment of hernia in adults. Methods We used mini-laparoscopic and self-decided needle-like instruments to perform 106 cases of Mesh replacement in addition to hernioplasty in treatment ot hernia in adults from January,1999 to Junuary,2001. Results Operation time ranged from 20min to 25min.Food-intake began in the operative day.No Complications occurred.The patient discharged 3d～4d after the operation.Following-up period lasting 5months to 2.5years showed no relapse occurred. Conclusions Mini-laparoscopic hernioplasty combined with Mesh strengthening is feasible in the treatment of hernia in adults.The method have the advantages ot mini-invasion,simple proccedures,shorter operation time and quicker recovery.
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Ojective To investigate the application of mini-laparoscopic herniotomy to the treatment of inguinal hernia in infants and children. Methods With the help of mini-laparoscope 600 children with indirect inguinal hernia were treated by purse-string ligature using lift-insert suture method from August 1998 to December 2000. Results There were 5 recurrences out of 600 cases, the recurrence rate being 0.83%, which was lower than that by the traditional method. Conclusions The principle of mini-laparoscopic herniotomy is sound and it is simple and convenient to handle. Small incision and minimal injuzy thought of as its additional advantages.
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Background and purpose:Single photonemisson computed tomography(PET) is recently available in many cities. It has been extensively used for the diagnosis of pulmonary lesions,especially in the differential diagnose of solitary pulmonary nodules(SPN) with PET.We retrospectively analysed 20 lung tumour patients with multifical lesions to investigate the value of PET scanning. Methods:20 cases with lung tumour patients who had multifical lesions were analyzed , the patients were treated from August 2004 to June 2005 in Shanghai Chest Hospital. All patients were examined with PET,X-ray,CT(computerized tomography) and SPECT(single photonemisson computed tomography). Some of them were detected with MRI because they were suspected to have spinal metastases. 14 cases were pathologically proved as lung cancer.Results:All(100%) of the primary lesions were positively detected by PET scanning. In addition to 100% sensitivity to the primary lesions, 6 cases of the metastatic lesions were confirmed by PET,in which 2 of them were pulmonary nodules (all bigger than 1cm in size),3 were mediastinal lymph nodes,and the other was a secondary tumor of the spine. 14 cases were negative on the PET image, 4 of 14 cases were false negative, 2 of them had pulmonary nodules (all smaller than 1cm), the other 2 were either mediastinal lymph nodes or a secondary tumors of the spine.Conclusions:PET scanning has high value in terms of improving diagnosis of the primary and metastatic pulmonary lesions, it is useful to define stage of tumor and chose proper treatment for the patients. PET scanning may not be a efficient tool when the size of nodules is smaller than 1 cm. Some of the secondary tumors of the spine maybe be PET negative.