Clinical characteristics of patients with listeriosis / 中南大学学报(医学版)

OBJECTIVES@#To investigate the clinical characteristics of patients with listeriosis and to provide a basis for diagnosis, treatment, prevention and control of hospital infection.@*METHODS@#A total of 10 inpatients, who suffered from the listeriosis in Xiangya Hospital, Central South University from January 2013 to June 2019, were retrospectively collected for this study. The characteristics of the patients' age, gander, basic information, case type, clinical manifestations, first consultation department, days of diagnosis, infection indicator, specimen type, results of drug sensitivity, treatment plan, hospital infection or not, outcome, follow-up data were analyzed.@*RESULTS@#Two cases were pregnant women and other were non-pregnant adults among 10 patients with listeriosis. Among them, there were 3 cases with hospital acquired infection. The age of patient onset was 27-71 years old, and the time from onset to diagnosis was 5-36 days. Five cases had fever, and other 5 cases had not fever. There were headache, fatigue, local pain, and other specialized symptoms in the 10 patients.The white blood cell count,the neutrophil ratio, the inflammatory index C-reactive protein, the procalcitonin were all increased, and the erythrocyte sedimentation was accelerated in the 10 patients.All the patients were sensitive to ampicillin, penicillin G, meropenem, and compound sinomine.@*CONCLUSIONS@#Listeriosis often affects the patients with low immunity, which often leads to misdiagnosis or missed diagnosis in clinic.So early prevention, early diagnosis, and early treatment can reduce mortality; it is important for departments of nosocomial infection management to manage patients' diet for avoiding outbreaks of listeriosis in hospital.

Preoperative Evaluation of the Texture of Pituitary Adenoma by MRI-Based Three-Dimensional Reconstruction / 中国医科大学学报

Objective To investigate the usefulness of three-dimensional reconstruction in the preoperative evaluation of the texture of pituitary tumors. Methods Seventy patients with pituitary tumors admitted to our hospital between January 2015 and July 2018 were enrolled in the study. All patients underwent enhanced MRI scanning before surgery. They were classified into the soft group, medium group, and tough group according to the tumor texture. The patient's clinical data, MRI images, and surgery conditions were collected.The Mimics software was used to reconstruct the three-dimensional models of pituitary adenomas. The volume and surface area of different tumor signal groups were calculated and analyzed. In addition, the relationships between tumor size, tumor resection, and postoperative complications were analyzed. Results The three-dimensionally reconstructed model of the pituitary adenoma had a clear outline and was consistent with the tumor area in the MRI images. The calculated average threshold accurately segmented the images. Grouped by the classification of texture, the differences of the proportions of each part were statistically significant (P ＜ 0.01). According to the ordinal polytomous logistics regression analysis, the proportion of the volume of the higher part positively correlated with the tumor texture (P ＜0.05), and the ratio of the surface area of the medium part to the overall surface area positively correlated with the tumor texture (P ＜ 0.05).Conclusion The use of Mimics software for 3 D reconstruction of preoperative MRI images can accurately predict the tumor texture in pituitary tumors and can provide a basis for the choice of surgical methods.

Surgical treatment of children sylvian cistern arachnoid cysts complicated with subdural hematoma / 中国小儿急救医学

Objective To investigate the clinical characteristics,surgical indications and methods of children sylvian cistern arachnoid cysts complicated with subdural hematoma.Methods Fifty childhood cases of sylvian cistern arachnoid cyst complicated with subdural hematoma were retrospectively analyzed,who were all surgically treated in the First Affiliated Hospital of China Medical University from July 2005 to August 2015.Among them,20 childhood cases were subacute subdural hematoma,30 childhood cases were chronic subdural hematoma.All patients underwent microscopic cyst excision,cystocistern fenestration plus hematoma removal surgery.During the surgery,firstly we resected the cyst wall tissue as far as possible,and then we communicated the cyst with subarachnoid space and cisterns,which could make the cerebrospinal fluid flowed unobstructedly.Results The course of every operation was smooth,and there was no severe complication postoperatively.Original symptoms and imaging manifestation resolved or improved in all patients.During a mean follow-up period of 5.7 years,there were no recurrent cases.Conclusion Children sylvian cistern arachnoid cyst can induce subdural hematoma.In this situation,microscopic cyst excision,cystocistern fenestration plus hematoma removal surgery is safe and effective.

Establishment of risk warning model for surgical site infection / 中国感染控制杂志

Objective To establish a risk warning model for surgical site infection(SSI), provide support for screening high risk population and finding suspected cases.Methods Clinical data of 5 067 patients who underwent abdominal surgery in 6 domestic hospitals from January 2013 to December 2015 were collected retrospectively, all cases were randomly divided into modeling group and validation group according to a 6:4 ratio, warning model was established by employing logistic regression, the area under the receiver operating characteristic curve (AUC) was used to evaluate discriminant ability of evaluation model, the maximum Youden index was as the optimum cut-off point.Results For the warning model of high-risk patients, AUC was 0.823, sensitivity and specificity were 78.81% and 74.33% respectively, positive predictive value and negative predictive value were 19.67% and 97.78% respectively.For the discriminant model of suspected infection cases, AUC was 0.978, sensitivity and specificity were 93.38% and 95.62% respectively, positive predictive value and negative predictive value were 62.95% and 99.45% respectively.Conclusion The early-warning model established in this study has better discrimination ability, which can provide a reference for the development of early warning and discrimination of healthcare-associated infection information system.

Awareness of hand hygiene knowledge and compliance status in Chinese hospitals / 中国感染控制杂志

Objective To understand the status of awareness of hand hygiene(HH)knowledge and compliance among health care workers (HCWs)in China,and provide scientific basis for further improvement of HH practice. Methods A multi-centre retrospective survey on awareness of HH knowledge and compliance was conducted in 200 nationwide hospitals in 2015.Results The awareness rates of HH methods and HH indications among HCWs were 86.5% and 82.5% respectively;cleaning staff had the lowest awareness rate of HH indications(69.9%),followed by the other interns and advanced-study students (70.2%),as well as medical technicians (79.8%);attendants had the lowest awareness rate of HH methods(76.9%),followed by advanced-study students and interns(81.0%),and cleaning staff (82.4%);HH knowledge awareness rate among HCWs in secondary hospitals was lower than tertia-ry hospitals,and the district-level hospitals had the lowest awareness rate of HH.HH compliance rate and correct rate were 70.1% and 74.9% respectively;the interns and advanced-study students were at a low level of compliance and correct rates (61.4% and 60.9% respectively);the municipal hospitals had the lowest compliance and correct rates,non-teaching hospitals were lower than teaching hospitals.Conclusion HH in primary hospitals is weak,HH of interns,advanced-study students,as well as attendants and cleaning staffs are not enough,HH management should be strengthened,awareness and compliance of HH should be improved.

Development and changing trend in monitoring of healthcare-associated in-fection in China / 中国感染控制杂志

Objective To summarize the effectiveness in monitoring activities for healthcare-associated infection (HAI)in China in the past 30 years,explore the changing trend in HAI monitoring,find a new model for the moni-toring of HAI in China.Methods A total of 194 comprehensive hospitals and military hospitals in 13 provinces (au-tonomous regions,municipalities)were selected,questionnaire survey was adopted to investigate the situation of HAI monitoring.Results Of 194 hospitals,184 (94.85%)had available data after being checked,incidence of HAI in secondary and tertiary hospitals were 0.78% and 1.58% respectively,difference was significant (P <0.01).Monitoring was divided into two stages,cumulative percentage of each monitoring activity before 2006 and during 2006-2016 were respectively as follows:environmental hygiene were 73.91% and 100.00%,disinfection ef-ficacy 69.57% and 97.28%,overall comprehensive monitoring 64.67% and 98.91%,surgical site infection(SSI) 13.04% and 94.57%,ICU HAI 4.89% and 87.50%,neonatal HAI 1.75% and 60.82%,multidrug-resistant or-ganisms(MDROs)5.43% and 95.65%,hand hygiene compliance 2.17% and 93.48%,antimicrobial agents 15.22% and 87.50%.The reporting rate of HAI outbreak in tertiary hospitals was higher than secondary hospitals (33.33% [n=37]vs 16.44%[n=12],P =0.01).Conclusion The monitoring of HAI in China starts late,but develops rapidly,defects still exist in HAI monitoring system,reporting rate of HAI cases is still high,reporting rate of HAI outbreak is low.

Training situation of provincial-level healthcare-associated infection train-ing agencies in China / 中国感染控制杂志

Objective To understand the current situation and existing problems in the training of healthcare-asso-ciated infection(HAI)management,and provide scientific basis for strengthening the management of HAI preven-tion and control system.Methods A questionnaire survey was adopted to investigate situation of training on HAI in 15 provincial-level HAI training agencies in China during the past 30 years,and basic condition of training on HAI management in recent 5 years.Results Among 15 provincial-level training agencies,66.67%(n=10)were respon-sible by HAI management quality control centers,80.00% have already conducted training in each city,53.33%carried out training for 10 to 20 times,33.34% performed training for ≤2 times per year.Of 33 728 trainees in 2011-2015,41.30% were 41-50 years old,61.82% were nursing staff,50.56% had bachelor degree,43.96%were with the intermediate professional title.Most trainers were HAI prevention and control experts in their respec-tive province,accounting for 68.07%,the curriculums were mainly designed on professional course,and only 26.78% were involved in management.Conclusion Professional structure of HAI management personnel is not reasonable,faculty is imbalance,knowledge update is lacking,and HAI training and education system need to be improved further.

Development situation of healthcare-associated infection management de-partments in the rational antimicrobial application and management in China / 中国感染控制杂志

Objective To understand the development situation of healthcare-associated infection (HAI)manage-ment departments in the rational antimicrobial application and management in hospitals in China.Methods A total of 166 hospitals from 12 provinces,municipalities,autonomous regions,and military hospitals were selected for survey,the participation of HAI management departments in the rational clinical antimicrobial application and man-agement in different years was compared.Results Of 166 hospitals,68(40.96%)in 2005,119(71.69%)in 2010, and 160(96.39%)in 2015 participated in the establishment of management organizations for rational antimicrobial application (χ2 =121.143,P <0.001).The percentage of HAI management departments participating in antimicro-bial management increased from 10.24%(n=17)in 2005 to 22.29%(n=37)in 2010,and 31.33%(n=52)in 2015 (χ2 =22.172,P < 0.001 ).The percentages of HAI management departments participating in formulating cata-logues for antimicrobial varieties and classification,stipulating permission for antimicrobial use,joining antimicrobi-al management teams,monitoring bacterial resistance,managing antimicrobial prophylaxis in clean incision,super-vising clinical antimicrobial use,conducting clinical consultation,and evaluating prescription were 10.87% -30.72% in 2005,25.90%-65.06% in 2010,and 36.14%-95.18% in 2015 (all P <0.01).Intensity of antimicro-bial use (defined daily dose/100 bed-days,DDD/ 100 bed-days)decreased from 69.16 in 2005 to 41.40 in 2015, antimicrobial usage rate decreased from 46.98% in 2005 to 36.90% in 2015,among patients receiving therapeutic antimicrobial use,specimens sending for pathogenic detection increased from 20.58% in 2005 to 49.39% in 2015. Conclusion Departments of HAI management in China play important role in management of rational antimicrobial application.

Prevention and control of catheter-associated urinary tract infection in China / 中国感染控制杂志

Objective To realize the current situation of prevention and control of catheter-associated urinary tract infection (CAUTI)since the development of healthcare-associated infection(HAI)management in China in the re-cent 30 years.Methods Random cluster sampling was used to select 165 secondary and tertiary hospitals in 13 provinces and cities in China,questionnaires were filled in,the content included time,scope,method,data feed-back,and incidence of CAUTI monitoring.Results Of 165 hospitals,92.12% (152/165)have implemented targe-ted monitoring,the implementation rate in tertiary hospitals was higher than secondary hospitals (98.08% [102/104]vs 81.97%[50/61],χ2 =13.748,P <0.001).Most hospitals (82.24%[125/152])only implemented monito-ring in intensive care units(ICUs)or partial ICUs.HAI management professionals,HAI control doctors and nurses in 69.08%(105/152)of hospitals jointly took responsibility for CAUTI monitoring.95.39% (145/152)of hospitals diagnosed CAUTI by combination of clinical manifestations and laboratory examination results.98.68%(150/152) of hospitals have gradually implemented intervention measures,such as strictly mastering the indications of urinary indwelling catheters,hand hygiene of health care workers,non-frequent change of urinary indwelling catheters,and necessity for daily assessment of catheterization.75.66% (115/152)of hospitals conducted feedback of monitored results to the whole hospital.Incidences of CAUTI in pre-2010,2010,and 2015 were 3.10‰,4.72‰,and 1.89‰respectively.Conclusion In the recent 30 years,monitoring on CAUTI in China has obtained achievement,CAUTI monitoring is gradually standardized and scientific,but the development at all levels of medical institutions is still imbalance,which needs to be improved further.

Occupational exposure and protection among health care workers in China / 中国感染控制杂志

Objective To understand the current situation of occupational exposure and protection among health care workers (HCWs ), and provide evidence for formulating preventive measures of occupational exposure. Methods From April 6,2016 to May 6,2016,questionnaire surveys were conducted in 158 different levels of hos-pitals in 13 provinces in China,occupational exposure,protection management,and monitoring of occupational expo-sure in the first year,2010,and 2015 was surveyed by cluster random sampling method.Results Occupational ex-posure in 81.65% (129/158)of hospitals was responsible by healthcare-associated infection management depart-ments;98.73%(156/158)of hospitals set up the relevant rules and regulations;77.22%(122/158)of hospitals had missing report of occupational exposure.A total of 11 116 times of occupational exposure occurred (1 542 cases in the first year,2 474 in 2010,and 7 100 in 2015).Of various types of occupational exposure,sharp injury accounted for 96.76%;among HCWs sustained occupational exposure,nursing staff accounted for 53.90%;the major de-partment that HCWs who sustained occupational exposure were general wards,operating rooms,and intensive care units;the main medical appliances related to occupational exposure were syringes,scalp needles,and surgical suture needles;high-risk behavior causing occupational exposure were intravenous injection,putting needles into the sharp con-tainers,and surgical suturing;among occupational exposure sources,HBV accounted for 58.69%.Conclusion HCWs in China face a high risk of occupational exposure,occurrence of occupational exposure should be reduced through gov-ernment legislation,application of safety appliances,standardizing behavior of HCWs,proper using of personal pro-tective equipment,strengthening education and training of HCWs,and establishing a sound occupational exposure report,evaluation and follow-up system.

Economic loss due to healthcare-associated infection in 68 general hospitals in China / 中国感染控制杂志

Objective To explore the direct economic loss caused by healthcare-associated infection(HAI)in general hospitals in China.Methods 68 hospitals were selected,a retrospective 1:1 matched survey was conducted to compare the direct medical cost in patients with and without HAI between January 1,2015 and December 31,2015. Results A total of 2 123 pairs of patients with and without HAI were included in the survey.The average cost of hospitalization in HAI and non-HAI groups were ￥25 845.30 and ￥12 006.14 respectively,￥13 839.16 on average was increased due to HAI.The average economic loss in provincial and ministerial levels of hospitals were￥21 409.83.The average economic loss in different regional hospitals were ￥9 725.42-￥18 909.59,and north China ranked the first.Economic loss caused by bloodstream infection and lower respiratory tract infection were more than other sites,which were ￥23 190.09 and ￥18 194.50 respectively.Conclusion HAI resulted in considerable direct economic loss.Prevention and control of HAI,especially bloodstream infection and lower respiratory tract infection should be paid more attention.

Development of healthcare-associated infection management organizations in China in the past 30 years / 中国感染控制杂志

Objective To understand the development of healthcare-associated infection(HAI)management organ-izations in China in the past 30 years.Methods Development of HAI management organizations in 12 provinces (municipalities,autonomous regions)in China was surveyed.Results A total of 166 hospitals were surveyed,96 (57.83%)were tertiary hospitals.Among 164 hospitals which had a history of development of HAI management department,46(28.05%)before 1995,63(38.14%)in 1995-2005,and 55(33.54%)in 2005-2015 set up HAI management departments.HAI management professionals per 1 000 beds in 165 hospitals decreased from 4.80 in 1995 to 4.09 in 2015,occupational categories in HAI management departments in 1995 -2015 were significantly different (χ2 =26.22,P <0.01).The constituent ratios of education background and profession of HAI manage-ment professionals in each province in 1995-2015 were significantly different(χ2 =242.91,47.10,respectively,all P <0.01).In 1995 and 2005,70.81%,53.30% of professionals were with college degree or below;in 2015,the percentage of professionals with bachelor’s degree,doctoral degree,and master’s degree were 53.79%,2.45%, and 22.86% respectively.Most professionals were nursing staff,but the percentage decreased from 58.38% in 1995 to 45.96% in 2015.Conclusion Although HAI management organizations have developed for 30 years and made some achievements,there still remain some problems,the proportion of professionals needs to be enhanced,and personnel structure should be optimized.

Intervention efficacy of perioperative antimicrobial use in arthroscopic surgery / 中国感染控制杂志

Objective To investigate perioperative antimicrobial prophylaxis in arthroscopic surgery in a hospital before and after intervention,evaluate intervention efficacy,and provide evidence for the rational clinical antimicro-bial application.Methods From August 2012,measures were taken to intervene perioperative antimicrobial use, perioperative antimicrobial use and surgical site infection(SSI)in 312 patients undergoing arthroscopic surgery be-tween September 2011 and August 2013 were retrospectively surveyed.Results A total of 312 patients were investi-gated,pre-and post-intervention were 150 and 162 cases respectively,SSI rates were both 0 before and after inter-vention. Antimicrobial usage rate after intervention was lower than before intervention (26.54% vs 100.00% ,χ2=1.781,P<0.001). Irrational antimicrobial use dropped obviously;average expense of antimicrobial agents dropped from (1165.69±756.33)yuan (RMB)before intervention to (32.71 ±119.29)yuan (RMB)after intervention (t= 3.330,P<0.001).Conclusion Perioperative antimicrobial usage rate in arthroscopic surgery at this hospital decreased significantly after intervention,rational use of antimicrobial agents has improved,SSI rate still remains zero.

Nationwide cross-sectional survey on healthcare-associated infection in 2014 / 中国感染控制杂志

Objective To investigate the nationwide prevalence of healthcare-associated infection (HAI),and es-tablish the related indexes of HAI.Methods A cross-sectional survey was conducted through combination of bed-side investigation and medical record reviewing,the prevalence of HAI in hospitals of National HAI Surveillance System and other hospitals voluntarily participated in the survey were investigated according to unified survey pro-gram.Results A total of 1 008 584 patients in 1 766 hospitals participated in the survey,26 972 cases of HAI occurred, prevalence rate of HAI was 2.67%,antimicrobial usage rate was 35.01%.Difference in prevalence rates of HAI and anti-microbial usage rates among hospitals with different number of beds were both significant (χ2 =1 599.21,3 458.40,re-spectively,both P <0.01).The main infection sites were lower respiratory tract (47.53%),urinary tract (11.56%)and surgical site(10.41%).A total of 13 784 pathogenic strains were isolated,the top five pathogens were Pseudomonas aeruginosa ,Escherichia coli ,Klebsiella pneumoniae ,Acinetobacter baumannii ,and Staphylococcus aureus .Prevalence rate of HAI and prophylactic antimicrobial usage rate in patients receiving operation of class Ⅰincision were 1.01% and 27.99% respectively,difference in prophylactic antimicrobial usage rates in patients receiving operation of classⅠincision at hospitals with different number of beds were significant (χ2 =400.34,P <0.01 );among patients receiving antimicrobial prophylaxis,percentage of specimens sending for bacterial detection was 45.89%,difference in bacterial detection rates in hospitals with different number of beds were significant (χ2 =9 189.90,P <0.01).Hospital with more than 900 beds had the highest prevalence rate of HAI(3.36%),lowest usage rate of antimicrobial agents(32.35%),and highest bacterial de-tection rate(56.03%).Conclusion Multiple indexes of this cross-sectional survey revealed that HAI management in China has achieved remarkable results;meanwhile,calculation of the percentile distribution of each index is convenient for self-evaluation for HAI-related work in each hospital.

Survey on prevalence of healthcare-associated infection in Xiangya Hospital in 15 years / 中国感染控制杂志

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.

Prevalence rates of healthcare-associated infection at a general hospital in 2013-2015 / 中国感染控制杂志

Objective To investigate the prevalence of healthcare-associated infection (HAI)in a hospital in 2013-2015,and provide reference for the improvement of HAI management.Methods Prevalence rates of HAI among patients in the First Affiliated Hospital of Zhengzhou University in 2013 -2015 were investigated with cross-sec-tional survey method,prevalence rates of HAI and constituent ratios of HAI sites in patients of different genders and different age groups were analyzed.Results In 2013 -2015,29 605 patients should be investigated,29 581 (99.92%)were actually investigated.Prevalence rates of HAI in 2013-2015 were 2.83%,2.14%,and 1 .73%,re-spectively,difference was significant(χ2 =27.521 ,P 30 age group increased with age.The top three sites for prevalence of HAI were lower respiratory tract (45.67%),upper respiratory tract (9.92%),and urinary tract (8.52%).Conclusion The prevalence rates of HAI decreased year by year in 2013-2015,which suggests that HAI prevention and control measures are effectively implemented.

Multicenter study on targeted monitoring of surgical site infection and risk factors / 中国感染控制杂志

Objective To investigate the status and risk factors of surgical site infection (SSI)in hospitals in Chi-na,so as to provide theoretical basis for the prevention and treatment of SSI.Methods Four types of surgeries (colorectal surgery,abdominal hysterectomy,femoral neck repair surgery,and vascular surgery)in 29 hospitals were monitored prospectively,risk factors for SSI were analyzed.Results A total of 6 309 surgical procedures were investigated,incidence of SSI was 1 .60%.Incidences of SSI in patients receiving colorectal surgery,abdominal hys-terectomy,femoral neck repair surgery,and vascular surgery were 4.47%(74/1 655 ),1 .03%(22/2 139),0.21 %(5/2 372),and 0.00% (0/143 )respectively.The incidences of SSI were different among different regions (χ2 =114.213,P <0.05).The most common SSI was superficial incisional infection,the next was deep incisional infec-tion.The major pathogens causing SSI were Escherichia coli ,Enterococcus spp .,coagulase negative staphylococ-cus ,Staphylococcus aureus ,and Klebsiella pneumoniae .The independent risk factors for SSI were male patients, long duration of surgery,and high NNIS score.Conclusion The risk of SSI is varied with different types of surger-ies.Male,long duration of surgery,and high NNIS score can increase the risk of postoperative SSI.

Targeted monitoring on surgical site infection and effect of intervention / 中国感染控制杂志

Objective To explore the incidence of surgical site infection (SSI)and compliance to bundled interven-tion measures,and evaluate the effect of bundled interventions on controlling SSI.Methods From October 2013 to September 2014,three types of surgeries (colorectal surgery,abdominal hysterectomy,and femoral neck repair sur-gery)in 29 hospitals in China were monitored,October 2013 to March 2014 was baseline investigated stage,April 2014 to September 2014 was intervention stage.Results A total of 6 166 episodes of surgeries were monitored,the incidence of SSI was 1 .64%,incidence of SSI following colorectal surgery,abdominal hysterectomy,and femoral neck repair surgery were 4.47%,1 .03%,and 0.21 % respectively.The P 75 time of three types of surgeries were 3,2,and 2 hours respectively.Compared with the baseline stage,the compliance to most intervention measures im-proved after intervention,the largest increase in the compliance to interventions was disinfection with chlorhexidine-containing disinfectant at surgical sites of colorectal surgery (increased by 29.09%),followed by preoperative shower of femoral neck repair surgery (increased by 26.24%),preoperative shower of colorectal surgery(increased by 22.95%),and skin preparation on the day of operation (increased by 20.75%).Incidences of SSI in three types of surgeries were not significantly different before and after intervention(all P >0.05).Conclusion The incidences of SSI are different among different types of surgeries,the compliance to most bundled intervention measures has im-proved to some extent after intervention,but effectiveness of intervention measures needs to be further observed.

Monitoring on occupational exposure among 3 362 medical postgraduates / 中国感染控制杂志

Objective To realize basic status of occupational exposure among medical postgraduates,and provide theoretical evidence for making occupational precaution measures.Methods Data about occupational exposure among medical postgraduates in a teaching hospital between January 2011 and December 2013 were analyzed retro-spectively.Results A total of 3 362 medical postgraduates were monitored,56 (1 .67%)sustained occupational ex-posure.The most common occupational exposure sites were left hand thumbs(n=15,26.79%),occupational expo-sure most frequently occurred during operation(n=29,51 .79%),a total of 40(71 .43%)occupational exposure oc-curred during the process of operation and invasive procedure,all were sharp injuries.46(82.14%)exposure sources were with bloodborne-transmitted diseases.Surgery students accounted for 66.07%(n =37)of students sustained occupational exposure,exposure rate in master’s candidates was higher than doctoral candidates(2.31 % vs 0.28%,χ2 =18.325,P <0.001 ).After timely treatment and preventive medication,none of the students were infected. Conclusion It is necessary to strengthen the occupational safety education for medical postgraduates,improve pre-caution awareness,standardize all kinds of procedures,and implement standard precaution;timely and effective treatment after exposure is important for reducing occupational injury among medical postgraduates.

Study on intervention in central line-associated bloodstream infection in intensive care units / 中国感染控制杂志

Objective To evaluate the effect of evidence-based bundle intervention strategy on reducing the inci-dence of central line-associated bloodstream infection (CLABSI).Methods Prospective and multicenter study was adopted,patients admitted to 54 intensive care units (ICUs)of 41 hospitals and with central venous catheters (CVCs)between October 1 ,2013 and September 30,2014 were monitored .Baseline data between October 2013 and March 2014 were collected as pre-intervention data;from April to September 2014,the participated hospitals performed intervention strategy,post-intervention data were compared with pre-intervention data.Results The usage rate of CVCs before and after intervention was significantly different (44.18% vs 44.63%,χ2 =5.526,P =0.019).Incidence of CLABSI before and after intervention was not significantly different(RR ,0.82[95%CI ,0.59-1 .13],P =0.10).Constituent ratio of catheter insertion sites between pre-and post-intervention was significantly different (χ2 =76.264,P <0.001),femoral vein catheterization rate as well as proportion of two and above catheter insertion sites after intervention decreased(17.25% VS 13.72%;2.27% VS 1 .44%,respectively);hand hygiene implementation rate and accuracy rate after intervention were both higher than before intervention (79.73% vs 76.14%,P <0.001 ;91 .47% vs 74.26%,P <0.001 ,respectively);constituent ratio of skin disinfectant applica-tion before and after intervention was significantly different(χ2 =3.861 ,P <0.001 ),proportion of chlorhexidine ethanol increased (29.62% VS 50.56%);except daily assessment and record,compliance to other prevention and control measures before and after intervention were all significantly different(all P <0.001);utilization rate of max-imal sterile barrier,qualified rate of dressing of operators,and port disinfection were all significantly enhanced. Conclusion Bundle intervention in intubation and maintenance are implemented effectively,but intervention effect on CLABSI needs further study.