Investigation on the status of healthcare-associated infections among 42 429 inpatients in Wuhan City / 公共卫生与预防医学

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.

Interaction of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students / 中华预防医学杂志

Objective@#To explore the interaction of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students.@*Methods@#From November 2015 to January 2016, 22 628 middle school students from Shenyang of Liaoning Province, Bengbu of Anhui Province, Xinxiang of Henan Province, Ulanqab of Inner Mongolia Autonomous Region, Chongqing Municipality, and Yangjiang of Guangdong Province were enrolled by using the multi-stage cluster convenience sampling method. A questionnaire was used to collect the data including demographic information, health literacy, second-hand smoke exposure, and psychopathological symptoms. A multivariate logistic regression model was used to analyze the interaction of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students.@*Results@#The age of students was (15.36±1.79) years old, of which 10 990 were boys, accounting for 48.6% of total students. The detection rate of psychopathological symptoms was 29.1% (6 581/22 628). The detection rate of psychopathological symptoms in those who were exposed to second-hand smoke was 38.1% (2 401/6 304), which was higher than that in the non-second-hand smoke exposure group [25.6% (4 180/16 324)] (P<0.001). The OR (95%CI) of the interaction between medium and low levels of overall health literacy, low level of interpersonal dimension of health literacy and second-hand smoke exposure was 1.19 (1.15-1.24), 2.00 (1.92-2.10) and 1.59 (1.52-1.66), respectively.@*Conclusion@#There was a positive interaction between middle and low levels of overall health literacy, low level of interpersonal dimension of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students.

Association of health literacy and smoking behaviors among middle school students in six cities of China / 中华预防医学杂志

Objective@#To explore the association between the health literacy (HL) and smoking behaviors in middle school students.@*Methods@#From November 2015 to January 2016, middle school students in Shenyang City of Liaoning Province, Bengbu City of Anhui Province, Xinxiang City of Henan Province, Ulanqab City of Inner Mongolia Autonomous Region, Chongqing City and Yangjiang City of Guangdong Province were enrolled by using a multistage stratified cluster sampling method. A total of 23 137 questionnaires were issued and 22 628 questionnaires were valid. A questionnaire survey was conducted to collect demographic information, HL and smoking behaviors. The low, middle, and high-level group were classified according to the tertile of HL score. A multiple logistic regression model was conducted to explore the association between the HL and smoking behaviors.@*Results@#The age of subjects was (15.4±1.8) years old, and HL score was (104.1±18.7) points. The proportion of former smoking, recent smoking and passive smoking was 9.2% (2 071), 2.8% (635) and 27.9% (6 304), respectively. The proportion of former smokers who tried to quit smoking was 50.1% (1 037/2 071). Compared to the high-level HL, the low-level HL increased the risk of former smoking [OR (95%CI): 1.85 (1.61−2.13)], recent smoking [OR (95%CI): 1.68 (1.33−2.14)] and passive smoking [OR (95%CI): 1.34 (1.23−1.46)], and decreased the likelihood of smoking cessation [OR (95%CI): 0.70 (0.53−0.92)], after adjusting for the gender, school type, registered residence, household structure, accommodation type, educational level of patients, and self-reported family economic status.@*Conclusion@#The HL of middle school students was related to their smoking behaviors.

Correlation of health literacy and mobile phone use dependence with psychopathological symptoms in middle school students / 中华预防医学杂志

Objective@#To explore the correlation of health literacy and mobile phone use dependence with psychopathological symptoms in middle school students.@*Methods@#22 628 middle school students in Shenyang, Bengbu, Xinxiang, Ulanqab, Chongqing and Yangjiang were enrolled by multistage cluster sampling method from November 2015 to January 2016. Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ), Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and Multidimensional Sub-health Questionnaire of Adolescents (MSQA) were applied to acquire basic characteristics, health literacy, mobile phone use dependence and psychopathological symptoms of subjects. Subjects were classified into three groups, low level (<P25), medium level (P25-P75) and high level (>P75), according to the percentile of the questionnaire score. Multivariate logistic regression model was used to analyze the correlation of health literacy, mobile phone with psychopathological symptoms.@*Results@#The students were (15.4±1.8) years old with 10 990 boys (48.6%). The score of health literacy of students were (104.1±18.7) points. The rate of mobile phone use dependence was 25.4% (5 752/22 628) and the rate of psychopathological symptoms was 29.1% (6 581/22 628). Compared with high health literacy level, medium and low health literacy levels were related to psychopathological symptoms, with OR (95%CI) about 2.30 (2.10-2.52) and 5.40 (4.89-5.97), respectively. Compared with mobile phone use independence, mobile phone use dependence was related to psychopathological symptoms, with OR (95%CI) about 3.60(3.37-3.85). The highest rate of psychopathological symptoms occurred in students with mobile phone use dependence and low health literacy level [68.0% (1 345/1 977)], with OR (95%CI) about 19.59 (17.07-22.48).@*Conclusion@#Health literacy and mobile phone use dependence are related factors of psychopathological symptoms in middle school students.

Association between childhood abuse experiences and smoking behavior among middle school students / 中国学校卫生

Objective@#The aim of this paper is to understand the prevalence of smoking behavior among middle school students and to analyze the impact of childhood abuse experience on smoking behavior of middle school students.@*Methods@#Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen, Zhengzhou, Nanchang and Guiyang as participants. A multivariate logistic regression model was established to analyze the effects of childhood abuse on smoking behavior among middle school students.@*Results@#The rate of smoking behavior among middle school students was 3.6%, male students (5.8%) were higher than female students (1.4%), senior high school (5.0%) was higher than junior high school (2.3%), and rural (6.0%) was higher than urban (2.8%). The differences were statistically significant(P<0.01). Those exposed to high-level of various types of childhood abuse had a higher rate of smoking behavior than those with low levels. Multivariate Logistic regression models showed that emotional abuse(OR=1.69, 95%CI=1.38-2.07), physical abuse(OR=2.17, 95%CI=1.78-2.64), sexual abuse(OR=2.56, 95%CI=2.10-3.12), emotional neglect(OR=2.27, 95%CI=1.89-2.74), physical neglect (OR=2.21, 95%CI=1.83-2.67) and childhood abuse experience (OR=2.66, 95%CI=2.21-3.21) increased the risk of smoking among middle school students independently(P<0.01).@*Conclusion@#Childhood abuse is closely assoliated with smoking behavior among middle school students. Strengthening the importance and intervention of childhood abuse is beneficial to the prevention and control of smoking behavior among middle school students.

Interactive effects between health literacy and mobile phone dependence as well as its relation with unintentional injuries in middle school students / 中华流行病学杂志

Objective To investigate the interaction between health literacy,mobile phone dependence and unintentional injuries in middle school students,and to provide guidance for prevention on unintentional injuries in adolescents.Methods From November 2015 to January 2016,a questionnaire survey was conducted among 22 628 middle school students in Shenyang of Liaoning province,Bengbu of Anhui province,Xinxiang of Henan province,Ulanqab of Inner Mongolia Autonomous Region,Chongqing and Yangjiang of Guangdong province.Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ),Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU),and Unintentional Injuries Assessment Scale and demographic variables were used to measure the health literacy,mobile phone dependence and unintentional injuries among the Chinese middle school students.Results The detection rates of mobile phone dependence and unintentional injuries were 25.4％ and 46.7％,respectively.The rates of unintentional injuries of middle school students with mobile phone dependence and with low,medium and high health literacy were 53.6％,44.4％ and 48.8％,48.1％,41.7％.Factors as mobile phone dependence,low and middle health literacy were positively related to unintentional injuries (OR=1.452,1.196,1.364).However,the multiplicative interaction between mobile phone dependence and health literacy on unintentional injuries was noticed significant (OR=1.217,95％CI:1.041-1.422).Conclusions Our results showed that the prevalence of unintentional injuries was relatively high in middle school students.Health literacy and mobile phone dependence seemed related to unintentional injuries.Interaction between health literacy and mobile phone dependence on unintentional injuries appeared significant.

Interactive effects between health literacy and mobile phone dependence as well as its relation with unintentional injuries in middle school students / 中华流行病学杂志

Objective To investigate the interaction between health literacy,mobile phone dependence and unintentional injuries in middle school students,and to provide guidance for prevention on unintentional injuries in adolescents.Methods From November 2015 to January 2016,a questionnaire survey was conducted among 22 628 middle school students in Shenyang of Liaoning province,Bengbu of Anhui province,Xinxiang of Henan province,Ulanqab of Inner Mongolia Autonomous Region,Chongqing and Yangjiang of Guangdong province.Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ),Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU),and Unintentional Injuries Assessment Scale and demographic variables were used to measure the health literacy,mobile phone dependence and unintentional injuries among the Chinese middle school students.Results The detection rates of mobile phone dependence and unintentional injuries were 25.4％ and 46.7％,respectively.The rates of unintentional injuries of middle school students with mobile phone dependence and with low,medium and high health literacy were 53.6％,44.4％ and 48.8％,48.1％,41.7％.Factors as mobile phone dependence,low and middle health literacy were positively related to unintentional injuries (OR=1.452,1.196,1.364).However,the multiplicative interaction between mobile phone dependence and health literacy on unintentional injuries was noticed significant (OR=1.217,95％CI:1.041-1.422).Conclusions Our results showed that the prevalence of unintentional injuries was relatively high in middle school students.Health literacy and mobile phone dependence seemed related to unintentional injuries.Interaction between health literacy and mobile phone dependence on unintentional injuries appeared significant.

Prevalence rates of healthcare-associated infection and community-associated infection in hospitalized patients in Wuhan City / 中国感染控制杂志

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.

Prevalence of Panton-Valentine leukocidin genes and antimicrobic resistance in Staphylococcus aureus isolates from outpatients with skin and soft-tissue infections in Wuhan city / 中华皮肤科杂志

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.