ABSTRACT
Objective To explore the retrograde contamination of drainage bag outlets,and provide basis for the formulation of related guideline for healthcare-associated infection(HAI)management. Methods On October 14,2016,with sterile manipulation,urine,5% glucose solution,glucose normal saline,sterile water,and 0.9% nor-mal saline were injected into anti-reflux drainage bags(anti-reflux group)and common drainage bags(common group)respectively,entrances of bags were sealed and bags were hung in two ways:outlets were 10 cm away from the ground(suspended group)and touched the ground(ground-touching group)respectively,specimens were col-lected from bag outlets to perform bacterial culture every 3 days,a total of 10 times of cultures were performed,re-trograde contamination of drainage bag outlets was observed dynamically.Results Retrograde contamination rate of drainage bag outlets of anti-reflux group was significantly lower than common group(7.7% vs 46.0%,P=0.000);suspended group was significantly lower than ground-touching group(17.9% vs 35.8%,P=0.000). Retrograde contamination rates of outlets of drainage bags filled with different properties of liquid were as follows:urine (54.3%)>5% glucose solution(34.5%)>glucose normal saline(24.3%)>0.9% normal saline(10.8%)>ste-rile water(10.5%),pairwise comparison showed a significant difference(P=0.000).The initial occurrence time of contamination in anti-reflux group and common group was on the 13thday and 7thday respectively,two group was significantly different on the 7thday(P=0.041). There was a medium intensity correlation between the types of drainage bags and liquid properties(PearsonC=0.5).Conclusion Different types of drainage bags,retention time,and liquid property can impact retrograde contamination of drainage bag outlets,regular urine culture during the use of drainage bags should be paid attention in clinical practice,so as to use antimicrobial agents rationally and guide replacement time of drainage bags.
ABSTRACT
<p><b>OBJECTIVE</b>A hepatitis B immunogenic complex therapeutic vaccine, yeast-derived recombinant HBsAg combined with human anti-HBs immunoglobulin (YIC), was evaluated for safety and immune response in phase I clinical trial.</p><p><b>METHODS</b>The subtypes IgG1, IgG2, IgG3 and IgG4 of serum anti-HBs collected from 20 immunized subjects were analyzed by ELISA. The lymphocyte proliferation assay was carried out in five subjects and was analyzed by 3H-thymidine incorporation. The assays for IFNgamma, IL-2, IL-4, IL-6, IL-10 and TNFalpha were measured using Human Cytometric Bead Array Kit with FACSCalibur.</p><p><b>RESULTS</b>The results showed that the subtypes of anti-HBs antibodies induced by 30, 60 and 90 microg YIC-immunized groups among all of the adult volunteers (20/20) were IgG1 and IgG3. The level of IgG1 was higher than that of IgG3 in each volunteer but the strength was different from each other. The rHBsAg-stimulated lymphocyte proliferation induced by three injections of 90 microg of YIC showed that the stimulation index was more than 2.0 in four out of the five individuals (4/5), ranging from 2.70 to 4.75. PHA-stimulated lymphocyte proliferation was not related to rHBsAg-stimulated lymphocyte proliferation. In the 60 microg YIC-immunized group there was no significant difference between the levels of IFNgamma, IL-2, IL-4, IL-6 and IL-10 at day 0 and day 42. At day 71, in comparison to day 0, the level of IFNgamma was higher in all eight subjects studied (P = 0.015) and the level of IL-2 was also increased in seven out of eight subjects (P = 0.002). In contrast, the levels of IL-4, IL-6, IL-10 and TNFalpha showed no significant difference in all the subjects (P-values: 0.298, 0.976, 0.202 and 0.996).</p><p><b>CONCLUSION</b>Our results indicate that this hepatitis B immunogenic complex therapeutic vaccine (YIC) can induce a potent anti-HBs response.</p>