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Objective:To study the clinical characteristics of neonatal community-acquired Novel Coronavirus (COVID-19) Omicron variant infection.Methods:From March 30 to May 15, 2022, the epidemiological characteristics, clinical manifestations and outcomes of neonatal cases of community-acquired COVID-19 Omicron variant infection admitted to the isolation ward of our hospital were analyzed.Results:A total of 7 neonates infected with community-acquired COVID-19 Omicron variant were treated, including 3 males and 4 females. All of them were term infants with clear epidemiological exposure history. The infection was originated from caregivers of close contact (parents or babysitters). The main clinical symptoms was upper respiratory tract infection, including fever (6 cases), nasal congestion (6 cases), cough (5 cases), runny nose (2 cases), poor appetite (2 cases) and diarrhea (1 case). On admission, no abnormalities were found in blood routine examination and C-reactive protein (CRP). All but one case had normal serum amyloid A (SAA). No obvious abnormalities were found on chest X-ray. All patients were isolated in single-patient rooms after admission. They received standard symptomatic treatment and regular nucleic acid tests. The first negative nucleic acid results came on median 17 d(8~26 d) after the onset of the disease. The patients were discharged after two consecutive (24 h apart) nucleic acid tests with CT value ≥35 and continued health-monitor at home. On discharge, 5 patients had nasal congestion and 2 of them had cough. During the follow-up 4~6 weeks after discharge, all patients gradually recovered without positive nucleic acid results.Conclusions:All 7 neonates with community-acquired COVID-19 Omicron variant infection have epidemiological exposure history. The main clinical symptoms are long-lasting upper respiratory tract infections. It takes a relatively long time for the nucleic acid to turn negative, however, the overall short-term prognosis is good.
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Objective To investigate the prevalence of nosocomial infection among inpatients in a tertiary hospital， and provide scientific evidence for hospital infection control and targeted surveillance. Methods A cross-sectional survey was conducted to investigate a total of 543 hospitalized patients using the hospital information system. Results The prevalence of hospital-acquired infection （HAI） was 4.24%， and that of community-acquired infection （CAI） was 23.39%. HAI prevalence differed significantly among the departments （ χ 2=148.870， P <0.05）， and was highest in the department of intensive care medicine （72.73%）. Sites of infection were significantly different between HAI and CAI （ χ 2=22.942， P =0.011）； however， the most frequent site of infection was lower respiratory tract in both HAI and CAI. Major pathogens for nosocomial infection were Gram-negative bacteria （56.92%）， mainly Escherichia coli and Klebsiella pneumoniae . Antimicrobial usage was observed in 31.68% of the patients， principally for therapeutic use of antibacterial drugs （80.23%） and a combination of drugs （88.95%）. Examination rate of pathogens following the antimicrobial usage was 72.08%. Conclusion The investigation on the prevalence of nosocomial infection may facilitate fully understanding the nosocomial infection. It warrants strengthening the monitoring in the departments of intensive care medicine and on multi-resistant bacteria， and achieving antimicrobial stewardship， so as to improve the awareness of hospital infection control in medical staff' and effectively reduce the occurrence of nosocomial infection.
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Objective To investigate the prevalence of nosocomial infection among inpatients in a tertiary hospital， and provide scientific evidence for hospital infection control and targeted surveillance. Methods A cross-sectional survey was conducted to investigate a total of 543 hospitalized patients using the hospital information system. Results The prevalence of hospital-acquired infection （HAI） was 4.24%， and that of community-acquired infection （CAI） was 23.39%. HAI prevalence differed significantly among the departments （ χ 2=148.870， P <0.05）， and was highest in the department of intensive care medicine （72.73%）. Sites of infection were significantly different between HAI and CAI （ χ 2=22.942， P =0.011）； however， the most frequent site of infection was lower respiratory tract in both HAI and CAI. Major pathogens for nosocomial infection were Gram-negative bacteria （56.92%）， mainly Escherichia coli and Klebsiella pneumoniae . Antimicrobial usage was observed in 31.68% of the patients， principally for therapeutic use of antibacterial drugs （80.23%） and a combination of drugs （88.95%）. Examination rate of pathogens following the antimicrobial usage was 72.08%. Conclusion The investigation on the prevalence of nosocomial infection may facilitate fully understanding the nosocomial infection. It warrants strengthening the monitoring in the departments of intensive care medicine and on multi-resistant bacteria， and achieving antimicrobial stewardship， so as to improve the awareness of hospital infection control in medical staff' and effectively reduce the occurrence of nosocomial infection.
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Una manera para lograr más efectividad en la decisión terapéutica en recién nacidos que cursan con infecciones, es tener conocimiento del microorganismo causal más común, según el tipo de infección por la cual cursa el paciente. Por ello el médico debe estar familiarizado con el mapa microbiológico de la institución donde trabaja y estar actualizado en el espectro de microorganismos habituales que informa la literatura, así como aquellos emergentes y reemergentes. Se revisa el estado actual de reportes de frecuencia de los microorganismos causales en recién nacidos con infecciones, tomados de la literatura médica nacional e internacional con el propósito de orientar al médico de asistencia del posible microorganismo causal más probable en base a la clínica del paciente y además, a tomar la clasificación de las infecciones como herramienta que aporta una guía de los agentes que afectan con más frecuencia al paciente recién nacido, y los factores de riesgo asociados. Se concluye que es factible y beneficioso este enfoque que le permite al médico asistencial ser más efectivo en la decisión del tratamiento a seguir. Es su deber estar familiarizado con el mapa microbiológico de la institución donde trabaja y estar actualizado en el espectro de microorganismos habituales que informa la literatura, así como aquellos emergentes y reemergentes(AU)
One way to achieve more effectiveness in therapeutic decisions related to newborns with infections is to be aware of the most common causal microorganism, depending on the type of infection the patient is suffering. Therefore, the physician should be familiar with the microbiological map of the institution where he/she works and be updated in the spectrum of common microorganisms reported by the literature, as well as those emerging and re-emerging. The current status of frequency reports of causal microorganisms in newborns with infections, taken from national and international literature, is reviewed to guide the assistance physician on the most likely possible causal microorganism based on the patient's clinic and also to use the classification of infections as a tool that provides guidance on the agents that most often affect the newborn patients, and associated risk factors. It is concluded that this approach that allows the assistance physician to be more effective in the decision of treatment to follow is feasible and beneficial. It is the physician's duty to be familiar with the microbiological map of the institution where he/she works and be updated on the spectrum of common microorganisms reported by the literature, as well as those emerging and re-emerging(AU)
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Humans , Infant, Newborn , Therapeutics , Effectiveness , Risk Factors , KnowledgeABSTRACT
Objective To investigate the distribution of carbapenem‐resistant Acinetobacter baumannii(CRAB) infections and its resistance to commonly used antibacterial drugs to provide a basis for infection control and rational use of antibacterial drugs in this area .Methods The clinical data and drug susceptibility test results in the patients with CRAB infection in our hospital from January 1 ,2013 to December 31 ,2014 were retrospectively analyzed .Results Eighteen strains of CRAB in community‐acquired in‐fection and 140 strains of CRAB in nosocomial infection were isolated ,the resistance rates to piperacillin/tazobactam ,gentamicin and tobramycin were higher than 80% ,which to ampicillin/sulbactam and levofloxacin were 64 .5% and 48 .2% respectively ,which to compound SMZ and amikacin were lower than 25% .The distribution of drug sensitivity results had no statistical difference between community CRAB infection and nosocomial CRAB infection (P>0 .05) .Conclusion The CRAB infection is mainly nosocomial in‐fection ,the empirical therapy could select compound SMZ and amikacin .
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Objective To analyze the clinical data of Staphylococcus aureus sputum culture positive cases and the antimicrobial susceptibility of Staphylococcus aureus strains isolated from them and provide the evidence for clinical diagnosis and treatment. Methods Retrospectively analyze the clinical data of Staphylococcus aureus sputum culture positive cases of our hospital from January 2014 to December 2014. Results The Staphylococcus aureus sputum culture positive cases was 111 in all, while antimicrobial sensitive test was performed in 110 cases, including MSSA in 27 cases (24.55%), MSRA in 83 cases (74.45%), community infection MSRA in 13 cases (15.66%), hospital infection MRSA in 70 cases (84.34%). The cases were mainly from the department of respiratory diseases, department of neurosurgery, ICU, the department of neurology, accounting for 75.68%. The risk rate of community acquired MRSA in patients from nursing center were significantly higher than that of hospital infection MRSA and MSSA (P = 0.004). The antimicrobial susceptibility rate of community infection MRSA to clindamycin, gentamicin, erythromycin, azithromycin was higher than that of hospital infection MRSA. Conclusion The susceptibility rate in non-β-lactams of community infeciton MRSA was higher than that of hospital infection MRSA.
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Objective To understand the drug resistance of Escherichiacoli in the bloodstream infections from community infec-tion and hospital infection,in order to provide the basis for clinical rational drug use.Methods According to the CLSI 2013 stran-dard,VITEK-2GN and AST-GN13 cards from France Bio-merieux company were used to identify the bacteria and analyze the drug susceptibility.The data was analyzed by SPSS 13.0.Results A total of 181 strains of Escherichiacoli were isolated from communi-ty-acquired and hospital-acquired bloodstream infections from January to December in 2014.There were 88 strains of community in-fection and 93 strains of hospital infection.The rates of ESBLs (+)strains isolated from community infection and hospital infection were 53.4% and 73.1% respectively.The ESBLs (+)rate of Escherichiacoli isolated from community infection was significantly lower than that from hospital infection (P =0.006).Antibiotics of resistance less than 10% in 181 strains of Escherichiacoli were Cefoperazone/Sulbactam,Piperacillin/Tazobactam,Ertapenem,Imipenem,Amikacin.The resistant rate of Hospital infection strains was generally higher than that of community infection strains.The ESBLs (+)rate of Escherichiacoli isolated from bloodstream in-fections of Urology Surgery wsa higher than that of other departments.Conclusion The drug resistance of Escherichiacoli in the bloodstream infections from hospital infection is higher than that from community infection.Using antibiotics rationally and strengthening the nosocomial infection surveillance of ICU and Surgery Ward are effective measures to control the bacterial drug re-sistance.
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Objective To investigate and analysis the prevalence rate of hospital infection and community infection,and to reduce the incidence of hospital infection.Methods First we investigated hospitalized patients in September 9,2013 by two ways which in-clude bedside investigation and reviewing the medical records;and then described the prevalence case of infection and the usage of antimicrobial agent by descriptive approach.Results Seven hundred and seventy patients were investigated with the rate of 100.00%;18 patients were hospital infection cases,the infection rate was 2.34%;most of the hospital infection cases was occur in lower respiratory tract;228 patients were community infection cases.The infection rate was 29.61%;the primary affected areas of community infection were respiratory and gastrointestinal tract;the structure of hospital infection pathogens were almost the same with the community infection,most of them were G- bacteria;186 patients were used antimicrobial agent in that day,the usage rate was 24.16%.Conclusion Promoting the managements of high risk departments and susceptible affected areas,making relevant rules of operation are the focus of our works in the future.
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Objective: To analyze the condition of infections caused by MDROs and effect of hospital infection monitoring measures. Methods: Patients with MDROs positive from July 2009 to December 2012were prospectively studied and given Bundle monitoring measures, patients with MDROs positive from January 2006 to June 2012 were retrospectively studied, the condition of hospital acquired infections caused by MDROs and the value of hospital infection monitoring measures were analyzed. Results:(1)the total cases of MDROs infection were 1782, including 839 cases of hospital infection and 944 cases of community infection, separately accounted for 47.08% and 52.92%; the incidence of ESBLs-ECO and MRSA were highest, separately 30.04%,39.09%;(2)after monitoring measures, the incidence of MDROs in surgery department(x2=15.273, P=0.001), internal medicine department(x2=7.532, P=0.021), gynaecology(x2=11.842, P=0.008) and obstetrics department(x2=10.842, P=0.010), paediatrics department(x2=8.834, P=0.017) were lower than those of before monitoring measures;(3)the incidence of hospital acquired infections caused by MDROs were negatively correlated with effective monitoring measures and positively correlated with ommunity infection. Conclusion:Bundle monitoring measures can contribute to the control of hospital acquired infections caused by MDROs.