RESUMEN
Objective@#To explore the relationship between different serum albumin and lymphocyte levels in patients with 2019-novel coronavirus (2019-nCoV) pneumonia (COVID-19).@*Methods@#A retrospective study was performed to identify the characteristics of the clinical data of 205 COVID-19 patients who were hospitalized in the Happy Street of Hanchuan People's Hospital, Xiaogan, Hubei Province from January 24 to February 12, 2020, including their general information, serum albumin (ALB) levels, lymphocyte counts (LYM), percentage of lymphocytes (LYM%) and other laboratory parameter levels. Low ALB group and normal ALB group were demarcated by the concentration of 35g/L, further to identify the differences of LYM and LYM% levels and the incidence of LYM and LYM% decline at different ALB levels between groups,as well as the correlation between ALB and LYM, LYM% levels in hypoalbuminemia conditions .@*Results@#17.5% of COVID-19 patients were associated with hypoalbuminemia. The levels of LYM and LYM% in the low ALB group were significantly lower than those in the normal ALB group (P <0.001). The incidence of LYM and LYM% decline in the low ALB group was significantly higher than those in the normal ALB group (P <0.001). The levels of LYM and LYM% in the low ALB group were significantly positively correlated with serum ALB concentrations (P <0.05).@*Conclusions@#The decrease of lymphocyte levels in COVID-19 patients may be correlated to hypoalbuminemia. COVID-19 patients complicated by hypoalbuminemia should be actively intervened to maintain serum albumin in the normal range.
RESUMEN
Objective:To explore the relationship between different serum albumin and lymphocyte levels in patients with 2019-novel coronavirus (2019-nCoV) pneumonia (COVID-19).Methods:A retrospective study was performed to identify the characteristics of the clinical data of 205 COVID-19 patients who were hospitalized in the Happy Street of Hanchuan People's Hospital, Xiaogan, Hubei Province from January 24 to February 12, 2020, including their general information, serum albumin (ALB) levels, lymphocyte counts (LYM), percentage of lymphocytes (LYM%) and other laboratory parameter levels. Low ALB group and normal ALB group were demarcated by the concentration of 35 g/L, further to identify the differences of LYM and LYM% levels and the incidence of LYM and LYM% decline at different ALB levels between groups,as well as the correlation between ALB and LYM, LYM% levels in hypoalbuminemia conditions .Results:17.5% of COVID-19 patients were associated with hypoalbuminemia. The levels of LYM and LYM% in the low ALB group were significantly lower than those in the normal ALB group ( P <0.001). The incidence of LYM and LYM% decline in the low ALB group was significantly higher than those in the normal ALB group ( P <0.001). The levels of LYM and LYM% in the low ALB group were significantly positively correlated with serum ALB concentrations ( P <0.05). Conclusions:The decrease of lymphocyte levels in COVID-19 patients may be correlated to hypoalbuminemia. COVID-19 patients complicated by hypoalbuminemia should be actively intervened to maintain serum albumin in the normal range.
RESUMEN
Objective To understand the risk factors of hospital-acquired pneumonia(HAP) due to Carbapenem-resistant Kleb-siella pneumonia (CRKP) ,and propose prevention and control measures to reduce the incidence of hospital infection rate .Methods A total of Klebsiella pneumonia infection 73 patients with HAP ,who were treated in the ICU of a tertiary hospital in Chongqing from January 2014 to March 2016 were included .The 27 cases with CRKP were assigned as case group ,46 cases with Carbapenem-susceptible Klebsiella pneumonia(CSKP) were included as control group .Univariate and the multivariate Logistic regression analy-sis was performed for the risk factors .Results Univariate analysis showed that ,before infection ,the use of antimicrobial agents≥7 days ,Carbopenems ,mechanical ventilation ≥7 days ,APACHE Ⅱ score ,and at least 11 factors were the risk factors for CRKP HAP .Multivariate Logistic regression analysis showed that ,Carbapenems ,and mechanical ventilation≥7 days before infection and APACHE Ⅱ score was an independent risk factor of CRKP HAP .Conclusion Carbapenems ,and mechanical ventilation≥7 days before infection and APACHE Ⅱ score are the independent risk factors for CRKP HAP .Rational use of antibiotics ,reducing me-chanical ventilation and doing good hand hygiene are effective measures to reduce the incidence of CRKP HAP .
RESUMEN
Objective To understand the risk factors of hospital-acquired pneumonia(HAP) due to Carbapenem-resistant Kleb-siella pneumonia (CRKP) ,and propose prevention and control measures to reduce the incidence of hospital infection rate .Methods A total of Klebsiella pneumonia infection 73 patients with HAP ,who were treated in the ICU of a tertiary hospital in Chongqing from January 2014 to March 2016 were included .The 27 cases with CRKP were assigned as case group ,46 cases with Carbapenem-susceptible Klebsiella pneumonia(CSKP) were included as control group .Univariate and the multivariate Logistic regression analy-sis was performed for the risk factors .Results Univariate analysis showed that ,before infection ,the use of antimicrobial agents≥7 days ,Carbopenems ,mechanical ventilation ≥7 days ,APACHE Ⅱ score ,and at least 11 factors were the risk factors for CRKP HAP .Multivariate Logistic regression analysis showed that ,Carbapenems ,and mechanical ventilation≥7 days before infection and APACHE Ⅱ score was an independent risk factor of CRKP HAP .Conclusion Carbapenems ,and mechanical ventilation≥7 days before infection and APACHE Ⅱ score are the independent risk factors for CRKP HAP .Rational use of antibiotics ,reducing me-chanical ventilation and doing good hand hygiene are effective measures to reduce the incidence of CRKP HAP .
RESUMEN
Objective To investigate the causes of a healthcare-associated lower respiratory tract infection(HA-LRTI) outbreak due to Enterobacter cloacae(E.cloacae), and provide basis for clinical prevention and control of HAI.Methods Epidemiological data of patients with E.cloacae HA-LRTI following bronchoalveolar lavage(BAL) in the departments of respiratory disease and thoracic surgery of a hospital were collected, antimicrobial resistance analysis on isolated pathogens from patients and environment was performed, pulsed-field gel electrophoresis (PFGE) was used for genotyping.Results On March 8-16, 2013, a total of 15 patients underwent BAL in the fiberobronchoscopy room in the departments of respiratory disease and thoracic surgery of a hospital, 13 of whom developed E.cloacae LRTI, 4 cases were community-associated infection (the initial case was included), the other 9 cases were HAI;8 environmental specimens were detected 2 strains of E.cloacae, the strains were from vacuum suction joint of fiberbronchoscope and scissors used for trimming disposable controllable sputum suction pipeline.15 strains of E.cloacae from environment and patients were screened by antimicrobial susceptibility testing, 11 strains were with similar antimicrobial susceptibility testing result, 2 of which were environmental strains, 6 were from inpatients, and 3 were from patients in community.PFGE typing of 11 strains revealed that there were 8 strains with the same genotype, 6 of which were from patients in department of thoracic surgery, 2 were from vacuum suction joint of fiberbronchoscope and scissors used for disposable controllable sputum suction pipeline;the other 3 strains were of the same genotype, and from departments of respiratory disease and thoracic surgery.Conclusion This outbreak is due to contamination of bronchofibroscope by the same E.cloacae strain, the strain is susceptible to the clinic commonly used antimicrobial agents, such events should be paid attention in clinic, the key to control infection is to take necessary measures for cutting off the spread of the epidemic.
RESUMEN
Objective To understand colonization of pathogens in nasal vestibular of health care workers (HCWs) in intensive care unit (ICU),and provide evidence for strengthening the prevention and control of healthcare-associated infection (HAI)in ICU.Methods On may 2015,colonization status of pathogens in nasal vestibular of uninfected HCWs in ICU were actively screened,bacterial culture,isolation and identification were performed.The surveyed results were analyzed and compared with antimicrobial resistance of pathogens from patients at the same stage.Results A total of 96 HCWs were surveyed,43 pathogenic strains were isolated from different HCWs’na-sal vestibular,isolation rate and carriage rate were both 44.79%.The main pathogenic bacteria was Staphylococcus aureus(n=15,34.88%),followed by Enterobacter aerogenes (n =9,20.93%)and Klebsiella pneumoniae (K . pneumoniae ,n=7,16.28%).There was a high detection rate of pathogens from nasal vestibular of doctors,HCWs who smoked frequently and those who never exercised (all P 50.00%,resistance rates to cefotaxime and imipenem were 28.57% and 14.29%respectively;resistance rates of 11 strains of K .pneumoniae from patients to furantoin was 100.00% during the same stage,but were sensitive to other commonly used antimicrobial agents.Resistance rate of 4 strains of Esche-richia coli (E.coli)to ampicillin was 75.00%,to gentamicin,tobramycin,levofloxacin,ciprofloxacin,and com-pound sulfamethoxazole were all 50.00%,6 strains of E.coli isolated from patients during the same period were found to be resistant to most commonly used antimicrobial agents.Conclusion Colonization rate of pathogens is high in nasal vestibular of HCWs in ICU,active screening and monitoring on colonization of pathogens in HCWs’ nasal vestibular is significant for preventing the occurrence and cross transmission of HAI among HCWs and pa-tients.
RESUMEN
Objective To investigate the basic data and quality control indicators of infection monitoring in 67 hospitals in Chongqing area ,and provide basic data for the exploration of hospital infection monitoring norms .Methods According to the sur‐vey of the basic data and quality control index of hospital infection monitoring by the national health planning commission ,a ques‐tionnaire survey was conducted in some medical institutions in Chongqing area ,and the data were collected and analyzed .Results A total of 67 valid questionnaires were collected ,21 for tertiary hospitals ,46 for secondary hospitals ,of which there were 5 teaching hospitals ,47 general hospital ,11 hospital of traditional Chinese medicine ,3 factories hospitals ,1 private hospital .Electronic medical records management system in 67 hospitals accounted for 71 .64% ,the hospital infection information system accounted for 83 .33% ,surgical anesthesia system accounting for 31 .34% ,antimicrobial drug management and monitoring system accounted for 68 .65% .Hospital infection monitoring was mainly based on routine monitoring and target monitoring ,the correct rate of monito‐ring objects was 74 .62% ,and the usage of antibiotics was 44 .78% in the operation room .Monitoring statistics took month as a u‐nit ,accounting for 73 .13% ,the correct rate of P75 value was not high when calculating the risk factors of NNIS operation ,opera‐tion and diagnosis and treatment operation confusion accounted for 97 .01% ,the knowledge and technology of microbiological exam‐ination was relatively low .Conclusion Basic data of hospital infection monitoring and quality control survey can understand the sit‐uation of hospital infection management ,it can help to improve the monitoring level of nosocomial infection by investigating the weak links and strengthening the intervention .
RESUMEN
Objective To understand the specimen sources,clinical characteristics,and antimicrobial resistance of Burkholderia cepacia (B .cepacia )isolated from infected patients in intensive care unit(ICU),so as to provide reference for guiding rational use of antimicrobial agents.Methods Clinical data of patients with B .cepacia infec-tion in an ICU between 2011 and 2014 were analyzed retrospectively,antimicrobial resistance of strains was ana-lyzed.Results A total of 267 B .cepacia strains were isolated,the major specimen sources were sputum (80.15%, n=214),blood(14.23%,n =38),and urine(3.37%,n =9).Antimicrobial susceptibility testing results revealed that B .cepacia had multiple resistance,and was naturally resistant to multiple clinically used antimicrobial agents, such as ampicillin,cefazolin,ampicillin/sulbactam,nitrofurantoin,and cefuroxime,resistant rates were all 100%;resistant rates to ceftazidime and levofloxacin were 4.12% and 3.00% respectively;resistant rate to compound sulfa-methoxazole had increased tendency(χ2 =5.885,P =0.015).Conclusion Isolation of B .cepacia in ICU increased year by year,antimicrobial resistance is serious,management and targeted monitoring of prevention and control of healthcare-associated infection should be strengthened,antimicrobial agents should be chosen according to antimi-crobial susceptibility testing results.