Investigation of multiple nosocomial infections using a semi-Markov multi-state model.

BACKGROUND: The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS). METHOD: This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI). RESULTS: The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be. CONCLUSION: The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.

Extraction, characterization and anti-oxidant activity of polysaccharide from red Panax ginseng and Ophiopogon japonicus waste.

Red ginseng and Ophiopogon japonicus are both traditional Chinese medicines. They have also been used as food in China for thousands of years. These two herbs were frequently used in many traditional Chinese patent medicines. However, the carbohydrate compositions of these two herbs were not normally used during the production of said medicine, such as Shenmai injection, resulting in a large amount of waste composed of carbohydrates. In this study, the extraction conditions were optimized by response surface methodology. The Shenmai injection waste polysaccharide was extracted by using distilled water that was boiled under the optimized conditions. The Shenmai injection waste polysaccharide (SMP) was thereby obtained. SMP was further purified by anion exchange chromatography and gel filtration. With this method, a neutral polysaccharide fraction (SMP-NP) and an acidic polysaccharide fraction (SMP-AP) were obtained. The results of structure elucidation indicated that SMP-NP was a type of levan, and SMP-AP was a typical acidic polysaccharide. SMP-NP exhibited potential stimulation activity on the proliferation of five different Lactobacilli strains. Therefore, SMP-AP could promote the antioxidant defense of IPEC-J2 cells. These findings suggest that Shenmai injection waste could be used as a resource for prebiotics and antioxidants.

Impact of a quality control circle on the incidence of catheter-associated urinary tract infection: An interrupted time series analysis.

BACKGROUND: To report a quality control circle (QCC) activity on the theme of reducing the incidence of catheter-associated urinary tract infection (CAUTI), and used an interrupted time series analysis to evaluate the impact of the QCC. METHODS: In a general tertiary hospital in Shenzhen, China, we carried out a QCC activity with the theme of reducing CAUTI from April 2017 to December 2017. Before the QCC, we carried out the routine measures; during the QCC, we implemented usual measures and the countermeasures of QCC, and after the QCC, we performed the routine measures and adhered to the core measures of QCC. The interrupted time series analysis method was used to analyze the changes in the CAUTI incidence during the 3 stages. RESULTS: Before, during, and after the QCC activities, the catheter use ratios and mean indwelling time both had a downward trend; meanwhile, the compliance rate of CAUTI prevention measures showed an upward trend. After the interventions, the CAUTI incidence decreased by 1.317‰ immediately, then gradually decreased by 0.510‰ per month. After the completion of QCC, the CAUTI incidence increased by 0.266‰ immediately and increased by 0.070‰ over time, but the difference was not statistically significant. CONCLUSIONS: The CAUTI incidence is reduced through QCC, providing a useful reference for the prevention of CAUTI and the development of medical quality improvement activities.