Exposure to infected/colonized roommates and prior room occupants increases the risks of healthcare-associated infections with the same organism.

BACKGROUND: The survival of pathogenic organisms in the healthcare environment plays a major role in acquiring healthcare-associated infections (HAIs). AIM: This meta-analysis was conducted to investigate whether pathogenic organisms can be transmitted from roommates and prior room occupants to other inpatients and thus increase the risks of HAIs. METHODS: PubMed (from January 1966) and Embase (from January 1974) were searched to identify studies up to March 2018. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Heterogeneity was assessed using the I-squared statistic. The random-effects model was applied which provides more conservative estimates. Subgroup analyses, cumulative meta-analysis, publication bias diagnosis, and sensitivity analysis were conducted. All the statistical analyses were performed using Stata statistical software version 9.0. RESULTS: Twelve studies including 33,153 subjects reported risk from exposure to infected/colonized roommates and nine studies including 49,839 subjects reported risk from infected/colonized prior room occupants. Exposure to infected/colonized roommates and prior room occupants were associated with the increased risks of HAIs with the same organism (odds ratio (OR) = 2.69, 95% confidence interval (CI) = 1.61-4.49; OR = 1.96, 95% CI = 1.36-2.68; respectively). Sensitivity analyses results did not show major changes in the overall findings. No publication bias was detected. CONCLUSIONS: This meta-analysis showed exposure to infected/colonized roommates and prior room occupants significantly increased the risks of HAIs with the same organism. Health authorities and hospitals should attach higher importance to the fact that current standards or practices for disinfection and isolation are often not sufficient to block transmission of pathogens in the healthcare settings, which may warrant enhanced terminal and intermittent disinfection and strict isolation for reducing HAIs.

An 8-year point-prevalence surveillance of healthcare-associated infections and antimicrobial use in a tertiary care teaching hospital in China.

Healthcare-associated infections (HAIs) are a major worldwide public-health problem, but less data are available on the long-term trends of HAIs and antimicrobial use in Eastern China. This study describes the prevalence and long-term trends of HAIs and antimicrobial use in a tertiary care teaching hospital in Hefei, Anhui, China from 2010 to 2017 based on annual point-prevalence surveys. A total of 12 505 inpatients were included; 600 HAIs were recorded in 533 patients, with an overall prevalence of 4.26% and a frequency of 4.80%. No evidence was found for an increasing or decreasing trend in prevalence of HAI over 8 years (trend χ2 = 2.15, P = 0.143). However, significant differences in prevalence of HAI were evident between the surveys (χ2 = 21.14, P < 0.001). The intensive care unit had the highest frequency of HAIs (24.36%) and respiratory tract infections accounted for 62.50% of all cases; Escherichia coli was the most common pathogen (16.67%). A 44.13% prevalence of antimicrobial use with a gradually decreasing trend over time was recorded. More attention should be paid to potential high-risk clinical departments and HAI types with further enhancement of rational antimicrobial use.

Effect of Cordyceps sinensis and Tripterygium wilfordii polyglycosidium on podocytes in rats with diabetic nephropathy.

The aim of the present study was to investigate the effects of Cordyceps sinensis (CS) and Tripterygium wilfordii polyglycosidium (TWP) on podocytes in rats with diabetic nephropathy (DN). DN rat models were established and divided randomly into normal control (group A), DN (group B), CS (group C), TWP (group D) and CS and TWP groups (group E). After 12 weeks, levels of 24-h urinary protein, blood urea nitrogen (BUN), serum creatinine (SCR), white blood cells, blood glucose (GLU), aspartate aminotransferase, alanine aminotransferase and kidney weight (KW)/body weight (BW) were determined. Renal pathological changes were evaluated using hematoxylin and eosin staining, whereas the structural changes in the podocytes were observed under a transmission electron microscope. The expression levels of nephrin and podocin were evaluated using immunofluorescence staining. Compared with group A, the SCR and BUN levels in group B were higher (P<0.05) and the GLU, KW/BW and the 24-h urine protein were markedly higher (P<0.01). Moreover, incidences of glomerular disorders, chronic tubulointerstitial damage and glomerular podocyte lesions in groups B, C, D and E were observed, compared with group A. The high cortical expression of nephrin and podocin protein decreased. Compared with group B, the KW/BW and 24-h urinary protein level in groups C, D and E were lower (P<0.01). The glomeruli, tubules and podocytes exhibited pathomorphological improvements and the nephrin and podocin protein expression levels were higher in the nephridial tissue. A decrease in KW/BW and the 24-h urinary protein level, as well as improvements in glomerular disorder, chronic tubulointerstitial damage and glomerular podocyte lesions, were observed in groups C, D and E. Therefore, the results demonstrated that CS and TWP exhibited a protective effect on the podocytes of rats with DN. Moreover, CS combined with TWP increased this protective effect.

[Effects of Cordyceps Sinensis and Tipterygium wilfordii Polyglycosidium on the podocytes in rats with diabetic nephropathy].

OBJECTIVE: To investigate the effects of Cordyceps Sinensis (CS) and Tripterygium wilfordii Polyglycosidium (TWP) on the podocytes in rats with diabetes nephropathy (DN). METHODS: Rat models of DN were established and rats were randomly divided into the normal control group (Group A), the DN group (Group B), the CS group (Group C), the TWP group (Group D), and the CS combined TWP group (Group E). The changes of 24-h urinary protein count (24-h pro), blood glucose (Glu), blood urea nitrogen (BUN), serum creatinine (SCr), white blood cell (WBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and kidney weight/body weight (KW/BW) were determined 12 weeks later. The renal pathological changes were evaluated by HE staining. The microstructural changes of podocytes were observed by transmission electron microscope. The expressions of nephrin and podocin were detected by immunofluorescence staining. RESULTS: Compared with Group A, the levels of SCr and BUN were higher (P < 0.05), Glu, KW/BW, and 24 h pro were obviously higher in Group B (P < 0.01). There were less glomerular disorder, chronic tubulointerstitial damage and glomerular podocyte lesion in Group B. The expressions of the massive cortical nephrin and podocin protein were obviously less in Group B. Compared with Group B, the KW/BW and 24 h pro in Group C, D, and E were lower (P < 0.01). The pathomorphological improvement was exhibited in the glomerulus, tubules, and podocytes. The protein expressions of nephrin and podocin were higher in the renal cortex. Compared with Group C, the KW/BW and 24-h pro decreased in Group D and E, the expressions of nephrin and podocin were enhanced, and the lesions of the glomerulus, tubules, and podocytes were alleviated, showing statistical difference (P < 0.01). The most significant changes happened in Group E. CONCLUSIONS: CS and TWP could alleviate the DN proteinuria, protect and repair podocytes of DN rats. Its mechanisms might be correlated with up-regulating the expressions of nephrin and podocin. The combined use of CS and TWP could increase the efficacy and attenuate adverse reactions of TWP.