Reducing catheter related bloodstream infection risk of infant with a prophylactic antibiotic therapy before removing peripherally inserted central catheter: A retrospective study.

PURPOSE: This study examined the efficacy of prescribing antibiotics, specifically a single dose of vancomycin, in reducing the incidence of culture-positive and culture-negative sepsis prior to the removal of peripherally inserted central catheters (PICCs). MATERIALS AND METHODS: We retrospectively reviewed charts of infants who had PICCs in a tertiary level hospital during the period from 2010 to 2019. The incidence of post-catheter removal clinical sepsis between the groups with or without antibiotics was compared. The antibiotic group was defined by receiving a single dose of vancomycin or any other antibiotic prior to line removal. RESULTS: We enrolled 585 PICC removal episodes in 546 infants for analysis. Antibiotics were given prior to removal in 257 cases (43.9%) and not given prior to removal in 328 cases (56.1%). There were 13 episodes of post-catheter removal clinical sepsis detected within 72 h (2.2%), 2 of which were culture-positive (0.3%). A 9.3-fold decrease in the odds for clinical sepsis was observed in the antibiotic group (p = 0.01). The incidence of post-catheter removal sepsis was decreased by a single prophylactic dose of vancomycin (p = 0.02), whereas the use of other antibiotics showed no effect (p = 0.35). Logistic regression analysis demonstrated that comorbidities with gastrointestinal diseases (p = 0.01), PICC insertion sites in the scalp and neck (p = 0.04), and no vancomycin administration prior to line removal (p = 0.02) were independent risk factors for subsequent clinical sepsis. CONCLUSION: A single prophylactic dose of vancomycin prior to PICC line removal might reduce clinical sepsis events in infants.

The Water Status in China and an Adaptive Governance Frame for Water Management.

China is increasingly facing water-related problems, such as water scarcity, pollution, and overexploitation of groundwater. This paper discusses the water status in China and claims that governance is the cause of water-related problems. The structure of the current water management is analyzed to conclude that the control-command is a static approach which is less capable of dealing with the uncertainty in the water resources system. An adaptive governance frame is introduced, which highlights the learning process and participation. The learning process avoids making the same mistake twice and the participation ensures the diversity of information, which are both necessary for water resources management.

Effects of soil water and heat relationship under various snow cover during freezing-thawing periods in Songnen Plain, China.

In this study, the spatial variations of soil water and heat under bare land (BL), natural snow (NS), compacted snow (CS) and thick snow (TS) treatments were analyzed. The relationship curve between soil temperature and water content conforms to the exponential filtering model, by means of the functional form of the model, it was defined as soil water and heat relation function model. On this basis, soil water and heat function models of 10, 20, 40, 60, 100, and 140 cm were established. Finally, a spatial variation law of the relationship effect was described based on analysising of the differences between the predicted and measured results. During freezing period, the effects of external factors on soil were hindered by snow cover. As the snow increased, the accuracy of the function model gradually improved. During melting period, infiltration by snowmelt affected the relationship between the soil temperature and moisture. With the increasing of snow, the accuracy of the function models gradually decreased. The relationship effects of soil water and heat increased with increasing depth within the frozen zone. In contrast, below the frozen layer, the relationship of soil water and heat was weaker, and the function models were less accurate.