The concepts of systemic inflammatory response syndrome (SIRS) and scoring system were defined by the journal of Bone in 1992. SIRS was described as occurrence of two or more clinical criteria in four ones (fever or hypothermia, tachypnea, tachycardia, and leukocytosis). An early diagnosis and estimation of systemic inflammation in patients is helpful for treatment selection. This paper reviews the application of SIRS scoring system, which has been extensively validated for large groups of critical care patients with severe injury and critical surgical diseases. Recent studies have documented SIRS score as a significant predictive parameter of adverse outcome in critical care patients. Furthermore, some studies also give us a suggestion on how to reduce the overload systemic response.
Cross Infection ; complications ; Humans ; Length of Stay ; Systemic Inflammatory Response Syndrome ; diagnosis ; mortality ; prevention & control

Outbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.
Betacoronavirus ; Coronavirus Infections ; epidemiology ; prevention & control ; Cross Infection ; prevention & control ; Emergency Service, Hospital ; Humans ; Pandemics ; prevention & control ; Patient Care Team ; Pneumonia, Viral ; epidemiology ; prevention & control ; Practice Guidelines as Topic ; Spinal Injuries ; diagnosis ; therapy ; Transportation of Patients

No abstract available.
Coronavirus Infections/*diagnosis/epidemiology/*prevention & control ; Cross Infection/*diagnosis/epidemiology/*prevention & control ; Disease Outbreaks/prevention & control/*statistics & numerical data ; Global Health/*trends ; Humans ; Incidence ; Population Surveillance/methods ; Republic of Korea/epidemiology

OBJECTIVETo understand the risk factors of measles among babies under 8-months-old and people ≥15 years old, in Gansu province.

METHODSLaboratory-confirmed measles cases were divided into two groups among children below 8-months-old and those ≥15 year olds. Descriptive epidemiology and 1:3 case control study were conducted to find out those related risk factors as:hospital exposure, contact with measles cases, vaccination, history of measles etc. so as to determine the risk factors and appropriate control measures.

RESULTSHistories of hospital exposure, contact with measles cases and travelling to other cities were risk factors for measles among babies younger than 8-months and people ≥15 year olds. Vaccination appeared a protective factor for people ≥15 years of age. From 42 cases and 126 controls, through multivariate analysis, results showed that hospital exposure was the only significant factor ( OR = 29.23, 95%CI:2.82-302.89)for those babies younger than 8-months. Factors as hospital exposure and travelling among cities for 7-21 days before being infected, were with significant importance ( OR = 5.15, 95% CI:2.28-11.63; OR = 5.48, 95%CI:1.38-21.69)for people ≥15 years of age, according to the observation from 74 cases and 222 controls.

CONCLUSIONIn order to reduce the incidence of measles among babies under 8-month-old and people ≥15 years old, efforts on control of nosocomial infection should be strengthened, while the routine immunization coverage need to be increased for the children at higher risks, to reduce the source of infection.

Adolescent ; Case-Control Studies ; China ; epidemiology ; Cross Infection ; Humans ; Incidence ; Infant ; Measles ; diagnosis ; epidemiology ; prevention & control ; Measles Vaccine ; administration & dosage ; Risk Factors ; Vaccination ; utilization

No abstract available.
Antiviral Agents/*therapeutic use ; Cross Infection/diagnosis/*prevention & control/transmission/virology ; Evidence-Based Medicine/standards ; Humans ; Infection Control/*standards ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Infectious Disease Transmission, Professional-to-Patient/prevention & control ; Influenza Vaccines/*administration & dosage ; Influenza, Human/diagnosis/*prevention & control/transmission/virology ; Occupational Health Services/*standards ; Risk Factors ; *Seasons ; Vaccination/*standards

Since May 20, 2015, when the first case of Middle East respiratory syndrome (MERS) in South Korea was confirmed, the cluster case in South Korea has grown to become the largest observed case following Saudi Arabia within the span of one month. Akin to what was observed in the Middle East, confirmed cases were infected through nosocomial transmission where the cluster is largely limited to patients, healthcare workers, and visitors to patients in healthcare facilities with confirmed cases. A major difference from the outbreaks in the Arabian Peninsula has been the large number of tertiary transmission cases in South Korea, which had reached forty cases by June 12. This observation may suggest that despite the lack of genetic mutation of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea, the virus may be behaving differently from that of the Middle East. The higher infectiousness of 'super-spreaders' in South Korea also suggests that this assertion should be under further investigation. Suggestions of inadequate triage in emergency rooms, particularly at Samsung Medical Center which accounts for the most nosocomial infection with 60 cases, have been made by several organizations as the basis for this rapid spread. This, however, does not account for the fact that triage was impossible to implement, since the presence of MERS-CoV in South Korea was unknown during the index patient's stay at the healthcare facilities. This paper aims to identify the key factors in the amplified spread of MERS-CoV in South Korea. The first is the initial failure to confirm diagnosis promptly and to isolate the index case after confirmation of MERS in hospital and the lack of detail in tracking potential exposures in the community of the index case before isolation. The second is the early inadequate measures the Korea Centers for Disease Control and Prevention took in categorizing close contacts. Due to inconsistencies in defining what constitutes close contact, a number of cases were neglected from quarantine and were not subjected to investigation. Finally, confirmed or potential MERS patients were admitted for treatment and observation at medical facilities without adequate disease control measures or rooms, such as ventilated single rooms or airborne precaution rooms. Due to the rigid position that MERS-CoV cannot be transmitted via airborne means, infection control measures has so far neglected evidence that smaller droplets (aerosol) containing the virus can act similar to airborne agents, which may account for the widespread and rapid transmission in a emergency room and a patient's room in hospital. Although the South Korean government expects newly confirmed cases to abate in the coming few weeks, without stringent implementation of clearly defined guidelines to control further transmissions, the cessation of the current trend may continue for an extended period. Additionally, due to the high infection rate of super-spreaders in South Korea, efforts to screen for potential super-spreaders and a thorough investigation of those confirmed to be super-spreaders should be done to quickly identify source of infection, to potentially lower the number of secondary, tertiary transmissions and prevent possible quaternary transmissions.
Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Coronavirus* ; Cross Infection ; Delivery of Health Care ; Diagnosis ; Disease Outbreaks ; Emergency Service, Hospital ; Epidemiology ; Humans ; Infection Control ; Korea ; Middle East* ; Public Health* ; Quarantine ; Saudi Arabia ; Temefos ; Triage ; Visitors to Patients

Spontaneous bacterial peritonitis (SBP) is defined as bacterial infections that occur in patients with cirrhosis and ascites without any significant intraperitoneal infection, accounting for approximately 10–30% of bacterial infections in hospitalized patients. SBP develops in patients with liver cirrhosis because bacterial translocations are increased by changes in the intestinal bacteria and mucosal barriers. In addition, the decreased host immune response cannot remove the bacteria and their products. The most common cause of SBP is Gram-negative bacteria, such as Escherichia coli and Klebsiella species, and infections by Gram-positive bacteria are increasing. SBP is diagnosed by the presence of >250 polymorphonuclear leukocyte/mm³ in ascites after paracentesis. If SBP is diagnosed, empirical antibiotic therapy should be started immediately. Empirical antibiotic treatment should distinguish between community acquired infections and nosocomial infections. Cirrhotic patients with gastrointestinal bleeding or low ascitic protein concentrations should consider primary prevention and those who recover from SBP should consider secondary prevention. This review describes the pathophysiology, diagnosis, treatment, and prevention of SBP.
Ascites ; Bacteria ; Bacterial Infections ; Community-Acquired Infections ; Cross Infection ; Diagnosis ; Escherichia coli ; Fibrosis ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Hemorrhage ; Humans ; Klebsiella ; Liver Cirrhosis ; Paracentesis ; Peritonitis* ; Primary Prevention ; Secondary Prevention

Severe cases infected with the coronavirus disease 2019 (COVID-19), named by the World Health Organization (WHO) on Feb. 11, 2020, tend to present a hypercatabolic state because of severe systemic consumption, and are susceptible to stress ulcers and even life-threatening gastrointestinal bleeding. Endoscopic diagnosis and treatment constitute an irreplaceable part in the handling of severe COVID-19 cases. Endoscopes, as reusable precision instruments with complicated structures, require more techniques than other medical devices in cleaning, disinfection, sterilization, and other reprocessing procedures. From 2016 to 2019, health care-acquired infection caused by improper endoscope reprocessing has always been among the top 5 on the list of top 10 health technology hazards issued by the Emergency Care Research Institute. Considering the highly infective nature of COVID-19 and the potential aerosol contamination therefrom, it is of pivotal significance to ensure that endoscopes are strictly reprocessed between uses. In accordance with the national standard "Regulation for Cleaning and Disinfection Technique of Flexible Endoscope (WS507-2016)," we improved the workflow of endoscope reprocessing including the selection of chemicals in an effort to ensure quality control throughout the clinical management towards COVID-19 patients. Based on the experience we attained from the 12 severe COVID-19 cases in our hospital who underwent endoscopy 23 times in total, the article provides an improved version of endoscopic reprocessing guidelines for bedside endoscopic diagnosis and treatment on COVID-19 patients for reference.
Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; China ; Coronavirus Infections ; diagnosis ; therapy ; Cross Infection ; prevention & control ; Disinfection ; methods ; Endoscopes ; virology ; Equipment Contamination ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Peracetic Acid ; Personal Protective Equipment ; Pneumonia, Viral ; diagnosis ; therapy ; Sterilization ; methods ; Workflow

Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; diagnosis ; therapy ; China ; Communicable Diseases ; diagnosis ; therapy ; Cross Infection ; prevention & control ; therapy ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Granulocyte-Macrophage Colony-Stimulating Factor ; therapeutic use ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant, Newborn ; Sepsis ; diagnosis ; therapy