Objective To systemically analyze family burden,quality of life of chronic hepatitis B and C patients in Shanghai and related influencing factors.Methods A representative sample of chronic hepatitis patients (n=1 478) and their family members (n=1 478) was randomly selected through a multi-stage cluster sampling from 30 communities in 10 districts of Shanghai.One patient and one family member of each family were interviewed using different questionnaires to collect related information.Based on Bronfenbrenner's ecological systems,psychological measurement,two-level random intercept model and multivariable structural equation model were applied to determine the effects and directions of the factors between life quality of chronic hepatitis patients and family burden.Results The mean score of quality of life of chronic hepatitis patients in Shanghai was 78.70 ± 13.25,the score of "specific module" was highest and the score of "social function" was lowest.Additionally,the mean score of burden reported by the family members was 12.62 ± 10.74,the score of"financial burden" was highest,and the score of"effect on family member's health" was lowest.Multivariable structural equation model indicated that eight factors were related with life quality and family burden of patients with chronic hepatitis.Among them,HCV infection,elevated serum alanine aminotransferase level,average monthly cost for patient ＞3 000 yuan (RMB) and poor health of family members were the direct risk factors for the life quality of the patients as well as family burden.The factor of drinking more than once a week influenced the patients' life quality directly and family burden indirectly.On the contrary,the factors of local household registration,hospitalization and family member's indifferent attitude to hepatitis B vaccination influenced the family burden of the chronic hepatitis patients directly and the life quality of the patients indirectly.Conclusion The findings could be used in the development of community based management and intervention of chronic hepatitis patients in Shanghai.

ObjectiveTo investigate a suspected outbreak of healthcare-associated infection with carbapenem-resistant Klebsiella pneumoniae (CRKP) in a geriatric emergency ward, and to provide references for the prevention and control of multidrug-resistant bacteria in a hospital in Shanghai. MethodsOn-site epidemiological investigation, combined with environmental hygiene monitoring and pulsed field gel electrophoresis (PFGE) molecular typing method, were adopted to investigate a suspected outbreak of CRKP infection in the geriatric emergency ward of a hospital from October to November 2022, aiming at finding out factors caused the outbreak before taking corresponding control measures. ResultsA total of 3 cases of healthcare-associated CRKP infection were identified, of which 2 cases were homologous to a previous case of community-associated CRKP infection. What’s more, the 2 cases lived in the same ward with the latter and with adjacent beds, but the third case was non-homologous to the community-associated infection case. A total of 46 samples were collected from the environmental surfaces and the hands of healthcare workers, of which 7 samples tested positive for CRKP and were identical to the strains from the 2 healthcare-associated infection cases and the 1 community-associated infection case, originating from the bedrails, bedside tables, surface of non-invasive ventilator, bed curtains and panels of monitoring equipment, with a detection rate of 15.22%. But none of the 11 samples from the hands of healthcare workers tested positive for CRKP. The outbreak was effectively controlled after taking specific prevention and control measures such as strengthening personnel management, intensifying environmental cleaning and disinfection and strictly enforcing hand hygiene among healthcare workers. Subsequently, no similar new cases were reported during the 14-day follow-up period. ConclusionIncomplete environmental cleaning and disinfection, as well as inadequate enforcement of hand hygiene among heatheare workers may have contributed to the suspected outbreak of CRKP in the geriatric emergency ward. Early warning and timely investigation of suspected outbreaks of multidrug-resistant bacteria are crucial for preventing and controlling such outbreaks in hospitals.