Objective To evaluate the clinical characteristics and risk factors of healthcare-associated urinary tract infection(HA-UTI)due to vancomycin-resistant Enterococcus(VRE),and provide basis for clinical prevention and control.Methods Patients with VRE HA-UTI in a tertiary first-class hospital in Guangdong Province from January 2021 to October 2023 were selected as the VRE group.A 1∶2 case-control study method was conducted to select pa-tients with vancomycin-sensitive Enterococcus(VSE)UTI as the VSE group.Clinical characteristics of two groups of patients were compared and analyzed.Risk factors for VRE HA-UTI were analyzed using univariate regression and logistic multivariate regression.Results A total of 32 patients in the VRE group and 64 patients in the VSE group were included in the analysis.In VRE group,most patients were female(68.75％),aged≥60 years(71.88％),and from intensive care unit(ICU,56.25％).The main detected pathogen was vancomycin-resistant Enterococcus faecium(VREfm,96.87％).The proportion of clinical symptoms such as fever and lumbago as well as the levels of procalcitonin(PCT)and C-reactive protein(CRP)in patients in the VRE group were all higher than those in the VSE group(all P＜0.05).Logistic regression analysis results showed that concomitant pulmonary infection(OR=6.890,95％CI:1.098-43.218,P=0.039),history of hypertension(OR=4.240,95％CJ:1.084-16.581,P=0.038),and cephalosporin antibiotic exposure before infection(OR=4.642,95％CI:1.270-16.967,P=0.020)were independent risk factors for VRE HA-UTI.There were 32 and 64 strains of Enterococcus detected from VRE group and VSE group,respectively.VRE had higher resistance rates to ciprofloxacin,amoxicillin,ampicillin,peni-cillin G,tetracycline,high concentration gentamicin,and levofloxacin than VSE(all P＜0.05).Conclusion Pa-tients with VRE HA-UTI often have multiple underlying diseases and poor nutritional status,and are highly resis-tant to multiple antimicrobial agents.Clinical attention should be focused on patients with concomitant pulmonary infection,history of hypertension,and exposure to cephalosporin antibiotics.

Objective To evaluate the clinical characteristics and risk factors of healthcare-associated urinary tract infection(HA-UTI)due to vancomycin-resistant Enterococcus(VRE),and provide basis for clinical prevention and control.Methods Patients with VRE HA-UTI in a tertiary first-class hospital in Guangdong Province from January 2021 to October 2023 were selected as the VRE group.A 1∶2 case-control study method was conducted to select pa-tients with vancomycin-sensitive Enterococcus(VSE)UTI as the VSE group.Clinical characteristics of two groups of patients were compared and analyzed.Risk factors for VRE HA-UTI were analyzed using univariate regression and logistic multivariate regression.Results A total of 32 patients in the VRE group and 64 patients in the VSE group were included in the analysis.In VRE group,most patients were female(68.75％),aged≥60 years(71.88％),and from intensive care unit(ICU,56.25％).The main detected pathogen was vancomycin-resistant Enterococcus faecium(VREfm,96.87％).The proportion of clinical symptoms such as fever and lumbago as well as the levels of procalcitonin(PCT)and C-reactive protein(CRP)in patients in the VRE group were all higher than those in the VSE group(all P＜0.05).Logistic regression analysis results showed that concomitant pulmonary infection(OR=6.890,95％CI:1.098-43.218,P=0.039),history of hypertension(OR=4.240,95％CJ:1.084-16.581,P=0.038),and cephalosporin antibiotic exposure before infection(OR=4.642,95％CI:1.270-16.967,P=0.020)were independent risk factors for VRE HA-UTI.There were 32 and 64 strains of Enterococcus detected from VRE group and VSE group,respectively.VRE had higher resistance rates to ciprofloxacin,amoxicillin,ampicillin,peni-cillin G,tetracycline,high concentration gentamicin,and levofloxacin than VSE(all P＜0.05).Conclusion Pa-tients with VRE HA-UTI often have multiple underlying diseases and poor nutritional status,and are highly resis-tant to multiple antimicrobial agents.Clinical attention should be focused on patients with concomitant pulmonary infection,history of hypertension,and exposure to cephalosporin antibiotics.

Objective:To explore the influence of online and offline family therapy based on the Satir model on emotions of adolescents with depressive disorder and their parents in remote areas.Methods:A total of 98 cases adolescents with depressive disorder treated in the psychosomatic medicine of the Second Affiliated Hospital of Nanchang University from January 2021 to June 2021 and their parents were selected as the objects. The adolescents with depressive disorder and their parents were randomly divided into the control group (49 parents and 49 adolescents) and the observation group (49 parents and 49 adolescents). The control group received the medical treatment (sertraline 100 mg/d) and the routine health education, while the observation group received the online and offline Satir family therapy on the basis of the intervention of the control group. Generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used to investigate the negative emotions of the parents of the two groups before and 12 weeks after the intervention. The screen for child anxiety related emotional disorders (SCARED) and depression self-rating scale for childhood (DSRS) were used to investigate the negative emotions of the adolescents before and 12 weeks after the intervention.The SPSS 20.0 software was used for statistical analysis. t test was used to compare the SCARED scale score and DSRS score changes of the adolescents in the two groups, and χ 2 test was used to compare the proportional changes of parents' anxiety and depression. Results:The scores of SCARED (51.55±12.69 vs 36.82±7.69, t=15.839) and DSRS (25.08±4.81 vs 16.88±2.16, t=13.047) of adolescents in the control group were significantly different before and after the intervention (both P<0.05). The scores of SCARED (51.16±15.84 vs 31.31±7.72, t=14.385) and DSRS (24.12±4.81 vs 14.08±2.03, t=14.723) of adolescents in the observation group were significantly different before and after the intervention (both P<0.05). After the intervention, the scores of SCARED and DSRS in the observation group were lower than those in the control group ( t=3.540, 6.609, both P<0.05). Before intervention, there was no significant difference in the proportion of anxiety and depression between the parents of the two groups (χ 2=1.837, 3.547, both P>0.05). After 12 weeks of intervention, there was a statistically significant difference in the proportion of anxiety and depression between the two groups, which were lower in the observation group than those in the control group (χ 2=5.995, 4.009, both P<0.05). Conclusion:Online + offline family therapy based on the Satir model can not only effectively reduce anxiety and depression of adolescents, but also effectively reduce anxiety and depression of their parents.It is especially suitable for outpatient management of children with depressive disorder in remote areas.