OBJECTIVE To evaluate the impact of bundle intervention measures on incidence of catheter-related in-fections in patients of neurosurgery intensive care unit(NICU).METHODS The related data regarding to incidence rates of hospital-associated infections and utilization rates of catheters were collected from the NICU patients of Renji Hospital,Shanghai Jiaotong University from 2007 to 2022.The effect of the bundle intervention measures on reducing the incidence of catheter-related infections was analyzed by means of interrupted tune series(ITS)method.RESULTS There was significant difference in the decline trend of incidence of the infections during the study(the trend x2=91.978,P＜0.001).ITS analysis showed that the utilization rate of catheters only presented the decline trend after the intervention(β2=-0.667,P=0.042),the utilization rate of ventilator tubes only de-clined after the intervention(β3=-26.375,P＜0.001).Th utilization rate of central venous catheters showed a downward trend before the intervention(β1=-2.525,P＜0.001)but did not change significantly after the inter-vention.The incidence of central line-associated bloodstream infection(CLABSI)was decreased(RR=0.268,95％CI:0.124 to 0.581),however,there was significant difference in the change of slope(RR=0.912,95％CI:0.730 to 1.140).The incidence of catheter-associated urinary tract infection(CAUTI)showed a downward trend(RR=0.796,95％CI:0.647 to 0.975),however,there was no significant difference in the change of the level(RR=1.543,95％CI:0.816 to 3.005).The incidence of ventilator-associated pneumonia(VAP)showed a downward trend(RR=0.829,95％CI:0.767 to 0.895),however,there was no significant difference in the change of the level(RR=0.817,95％CI:0.595 to 1.114).CONCLUSIONS The bundle intervention measures may effectively reduce the incidence of catheter-related infections.The incidence rates of the catheter-related infections vary in the chan-ging trends after the interventions are taken,indicating that it is necessary to comprehensively take the character-istics of catheter-related infections into account when carrying out the bundle intervention measures and continu-ously optimize the control strategies.

OBJECTIVE Liver transplantation is an important mean for treatment of the children with end-stage liv-er disease,but the postoperative infections remain a major and potentially fatal complication.Due to the unique physiological and immunological characteristics of the children,the types and risk factors for the postoperative in-fections differ from those in adults.This review summarizes the current status of research on the postoperative in-fections among the liver transplantation children in recent years and focuses on the major risk factors such as pre-operative state,intraoperative procedures,immunosuppression and postoperative management.The prevention and control strategies were put forward to reduce the risk of infection and raise the rate of successful transplanta-tion by optimizing the assessment and strengthening perioperative management,individualized immunization strat-egies and multidisciplinary collaboration.

OBJECTIVE To evaluate the impact of bundle intervention measures on incidence of catheter-related in-fections in patients of neurosurgery intensive care unit(NICU).METHODS The related data regarding to incidence rates of hospital-associated infections and utilization rates of catheters were collected from the NICU patients of Renji Hospital,Shanghai Jiaotong University from 2007 to 2022.The effect of the bundle intervention measures on reducing the incidence of catheter-related infections was analyzed by means of interrupted tune series(ITS)method.RESULTS There was significant difference in the decline trend of incidence of the infections during the study(the trend x2=91.978,P＜0.001).ITS analysis showed that the utilization rate of catheters only presented the decline trend after the intervention(β2=-0.667,P=0.042),the utilization rate of ventilator tubes only de-clined after the intervention(β3=-26.375,P＜0.001).Th utilization rate of central venous catheters showed a downward trend before the intervention(β1=-2.525,P＜0.001)but did not change significantly after the inter-vention.The incidence of central line-associated bloodstream infection(CLABSI)was decreased(RR=0.268,95％CI:0.124 to 0.581),however,there was significant difference in the change of slope(RR=0.912,95％CI:0.730 to 1.140).The incidence of catheter-associated urinary tract infection(CAUTI)showed a downward trend(RR=0.796,95％CI:0.647 to 0.975),however,there was no significant difference in the change of the level(RR=1.543,95％CI:0.816 to 3.005).The incidence of ventilator-associated pneumonia(VAP)showed a downward trend(RR=0.829,95％CI:0.767 to 0.895),however,there was no significant difference in the change of the level(RR=0.817,95％CI:0.595 to 1.114).CONCLUSIONS The bundle intervention measures may effectively reduce the incidence of catheter-related infections.The incidence rates of the catheter-related infections vary in the chan-ging trends after the interventions are taken,indicating that it is necessary to comprehensively take the character-istics of catheter-related infections into account when carrying out the bundle intervention measures and continu-ously optimize the control strategies.

OBJECTIVE Liver transplantation is an important mean for treatment of the children with end-stage liv-er disease,but the postoperative infections remain a major and potentially fatal complication.Due to the unique physiological and immunological characteristics of the children,the types and risk factors for the postoperative in-fections differ from those in adults.This review summarizes the current status of research on the postoperative in-fections among the liver transplantation children in recent years and focuses on the major risk factors such as pre-operative state,intraoperative procedures,immunosuppression and postoperative management.The prevention and control strategies were put forward to reduce the risk of infection and raise the rate of successful transplanta-tion by optimizing the assessment and strengthening perioperative management,individualized immunization strat-egies and multidisciplinary collaboration.

OBJECTIVE To investigate the changes of air aerosols in the digestive endoscope cleaning and disinfec-tion room under real working conditions and observe the purification effects of aerosols under different ventilation and disinfection modes.METHODS Under the real working conditions(with both the air conditioner and recircu-lating air disinfection machine under the working mode),the air samples were collected every 1 hour from 8:00 to 16:00 from the digestive endoscope cleaning and disinfection room of Ren Ji Hospital,Shanghai Jiao Tong U-niversity School of Medicine from May 2023 to Oct.2023;the contents of particulate matters(PM)and microor-ganisms in the air were detected.At the busiest moment of the cleaning and disinfection room,the air was respec-tively sampled from the cleaning and disinfection room with the working condition modes of air condition systems,recirculating air disinfection machine or natural ventilation before the starting of systems and after the work for 0.5 hour,1 hour and 2 hours.The contents of PMs and microorganisms were detected.RESULTS The PM0.5 con-centrations during various time periods met the Grade 9 ISO clean room standard(≤35,200 particles/L)under the real working conditions,and the content of airborne viable particles also conformed to the Class Ⅲ environmental requirements(≤500 CFU/m3).All of the three ventilation and disinfection methods showed certain effects on purification of the con-tents of PM0.5 and microorganisms after the ventilation for 2 hours,the contents of PMs and microorganisms of the air disinfection machine group decreased most remarkably,followed by the air conditioner group,the natural ventilation group the least.There were no significant differences in the PM concentration and the content of microorganisms among the three groups at the time points;there were only significant differences in the PM concentration and the content of mi-croorganisms of the air disinfection machine group after the ventilation for 2 hours,0.5 hour and 1 hour(P＜0.05).CONCLUSIONS Both the air conditioning systems and recirculating air disinfection machine under the working con-dition mode have certain effect on purification of the contents of PM and microorganisms,and the specific effect need to be further studied.The implementation of multicenter dynamic surveillance with the help of intelli-gent techniques may provide reference for the optimization of ventilation and disinfection strategies.

OBJECTIVE To investigate the changes of air aerosols in the digestive endoscope cleaning and disinfec-tion room under real working conditions and observe the purification effects of aerosols under different ventilation and disinfection modes.METHODS Under the real working conditions(with both the air conditioner and recircu-lating air disinfection machine under the working mode),the air samples were collected every 1 hour from 8:00 to 16:00 from the digestive endoscope cleaning and disinfection room of Ren Ji Hospital,Shanghai Jiao Tong U-niversity School of Medicine from May 2023 to Oct.2023;the contents of particulate matters(PM)and microor-ganisms in the air were detected.At the busiest moment of the cleaning and disinfection room,the air was respec-tively sampled from the cleaning and disinfection room with the working condition modes of air condition systems,recirculating air disinfection machine or natural ventilation before the starting of systems and after the work for 0.5 hour,1 hour and 2 hours.The contents of PMs and microorganisms were detected.RESULTS The PM0.5 con-centrations during various time periods met the Grade 9 ISO clean room standard(≤35,200 particles/L)under the real working conditions,and the content of airborne viable particles also conformed to the Class Ⅲ environmental requirements(≤500 CFU/m3).All of the three ventilation and disinfection methods showed certain effects on purification of the con-tents of PM0.5 and microorganisms after the ventilation for 2 hours,the contents of PMs and microorganisms of the air disinfection machine group decreased most remarkably,followed by the air conditioner group,the natural ventilation group the least.There were no significant differences in the PM concentration and the content of microorganisms among the three groups at the time points;there were only significant differences in the PM concentration and the content of mi-croorganisms of the air disinfection machine group after the ventilation for 2 hours,0.5 hour and 1 hour(P＜0.05).CONCLUSIONS Both the air conditioning systems and recirculating air disinfection machine under the working con-dition mode have certain effect on purification of the contents of PM and microorganisms,and the specific effect need to be further studied.The implementation of multicenter dynamic surveillance with the help of intelli-gent techniques may provide reference for the optimization of ventilation and disinfection strategies.

ObjectiveTo investigate a suspected outbreak of carbapenem-resistant Acinetobacter baumannii （CRAB） nosocomial infection in an intensive care unit （ICU） and provide scientific evidence for prevention and control of multi-drug resistant nosocomial infection. MethodsClinical and epidemiological data of 4 patients with CRAB infection were retrospectively investigated in the ICU of Renji Hospital in November 2021. Environmental hygiene monitoring and multilocus sequence typing （MLST） were conducted and intervention measures were taken. ResultsA total of 4 cases with CRAB infection were identified， among which 1 case was determined to be community-acquired and3 cases were hospital-acquired. The isolated strains shared the same drug resistance， and were all classified into ST368 type. In the surface and hand samples （n=40）， 2 CRAB strains were detected in the air filter beside the bed of the first case， with a detection rate of 5%. After adopting comprehensive prevention and control strategies， including environmental cleaning and disinfection， hand hygiene， staff management and training， and supervision， no similar case with CRAB infection was found. ConclusionThis suspected outbreak of CRAB nosocomial infection may be induced by inadequate environmental cleaning and disinfection， and inadequate implementation of hand hygiene. Timely identification， investigation， and targeted measures remain crucial to effective control of possible nosocomial infection.

ObjectiveTo understand the use of antibiotics in inpatients and the incidence and trend of hospital infections， to explore the implementation effect of comprehensive management measures， and to provide reference for hospitals to use antibiotics reasonably. MethodsBased on the hospital infection monitoring and management system， a retrospective analysis and comparison were conducted on the use of antibiotics， submission of microbial test samples， and incidence of hospital infections among inpatients in a tertiary hospital from 2012 to 2021. ResultsFrom 2012 to 2021， the use of antibiotics showed a downward trend， from 50.82% in 2012 to 41.29% in 2021. At the same time， the use rate of restricted and special antibiotics had also decreased， and the use rate of restricted and special antibiotics in patients without hospital infection was significantly lower than that in patients with hospital infection， and the microbial testing rate was also on the rise. The annual incidence rate of hospital infection was 0.69%‒1.92%， and the annual case-time prevalence rate was 0.79%‒2.17%. The annual average rate of the above two in 10 years was 1.18% and 1.34%， respectively. The results of the exponential smoothing model also showed that the utilization rate of antibiotics was decreasing and the incidence of nosocomial infection was stable. ConclusionLarge general hospitals took comprehensive management measures to strengthen the management of rational use of antibiotics， which led to a decline in the use rate of antibacterial drugs for inpatients and an increase in the rate of microbial examination. At the same time， the overall incidence of hospital infection was relatively stable， suggesting that the comprehensive management measures of antibacterial drugs in hospitals had achieved certain results. The current measures need to be optimized in the future to continuously improve the management level of rational use of antibacterial drugs.

Caliciviridae Infections ; prevention & control ; therapy ; Disease Outbreaks ; prevention & control ; Humans ; Norovirus ; Practice Guidelines as Topic