1.Cross-sectional survey of healthcare-associated infection in 5 736 medical institutions across China in 2024
Cui ZENG ; Wuqiang GAO ; Fu QIAO ; Hui ZHAO ; Xu FANG ; Linping LI ; Xiuwen CHEN ; Jiansen CHEN ; Dan LI ; Yuan ZHOU ; Lingli YU ; Qinglan MENG ; Xia MOU ; Lijuan XIONG ; Weiguang LI ; Ding LIU ; Jiaqing XIAO ; Limei OU ; Baozhen LI ; Jun YIN ; Haojun ZHANG ; Qiang FU ; Qun LU ; Biao WU ; Ya-wei XING ; Shumei SUN ; Shuncai WANG ; Longmin DU ; Jingping ZHANG ; Wen-ying HE ; Gui CHENG ; Nan REN ; Xun HUANG ; Anhua WU
Chinese Journal of Infection Control 2025;24(11):1572-1583
Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27%.The number of HAI episodes was 38 032,and case prevalence rate was 1.38%.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66%to 2.35%.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65%.The most common infection site was the lower respiratory tract(44.66%),followed by the urinary tract(12.94%),surgical site(9.32%),upper respiratory tract(7.02%),and bloodstream infection(5.78%).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02%),department of neurosurgery(5.51%),and department(group)of hematology(5.34%).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10%)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76%),Pseudomonas aeruginosa(13.33%),Escherichia coli(12.79%),Acinetobacter baumannii(9.23%),and Staphylococcus aureus(7.88%).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71%.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18%.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46%.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.
2.Investigation on Risk Stratification of Atherosclerotic Cardiovascular Disease and Target Achievement of Lipid and Blood Pressure in Community-Based Hypertensive Patients
Yun-li PENG ; Lu-qiang YIN ; Jie-tao LU ; Qin XIAO ; Xiu-lan ZHU
Progress in Modern Biomedicine 2025;25(14):2315-2321
Objective:This study aimed to investigate the atherosclerotic cardiovascular disease(ASCVD)risk stratification and target achievement of lipid and blood pressure control among community-based hypertensive patients,with the goal of optimizing integrated management strategies.Methods:A total of 2832 hypertensive patients registered in 2021 at the Bicheng Community Health Service Center in Bishan District of Chongqing,were included.Baseline data were collected through retrospective analysis of health records.Non-high-density lipoprotein cholesterol(non-HDL-C)levels and estimated glomerular filtration rate(eGFR)were calculated.ASCVD risk stratification was performed,and target achievement for lipid and blood pressure control were analyzed,including comparisons among patients with different comorbidities.Results:Based on ASCVD risk stratification,patients were categorized as follows:ultra-high risk(22 cases,0.78%),very high risk(111 cases,3.92%),high risk(1324 cases,46.75%),moderate risk(997 cases,35.20%),and low risk(378 cases,13.35%).The LDL-C target achievement rate was 4.55%(1/22)in the ultra-high risk group and 15.32%(17/111)in the very high risk group,with blood pressure target achievement rate of 18.18%(4/22)and 11.71%(13/111),respectively.In the high-risk group,LDL-C and blood pressure target achievement rate were only 4.76%(63/1324)and 8.08%(107/1324),while moderate-risk groups showed 25.68%(256/997)and 26.18%(261/997),respectively.The low-risk group achieved 99.74%(377/378)LDL-C target achievement and 30.69%(116/378)blood pressure target achievement.Patients with ischemic stroke had a significantly higher lipid target achievement rate(13.73%,7/51)compared to non-ischemic stroke patients(6.40%,178/2781)(P<0.05).Similarly,those with coronary heart disease(12.65%,13/87)exhibited higher lipid target achievement than non-coronary heart disease patients(6.27%,172/2745)(P<0.05).However,no significant difference was observed between hypertensive patients with diabetes(8.04%,52/647)and non-diabetic patients(6.09%,133/2185)(P>0.05),or between those with chronic kidney disease(CKD)stages 3/4(6.72%,16/238)and non-CKD 3/4 patients(6.52%,169/2594)(P>0.05).Conclusion:Over half of the community-based hypertensive patients were classified as high-risk or above in ASCVD stratification,yet their lipid and blood pressure target achievement rates were markedly suboptimal.Hypertension patients with comorbidities,particularly diabetes or CKD stages 3/4,showed poor lipid target achievement.These findings underscore the necessity of incorporating ASCVD risk stratification into community management assessments for hypertensive patients,enhancing personalized management for high-risk populations,and prioritizing lipid target achievement in those with diabetes or CKD stages 3/4.
3.Investigation on Risk Stratification of Atherosclerotic Cardiovascular Disease and Target Achievement of Lipid and Blood Pressure in Community-Based Hypertensive Patients
Yun-li PENG ; Lu-qiang YIN ; Jie-tao LU ; Qin XIAO ; Xiu-lan ZHU
Progress in Modern Biomedicine 2025;25(14):2315-2321
Objective:This study aimed to investigate the atherosclerotic cardiovascular disease(ASCVD)risk stratification and target achievement of lipid and blood pressure control among community-based hypertensive patients,with the goal of optimizing integrated management strategies.Methods:A total of 2832 hypertensive patients registered in 2021 at the Bicheng Community Health Service Center in Bishan District of Chongqing,were included.Baseline data were collected through retrospective analysis of health records.Non-high-density lipoprotein cholesterol(non-HDL-C)levels and estimated glomerular filtration rate(eGFR)were calculated.ASCVD risk stratification was performed,and target achievement for lipid and blood pressure control were analyzed,including comparisons among patients with different comorbidities.Results:Based on ASCVD risk stratification,patients were categorized as follows:ultra-high risk(22 cases,0.78%),very high risk(111 cases,3.92%),high risk(1324 cases,46.75%),moderate risk(997 cases,35.20%),and low risk(378 cases,13.35%).The LDL-C target achievement rate was 4.55%(1/22)in the ultra-high risk group and 15.32%(17/111)in the very high risk group,with blood pressure target achievement rate of 18.18%(4/22)and 11.71%(13/111),respectively.In the high-risk group,LDL-C and blood pressure target achievement rate were only 4.76%(63/1324)and 8.08%(107/1324),while moderate-risk groups showed 25.68%(256/997)and 26.18%(261/997),respectively.The low-risk group achieved 99.74%(377/378)LDL-C target achievement and 30.69%(116/378)blood pressure target achievement.Patients with ischemic stroke had a significantly higher lipid target achievement rate(13.73%,7/51)compared to non-ischemic stroke patients(6.40%,178/2781)(P<0.05).Similarly,those with coronary heart disease(12.65%,13/87)exhibited higher lipid target achievement than non-coronary heart disease patients(6.27%,172/2745)(P<0.05).However,no significant difference was observed between hypertensive patients with diabetes(8.04%,52/647)and non-diabetic patients(6.09%,133/2185)(P>0.05),or between those with chronic kidney disease(CKD)stages 3/4(6.72%,16/238)and non-CKD 3/4 patients(6.52%,169/2594)(P>0.05).Conclusion:Over half of the community-based hypertensive patients were classified as high-risk or above in ASCVD stratification,yet their lipid and blood pressure target achievement rates were markedly suboptimal.Hypertension patients with comorbidities,particularly diabetes or CKD stages 3/4,showed poor lipid target achievement.These findings underscore the necessity of incorporating ASCVD risk stratification into community management assessments for hypertensive patients,enhancing personalized management for high-risk populations,and prioritizing lipid target achievement in those with diabetes or CKD stages 3/4.
4.Cross-sectional survey of healthcare-associated infection in 5 736 medical institutions across China in 2024
Cui ZENG ; Wuqiang GAO ; Fu QIAO ; Hui ZHAO ; Xu FANG ; Linping LI ; Xiuwen CHEN ; Jiansen CHEN ; Dan LI ; Yuan ZHOU ; Lingli YU ; Qinglan MENG ; Xia MOU ; Lijuan XIONG ; Weiguang LI ; Ding LIU ; Jiaqing XIAO ; Limei OU ; Baozhen LI ; Jun YIN ; Haojun ZHANG ; Qiang FU ; Qun LU ; Biao WU ; Ya-wei XING ; Shumei SUN ; Shuncai WANG ; Longmin DU ; Jingping ZHANG ; Wen-ying HE ; Gui CHENG ; Nan REN ; Xun HUANG ; Anhua WU
Chinese Journal of Infection Control 2025;24(11):1572-1583
Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27%.The number of HAI episodes was 38 032,and case prevalence rate was 1.38%.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66%to 2.35%.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65%.The most common infection site was the lower respiratory tract(44.66%),followed by the urinary tract(12.94%),surgical site(9.32%),upper respiratory tract(7.02%),and bloodstream infection(5.78%).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02%),department of neurosurgery(5.51%),and department(group)of hematology(5.34%).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10%)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76%),Pseudomonas aeruginosa(13.33%),Escherichia coli(12.79%),Acinetobacter baumannii(9.23%),and Staphylococcus aureus(7.88%).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71%.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18%.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46%.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.
5.The efficacy and safety of nebulized inhalation of recombinant human interferon α1b in the treatment of pediatric respiratory syncytial viral associated lower respiratory tract infections: a multicenter, randomized, double-blind, placebo-controlled phase Ⅲ clinical study
Xiaohui LIU ; Baoping XU ; Yunxiao SHANG ; Han ZHANG ; Zhenkun ZHANG ; Guangyu LIN ; Ju YIN ; Aihua CUI ; Guocheng ZHANG ; Zhaoling SHI ; Liwei GAO ; Chunming JIANG ; Junmei BIAN ; Yongjian HUANG ; Rongfang ZHANG ; Xiaomei LIU ; Xiaoqing YANG ; Yu TANG ; Lili ZHONG ; Hongmei QIAO ; Chuangli HAO ; Yuqing WANG ; Qubei LI ; Ling CAO ; Yungang YANG ; Ling LU ; Rongjun LIN ; Xingzhen SUN ; Wei ZHOU ; Qiang CHEN ; Jikui DENG ; Yuejie ZHENG ; Lin ZHAO ; Tao AI ; Xiaohong LIU ; Xiaoxia LU ; Ning JIANG ; Ming LI
Chinese Journal of Applied Clinical Pediatrics 2025;40(3):180-186
Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.
6.Prediction of risk for acute kidney injury and its progression to mortality in obese patients admitted to ICU postoperatively
Qiang LI ; Guo MU ; Wenzhang WANG ; Jie YIN ; Xuan YU ; Bin LU ; Qian LI ; Jun ZHOU
Journal of Army Medical University 2025;47(10):1110-1125
Objective To develop a machine learning-based risk prediction model for postoperative acute kidney injury(AKI)and a model for mortality in obese patients admitted to intensive care unit(ICU)in order to improve early warning and prognostic evaluation to support clinical decision-making.Methods Data of obese postoperative ICU patients were retrospectively retrieved from the MIMIC-Ⅳ and eICU databases for statistical analysis.Ultimately,2 520 patients(670 from MIMIC-Ⅳ and 1 850 from eICU databases)were included to build the risk prediction models for AKI and mortality.The data included demographic information,vital signs,laboratory findings,surgical types,comorbidities,and medication use.After data cleaning and preprocessing,Boruta feature selection was applied,followed by the construction of prediction models using 7 machine learning algorithms,that is,Gradient Boosting Machine(GBM),Generalized Linear Model(GLM),k-Nearest Neighbors(KNN),Na?ve Bayes(NB),Neural Network(NNET),Support Vector Machine(SVM),and XGBoost.Model performance was evaluated through cross-validation and external validation.Results In the risk prediction models of AKI,the SVM model achieved the highest AUC value of 0.80 in the testing set and 0.71 in the external validation test.For the risk prediction models of mortality,the GBM model outperformed others in the prediction,attaining an AUC value of 0.91 in the testing set.Conclusion Risk predictive models for postoperative AKI and mortality in obese ICU patients are successfully constructed,and are valuable tools for clinicians to optimize early intervention and improve clinical outcomes for the patients.
7.Effect of Modified of Bazhentang Combined with Guishentang on Th1/Th2 Immune Balance in Mouse Model of Embryo Implantation Dysfunction
Qiang DENG ; Fengying WU ; Lu YIN ; Jun WANG ; Zhaoyang YE ; Jiamei HUANG ; Zhichun JIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):68-76
ObjectiveTo investigate the mechanism of the modified of Bazhentang combined with Guishentang in improving pregnancy outcomes in mouse models of embryo implantation dysfunction by regulating T helper 1/T helper 2 (Th1/Th2) immune balance. MethodsEighty ICR female mice were randomly divided into four groups (n=20 per group) on gestational day 1 (GD1): control, model, western medicine, and traditional Chinese medicine (TCM) groups. Except for the control group, all mice received mifepristone solution (0.2 mg/mouse) via oral gavage on GD4 to induce embryo implantation dysfunction. The TCM group received a water decoction of the modified of Bazhentang combined with Guishentang (20.8 g·kg-1), with the western medicine group administered dydrogesterone (3.9 mg·kg-1), and the control/model groups given equal volumes of saline. All treatments were administered once daily from GD1 until one day before sample collection. Outcomes included implantation site counts (macroscopic observation), pregnancy rates, body weight, endometrial histopathology (hematoxylin-eosin staining), uterine expression of T-box expressed in T cells (T-bet), GATA-binding protein 3 (GATA3), interferon gamma (IFN-γ), and interleukin-4 (IL-4) at protein (Western blot) and mRNA (real-time polymerase chain reaction, Real-time PCR) levels, serum IFN-γ and IL-4 levels (enzyme-linked immunosorbent assay, ELISA), and Th1/Th2 immune balance evaluated by calculating T-bet/GATA3 and IFN-γ/IL-4 ratios. ResultsCompared to the control group, the model group showed no significant change in pregnancy rate but exhibited a marked reduction in average implantation sites and body weight (P<0.01). Histopathological analysis revealed endometrial abnormalities, including decreased glandular density, stromal compaction, and absence of nucleolar vacuoles. At the molecular level, uterine tissue in the model group demonstrated significantly upregulated expression of T-bet and IFN-γ (P<0.05, P<0.01), alongside markedly downregulated GATA3 and IL-4 expression (P<0.05, P<0.01). Serum analysis confirmed markedly elevated IFN-γ (P<0.01) and reduced IL-4 levels (P<0.01), resulting in significantly increased T-bet/GATA3 and IFN-γ/IL-4 ratios (P<0.01). Compared to the model group, pregnancy rates in all treatment groups showed no significant change. Implantation sites and body weight increased substantially (P<0.01), with restored endometrial morphology characterized by enhanced glandular density, stromal edema, and reappearance of nucleolar vacuoles. Significant downregulation of T-bet and IFN-γ (P<0.01) and upregulation of GATA3 and IL-4 (P<0.05, P<0.01) in uterine tissue were observed. Serum IFN-γ levels were significantly reduced (P<0.05, P<0.01), while IL-4 levels were significantly elevated (P<0.05). The Th1/Th2 ratios were significantly decreased (P<0.01). ConclusionThe modified of Bazhentang combined with Guishentang significantly enhances the number of embryo implantation sites in mice with embryo implantation dysfunction, potentially through modulating T-bet/GATA3 expression, restoring Th1/Th2 immune balance, and improving endometrial receptivity.
8.National bloodstream infection bacterial resistance surveillance report 2023: Gram-positive bacteria
Chaoqun YING ; Jinru JI ; Zhiying LIU ; Qing YANG ; Haishen KONG ; Jiangqin SONG ; Hui DING ; Yanyan LI ; Yuanyuan DAI ; Haifeng MAO ; Pengpeng TIAN ; Lu WANG ; Yongyun LIU ; Yizheng ZHOU ; Jiliang WANG ; Yan JIN ; Donghong HUANG ; Hongyun XU ; Peng ZHANG ; Xinhua QIANG ; Hong HE ; Lin ZHENG ; Junmin CAO ; Zhou LIU ; Ying HUANG ; Yan GENG ; Haiquan KANG ; Dan LIU ; Guolin LIAO ; Lixia ZHANG ; Fenghong CHEN ; Yanhong LI ; Baohua ZHANG ; Haixin DONG ; Xiaoyan LI ; Donghua LIU ; Qiuying ZHANG ; Xuefei HU ; Liang GUO ; Sijin MAN ; Dijing SONG ; Rong XU ; Youdong YIN ; Kunpeng LIANG ; Aiyun LI ; Zhuo LI ; Hongxia HU ; Guoping LU ; Jinhua LIANG ; Qiang LIU ; Yinqiao DONG ; Jilu SHEN ; Shuyan HU ; Liang LUAN ; Jian LI ; Ling MENG ; Dengyan QIAO ; Xiusan XIA ; Bo QUAN ; Dahong WANG ; Chunhua HAN ; Xiaoping YAN ; Fei LI ; Shifu WANG ; Ping SHEN ; Yunbo CHEN ; Yonghong XIAO
Chinese Journal of Clinical Infectious Diseases 2025;18(2):118-132
Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System(BRICS)during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute(CLSI). Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus( n=1 544,35.2%),coagulase-negative Staphylococci( n=1 441,32.9%), Enterococcus faecium( n=574,13.1%), Enterococcus faecalis( n=385,8.8%),and α-hemolytic Streptococci( n=187,4.3%). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococci(MRCNS)was 26.2%(405/1 544)and 69.8%(1 006/1 441),respectively. Notably,all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility(>97.0%)to cephalobiol,rifampicin,trimethoprim-sulfamethoxazole,linezolid,minocycline,tigecycline,and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium(resistance to vancomycin and teicoplanin:both 1.7%)compared to Enterococcus faecalis(both 0.3%). The detection rates of MRSA and MRCNS exhibited significant regional variations across the country( χ2=17.674 and 148.650,respectively,both P<0.001). No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA( χ2=14.111, P<0.001)and MRCNS( χ2=4.828, P=0.028)in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA( χ2=18.986, P<0.001)and MRCNS( χ2=4.477, P=0.034)in less developed regions(per capita GDP
9.National bloodstream infection bacterial resistance surveillance report (2023) : Gram-negative bacteria
Jinru JI ; Zhiying LIU ; Chaoqun YING ; Qing YANG ; Haishen KONG ; Jiangqin SONG ; Hui DING ; Yanyan LI ; Yuanyuan DAI ; Haifeng MAO ; Pengpeng TIAN ; Lu WANG ; Yongyun LIU ; Yizheng ZHOU ; Jiliang WANG ; Yan JIN ; Donghong HUANG ; Hongyun XU ; Peng ZHANG ; Xinhua QIANG ; Hong HE ; Lin ZHENG ; Junmin CAO ; Zhou LIU ; Ying HUANG ; Yan GENG ; Haiquan KANG ; Dan LIU ; Guolin LIAO ; Lixia ZHANG ; Fenghong CHEN ; Yanhong LI ; Baohua ZHANG ; Haixin DONG ; Xiaoyan LI ; Donghua LIU ; Qiuying ZHANG ; Xuefei HU ; Liang GUO ; Sijin MAN ; Dijing SONG ; Rong XU ; Youdong YIN ; Kunpeng LIANG ; Aiyun LI ; Zhuo LI ; Hongxia HU ; Guoping LU ; Jinhua LIANG ; Qiang LIU ; Yinqiao DONG ; Jilu SHEN ; Shuyan HU ; Liang LUAN ; Jian LI ; Ling MENG ; Dengyan QIAO ; Xiusan XIA ; Bo QUAN ; Dahong WANG ; Chunhua HAN ; Xiaoping YAN ; Fei LI ; Shifu WANG ; Ping SHEN ; Yunbo CHEN ; Yonghong XIAO
Chinese Journal of Clinical Infectious Diseases 2025;18(1):47-62
Objective:To report the results of bacterial resistant investigation collaborative system(BRICS)on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023,and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute(CLSI). WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period,11 492 strains of Gram-negative bacteria were collected from 60 hospitals,of which 10 098(87.9%)were Enterobacterales and 1 394(12.1%)were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli(50.0%), Klebsiella pneumoniae(26.1%), Pseudomonas aeruginosa(5.1%), Acinetobacter baumannii complex(5.0%)and Enterobacter cloacae complex(4.1%). The ESBL-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus mirablilis were 46.8%(2 685/5 741),18.3%(549/2 999)and 44.0%(77/175),respectively. The prevalence of carbapenem-resistant Escherichia coli(CREC)and carbapenem-resistant Klebsiella pneumoniae(CRKP)were 1.3%(76/5 741)and 15.0%(450/2 999);32.9%(25/76)and 78.0%(351/450)of CREC and CRKP were sensitive to ceftazidime/avibactam combination,respectively. 94.7%(72/76)and 90.2%(406/450)of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore,57.9%(44/76)and 79.1%(356/450)were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)complex was 64.6%(370/573),while more than 80.0% of CRAB complex was sensitive to tigecycline,eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa(CRPA)was 17.0%(99/581). There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China,with statistically significant differences in the prevalence of CREC,CRKP,CRPA and CRAB complex( χ2=10.6,28.6,10.8 and 19.3, P<0.05). The prevalence of ESBL-producing Escherichia coli, CREC,CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals( χ2=12.5,9.8,12.7 and 57.8,all P<0.01). Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China,and Escherichia coli is ranked in the top,while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend,CREC infecton maintains a low prevalence level,and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.
10.Ultra-long-term follow-up of renal denervation in patients with resistant hypertension and mild chronic kidney disease
Li WANG ; Hao ZHANG ; Chao LI ; Xuemei YIN ; Zhuqing LI ; Qiang HE ; Xiaoqiang SUN ; Dachuan XIA ; Deling KONG ; Chengzhi LU
Chinese Journal of Cardiology 2025;53(10):1119-1125
Objective:To investigate the ultra-long-term antihypertensive efficacy, safety, major adverse events, and survival benefits of renal denervation (RDN) in patients with resistant hypertension (rHTN) and mild chronic kidney disease (CKD).Methods:This real-world, single-center retrospective study enrolled patients with rHTN and mild CKD who underwent RDN at Tianjin First Central Hospital between October 2011 and June 2016. Office blood pressure, home self-measured blood pressure, 24-hour ambulatory blood pressure, serum creatinine, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio were collected at baseline and at 1, 5, and 13 years post-RDN. The total daily defined dose of antihypertensive medications at 13 years post-RDN was recorded, along with endpoint events during follow-up, including cardiovascular death, all-cause death, hospitalization for heart failure, myocardial infarction, and stroke. Patients were stratified according to CKD stage (G1-G2 vs. G3a) and baseline systolic blood pressure (mild-to-moderate vs. severe hypertension), and follow-up data were compared across subgroups.Results:A total of 40 patients were included, aged (51±15) years, including 26 (65%) males. At the 13-year follow-up, office systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased by (-32±20) mmHg and (-15±14) mmHg (1 mmHg=0.133 kPa), respectively; reductions in home self-measured blood pressure (SBP: (-25±14) mmHg, DBP: (-10±11) mmHg) and 24-hour ambulatory blood pressure (SBP: (-16±9 mmHg, DBP: (-10±6) mmHg) were also observed, alongside a reduction in the total daily defined dose of antihypertensive medications by (1.1±0.9) compared to baseline. Renal function assessments showed no significant differences at 13 years versus baseline in serum creatinine ((105±51) μmol/L vs. (96±22) μmol/L), estimated glomerular filtration rate ((72±22) ml·min -1·1.73 m -2 vs. (78±17) ml·min -1·1.73 m -2), or urine albumin-to-creatinine ratio ((101±86) mg/g vs. (127±82) mg/g) (all P>0.05). All-cause and cardiovascular mortality rates during follow-up were 13% (5/40) and 8% (3/40), respectively. Subgroup analysis results showed that, although CKD G1-G2 patients had smaller reductions in office SBP ((-31±20) mmHg vs. (-34±19) mmHg) and DBP ((-13±10) mmHg vs. (-25±18) mmHg) compared to G3a patients at 13 years, intergroup differences were not significant (all P>0.05). In contrast, severe hypertension subgroup exhibited greater reductions in office SBP ((-55±13) mmHg vs. (-20±10) mmHg) and DBP ((-24±17) mmHg vs. (-13±10) mmHg) versus mild-to-moderate hypertension subgroup (all P<0.05). Conclusion:RDN demonstrates sustained antihypertensive efficacy with favorable renal safety in rHTN patients with mild CKD. Patients with higher baseline systolic blood pressure may exhibit better responsiveness to RDN.

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