Objective To analyze the clinical characteristics and risk factors of vancomycin-resistant En-terococcus faecium(VRE-fm)isolated from urine,and to provide a scientific basis for the prevention and treatment of VRE-fm in clinic.Methods The clinical data and drug sensitivity results of 60 patients with VRE-fm strains isolated from urine in this hospital from January 2017 to June 2023 were retrospectively ana-lyzed.The patients were divided into the infection group(n=46)and the non-infection group(n=16)accord-ing to the status of urinary tract infection.Univariate and multivariate logistic regression were used to analyze the risk factors of urinary tract infection caused by VRE-fm.Results Among the 60 patients with VVRE fm strain isolated from urine,43 cases(71.7%)were female,36 cases(60.0%)were≥65 years old,42 cases(70.0%)had a history of indignant catheter,and the median length of hospitalization was 26.5 days.The re-sults of in vitro VRE-fm drug sensitivity test showed that the resistance rate of Teicolanin was 95%,and the resistance rate of linezolid and tigacycline were 1.7%.Multivariate logistic regression analysis showed that u-rinary sludge white blood cell count＞5/HP was an independent risk factor for VRE-fm urinary tract infec-tion(P＜0.05).Conclusion Urine-isolated VRE-fm infections were more common in female,older patients and were significantly associated with a history of indwelling catheters.

Objective To investigate the risk factors for carbapenem-resistant Acinetobacter baumannii(CRAB)bloodstream infection in intensive care units(ICU)and construct a nomogram prediction model.Methods A retrospective analysis was conducted on the medical records of patients with CRAB bloodstream(BSI)infection in the ICU ward of the First Afliated Hospital,Sun Yat-sen University from January 1,2018 to December 31,2023.Cox regression analysis was usedo determine the risk factors for death in patients with CRAB bloodstream infection and to construct a nomogram.prediction model.The predictive ability of the no-mogramprediction model was evaluated by drawing calibration curves,receiver operating characteristic(ROC)curves,and consistency index(C-index).Results Septic shock(HR=7.770,95％CI:1.852-32.593)was an independent risk factor for mortality in patients with CRAB bloodstream infections,and hospitalisation day＞14 d(HR=0.331,95％CI:0.165-0.665)was an independent protective factor for mortality in patients with CRAB bloodstream infections.A nomogram was constructed based on the above factors,with a C-index of 0.725(95％CI:0.652-0.798).The predictive efficacy of patient survival rates at 20 d and 30 d was 0.831(95％CI:0.752-0.910)and 0.826(95％CI:0.715-0.937),respectively.The calibration curve was well fit-ted.Conclusion Septic shock was an independent risk factor for mortality in patients with CRAB bloodstream infections,and hospitalisation days＞14 d was an independent protective factor for mortality in patients CRAB BSI infections.The nomogram prediction model constructed accordingly has good predictive value for the sur-vival rate of patients in the intensive care unit who undergo CRAB bloodstream infections.

Objective To explore the bloodstream infection of refractory drug-resistant Pseudomonas aeruginosa(DTR-PA)patients with clinical characteristics and risk factors.Methods Clinical data of patients with Pseudomonas aeruginosa bloodstream infection in the First Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2022 were retrospectively analyzed.Multivariate Logistic regression analysis was used to explore the independent risk factors for DTR-PA bloodstream infection.Cox proportional hazards regression was used to explore the risk factors related to the death of Pseudomonas aeruginosa bloodstream in-fection.Results A total of 114 patients with Pseudomonas aeruginosa bloodstream infection were enrolled,with an average age of(51.05±17.55)years.The 28 d mortality was 14.0％(16/114),and 24 patients(21.1％,24/114)had DTR-PA.Age,ICU admission,diabetes,hypoproteinemia and septic shock were associ-ated with DTR-PA bloodstream infection(P＜0.05).Multivariate Logistic regression analysis showed that septic shock was an independent risk factor for DTR-PA bloodstream infection(P＜0.05).ICU admission was an independent risk factor for the death of patients with DTR-PA and Pseudomonas aeruginosa blood-stream infection(P＜0.05).Conclusion There are many risk factors for DTR-PA bloodstream infection.Septic shock and ICU admission are independent risk factors for DTR-PA bloodstream infection and death,respectively.