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.

Objective To employ the mesh meta analysis to compare the effectiveness and safety of short-term reaching-standard treatment in the patients with moderate to severe atopic dermatitis among the different biologics.Methods The randomized controlled trials (RCT) were retrieved from the databases of CNKI,Chinese Biomedical Literature Database,Wanfang,VIP,PubMed,Cochrane Library and Embase data-bases.The retrieval time was from the database establishment to August,2023.The related literatures on the biologics for treating moderate to severe atopic dermatitis were collected.The literatures were screened by the inclusion and exclusion standards,the literature quality was evaluated and the data were extracted.Then the mesh meta analysis was performed by using RevMan 5.3 and Stata 16.0 softwares.Results A total of 754 ar-ticles were retrieved,and 11 articles were finally included,involving in 14 RCT with a total sample number of 5528 cases.There were 4 intervention methods,including placebo and 3 kinds of drugs.The drugs were Dupi-lumab,Lebrikizumab and Tralokinumab.The results showed that for each of effectiveness indicator,different medication regimens had different performance,after comprehensively meeting the treatment criteria,Dupri-uliumab was superior to Lebrikizumab,and Lebrikizumab was superior to Tralokinumab.There was no statis-tical difference in adverse reactions between the three drugs and placebo (P>0.05).Conclusion Dupilumab is currently the most effective biologic agent for short-term target treatment,capable of reducing inflamma-tion and improving skin symptoms.Future studies should further evaluate its long-term efficacy and safety to guide clinical application.