OBJECTIVE To investigate the changes of etiological submission rates before the antimicrobial therapy after a series of intervention measures were taken so as to optimize the use and management of antibiotics.METHODS A total of 97,146 patients who were hospitalized and treated with antibiotics in the First Affiliated Hospital of Soochow University from Jul.2021 to Jun.2024 were recruited as the research subjects.Jan.2023 was set as the time node of intervention,the time period from Jul.2021 to Dec.2022 was assigned as the pre-interven-tion group,and the time period from Jan.2023 to Jun.2024 was assigned as the post-intervention group.The etio-logical submission rates before the antimicrobial therapy were observed by interrupted time series before and after the intervention measures were taken.The changes of isolation rates of multidrug-resistant organisms and inci-dence of hospital-associated infections were estimated by chi-square test.RESULTS The etiological submission rates before the antimicrobial therapy,etiological submission rates before combined use of major antibiotics and etiological submission rates relating to diagnosis of hospital-associated infections were higher after the intervention than before the intervention(all P＜0.05).The interrupted time series analysis showed that from the perspective of long-term benefit,the intervention measures could raise the etiological submission rates before the use of re-stricted,special grades of antibiotics and general antibiotics,and the net benefits were 0.85％,0.67％and 0.68％,respectively(all P＜0.05);there was no significant difference in the etiological submission rate before the com-bined use of major antibiotics.After the intervention,the incidence of multidrug-resistant organisms infection de-creased from 0.46％to 0.27％(P＜0.001);the isolation rate of multidrug-resistant organisms was 25.73％after the intervention,27.47％before the intervention,and there was no significant difference.CONCLUSIONS Scientif-ic and reasonable interventions may effectively raise the etiological submission rates before the antimicrobial thera-py,however,the etiological submission rate for combined use of major antibiotics and the isolation rate of multi-drug-resistant organisms are not improved remarkably.It is necessary to further formulate targeted interven-tion measures so as to push forward high-quality development of infection control.

OBJECTIVE To investigate the changes of etiological submission rates before the antimicrobial therapy after a series of intervention measures were taken so as to optimize the use and management of antibiotics.METHODS A total of 97,146 patients who were hospitalized and treated with antibiotics in the First Affiliated Hospital of Soochow University from Jul.2021 to Jun.2024 were recruited as the research subjects.Jan.2023 was set as the time node of intervention,the time period from Jul.2021 to Dec.2022 was assigned as the pre-interven-tion group,and the time period from Jan.2023 to Jun.2024 was assigned as the post-intervention group.The etio-logical submission rates before the antimicrobial therapy were observed by interrupted time series before and after the intervention measures were taken.The changes of isolation rates of multidrug-resistant organisms and inci-dence of hospital-associated infections were estimated by chi-square test.RESULTS The etiological submission rates before the antimicrobial therapy,etiological submission rates before combined use of major antibiotics and etiological submission rates relating to diagnosis of hospital-associated infections were higher after the intervention than before the intervention(all P＜0.05).The interrupted time series analysis showed that from the perspective of long-term benefit,the intervention measures could raise the etiological submission rates before the use of re-stricted,special grades of antibiotics and general antibiotics,and the net benefits were 0.85％,0.67％and 0.68％,respectively(all P＜0.05);there was no significant difference in the etiological submission rate before the com-bined use of major antibiotics.After the intervention,the incidence of multidrug-resistant organisms infection de-creased from 0.46％to 0.27％(P＜0.001);the isolation rate of multidrug-resistant organisms was 25.73％after the intervention,27.47％before the intervention,and there was no significant difference.CONCLUSIONS Scientif-ic and reasonable interventions may effectively raise the etiological submission rates before the antimicrobial thera-py,however,the etiological submission rate for combined use of major antibiotics and the isolation rate of multi-drug-resistant organisms are not improved remarkably.It is necessary to further formulate targeted interven-tion measures so as to push forward high-quality development of infection control.

Objective To investigate the morbidity and risk factors of peripherally inserted central catheter (PICC) related bloodstream infection and the distribution and antimicrobial susceptibility of pathogens in patients with hematological malignancy for better prevention and management of such infections. Methods The relevant data were collected from the patients with hematologic malignancy and PICC in hematology department from July 2013 to November 2016. The risk factors of PICC related bloodstream infection were analyzed. Blood samples and catheter-related blood samples were taken for culture of pathogens. The pathogens were identified on VITEK-32. Antimicrobial susceptibility was tested by using Kirby-Bauer method. Results A total of 10 213 patients with PICC were included in this study. PICC related bloodstream infection was identified in 280 (2.74％) patients, about 0.55 per 1 000 PICC days. The main risk factors of PICC related bloodstream infection were type of hematological malignancy (P＜0.001) and days of indwelling PICC (P＜0.001). A total of 322 strains of pathogenic bacteria were isolated, including gam-negative bacteria (73.91％), gam positive bacteria (22.05％) and fungus (4.04％). The gram-negative species isolated from bloodstream were mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. E. coli and K. pneumoniae isolates were relatively sensitive to piperacillin-tazobactam, cefepime, cefoperazone-sulbactam, imipenem, gentamicin and amikacin. S. maltophilia isolates were relatively sensitive to piperacillin-tazobactam, ceftazidime, cefoperazone sulbactam and ciprofloxacin, while P. aeruginosa strains were relatively sensitive to the commonly used anti-Pseudomonas antibiotics. The gram-positive isolates including Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus haemolyticus were all susceptible to vancomycin, linezolid, and teicoplanin. The most frequently identified fungal species was Candida tropicalis. Conclusions Prolonged duration of PICC may increase the risk of central line-associated bloodstream infection (CLABSI). The incidence of CLABSI is associated with the type of hematological malignancy. CLABSI pathogens are mainly gram-negative microorganisms with various levels of antibiotic resistance. Clinicians should adhere to standard operating procedures, strengthen surveillance of patients with PICC, evaluate the risk dynamically, and remove PICC as early as possible.

OBJECTIVETo explore whether the tagging single nucleotide polymorphisms (SNPs) within EPHX1 gene were involved in the genetic susceptibility to coal worker's pneumoconiosis (CWP) by case-control study.

METHODSThis study consisted of 697 CWP patients and 694 controls. All the subjects were Han Chinese, underground coal miners and recruited from coal mines of Xuzhou Mining Business Group Co Ltd.. The venous blood samples were obtained from all subjects and extracted genome DNA from the isolated leucocytes. Three SNPs were selected from the HapMap and the genotyping was done by the TaqMan method with the ABI 7900HT Real Time PCR system.

RESULTSThe Single SNP analyses showed that the genotype frequencies of EPHX1 (rs2234922) was significantly associated with decreased risk of CWP under co-dominant model (OR = 0.22, 95% CI = 0.06~0.79, P = 0.020), recessive model (OR = 0.23, 95% CI = 0.06~0.82, P = 0.023), and addictive model (OR = 0.75, 95% CI = 0.58~0.96, P = 0.022). The further stratification analysis showed that the risk of CWP will significantly decreased in non-smoking groups (OR = 0.10, 95% CI = 0.01~0.83, P = 0.033).

CONCLUSIONSOur results suggest that individuals with the EPHX1 (rs223492) GG genotype was associated with a dereased risk of CWP, and it has a protective effect on the developing CWP.

Anthracosis ; genetics ; Case-Control Studies ; Coal ; Epoxide Hydrolases ; genetics ; Genetic Predisposition to Disease ; Genotype ; Humans ; Polymorphism, Single Nucleotide ; Risk Factors ; Sequence Analysis, DNA