Objective:To investigate the pathogen distribution, temporal trends in the rates of antimicrobial resistance, and susceptibility of bloodstream isolates and comparatively explore the epidemiological characteristics of bloodstream infections in hematology departments across 56 healthcare facilities in Guangdong Province from 2020 to 2024.Methods:A multicenter analysis was conducted to evaluate the constituent ratio of different pathogens isolated from clinical isolate data from bloodstream specimens in hematology, respiratory, and intensive care unit (ICU) departments across 56 healthcare facilities in Guangdong Province (2020-2024), and antimicrobial resistance trends in pathogens with high-detection rate over 5 years were assessed. Carbapenem-resistant Gram-negative organisms (CRO) were randomly sampled for carbapenemase gene detection and in vitro antimicrobial susceptibility tests with novel antimicrobial agents.Results:From 2020 to 2024, a total of 8 968, 6 440, and 25 511 bloodstream isolates were identified in the hematology, respiratory, and ICU departments, respectively, across 56 participating facilities in Guangdong Province, with significant differences in the pathogen constituent ratio among departments ( P<0.001). Notably, the hematology department demonstrated a predominance of Escherichia coli (24.1%), Klebsiella pneumoniae (17.5%), Pseudomonas aeruginosa (11.7%), coagulase-negative Staphylococci (15.2%), and Staphylococcus aureus (5.1%). In the resistance analysis, the rates of meropenem resistance of Escherichia coli and Klebsiella pneumonia increased from 6.7% and 5.8% (2020) to 14.0% and 15.8% (2024), respectively. Conversely, Pseudomonas aeruginosa exhibited a declining trend in the rate of meropenem resistance (6.2% to 1.9%) and imipenem (10.2% to 6.1%) during the same period. Acinetobacter baumannii demonstrated a biphasic resistance pattern to common antimicrobial agents, characterized by an initial decline, followed by a rebound. In this study, the susceptibility rates to conventional antimicrobial agents were significantly higher in Staphylococcus aureus versus coagulase-negative Staphylococci, with no glycopeptide- or linezolid-resistant strains detected. Notably, the prevalence of vancomycin-resistant Enterococcus faecium increased from 0 in 2020 to 23.1% in 2024. CRO carbapenemase phenotypes through active surveillance revealed that 80% Escherichia coli isolates were carrying blaNDM, 90% Klebsiella pneumoniae isolates were carrying blaKPC, 10% Pseudomonas aeruginosa isolates were carrying blaVIM, and 100% Acinetobacter baumannii were carrying blaOXA-23. The results of the antimicrobial susceptibility test in CRO revealed that carbapenem-resistant Escherichia coli (CRECO) demonstrated a 0 resistance rate to tigecycline, polymyxin B, and aztreonam/avibactam, whereas carbapenem-resistant Klebsiella pneumoniae exhibited a 0 resistance rate to aztreonam/avibactam, ceftazidime/avibactam, and imipenem/relebactam. Carbapenem-resistant Pseudomonas aeruginosa exhibited a 95.0% susceptibility rate to amikacin and polymyxin B, with a 45.0% resistance rate to ceftazidime/avibactam. In contrast, carbapenem-resistant Acinetobacter baumannii demonstrated complete susceptibility (100.0%) to sulbactam/durlobactam (MIC90=2 μg/ml), whereas eravacycline showed MIC50 and MIC90 values of 1 and 2 μg/ml, respectively. Conclusion:The pathogen constituent ratio of bloodstream isolates differed significantly among hematology, respiratory, and ICU departments. Notably, although CRO exhibited an escalating prevalence, it sustained high susceptibility to novel antimicrobial agents.

Objective:To explore the potential categories and characteristics of social alienation among family caregivers of patients with dementia, and to analyze the related influencing factors, providing reference for healthcare professionals to develop targeted intervention programs and improve the quality of care.Methods:A cross-sectional survey method was used to conveniently select family caregivers of dementia patients who were hospitalized or attended outpatient clinics at Tianyou Hospital Affiliated to Wuhan University of Science and Technology and the Central Theater General Hospital from December 2023 to July 2024 as survey objects. The general demographic information questionnaire, General Alienation Scale, Role Overload Scale, Adaptation, Partnership, Growth, Affection and Resolve, Type D Personality Scale-14, and Barthel Index were conducted for investigation. Latent profile analysis was used to explore potential categories of social alienation among family caregivers of people with dementia, and influential factors were explored through Logistic regression.Results:A total of 226 questionnaires were distributed and 220 valid questionnaires were collected, including 67 males and 153 females, with an age of (61.39 ± 9.42) years. The potential categories of social alienation of family caregivers of patients with dementia were categorized into low social alienation-low skepticism group (111 cases, 50.5%) and high social alienation-meaninglessness group (109cases, 49.5%). Patients′ age, self-care ability, dementia type, caregiver′s literacy, place of residence, occupational status, perceived health status, Length of care, per capita monthly family income, type D personality, role overload, and family caring were statistically different in the potential profile of social alienation ( t = 2.04, -16.48, 15.53; χ2 values were 3.84 - 109.23, all P< 0.05). Logistic regression analysis showed that the caregiver′s length of caregiving years (>5 years), role overload, family caring, type D personality (no), patient′s dementia type (mixed dementia), and self-care ability (mild dependence) were influential factors in the category of social alienation of family caregivers of patients with dementia ( OR values were 0.000 - 70.970, all P<0.05). Conclusions:There is group heterogeneity in the social alienation of family caregivers of patients with dementia, and healthcare professionals should focus on the differences in the type of disease, self-care ability, and years of caregiving experience of caregivers, and formulate personalized and precise interventions from caregiver personality traits, role overload, and family care to reduce the level of their social alienation.

Objective:To visualize and analyze the scientific achievements of psychological distress of family caregivers for patients with dementia based on Web of Science, to clarify the current research status, hotspots, and frontiers in this field.Methods:The literature on psychological distress of family caregivers for patients with dementia collected in the core collection of Web of Science from 2005 to 2024 were retrieved. VOSviewer, CiteSpace, BICOMB, gCLUTO were used to analyze the annual number of publications, countries, institutions, authors, journals and keywords.Results:A total of 794 articles were included, and the overall number of articles was on the rise. A total of 41 countries published articles. United States had the largest number (251 articles) and the closest cooperation with other countries. The institution with the largest number of publications was from United Kingdom (42 articles), the authors with the largest output were from United States and Spain (both 12 articles), and the journal with the largest number of publications was Aging & Mental Health (53 articles). Five clusters: psychological distress performance; mental and behavioral symptoms associated with dementia patients; a systematic review of family care for dementia patients; the relationship between psychological distress and care burden, quality of life, mental health; the influence of psychological distress on family caregivers of dementia patients were obtained by keyword clustering analysis. The most prominent keyword was "individual", "acceptance and commitment therapy" and "reliability" were emerging burst keywords. Conclusions:United States and United Kingdom are in a leading position in the field, and the research in China lacks international cooperation. Psychological distress performance and the relationship between psychological distress and care burden, quality of life, mental health are the current research hotspots. Acceptance and commitment therapy reliability research and personalized interventions are research trends.

Objective:To explore the potential categories and characteristics of social alienation among family caregivers of patients with dementia, and to analyze the related influencing factors, providing reference for healthcare professionals to develop targeted intervention programs and improve the quality of care.Methods:A cross-sectional survey method was used to conveniently select family caregivers of dementia patients who were hospitalized or attended outpatient clinics at Tianyou Hospital Affiliated to Wuhan University of Science and Technology and the Central Theater General Hospital from December 2023 to July 2024 as survey objects. The general demographic information questionnaire, General Alienation Scale, Role Overload Scale, Adaptation, Partnership, Growth, Affection and Resolve, Type D Personality Scale-14, and Barthel Index were conducted for investigation. Latent profile analysis was used to explore potential categories of social alienation among family caregivers of people with dementia, and influential factors were explored through Logistic regression.Results:A total of 226 questionnaires were distributed and 220 valid questionnaires were collected, including 67 males and 153 females, with an age of (61.39 ± 9.42) years. The potential categories of social alienation of family caregivers of patients with dementia were categorized into low social alienation-low skepticism group (111 cases, 50.5%) and high social alienation-meaninglessness group (109cases, 49.5%). Patients′ age, self-care ability, dementia type, caregiver′s literacy, place of residence, occupational status, perceived health status, Length of care, per capita monthly family income, type D personality, role overload, and family caring were statistically different in the potential profile of social alienation ( t = 2.04, -16.48, 15.53; χ2 values were 3.84 - 109.23, all P< 0.05). Logistic regression analysis showed that the caregiver′s length of caregiving years (>5 years), role overload, family caring, type D personality (no), patient′s dementia type (mixed dementia), and self-care ability (mild dependence) were influential factors in the category of social alienation of family caregivers of patients with dementia ( OR values were 0.000 - 70.970, all P<0.05). Conclusions:There is group heterogeneity in the social alienation of family caregivers of patients with dementia, and healthcare professionals should focus on the differences in the type of disease, self-care ability, and years of caregiving experience of caregivers, and formulate personalized and precise interventions from caregiver personality traits, role overload, and family care to reduce the level of their social alienation.

Objective:To visualize and analyze the scientific achievements of psychological distress of family caregivers for patients with dementia based on Web of Science, to clarify the current research status, hotspots, and frontiers in this field.Methods:The literature on psychological distress of family caregivers for patients with dementia collected in the core collection of Web of Science from 2005 to 2024 were retrieved. VOSviewer, CiteSpace, BICOMB, gCLUTO were used to analyze the annual number of publications, countries, institutions, authors, journals and keywords.Results:A total of 794 articles were included, and the overall number of articles was on the rise. A total of 41 countries published articles. United States had the largest number (251 articles) and the closest cooperation with other countries. The institution with the largest number of publications was from United Kingdom (42 articles), the authors with the largest output were from United States and Spain (both 12 articles), and the journal with the largest number of publications was Aging & Mental Health (53 articles). Five clusters: psychological distress performance; mental and behavioral symptoms associated with dementia patients; a systematic review of family care for dementia patients; the relationship between psychological distress and care burden, quality of life, mental health; the influence of psychological distress on family caregivers of dementia patients were obtained by keyword clustering analysis. The most prominent keyword was "individual", "acceptance and commitment therapy" and "reliability" were emerging burst keywords. Conclusions:United States and United Kingdom are in a leading position in the field, and the research in China lacks international cooperation. Psychological distress performance and the relationship between psychological distress and care burden, quality of life, mental health are the current research hotspots. Acceptance and commitment therapy reliability research and personalized interventions are research trends.

Objective:To investigate the pathogen distribution, temporal trends in the rates of antimicrobial resistance, and susceptibility of bloodstream isolates and comparatively explore the epidemiological characteristics of bloodstream infections in hematology departments across 56 healthcare facilities in Guangdong Province from 2020 to 2024.Methods:A multicenter analysis was conducted to evaluate the constituent ratio of different pathogens isolated from clinical isolate data from bloodstream specimens in hematology, respiratory, and intensive care unit (ICU) departments across 56 healthcare facilities in Guangdong Province (2020-2024), and antimicrobial resistance trends in pathogens with high-detection rate over 5 years were assessed. Carbapenem-resistant Gram-negative organisms (CRO) were randomly sampled for carbapenemase gene detection and in vitro antimicrobial susceptibility tests with novel antimicrobial agents.Results:From 2020 to 2024, a total of 8 968, 6 440, and 25 511 bloodstream isolates were identified in the hematology, respiratory, and ICU departments, respectively, across 56 participating facilities in Guangdong Province, with significant differences in the pathogen constituent ratio among departments ( P<0.001). Notably, the hematology department demonstrated a predominance of Escherichia coli (24.1%), Klebsiella pneumoniae (17.5%), Pseudomonas aeruginosa (11.7%), coagulase-negative Staphylococci (15.2%), and Staphylococcus aureus (5.1%). In the resistance analysis, the rates of meropenem resistance of Escherichia coli and Klebsiella pneumonia increased from 6.7% and 5.8% (2020) to 14.0% and 15.8% (2024), respectively. Conversely, Pseudomonas aeruginosa exhibited a declining trend in the rate of meropenem resistance (6.2% to 1.9%) and imipenem (10.2% to 6.1%) during the same period. Acinetobacter baumannii demonstrated a biphasic resistance pattern to common antimicrobial agents, characterized by an initial decline, followed by a rebound. In this study, the susceptibility rates to conventional antimicrobial agents were significantly higher in Staphylococcus aureus versus coagulase-negative Staphylococci, with no glycopeptide- or linezolid-resistant strains detected. Notably, the prevalence of vancomycin-resistant Enterococcus faecium increased from 0 in 2020 to 23.1% in 2024. CRO carbapenemase phenotypes through active surveillance revealed that 80% Escherichia coli isolates were carrying blaNDM, 90% Klebsiella pneumoniae isolates were carrying blaKPC, 10% Pseudomonas aeruginosa isolates were carrying blaVIM, and 100% Acinetobacter baumannii were carrying blaOXA-23. The results of the antimicrobial susceptibility test in CRO revealed that carbapenem-resistant Escherichia coli (CRECO) demonstrated a 0 resistance rate to tigecycline, polymyxin B, and aztreonam/avibactam, whereas carbapenem-resistant Klebsiella pneumoniae exhibited a 0 resistance rate to aztreonam/avibactam, ceftazidime/avibactam, and imipenem/relebactam. Carbapenem-resistant Pseudomonas aeruginosa exhibited a 95.0% susceptibility rate to amikacin and polymyxin B, with a 45.0% resistance rate to ceftazidime/avibactam. In contrast, carbapenem-resistant Acinetobacter baumannii demonstrated complete susceptibility (100.0%) to sulbactam/durlobactam (MIC90=2 μg/ml), whereas eravacycline showed MIC50 and MIC90 values of 1 and 2 μg/ml, respectively. Conclusion:The pathogen constituent ratio of bloodstream isolates differed significantly among hematology, respiratory, and ICU departments. Notably, although CRO exhibited an escalating prevalence, it sustained high susceptibility to novel antimicrobial agents.

Objective:To explore the change trajectory and influencing factors of benefit finding of family caregivers of patients with lung cancer, so as to provide reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From September 2021 to October 2022, 232 family caregivers of patients with lung cancer from General Hospital of PLA Central Theater Command and Tianyou Hospital affiliated to Wuhan University of Science and Technology were collected by convenience sampling method. The level of benefit finding of family caregivers was investigated at 1 month, 3 months and 6 month, after the patients were diagnosed. Growth Mixture Model was applied to identify distinct trajectory categories. Multinomial Logistic regressions were performed to analyze predictors of trajectory categories.Results:The overall level of benefit finding of family caregivers of lung cancer patients showed an upward trend over time ( F=83.06, P<0.01), from 1 month (47.02 ± 14.79) to 6 months (58.13 ± 13.18). Three categories of benefit finding trajectories were identified, named as "the high level-decline group" 12 cases, "the moderate level-stability group" 67 cases, and "the low level-elevation group" 153 cases. Univariate analysis showed that age and education level of family caregivers, average income per person in patient family, type of medical payment, whether the tumor was metastasized, the treatment method of the patient, whether they lived with the patient, and whether they had co-caregivers were related to the category of benefit finding trajectory ( χ2 values were 6.71-15.05, all P<0.05). Multivariate Logistic regression analysis showed that age and education level of family caregivers, average income per person in patient family, treatment method of the patient and whether they lived with the patients were the main influencing factors of benefit finding trajectory categories(all P<0.05). Conclusions:The benefit finding of family caregivers of lung cancer patients showed different trajectories with the time of diagnosis, and the overall level shows an upward trend. More than half of the family caregivers belong to the low level-elevation group. Medical staff should give family caregivers stage and specific nursing intervention according to the change trajectory of benefit finding and its influencing factors.