1.Advance in application of artificial intelligence in hospital infection prevention and control
Tielin ZHU ; Yao CHEN ; Pengxiang ZHANG ; Yu WANG ; Jinhai LI ; Chunqin YUAN
Chinese Journal of Nosocomiology 2025;35(17):2696-2701
Infection Prevention and Control(IPC)programs are crucial for prevention of hospital-associated infec-tions(HAIs),health and safety of patients and health care workers.The major task confronting the health care is to effectively carry out the IPC programs so as to raise the efficiency and quality of management of HAIs.In recent years,the rapid development of artificial intelligence(AI)technology has provided new ideas for the management of HAIs.The application and progress of research on application of AI technologies such as machine learning,nat-ural language processing and computer vision in surveillance,early warning,diagnosis,prevention and control,smart medical equipment and management of antibiotics were reviewed in the article.Meanwhile,the problems and challenges confronting the AI application,such as technical breakthroughs,data privacy and health care work-ers' acceptance,were also expounded.In the future,it is necessary to push forward the technology research and development,establish the safe and reliable data management system,increase the experience of health care work-ers and energize the interdisciplinary cooperation on IPC.
2.Epidemiological characteristics and trends of postoperative pneumonia in 22 tertiary general hospitals in Jiangsu Province
Hui QIU ; Ping JIANG ; Ping WANG ; Tielin ZHU ; Yan XU ; Tingrui WANG ; Yan SUN ; Yu ZHANG ; Yujuan HOU ; Xiaoming KONG ; Xiaoxu CHEN ; Lanping SHI ; Xiuying LI ; Jing BAI ; Yan WANG ; Huili YUAN ; Bo WANG ; Ying ZHANG ; Jinxia XU ; Ting MA ; Minghua YAN ; Yanan CHEN
Chinese Journal of Infection Control 2025;24(11):1594-1600
Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43%.The incidence in 2023 was 0.37%,which was lower than that in 2022(0.49%),with statistically significant difference(P<0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71%),cardiothoracic surgery(2.91%),and general surgery(0.77%).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44%,which was higher than that in other tertiary hospitals(0.37%).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P>0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio<200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39%vs 0.47%,P<0.001),while the incidence of POP in hospitals with a proportion ≥30%of full-time staff being doctors was higher than that in hospitals with a proportion<30%(0.45%vs 0.36%,P<0.001).The incidence of POP in male patients was higher than that in female patients(0.62%vs 0.26%,P<0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged<65(0.73%vs 0.26%,P<0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95%,22.72%,and 15.45%,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75%,21.45%,and 32.28%,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P<0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.
3.Advance in application of artificial intelligence in hospital infection prevention and control
Tielin ZHU ; Yao CHEN ; Pengxiang ZHANG ; Yu WANG ; Jinhai LI ; Chunqin YUAN
Chinese Journal of Nosocomiology 2025;35(17):2696-2701
Infection Prevention and Control(IPC)programs are crucial for prevention of hospital-associated infec-tions(HAIs),health and safety of patients and health care workers.The major task confronting the health care is to effectively carry out the IPC programs so as to raise the efficiency and quality of management of HAIs.In recent years,the rapid development of artificial intelligence(AI)technology has provided new ideas for the management of HAIs.The application and progress of research on application of AI technologies such as machine learning,nat-ural language processing and computer vision in surveillance,early warning,diagnosis,prevention and control,smart medical equipment and management of antibiotics were reviewed in the article.Meanwhile,the problems and challenges confronting the AI application,such as technical breakthroughs,data privacy and health care work-ers' acceptance,were also expounded.In the future,it is necessary to push forward the technology research and development,establish the safe and reliable data management system,increase the experience of health care work-ers and energize the interdisciplinary cooperation on IPC.
4.Epidemiological characteristics and trends of postoperative pneumonia in 22 tertiary general hospitals in Jiangsu Province
Hui QIU ; Ping JIANG ; Ping WANG ; Tielin ZHU ; Yan XU ; Tingrui WANG ; Yan SUN ; Yu ZHANG ; Yujuan HOU ; Xiaoming KONG ; Xiaoxu CHEN ; Lanping SHI ; Xiuying LI ; Jing BAI ; Yan WANG ; Huili YUAN ; Bo WANG ; Ying ZHANG ; Jinxia XU ; Ting MA ; Minghua YAN ; Yanan CHEN
Chinese Journal of Infection Control 2025;24(11):1594-1600
Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43%.The incidence in 2023 was 0.37%,which was lower than that in 2022(0.49%),with statistically significant difference(P<0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71%),cardiothoracic surgery(2.91%),and general surgery(0.77%).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44%,which was higher than that in other tertiary hospitals(0.37%).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P>0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio<200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39%vs 0.47%,P<0.001),while the incidence of POP in hospitals with a proportion ≥30%of full-time staff being doctors was higher than that in hospitals with a proportion<30%(0.45%vs 0.36%,P<0.001).The incidence of POP in male patients was higher than that in female patients(0.62%vs 0.26%,P<0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged<65(0.73%vs 0.26%,P<0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95%,22.72%,and 15.45%,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75%,21.45%,and 32.28%,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P<0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.
5.Characteristics of baseline viral load before antiretroviral therapy in newly reported HIV-infected patients in Tianjin, 2019-2022
Xuan ZHAO ; Jinyu HOU ; Jingjin ZHU ; Minna ZHENG ; Long LI ; Tielin NING ; Maohe YU
Chinese Journal of Epidemiology 2024;45(3):353-357
Objective:To understand the baseline viral load (VL) of newly reported HIV- infected patients before antiretroviral therapy and related factors in Tianjin.Methods:Data were obtained from the China Disease Control and Prevention Information System, and the study subjects were HIV-infected patients before the first antiretroviral therapy in Tianjin from 2019 to 2022, and the information about their socio-demographic characteristics, baseline CD4 +T lymphocyte (CD4) counts before antiretroviral therapy and baseline VL test results were collected, the baseline high VL was defined as ≥100 000 copies/ml. The effect of different factors on viral load were analyzed. Software SPSS 24.0 was used for statistical analysis. Results:A total of 1 296 newly reported HIV-infected patients were included in the study, in whom 15.89% (206/1 296) had high baseline VL, and multifactorial logistic regression analysis showed that those with history of STD (a OR=1.45, 95% CI:1.00-2.08) were more likely to have high baseline VL. Compared with those with baseline CD4 counts <200 cells/μl, those with baseline CD4 counts 200-350 cells/μl (a OR=0.40, 95% CI: 0.27-0.57), 351-500 cells/μl (a OR=0.32, 95% CI: 0.20-0.49), and >500 cells/μl (a OR=0.30, 95% CI: 0.18-0.49) were less likely to have high baseline VL. Conclusions:The proportion of HIV-infected patients with high baseline VL before antiretroviral therapy was low in Tianjin during 2019-2022. History of STD and baseline CD4 counts <200 cells/μl were associated with high baseline VL in HIV-infected patients, to which close attention needs to be paid in AIDS prevention and control.
6.Analysis of human papillomavirus infection status and related factors among men who have sex with men in Tianjin
Huijuan LI ; Jianyun BAI ; Maohe YU ; Xiaoyue DONG ; Tielin NING ; Jingjin ZHU ; Ying ZHANG
Chinese Journal of Epidemiology 2024;45(12):1693-1699
Objective:The status quo and related factors of human papillomavirus (HPV) infection in multiple parts of men who have sex with men (MSM) in Tianjin were analyzed.Methods:Using the cross-sectional survey method, a total of 600 MSM were recruited in Tianjin from September to December 2023, including 200 (18-26 years old), 300 (27-45 years old), and 100 (≥46 years old) stratificaed by age group. Questionnaire survey was used to collect knowledge and behavioral information related to demography and STD prevention and treatment. Exfoliated cells from genital, perianal and oral cavity were collected for HPV typing detection. Logistic regression model was used to analyze the related factors of HPV infection.Results:The infection rate of HPV was 53.67% (322/600) in MSM, with high-risk type as 41.17% (247/600), low-risk type as 27.17% (163/600). The infection rate of HPV in both multiple and single types was 26.83% (161/600).The infection rates of genotypes covered by nine-valent HPV vaccine, quadrivalent HPV vaccine and bivalent HPV vaccine were 36.83% (221/600), 25.17% (151/600) and 9.50% (57/600), respectively.The infection rates of genital HPV, high-risk or low-risk types were 24.67% (148/600), 16.67% (100/600) and 11.00% (66/600), respectively. The infection rates of perianal HPV, high-risk or low-risk types were 42.00% (252/600), 30.17% (181/600) and 20.50% (123/600), respectively. The infection rates of oral HPV high-risk and low-risk types were 3.17% (19/600), 2.33% (14/600) and 1.17% (7/600), respectively. Divorce or widowhood (a OR=2.38, 95% CI: 1.26-4.50), history of homosexual anal intercourse in the past 6 months (a OR=2.28, 95% CI: 1.00-5.50), and use of dependent drugs (including new psychoactive substances) (a OR=1.62, 95% CI: 1.02-2.58) were risk factors for genital HPV infection. College degree/university degree or above (a OR=0.36, 95% CI: 0.16-0.81) was a protective factor for perianal HPV infection, and a history of drug dependence (a OR=1.85, 95% CI: 1.19-2.88) was a risk factor. Conclusions:MSM in Tianjin was a high-risk group for HPV infection, and the HPV infection in the perianal area was more severe than in the genital area and oral area.Marital status, education level, history of homosexual anal sex in the past 6 months, and history of drug dependence were related factors of HPV infection among MSM.
7.Study of auxiliary diagnostic value of viral load test for samples with indeterminate HIV antibody detection results
Xuan ZHAO ; Shaohui CHENG ; Minna ZHENG ; Long LI ; Jingjin ZHU ; Tielin NING
Chinese Journal of Epidemiology 2016;37(7):992-995
Objective To evaluate the auxiliary diagnostic value of viral load test for samples with indeterminate HIV antibody detection results.Methods Thirty-two samples with indeterminate HIV antibody detection results collected from MSM were used for two viral load tests in Tianjin in 2015.Follow up was conducted for this population to confirm their HIV infection status.Results Virus loads were detected in the 2 viral load tests.In the follow-up survey,the results of HIV antibody test of all the samples were positive.The results of viral load test were completely consistent with those of HIIV antibody confirmation test.Conclusion The viral load test was effective in the auxiliary diagnosis of HIV infection in window phase,which can be used for the samples with indeterminate HIV antibody detection results.
8.Mechanical thrombectomy versus Intra-arterial Thrombolysis in Patients with Stroke Caused by Acute ce-rebral Arterial Occlusions:A Single-center study
Zhaohui MA ; Guifu LI ; Jinsong YOU ; Jixiang ZHU ; Wangchi LUO ; Yingguang ZHANG ; Jianwen GUO ; Fajun CHEN ; Yao SHI ; DaoJin XUE ; Foming ZHANG ; Longlong WEN ; Wenyan ZHU ; Zhenyun GU ; Yan HUANG ; Tielin LI
Chinese Journal of Nervous and Mental Diseases 2015;(7):406-411
Objective To investigate the safety and efficacy of mechanical thrombectomy (MT) compared with In?tra-arterial Thrombolysis (IAT) treatment in patients with severe acute ischemic stroke (AIS) caused by large cerebral ar?tery occlusion. Method The patients with AIS caused by large cerebral artery occlusion and underwent MT or IAT from 2005 May to 2014 May was included. A retrospective analysis was conducted on the onset to emergency(OTE)time, emergency to acupuncture(ETA)time, acupuncture to recanalization (ATR) time, stroke severity as measured by the Na?tional Institutes of Health Stroke Scale (NIHSS) score, and site of arterial occlusion on magnetic resonance angiography (MRA). A comparison was made between MT and IAT patients in rates of recanalization, symptomatic intracranial bleed?ing (SIB), mortality, and functional outcome. Three-month favourable outcome was defined as a modified Rankin Scale (mRS) score≤2. Result One hundred and two AIS patients were treated with MT and 50 with IAT. There was no differ?ence between MT and IAT groups with regard to demographics, onset NIHSS score (13.37±6.95 vs. 12.70±6.11;P=0.572) and discharge NIHSS score (8.40 ± 6.69 vs. 7.53 ± 7.28, P= 0.522) and the change of NIHSS score (3.87 ± 7.14 vs. 4.26 ± 5.42, P=0.766). There were significantly differences between MT and IAT groups in the OTE time (Median 300 min vs. 120 min,Z=-5.704,P=0.000) , ATR time (Median 30 min vs. 65 min,Z=-5.011,P=0.001) ,recanalization (91.2%vs. 60.0%,P =0.01),the rate of AIB(21.7% vs. 36.0%,P =0.046),3-month mortality (16.6% vs. 26.0%,P =0.043). The above parameters were better in MT group than in the IAT group. There were no significant differences between MT and IAT groups in the rate of SIB (12% vs. 16%,P =0.055), the NIHSS change(Median 3 vs. 4,Z =-0.236,P =0.823) and mRS score on 90d ( 48.2%vs. 46.0%, P=0.823). MT patients had significantly higher percentages of stent use (22.5%vs. 8%,P=0.018) . The Recanalization for ICA(81.8%vs. 55.6%,P=0.048),BA(93.1%vs. 55.6%,P=0.032)and MCA( 97.5% vs. 60.0%,P =0.026)was higher in MT group than in IAT group .The SIB rate for ICA(13.8% vs. 33.3%,P =0.000),BA(13.8%vs. 33.3%,P=0.000)was lower in MT group than in IAT group . The mortality rate of was significant?ly lower in MT than in IAT group for MCA (2.5%vs. 20.0%,P=0.000) . the good outcome rate for BA was higher in MT group than in IAT group(41.3%vs. 22.2%,P﹤0.01). Conclusions Compared to IAT,MT can provide broader time win?dow,higher recanalization rate and better outcome in patients with severe acute ischemic stroke (AIS) caused by large ce?rebral artery occlusion.
9.Angiographic features and clinical significance of kinking of extracranial internal carotid artery
Yingguang ZHANG ; Jixiang ZHU ; Guifu LI ; Xiaoxin BAI ; Wenyan ZHU ; Shengping HUANG ; Tielin LI ; Hao LIN ; Wangchi LUO
Chinese Journal of Radiology 2009;43(2):181-184
Objective To investigate the clinical manifestations, angiographic features and clinical significance of kinking of extracranial internal carotid artery (ICA). Methods The clinical and radiological data of 21 patients with kinking of extracranial ICA were retrospectively reviewed in our hospital from April 2003 to July 2007. Fisher exact test was performed. Results Of the 21 patients, 7 hod no clinical symptoms, the other 14 showed manifestations of cerebral iachemia with varying degree. One of the characteristic clinical manifestations that neck rotation or specific positions of head and neck might induce the occurrence of clinical symptoms was found in 5 cases. The whole-brain coverage DSA accurately showed the location of kinking of extracranial ICA and the degree of vascular stenosis. In patients with α < 66%, 80% > α≥ 66% and α≥ 80%, clinical symptoms were found in 3 out of 5,7 out of 10 and 4 out of 6 patients, respectively. Fisher exact test revealed that the positive rates of clinical symptoms in three groups had no significant difference (P > 0. 05). Conclusion Kinking of extracranial ICA is a frequent vascular morphologic variation, and it is also a kind of potential disease. The whole-brain coverage DSA is a relatively reliable method to detect this variation.
10.The clinical observation of local intraarterial thrombolysis in acute ischemic stroke of the anterior circulation
Xiaoxin BAI ; Shengping HUANG ; Tielin LI ; Hao LIN ; Wangchi LUO ; Xuelian LI ; Wenyan ZHU ; Yefeng CAI ; Yan HUANG
Clinical Medicine of China 2008;24(12):1210-1213
Objective To evaluate the short-term outcome of local intraarterial thrombolysis in patients with acute ischemic stroke of the anterior circulation. Methods 24 patients with acute ischemic stroke of the anterior cir-culation within 8 hours were treated by local intraarterial thrombolysis. Arterial recanalization was divided into total, partial and occlusive respectively according to angiography. Evaluation of clinical outcome was performed on the 30th day after thrombolysis,and was classified as good for Modified Rankin Scale (MRS) scores of 0 to Ⅲ and poor for MRS scores of Ⅳ to Ⅵ. Results Total recanalization was obtained in 54.2 % of patients, partial recanalization in 25.0%. Clinical outcome was good in 15 patients (62.5%). Cerebral hemorrhage occurred in 4 patients (16.7%). Four patients died (16.7%). Conclusion Local intraarterial thrombolysis is an effective method for treatment of a-cute iachemic stroke of the anterior circulation. It needs further practice and long-term follow-up study on safety and long-term efficacy.

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