Objective:To construct a dynamic competency assessment system suitable for standardized training of resident physicians in the department of pediatric infectious diseases, verify its teaching practice effectiveness, and enhance the core competence of specialist physicians.Methods:Based on the Delphi method, an evaluation system was constructed. Through two rounds of expert consultation ( n=20, authority coefficient Cr=0.889-0.895), 5 primary indicators, 13 secondary indicators, and 38 tertiary indicators were established, covering dimensions such as clinical thinking, operational skills, and professional ethics. The hierarchical and progressive design and dynamic feedback mechanism were adopted. Sixty residents were randomly divide into an observation group (dynamic evaluation system) and a control group (traditional evaluation). Differences between the two groups were compared in terms of short-term teaching effectiveness (e.g., OSCE assessment and Mini CEX score) and long-term clinical competencies (e.g., exit assessment pass rate and incidence of adverse events). SPSS 24.0 was used for t-test, Mann Whitney U test, and internal consistency test (Cronbach's alpha=0.89). Results:The observation group outperformed the control group in core specialty competencies and clinical practice outcomes. In terms of core specialty competencies, the observation group had a higher response speed score for pathogen results [(4.10±0.84) vs. (3.60±0.95), P=0.042]. This indicates that the dynamic evaluation system effectively enhanced the ability of trained physicians to quickly adjust treatment plans based on pathogenic evidence. The implementation rate of infection prevention and control standards and diagnostic accuracy were also higher in the observation group compared to the control group, reflecting the advantages of this system in standardizing clinical operations and improving diagnostic levels. In terms of long-term clinical competencies, the observation group showed significantly increased exit assessment pass rate and significantly decreased incidence of medical adverse events, further verifying the continuous promotion effect of the dynamic evaluation system on the clinical competence of trained physicians. Conclusions:The dynamic evaluation system constructed in this study can effectively enhance the core specialty competencies (e.g., pathogen response and infection prevention and control) and long-term clinical competence of residents in the department of pediatric infectious diseases, providing scientific basis for optimizing the training models of specialist physicians.

Objective:To explore the clinical characteristics and serogroup distribution of meningococcal meningitis.Methods:This study was a case series summary of the demographic data, laboratory results, vaccination history, clinical diagnoses,treatment and prognosis of 16 children with meningococcal meningitis who were hospitalized in Department of Infectious Diseases, Hunan Children′s Hospital from April 2014 to March 2024. According to ages, these patients were divided into infants and toddlers (≤3 years) and school-aged children (6-15 years) groups. Between-group comparison was performed using Independent samples t-test and Mann-Whitney U test. Results:A total of 16 hospitalized patients were included, of whom 8 were male and 8 female. The age of these patients at visit was 4.25 (0.33, 12.30) years. The cases presented a sporadic distribution. There were 11 cases from rural regions, 6 patients were unvaccinated due to age restriction.All patients presented with acute onset, with neurological symptoms manifesting within 0.6 (0.5, 1.0) days, and the duration of hospitalization was 20 (12, 28) days. There were 10 typical cases and 6 fulminant cases, with fever duration ≤7 days in 7 cases. Clinical manifestations included petechiae and purpura in 8 cases, shock in 3 cases, respiratory failure in 3 cases, and disseminated intravascular coagulation in 4 cases. There were 8 cases in both the infant and toddlers group and the school-aged childrengroup, 5 cases in the infant and toddler group manifested seizures. In contrast, in the school-aged children group, 6 individuals exhibited headache, nausea, and vomiting, while 4 cases demonstrated signs of altered consciousness. The C-reactive protein level in the 16 patients was 124.5 (71.3, 212.3) mg/L, and the procalcitonin level was 26.8 (11.0, 92.8) μg/L, the normal values are 0-8.0 mg/L for C-reactive protein and 0-0.5 μg/L for procalcitonin. Compared to the school-aged children group, the infants and toddlers group showed lower white blood cell counts ((7±4)×10 9vs. (17±10)×10 9/L, t=-2.36, P=0.034). All patients tested positive for pathogens, serogroup identification revealed a diverse distribution, including 1 case each of serogroups C, W135, and X; 4 cases of serogroup B; 3 cases of serogroup Y; and 6 cases that remained ungrouped. A total of 10 strains of Neisseria meningitidis were cultured, 7 strains were resistant to sulfonamides, 5 strains to penicillin, and 3 strains to levofloxacin and ciprofloxacin. A total of 9 patients treated with meropenem, and all cases showed improvement and were discharged without any fatalities. At discharge, 1 case had profound sensorineural hearing loss, and 5 patients required rehabilitation treatment due to sequelae. Conclusions:Meningococcal meningitis predominantly affected children aged ≤3 years and 6-15 years. The white blood cell count in meningococcal meningitis patients aged ≤3 years was lower. The serogroups of Neisseria meningitidis were highly diverse, with cases of serogroups X and Y identified. Since isolated Neisseria meningitidis has shown resistance to penicillin and other antibiotics, it is crucial to be vigilant about potential antimicrobial susceptibility when clinical efficacy is poor.

Objective:To construct a dynamic competency assessment system suitable for standardized training of resident physicians in the department of pediatric infectious diseases, verify its teaching practice effectiveness, and enhance the core competence of specialist physicians.Methods:Based on the Delphi method, an evaluation system was constructed. Through two rounds of expert consultation ( n=20, authority coefficient Cr=0.889-0.895), 5 primary indicators, 13 secondary indicators, and 38 tertiary indicators were established, covering dimensions such as clinical thinking, operational skills, and professional ethics. The hierarchical and progressive design and dynamic feedback mechanism were adopted. Sixty residents were randomly divide into an observation group (dynamic evaluation system) and a control group (traditional evaluation). Differences between the two groups were compared in terms of short-term teaching effectiveness (e.g., OSCE assessment and Mini CEX score) and long-term clinical competencies (e.g., exit assessment pass rate and incidence of adverse events). SPSS 24.0 was used for t-test, Mann Whitney U test, and internal consistency test (Cronbach's alpha=0.89). Results:The observation group outperformed the control group in core specialty competencies and clinical practice outcomes. In terms of core specialty competencies, the observation group had a higher response speed score for pathogen results [(4.10±0.84) vs. (3.60±0.95), P=0.042]. This indicates that the dynamic evaluation system effectively enhanced the ability of trained physicians to quickly adjust treatment plans based on pathogenic evidence. The implementation rate of infection prevention and control standards and diagnostic accuracy were also higher in the observation group compared to the control group, reflecting the advantages of this system in standardizing clinical operations and improving diagnostic levels. In terms of long-term clinical competencies, the observation group showed significantly increased exit assessment pass rate and significantly decreased incidence of medical adverse events, further verifying the continuous promotion effect of the dynamic evaluation system on the clinical competence of trained physicians. Conclusions:The dynamic evaluation system constructed in this study can effectively enhance the core specialty competencies (e.g., pathogen response and infection prevention and control) and long-term clinical competence of residents in the department of pediatric infectious diseases, providing scientific basis for optimizing the training models of specialist physicians.

Objective:To explore the clinical characteristics and serogroup distribution of meningococcal meningitis.Methods:This study was a case series summary of the demographic data, laboratory results, vaccination history, clinical diagnoses,treatment and prognosis of 16 children with meningococcal meningitis who were hospitalized in Department of Infectious Diseases, Hunan Children′s Hospital from April 2014 to March 2024. According to ages, these patients were divided into infants and toddlers (≤3 years) and school-aged children (6-15 years) groups. Between-group comparison was performed using Independent samples t-test and Mann-Whitney U test. Results:A total of 16 hospitalized patients were included, of whom 8 were male and 8 female. The age of these patients at visit was 4.25 (0.33, 12.30) years. The cases presented a sporadic distribution. There were 11 cases from rural regions, 6 patients were unvaccinated due to age restriction.All patients presented with acute onset, with neurological symptoms manifesting within 0.6 (0.5, 1.0) days, and the duration of hospitalization was 20 (12, 28) days. There were 10 typical cases and 6 fulminant cases, with fever duration ≤7 days in 7 cases. Clinical manifestations included petechiae and purpura in 8 cases, shock in 3 cases, respiratory failure in 3 cases, and disseminated intravascular coagulation in 4 cases. There were 8 cases in both the infant and toddlers group and the school-aged childrengroup, 5 cases in the infant and toddler group manifested seizures. In contrast, in the school-aged children group, 6 individuals exhibited headache, nausea, and vomiting, while 4 cases demonstrated signs of altered consciousness. The C-reactive protein level in the 16 patients was 124.5 (71.3, 212.3) mg/L, and the procalcitonin level was 26.8 (11.0, 92.8) μg/L, the normal values are 0-8.0 mg/L for C-reactive protein and 0-0.5 μg/L for procalcitonin. Compared to the school-aged children group, the infants and toddlers group showed lower white blood cell counts ((7±4)×10 9vs. (17±10)×10 9/L, t=-2.36, P=0.034). All patients tested positive for pathogens, serogroup identification revealed a diverse distribution, including 1 case each of serogroups C, W135, and X; 4 cases of serogroup B; 3 cases of serogroup Y; and 6 cases that remained ungrouped. A total of 10 strains of Neisseria meningitidis were cultured, 7 strains were resistant to sulfonamides, 5 strains to penicillin, and 3 strains to levofloxacin and ciprofloxacin. A total of 9 patients treated with meropenem, and all cases showed improvement and were discharged without any fatalities. At discharge, 1 case had profound sensorineural hearing loss, and 5 patients required rehabilitation treatment due to sequelae. Conclusions:Meningococcal meningitis predominantly affected children aged ≤3 years and 6-15 years. The white blood cell count in meningococcal meningitis patients aged ≤3 years was lower. The serogroups of Neisseria meningitidis were highly diverse, with cases of serogroups X and Y identified. Since isolated Neisseria meningitidis has shown resistance to penicillin and other antibiotics, it is crucial to be vigilant about potential antimicrobial susceptibility when clinical efficacy is poor.