Objective To study the risk factors and strain resistance of Escherichia coli with extended-spectrum β-lactamases(ESBL)-producing bloodstream infection,so as to provide clinical basis for rational use of antibiotics and effective prevention and control of bloodstream infection.Methods The clinical data of patients with bloodstream infections caused by Escherichia coli in a tertiary hospital in Chongqing from January 2018 to December 2022 were retrospectively collected.The clinical characteristics and drug resistance of bloodstream infections caused by Escherichia coli were statistically analysed.According to the ESBL confirmation test of Escherichia coli strains,the patients were divided into the ESBL-producing group and the non-ESBL-producing group.The chi-square test was used to compare the differences in influencing factors between the two groups,and then the independent influencing factors of ESBL production were analyzed through multivariate Logistic regression.Results A total of 408 patients were included.The detection rate of ESBL-producing strains was 60.3％(246/408),and the detection rates in the nephrology department and the intensive care unit were relatively high(both＞76.0％).Diabetes[OR=1.98,95％CI(1.24,3.17)]and urinary tract intubation[OR=1.60,95％CI(1.02,2.51)]were independent influencing factors for bloodstream infection with ESBL-producing Escherichia coli.The resistance rate of ESBL-producing Escherichia coli to levofloxacin and ceftriaxone was＞90.0％.Moreover,the resistance rates of the second-generation cephalosporins(except ceftazidime),compound sulfamethoxazole,ciprofloxacin and amtronam were significantly higher than those in the non-ESBL-producing group(P＜0.05).Both groups of strains showed high sensitivity to amikacin and carbapenem drugs.Conclusion The severe current situation of bloodstream infections caused by ESBL-producing Escherichia coli in this region showing a high prevalence of drug resistance characteristics.Diabetes and urinary tract intubation,as independent risk factors,suggest that key monitoring should be implemented for such high-risk populations in clinical practice.Given that ESBL-producing strains remain sensitive to carbapenems and amikacin,it can be recommended as the first empirical medication.It is of great public health significance to achieve the effect of curbing the spread of such multi-drug resistant bacteria by establishing an early warning system based on risk factor assessment and standardized management of invasive operations.

Objective To study the risk factors and strain resistance of Escherichia coli with extended-spectrum β-lactamases(ESBL)-producing bloodstream infection,so as to provide clinical basis for rational use of antibiotics and effective prevention and control of bloodstream infection.Methods The clinical data of patients with bloodstream infections caused by Escherichia coli in a tertiary hospital in Chongqing from January 2018 to December 2022 were retrospectively collected.The clinical characteristics and drug resistance of bloodstream infections caused by Escherichia coli were statistically analysed.According to the ESBL confirmation test of Escherichia coli strains,the patients were divided into the ESBL-producing group and the non-ESBL-producing group.The chi-square test was used to compare the differences in influencing factors between the two groups,and then the independent influencing factors of ESBL production were analyzed through multivariate Logistic regression.Results A total of 408 patients were included.The detection rate of ESBL-producing strains was 60.3％(246/408),and the detection rates in the nephrology department and the intensive care unit were relatively high(both＞76.0％).Diabetes[OR=1.98,95％CI(1.24,3.17)]and urinary tract intubation[OR=1.60,95％CI(1.02,2.51)]were independent influencing factors for bloodstream infection with ESBL-producing Escherichia coli.The resistance rate of ESBL-producing Escherichia coli to levofloxacin and ceftriaxone was＞90.0％.Moreover,the resistance rates of the second-generation cephalosporins(except ceftazidime),compound sulfamethoxazole,ciprofloxacin and amtronam were significantly higher than those in the non-ESBL-producing group(P＜0.05).Both groups of strains showed high sensitivity to amikacin and carbapenem drugs.Conclusion The severe current situation of bloodstream infections caused by ESBL-producing Escherichia coli in this region showing a high prevalence of drug resistance characteristics.Diabetes and urinary tract intubation,as independent risk factors,suggest that key monitoring should be implemented for such high-risk populations in clinical practice.Given that ESBL-producing strains remain sensitive to carbapenems and amikacin,it can be recommended as the first empirical medication.It is of great public health significance to achieve the effect of curbing the spread of such multi-drug resistant bacteria by establishing an early warning system based on risk factor assessment and standardized management of invasive operations.

Objective By analyzing the characteristics of PI system in the US,especially its advantages,to learn the ways and means in the cultivation of postgraduates' innovative ability.Combined with the current situation of medical postgraduate training in China,some countermeasures in line with the actual situation of our country and the cultivation characteristics of medical graduate students' innovative ability were proposed.Methods Conducting literature review by using the CNKI and logging on to the official website of relevant agencies to collect and summarize related research data.Results Concrete suggestions from four aspects were proposed:Encourage medical graduate students to participate in scientific and technological research,well-planning of scientific research resources,optimizing and perfecting the mentor-mentee system and constructing a reasonable mechanism for achievement distribution.Conclusions The PI system in American scientific research field can be used for reference in the form and content of cultivating the innovative ability of medical postgraduates in China.

Objective To investigate hand hygiene(HH) status among health care workers(HCWs) in municipal hospitals in Chongqing City, and provide the basis for making effective HH management strategies.Methods In April-June 2016, HH status among 111 HCWs in 24 municipal hospitals of this city were investigated through questionnaire survey, on-site observation, and hand surface sampling.Results All surveyed departments are installed special hand washing facilities, all surveyed HCWs were performed HH through hand-washing by running water.The proportion of HCWs' hand-washing by disinfectant was higher than six-step hand washing (73.87% [n=82] vs 37.84%[n=42], χ2=29.23, P<0.01);the implementation rate of HH before touching patient was higher than that after touching patients (99.10%[n=110] vs 89.19%[n=99], χ2=9.88, P<0.01).During the process of diagnosis and treatment activities, the maximal total number of bacteria on the surface of hand before and after HH were 475 CFU/cm2 and 85 CFU/cm2 respectively, hand surface colony count after HH was higher than before HH(P<0.01).Age, gender, department, and occupation are important factors influencing HH.The total number of bacteria on hand surface of nurses was higher than non-nurse HCWs, the total number of bacteria on hand surface of female, nurses, and HCWs in class I environment were all higher than male, non-nurse HCWs and HCWs in other types of environment, there were significant difference among the groups (all P<0.05).Qualified rates of HH of each group improved after hand washing, the total number of bacterial colony on hands of HCWs all decreased.Conclusion Hand washing facilities and HH efficacy are good in Chongqing municipal hospitals, however,HH compliance needs to be improved among HCWs aged≥35 years,male HCWs, HCWs in class III and IV environmental departments, as well as non-nurse HCWs.