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Prevention and Control Strategies of nosocomial infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

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Advances in Infectious Diseases 2024年第1期14卷 233-247页

作者： Minfang Wang Wenyi Ye Zhe Han Lu Yang Dawei Huang Xuxia Yu Yuexian Zhu Shuangying Huang Ying Yang Tieer Gan Department of Hospital infection Control The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China Medical Department The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China Logistics Department The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China Outpatient Department The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China Nursing Department The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China State Key Laboratory for Diagnosis and Treatment of Infectious Diseases The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

关键词： Corona Virus Disease 2019 nosocomial infection Prevention and Control Strategy Effectiveness Evaluation

Is every microorganism detected in the intensive care unit a nosocomial infection?Isn’t prevention more important than detection?

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World Journal of Clinical Cases 2022年第20期10卷 7184-7186页

作者： Fatma Yildirim Irem Karaman Mehmet Yildirim Department of Pulmonary Disease and Critical Care Medicine Pulmonary Intensive Care UnitUniversity of Health SciencesDışkapıYıldırım Beyazıt Training and Research HospitalAnkara 06110Turkey School of Medicine Bahcesehir UniversityIstanbul 34740Turkey Department of Internal Medicine Internal Medicine Intensive Care UnitUniversity of Health SciencesDışkapıYıldırım Beyazıt Training and Research HospitalAnkara 06110Turkey

The present letter to the editor is related to the study entitled“Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors.”Not every microorganism grown in samples taken from critically ill patients can be considered as an infectious *** and adequate information about nosocomial infections is essential in introducing effective prevention programs in ***,the development and implementation of care bundles for frequently used medical devices and invasive treatment devices(e.g.,intravenous catheters and invasive ventilation),adequate staffing not only for physicians,nurses,and other medical staff but also for housekeeping staff,and infection surveillance and motivational feedback are key points of infection prevention in the intensive care unit.

关键词： Critical care Prevention Intensive care unit nosocomial infection Detection

nosocomial infection control in healthcare settings: Protection against emerging infectious diseases

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Infectious Diseases of Poverty 2016年第1期5卷 266-268页

作者： Chuanxi Fu Shengyong Wang Guangzhou Center for Disease Control and Prevention Guangzhou 510440China Medical College Jinan UniversityGuangzhou 510632China

The Middle East respiratory syndrome(MERS)outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures *** infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV *** control in healthcare settings,in which patients with emerging infectious diseases such as MERS,Ebola virus disease,and the severe acute respiratory syndrome(SARS)are diagnosed and treated,are often *** it comes to emerging or unknown infectious diseases,before the imported case was finally identified or community transmission was reported,cases have often occurred in clusters in healthcare *** infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

关键词： Middle East respiratory syndrome(MERS) nosocomial infection Severe acute respiratory syndrome(SARS)

Application of Human Adenovirus Genotyping by Phylogenetic Analysis in an Outbreak to Identify nosocomial infection

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Virologica Sinica 2021年第3期36卷 393-401页

作者： Chuanyu Yang Chunmei Zhu Yuan Qian Jie Deng Baoyuan Zhang Runan Zhu Fang Wang Yu Sun Dongmei Chen Qi Guo Yutong Zhou Lei Yu Ling Cao Linqing Zhao Laboratory of Virology Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijing 100020China Department of Respiratory Medicine Affiliated Children's HospitalCapital Institute of PediatricsBeijing 100020China Hospital infection-Control Department Affiliated Children’s HospitalCapital Institute of PediatricsBeijing 100020China

nosocomial infections are common in pediatric patients and can be fatal in infants and immunocompromised patients. In September 2018, a high positive rate of human adenovirus HAdV was occurred among hospitalized children in the Children's Hospital Affiliated to the Capital Institute of Paediatrics in Beijing. To investigate whether this outbreak of HAdV was related to nosocomial infections or the result of community infections, we collected respiratory specimens from patients with acute respiratory infections in a respiratory ward during June to December 2018, and screened for respiratory viruses. Among 1,840 cases included, 95(5.2%, 95/1840) were positive for HAdV and 81 were genotyped based on phylogenetic analysis, including seven as HAdV-1(8.6%), 30 HAdV-3(37.0%), two HAdV-6(2.5%), and 42 HAdV-7(51.9%). More HAdV-positive samples were collected in August(4.7%, 12/255), September(15.0%, 41/274) and October(6.9%, 17/247), with a peak in September 2018. By combining the results of HAdV phylogenetic analysis with clinical data of patients, there were 77 cases(4.2%, 77/1840;81.1%, 77/95) excluded from nosocomial infections, eight cases representing possible infections transmitted by visitors or attending parents, three cases without sequences that might have been due to infection transmitted by roommates positive for HAdV, one case of a roommate without an HAdV sequence, and six cases that shared highly homologous sequences with those of their roommates, for which nosocomial infections might be considered. In conclusion, genotyping of HAdVs based on phylogenetic analysis combined with clinical information provides a powerful method to distinguish nosocomial infections from community acquired infection, especially when tracing the origins of nosocomial infections.

关键词： Acute respiratory tract infection Human adenovirus(HAdV) Phylogenetic analysis nosocomial infection

Pantoea SPP: A New nosocomial infection in the Neonatal Intensive Care Unit

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Open Journal of Pediatrics 2023年第2期13卷 181-188页

作者： Soraya Hani Fatima Ezzahra Tahiri Abdessamad Lalaoui Fatiha Bennaoui Nabila Soraa Nadia El Idrissi Slitine Fadl Mrabih Rabou Maoulainine Neonatal Resuscitation Service Mother and Child Hospital Mohamed VI University Hospital Marrakech Morocco Laboratory of Childhood Health and Development Faculty of Medicine and Pharmacy of Marrakech Cadi Ayyad University Marrakech Morocco Microbiology Laboratory Arrazi Hospital Mohammed VI University Hospital Marrakech Morocco

Pantoea SPP is a gram-negative bacillus, which usually colonizes plants, soil and water. This pathogen very rarely causes neonatal sepsis. The most common infections caused by Pantoea SPP are septic arthritis or synovitis, meningitis frequently complicated by brain abscess, upper respiratory infections, and peritonitis. We present the case of a premature infant who presented neonatal respiratory distress and whose evolution was complicated by the occurrence of a nosocomial infection for which a blood culture was performed isolating the germ Pantoea SPP. The patient’s management was initially centered on non-invasive ventilation with antibiotherapy based on carbapenem and aminoglycoside. Due to the clinical and biological worsening, the neonate was intubated and sedated and put on colymicin. The evolution was unfavorable marked by a death at 16th days of life. Considering the high pathogenicity of this germ and its multi-resistance to antibiotics, it is crucial to know the clinical spectrum of Panteoa SPP infections in neonatal intensive care units, in order to palliate the fulminant evolution of multifocal attacks due to this germ.

关键词： Newborn Premature nosocomial infection Pantoea SPP Neonatal Resuscitation Antibiotic Therapy

Research and Development of Butterfly Microfluidic Gene Chip for 19 Common Pathogenic Microorganisms of nosocomial infection

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Journal of Clinical and Nursing Research 2022年第1期6卷 80-85页

作者： Jingjing Yu Xu Zhang Jinhai Tian Rong Ma Qi Huang Jia Cao Jia Wang Libin Wang The General Hospital of Ningxia Medical University Department of Beijing National Biochip Research Center sub-center in NingxiaYinchuan 750004Ningxia Hui Autonomous RegionChina

Based on butterfly microfluidic gene chip technology,a method for rapid,accurate and efficient detection of 19 common pathogenic microorganisms of nosocomial infection was established,and a butterfly microfluidic gene chip with high-throughput detection was designed and *** constant temperature amplification technology,using the polymerase with chain replacement function to react at constant temperature(65℃)and combined with microfluidic chip technology,primers were designed according to the target genes of 19 pathogenic microorganisms,and a butterfly microfluidic gene chip which can detect 19 common pathogenic microorganisms of nosocomial infection was made to simplify the inspection operation process and verify the sensitivity of the *** butterfly microfluidic gene chip can be used for the rapid and efficient detection of 19 common pathogenic microorganisms of nosocomial infection,and provides a new idea for the detection and auxiliary diagnosis of pathogenic microorganisms of nosocomial infection.

关键词： nosocomial infection Butterfly microfluidic gene chip High throughput

Morbidity and Mortality of nosocomial infection after Cardiovascular Surgery： A Report of 1606 Cases

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Current Medical Science 2018年第2期38卷 329-335页

作者： Wan-li JIANG Xiao-ping HU Zhi-peng HU Zheng TANG Hong-bing WU Liang-hao CHEN Zhi-wei WANG Ying-an JIANG Department of Cardiovascular Surgery Renmin Hospital of Wuhan UniversityWuhan 430060 China Department of Infectious Diseases Renmin Hospital of Wuhan UniversityWuhan 430060 China

nosocomial infection （NI） is one of the most significant complications arising after open heart surgery, and leads to increased mortality, hospitalization time and health resource allocation. This study investigated the morbidity, mortality, and independent risk factors associated with NI following open heart surgery. We retrospectively surveyed the records of 1606 consecutive cardiovascular surgical patients to identify those that developed NI. The NI selection criteria were based on the Centers for Disease Control and Prevention （CDC） guidelines. The term NI encompasses surgical site infection （SSI）, central venous catheter-related infection （CVCRI）, urinary tract infection （UTI）, respiratory tract infection and pneumonia （RTIP）, as well as other types of infections. Of 1606 cardiovascular surgery patients, 125 developed NI （7.8%, 125/1606）. The rates of NI following surgery for congenital malformation, valve replacement, and coronary artery bypass graft were 2.6% （15/587）, 5.5% （26/473） and 13.6% （32/236）, respectively. The NI rate following surgical repair of aortic aneurysm or dissection was 16.8% （52/310）. Increased risk of NI was detected for patients with a prior preoperative stay 〉3 days （OR=2.11, 95% CI=1.39-3.20）, diabetes （OR=2.00, 95%=CI 1.26-3.20）, length of surgery 〉6 h （OR=2.26, 95% CI=1.47-3.47）, or postoperative cerebrovascular accident （OR=4.08, 95% CI=1.79-9.29）. Greater attention should be paid toward compliance with ventilator and catheter regulations in order to decrease NI morbidity and mortality following cardiovascular procedures.

关键词： nosocomial infection cardiovascular surgery morbidity mortality

Development of a questionnaire assessing nursing staff’s knowledge,attitude,and practice on the prevention of the nosocomial infection in elderly patients:testing reliability and validity

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Frontiers of Nursing 2021年第2期8卷 141-151页

作者： Fu-Lin Cai Xiu-Feng Chen Yong-Xin Wang Nursing Department The First Affiliated Hospital of Anhui University of Science and Technology(Huainan First People’s Hospital)HuainanAnhui 232007China Department of Postgraduates Bengbu Medical CollegeBengbuAnhui 233030China

Objective:To develop a questionnaire assessing nursing staff’s knowledge,attitude,and practice on the prevention of the nosocomial infection in elderly patients and test its reliability and ***:After the drafted questionnaire was developed,two rounds of Delphi survey were conducted by consulting experts to improve the ***,700 copies of the questionnaire were distributed to nursing staff to assess its reliability and ***:Exploratory factor analysis(EFA)identifies 3 aspects,namely knowledge,attitude,and practice,with a total of 38 *** Cronbach’s a coefficients of the questionnaire and each of the aspects are 0.85,0.80,0.886,and 0.77(>0.7),*** factor analysis(CFA)of each of the aspects are c2/df=3.99,2.26,and 3.32;Goodness-of-fit index(GFI)=0.91,0.97,and 0.92;Root mean square error of approximation(RMSEA)=0.06,0.04,and 0.05;Comparative fit index(CFI)=0.91,0.96,and ***:Through this study,it can be ascertained whether the developed questionnaire enjoys sound reliability and validity in assessing nursing staff’s knowledge,attitude,and practice on preventing the nosocomial infection in elderly patients and thus has certain application value.

关键词： nurse Delphi method elderly patient nosocomial infection questionnaire

Analysis on Risk Factors of nosocomial infection in Orthopedic Patients and Research on Nursing Strategies

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国际感染病学（电子版） 2016年第1期5卷 27-30页

作者： Zhitao Guo Department of Emergency Medicine Tianjin Xiqing Hospital

Orthopedic patients mostly comprise traumatic patients and elderly or sick individuals. More patients with emergency surgery suffer from open wounds and serious pollution, and operation time is relatively long. Thus, orthopedic patients with surgical incision infection account for a large proportion of incidence of hospital infection. Orthopedic patients are also bedridden for long periods, and they receive poor bone tissue blood supply. In surgical incision infections, mild cases suffer from delayed wound healing, whereas severe cases can form osteomyelitis. This study reviews progress of research on risk factors of nosocomial infection among orthopedic patients in recent years.

关键词： orthopedic patients trauma nosocomial infection