Surgical site infections are the common healthcare-associated infections. This article introduced the guidelines on the prevention and control of surgical site infection in using from background, making progress, and recommendations, to give directions for clinicians and infection prevention and control professionals choosing appropriately for decreasing surgical site infection risks.
It has been certificated that hip and knee arthroplasty can improve quality of life and relieving pain and discomfort for ageing population and patients with muscloskeletal disorders. However, the outcomes of prosthetic joint infections (PJI) after arthroplasty usually are disastrous. The incidence of PJI is lower, but the number of this population is huge, which makes the strong impacts on quality of life for patients and healthcare economics. This review discusses the prevention strategies of PJI based on clinical epidemiology, diagnostic definition, pathogenesis, microbiology and risk factors, combined with some guidelines for prevention surgical site infections published recently.
This paper expounds the classification and characteristics of healthcare-associated infections (HAI) surveillance systems from the perspective of the informatization needs of HAI monitoring, explains the determination requirements of numerator and denominator in the surveillance statistical data, and introduces the regular verification for auditing the quality of HAI surveillance. The basic knowledge of machine learning and its achievements are introduced in processing surveillance data as well. Machine learning may become the mainstream algorithm of HAI automatic monitoring system in the future. Infection control professionals should learn relevant knowledge, cooperate with computer engineers and data analysts to establish more effective, reasonable and accurate monitoring systems, and improve the outcomes of HAI prevention and control in medical institutions.
Cardiac implantable electronic device (CIED) is commonly used to treat arrhythmias. The amount of CIED implantation has increased year by year since its first application in 1958. At the same time, the CIED infection rate also increases significantly. Although the infection rate is very low for the primary implantation, the consequences of CIED infection are serious, and it is often necessary to remove the equipment for treatment. The mortality rate in patients with CIED infections is high, and the economic burden is huge. In this paper, the epidemiology, pathogenesis and pathogen, manifestations and diagnosis, risk factors, treatment and preventive measures of CIED infection were systematically described based on the recently published guidelines and international consensus literature, so as to provide theoretical guidance for the prevention of CIED infections.
Antimicrobial stewardship (AMS) is an important means to control bacterial resistance. The unique situation of intensive care unit (ICU) poses a challenge to AMS. This article reviews the literature on AMS in the ICU at home and abroad in recent years, and summarizes the related measures of AMS. Effective AMS measures in the ICU include setting up a multidisciplinary AMS team, using rapid microbial diagnosis technology to shorten the time of diagnosis, using non-culture methods to assess the necessity of antimicrobial therapy for patients with suspected sepsis, and evaluating the effectiveness of antimicrobial therapy as early as possible and optimizing it. These initiatives aim to increase the rational use of antimicrobials in ICU, reduce the risk of multidrug-resistant infections, and improve patients’ condition.
Endoscopic retrograde cholangiopancreatography is one of the main methods for the diagnosis and treatment of biliary tract and pancreatic diseases. Compared with other digestive endoscopes, duodenoscopy has a special structure. Since the outbreaks of nosocomial infections caused by the transmission of multidrug-resistant organism through duodenoscopy in 2010, the reprocessing and design of digestive endoscopes represented by duodenoscopy have faced new challenges. This article reviews the international advances in duodenoscopy reprocessing in the past 10 years including the structural characteristics of duodenoscope, related infection outbreak cases, outbreak control measures, and the use of disposable duodenoscopy, so as to provide guidance and reference for the duodenoscopy reprocessing and related nosocomial infections prevention and control work in China.
ObjectiveTo establish a predictive model of surgical site infection (SSI) following colorectal surgery using machine learning.MethodsMachine learning algorithm was used to analyze and model with the colorectal data set from Duke Infection Control Outreach Network Surveillance Network. The whole data set was divided into two parts, with 80% as the training data set and 20% as the testing data set. In order to improve the training effect, the whole data set was divided into two parts again, with 90% as the training data set and 10% as the testing data set. The predictive result of the model was compared with the actual infected cases, and the sensitivity, specificity, positive predictive value, and negative predictive value of the model were calculated, the area under receiver operating characteristic (ROC) curve was used to evaluate the predictive capacity of the model, odds ratio (OR) was calculated to tested the validity of evaluation with a significance level of 0.05.ResultsThere were 7 285 patients in the whole data set registered from January 15th, 2015 to June 16th, 2016, among whom 234 were SSI cases, with an incidence of SSI of 3.21%. The predictive model was established by random forest algorithm, which was trained by 90% of the whole data set and tested by 10% of that. The sensitivity, specificity, positive predictive value, and negative predictive value of the model were 76.9%, 59.2%, 3.3%, and 99.3%, respectively, and the area under ROC curve was 0.767 [OR=4.84, 95% confidence interval (1.32, 17.74), P=0.02].ConclusionThe predictive model of SSI following colorectal surgery established by random forest algorithm has the potential to realize semi-automatic monitoring of SSIs, but more data training should be needed to improve the predictive capacity of the model before clinical application.
Objective To explore the influencing factors of medical staff’s preventive behaviors of occupational exposure using health belief model. Methods A questionnaire was used to investigate the health beliefs and prevention-related behaviors of medical staff in Shuguang Hospital Affilliated to Shanghai University of Traditional Chinese Medicine from July 2018 to June 2019. The preventive behaviors and health beliefs of health workers with different occupational categories and working years were analyzed descriptively, and the influence of health beliefs on preventive behaviors was analyzed with multiple linear regression. Results There were 400 copies of questionnaire dispatched and 384 recovered. Among the survey respondents, 258 (67.19%) were females, 169 (44.01%) were aged 20-30 years, and 203 (52.86%) had worked for 5 or less years; 158 (41.15%) had sharp injury experience, 171 (44.53%) had experience of exposure to blood or body fluids, and 290 (75.52%) were actively immunized by injecting vaccines. The total score of compliance with standard preventive behaviors of the 384 respondents was 6.94±3.12. The scores of perceived susceptibility, perceived severity, perceived barriers, perceived benefits, and perceived self-efficacy were 24.87±4.56, 31.27±5.92, 16.50±5.77, 36.06±5.60, and 15.27±2.98, respectively. The total score of health beliefs was 123.97±15.91. The compliance with standard preventive behaviors and total score of health beliefs of logistics staff were lower than those of other respondents (P<0.05). The scores of perceived barriers of medical technicians and clinicians were significantly higher than that of nurses (P<0.05). The scores of perceived benefits and perceived self-efficacy of clinicians were lower than those of nurses (P<0.05). Respondents who had worked for 6-10 years had better compliance with standard preventive behaviors than interns and the ones who had worked for 11-15 years (P<0.05), and had a lower total score of health beliefs than the ones who had worked for over 16 years (P<0.05). Respondents who had worked for over 16 years had better scores of perceived benefits and perceived self-efficacy (P<0.05), and had a lower score of perceived barriers (P<0.05). The results of multiple linear regression analysis showed that gender [nonstandardized partial regression coefficient (b)=–0.644, 95% confidence interval (CI) (–1.162, –0.125), P=0.015], educational background [b=1.367, 95%CI (1.245, 1.587), P<0.001], and score of perceived barriers [b=0.044, 95%CI (0.004, 0.084), P=0.031] were influencing factors of medical staff’s preventive behavior compliance. Conclusions The score of perceived barriers is a main factor that prevents medical staff from implementing standard preventive measures. In the occupational exposure training program, it may be effective to help medical staff establish good standard prevention habits by improving the awareness of obstacles.
Objective To provide theoretical basis for the reasonable selection of personal protective equipment by analyzing the willingness of protection and the contamination of severe acute respiratory syndrome coronavirus 2 of medical staff in the designated hospital for treatment of coronavirus disease 2019. Methods The medical staff of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine who entered the contaminated area from May 1 to 31, 2022 were collected as the study subjects. A simple random sampling method was adopted to investigate the willingness of protection of different medical staff leaving the cabin. Contamination of severe acute respiratory syndrome coronavirus2 was detected by fluorescence polymerase chain reaction. Results A total of 70 medical staff were included. There were 61 nurses and 38 in intensive care unit. The survey showed that 47 medical staff chose disposable isolation clothes, 44 medical staff chose protective face screen and 69 medical staff chose double-layer shoe cover/boot cover. A total of 640 specimens were collected. Six positive samples for severe acute respiratory syndrome coronavirus2 nucleic acid test were detected, with a positive rate of 0.94%. All the positive samples were sampled from the sole of a protective clothing. Six positive samples were willing to choose double-layer shoe cover/boot cover. Conclusions The medical staff in designated hospital for treatment of coronavirus disease 2019 tend to take high protection during daily medical activities. However, personal protective equipment is less likely to be contaminated by severe acute respiratory syndrome coronavirus2, and it should be selected rationally to avoid excessive protection.