Objective To establish a detection method of high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS) for 12 sulfonamide drugs in disinfectant cream products. Methods High performance LC-MS/MS method was used to establish a detection method for sulfonamide drugs in disinfectant cream products. Results A total of 37 commercially available disinfectant cream products were tested, and 11 out of 12 target substances had matrix effect (ME) values ranging from 0.8 to 1.2, indicating a relatively small impact of ME. The linear relationship of 12 sulfonamide drugs was good within the range of 0.5-100 μg/L (r>0.999), with a detection limit of 0.000 25-0.016 mg/kg and a quantification limit of 0.000 50-0.054 mg/kg. The average recovery rate was 70.6％-130％, and the relative standard deviation (RSD) was 1.8％-8.6％. Conclusion The method established in this study is simple, rapid, and highly sensitive, and is suitable for the simultaneous determination of 12 sulfonamide drugs in disinfectant cream products.
Objective To optimize the preparation process of Cangai tincture using Box-Behnken response surface methodology. Methods Taking the extraction rate of Atractylodes macrocephala as the evaluation index, based on single factor experiments, ethanol concentration, solid-liquid ratio, and extraction time were selected as influencing factors. Box Behnken response surface methodology was used to optimize the extraction process parameters, and a quadratic polynomial regression model was established to verify the reliability of the experimental evaluation model. Results The optimal extraction process conditions for Cangai Tincture were: ethanol concentration of 95％, solid-liquid ratio of 1:20 (g/mL), and extraction time of 5 d. Under these optimized conditions, the relative deviation between the measured and model predicted extraction rates of Atractylodes macrocephala was less than 5％. Conclusion The mathematical model established by Box Behnken response surface methodology can effectively optimize the extraction process of Cangai Tincture. After optimization, the process is stable, feasible, and has good reproducibility, which can provide experimental basis for the development of Cangai Tincture formulations and potential disinfection applications.
Objective To investigate the effects of different cleaning and disinfection methods on the cleaning and disinfection efficacy and structural properties of medical fabrics. Methods Fabrics were divided into control group and experimental group. Two different cleaning and disinfection methods of high-temperature washing with alkaline laundry detergent and low-temperature washing with a new type of detergent and quaternary ammonium salt disinfectant were applied, and samples were collected for testing. After a specific number of washing cycles according to the above two methods, changes in fabric fibers were observed under scanning electron microscopy. Results There was no statistically significant difference in bacterial colony counts between the control and experimental groups before washing for surgical gowns, surgical drapes, and patient bed sheets. After washing, the microbial test results of both groups for surgical gowns and surgical drapes met the requirements of the specification; the colony count in the experimental group was significantly lower than that in the control group (t=2.827, P=0.008), and the microbial reduction rate in the experimental group was higher than that in the control group (t=-2.578, P=0.014). For patient bed sheets after washing, both groups met the specification requirements; the colony count in the experimental group was significantly lower than that in the control group (t=2.587, P=0.012), while there was no significant difference in the microbial reduction rate between the two groups (t=-1.961, P=0.053). The fabric structure influence experiment showed that the fabrics in the control group exhibited more severe wear and more obvious fading compared with those in the experimental group. Conclusion Under the premise of meeting the fabric hygiene indicators, the cleaning and disinfection method of the control group had a significant impact on the appearance and fabric structure of medical fabrics.
Objective To compare the disinfection effects of a new type of high-oxygen membrane air disinfection machine and a plasma air disinfection machine on the air in the intensive care unit (ICU) of a hospital. Methods Two types of air disinfection machines were placed in the same room of the ICU in different time periods. Under the conditions of unmanned state and human-machine coexistence, a six-stage sieve pore air impact sampler was used to sample the air before disinfection, 1 h and 2 h after disinfection. The killing effect of the two disinfection machines on natural bacteria in the air was compared. Results Under the conditions of unmanned state and human-machine coexistence, the average extinction rates of natural bacteria in the air after 1 h of disinfection by the high-oxygen membrane air disinfection machine were 81.91% and 75.35%, respectively. After 2 h of disinfection, the rates were 88.62% and 87.68%, respectively.They were higher than that of plasma air disinfection machine, and the differences were statistically significant (P<0.001); The number of microbial species in the air decreased 2 h after disinfection using two types of disinfection machines, but micrococcus and mucor fungi could still be detected. Conclusion As a new type of air disinfection machine, the high-oxygen membrane air disinfection machine has good disinfection effect and can be used for air disinfection in areas such as intensive care units in medical institutions.
Objective To observe the terminal disinfection effect of intensive care unit (ICU) in a hospital, and to provide a basis for the prevention and control of nosocomial infection. Methods On-site sampling and quantitative bacterial detection were used to evaluate the terminal disinfection effect of ICU in a hospital. Results The terminal disinfection of ICU in the hospital was carried out using quaternary ammonium salt disinfectant wipes and chlorine effervescent tablets aqueous solution wipes with 500 mg/L available chlorine for wiping and disinfecting the surface of objects twice. The ground was disinfected using chlorine-containing disinfectant towel for wiping. The bed unit was disinfected using isolation cabin of a vaporized hydrogen peroxide disinfection machine; and then the entire indoor space was disinfected using vaporized hydrogen peroxide for sealed fumigation. The qualified rate of disinfection effect of object surfaces after terminal disinfection was 93.37％, and the qualified rate of disinfection effect of bed units was 100.00％, and the qualified rate of disinfection effect of indoor space was 87.91％. No pathogenic bacteria were detected on the high-frequency contact surface after disinfection. Conclusion The terminal disinfection effect of ICU ward in this hospital is good, indicating the emphasis on timeliness in ICU terminal disinfection.
Objective To investigate the hygiene and disinfection quality of kindergartens in Jiading District, Shanghai, and to provide evidence for the prevention of infectious diseases in kindergartens. Methods Sampling and monitoring of disinfection status were conducted at 212 kindergartens in Jiading District, Shanghai from 2018 to 2023. Results A total of 3 226 samples were collected from 2018 to 2023, with an overall qualified rate of 97.71％. Among different monitoring items, the qualified rate of air was the highest (99.66％), while that of staff hands was the lowest (92.61％). The overall qualified rates of disinfection quality in public and private kindergartens were 97.91％ and 96.99％, respectively. The qualified rate of tableware in public kindergartens was higher than that in private kindergartens (P<0.05). The overall qualified rate of hand hygiene among staff was 90.72％, and the qualified rate of health care teachers' hands was higher than that of nutrition staff's hands (P=0.043). Conclusion From 2018 to 2023, the disinfection quality of kindergartens in Jiading District, Shanghai, remained at a relatively high level. Hand hygiene of staff and disinfection of tableware in private kindergartens were weak links. Targeted disinfection technology training should be conducted regularly, and disinfection equipment, facilities, and hygiene management systems should be improved to ensure disinfection quality.
Objective To investigate the etiological characteristics and risk factors for severe pneumonia (SP) in elderly patients with comorbidities, and to develop a risk prediction model. Methods A total of 124 elderly patients with≥2 types of chronic underlying diseases admitted to our hospital from December 2022 to December 2024 were retrospectively enrolled. Patients were divided into SP group (n=41) and non-SP group (n=83) according to the occurrence of SP. Univariate and multivariate logistic regression analyses were used to identify independent risk factors. A nomogram prediction model was established, and its performance was evaluated using the concordance index (C-index), calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results In elderly patients with comorbidities and SP, Gram-negative bacteria were the predominant pathogens, with Klebsiella pneumoniae being the most common (34.55％). Multivariate logistic regression showed that more than two comorbidities, Klebsiella pneumoniae infection, Pseudomonas aeruginosa infection, and hospital stay≥14 d were independent risk factors for SP (P<0.05). The nomogram model showed good predictive performance, with a C-index of 0.851 and an AUC of 0.838. Conclusion SP in elderly patients with comorbidities is predominantly caused by Gram-negative bacteria and is associated with multiple factors. The established prediction model has good discrimination and clinical applicability, which may facilitate early identification of high-risk patients.
Objective To analyze the distribution characteristics of pathogenic bacteria and related risk factors of nosocomial infections in elderly patients with chronic heart failure (CHF). Methods A retrospective study was conducted to select 200 elderly CHF inpatients admitted to our hospital from January 2020 to January 2022 as the research subjects. According to whether nosocomial infection occurred during hospitalization, the patients were divided into the infection group (n=21) and the non-infection group (n=179). The infection site and pathogen composition of patients were analyzed in the infection group; clinical data from all patients was collected and multiple logistic regression analysis was used to identify risk factors for nosocomial infections in CHF patients. Results Among the 21 infected patients, respiratory tract infections accounted for the highest proportion (38.10％). A total of 46 strains of pathogenic bacteria were isolated, with Gram negative bacteria being the main strain, accounting for a total of 32 strains (69.57％). Multivariate logistic regression analysis showed that comorbidity with diabetes, invasive procedures and hospital stay ≥2 months were independent risk factors for nosocomial infection in elderly CHF patients (P<0.05). Conclusion Nosocomial infections in elderly CHF patients are mainly in the respiratory tract, and the pathogenic bacteria are mainly gram-negative bacteria. The main risk factors were diabetes, invasive procedures and long hospital stay. Clinical monitoring and targeted intervention should be strengthened for high-risk population.
Objective To investigate the incidence of postoperative nosocomial infections in patients with atrial fibrillation (AF) undergoing cardiac valve replacement (CVR), and analyze its independent risk factors, so as to provide evidence for early identification of high-risk individuals for infection in clinical practice. Methods Patients diagnosed with AF and undergoing CVR in a hospital in Shandong Province from January 2018 to December 2019 were selected as the study subjects. Their clinical data were retrospectively collected, and the incidence of postoperative nosocomial infections was investigated. Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for postoperative nosocomial infections. Results A total of 281 patients undergoing CVR were included, with 69 cases of postoperative nosocomial infections, resulting in an infection rate of 24.56％. The main infection site was the lungs (56 cases, accounting for 81.16％). A total of 31 strains of pathogenic bacteria were isolated, with the highest proportion of Gram-negative bacteria (24 strains, accounting for 77.42％). Multivariate logistic regression analysis showed that NYHA functional class ≥Ⅲ, actual hospital stay ≥25 d, operation duration ≥312 min, and indwelling catheter duration ≥8 d were independently associated with postoperative nosocomial infections. Conclusion The incidence of postoperative nosocomial infections is high in patients with AF undergoing CVR. Clinically, it is important to strengthen perioperative infection risk assessment and targeted intervention for this population, with a focus on respiratory tract management, invasive device management, and reduction of unnecessary hospital stays and indwelling durations.
Objective To understand the status of facilities of disinfection rooms and the knowledge of disinfection among the staff in public places, and to provide scientific basis for strengthening supervision and regulation. Methods A questionnaire survey was conducted to investigate the status of disinfection facilities and knowledge of disinfection practitioners in three types of public places, including accommodation, beauty and hairdressing, and public bathrooms, in Bengbu City. Results Among the 60 public places that should have disinfection rooms, 81.67％ had already set up disinfection rooms, with a setting up rate of 91.49％ in accommodation industry. The difference in the setting rate of disinfection rooms among the three types of places was statistically significant (χ2=14.000, P<0.01). The total area of the disinfection room was positively correlated with the business area (r=0.903, P<0.01). The main disinfection method was chemical disinfection (88.89%). 61.90％ of the units equipped with cleaning cabinets in the disinfection room, 76.16％ equipped with proportioning containers, and 28.57％ without debris in the disinfection room; The qualification rates of disinfection system, disinfection records, disinfection procedures, and knowledge training records were 68.25％, 15.87％, 12.70％, and 20.63％, respectively. Among disinfection practitioners, the average scores of disinfection knowledge for management personnel, servers, and individual owners were 7.06 points, 3.79 points, and 2.10 points, respectively, and the differences in scores among the three types of personnel were statistically significant (F=33.210, P<0.01). Conclusion There is still room for improvement in the disinfection management level of public places in the city, and further supervision and training are needed to enhance the level of social health services.
Objective To investigate the factors influencing environmental disinfection adherence among patients with pulmonary tuberculosis (PTB) during home isolation, and to evaluate the effect of different intervention models on improving adherence. Methods A prospective randomized controlled trial was conducted involving 425 PTB patients undergoing home isolation in Nanhu District between January 2021 and December 2023. Using a random number table, participants were allocated in a 1:1:1 ratio to a control group receiving routine management (n=140), intervention group A receiving health education plus electronic educational materials (n=142), and intervention group B receiving health education combined with material support and proactive follow-up (n=143). The study consisted of two phases. In the first phase (pre-intervention), all participants were assessed using the Disinfection Adherence Scale, which was designed based on the Morisky scale (total score≤5 indicating low adherence and≥6 indicating good adherence). Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with disinfection adherence. In the second phase, after a six-month intervention period, disinfection behaviors were reassessed and the effects of the three intervention strategies were compared. Results Multivariate Logistic analysis revealed that age≥60 years (OR=0.482), higher educational attainment (OR=2.915), monthly household income≥5 000 RMB (OR=2.259), availability of a separate living room (OR=2.691), receipt of proactive follow-up by healthcare professionals (OR=6.424), and higher tuberculosis-related knowledge scores (OR=1.420) were independent determinants of adherence to home environmental disinfection. The intervention group B showed significantly higher rates of disinfection adherence, ventilation and surface disinfection compliance, mask wearing, and follow-up satisfaction compared to the other two groups (P<0.001). Conclusion Adherence to environmental disinfection among PTB patients during home isolation is influenced by a combination of sociodemographic characteristics, living conditions, and healthcare support factors. A comprehensive intervention model integrating health education, material support and proactive follow-up is highly effective in enhancing adherence and infection control outcomes, and merits wider implementation.
Objective To explore the prevention and control effect of hospital infection information management based on the iceberg model on multidrug-resistant bacteria (MDRO) infection in intensive care units (ICU). Methods The period from January to December 2023 was as the pre-intervention phase (conventional management), while the period from January to December 2024 was as the post-intervention phase (hospital infection information management based on the iceberg model), and 308 ICU inpatients were randomly selected as the research subjects in each phase. The infection rate of MDRO, strain distribution, implementation rate of prevention and control measures, invasive operation related infection rate, hospital infection related indicators, and hand hygiene compliance between two phases were compared. Results The MDRO infection rate (4.44％) and infection case rate (6.83％) in 2024 were lower than those in 2023 and 2022. The distribution of strains between 2022 and 2024 was mainly carbapenem resistant Acinetobacter baumannii (CRAB), followed by methicillin-resistant Staphylococcus aureus (MRSA). After intervention, the implementation rates of various infection control measures were higher than before intervention (P<0.05); The incidence of catheter-related urinary tract infections, central vascular related bloodstream infections, and ventilator-associated pneumonia decreased compared to before intervention, but the differences were not statistically significant (P>0.05). The pathogen testing rate (93.83％) of hospital infection cases was higher than that before intervention (80.52％) (P<0.001); the hand hygiene compliance at each observation point was higher than that before intervention (P<0.001). Conclusion The information management of hospital infections based on the iceberg model can improve the implementation rate of various prevention and control measures for MDRO in ICU, and improve the hand hygiene compliance of medical staff, thereby reduce the MDRO infection rate.
Objective To investigate the prevalence and trend of healthcare-associated infections (HAIs) in a tertiary hospital in Fujian Province from 2018 to 2022, and to provide evidence for targeted infection prevention and control. Methods Cross-sectional surveys were conducted among all inpatients present on the survey days from 2018 to 2022. Data on HAI prevalence, infection sites, department distribution, pathogen detection, and antimicrobial use were collected and analyzed. Results A total of 5 792 inpatients were eligible for the surveys, and 5 790 were investigated, with an overall survey completion rate of 99.97％. The annual prevalence of HAIs ranged from 1.94％ to 3.12％, with a mean prevalence of 2.59％. No statistically significant difference was observed among different years (χ2=4.022, P=0.404), and no significant linear trend was found (χ2trend=3.284, P=0.073). Lower respiratory tract infection was the most common infection site, accounting for 61.11％ of all HAI episodes. The departments with the highest mean HAI prevalence were neurosurgery, general ICU, and respiratory ICU, with rates of 18.59％, 12.07％, and 10.53％, respectively. The prevalence of HAIs in the oncology department showed an increasing trend (χ2trend=6.266, P=0.012). A total of 101 pathogens were isolated, among which Gram-negative bacteria predominated (76.24％), mainly Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. The mean antimicrobial use rate was 33.96％, mainly for therapeutic use and monotherapy. The proportion of antimicrobial monotherapy increased over time (χ2trend=5.079, P=0.024), whereas dual therapy decreased (χ2trend=5.698, P=0.017). The microbiological examination rate among patients receiving therapeutic antimicrobials ranged from 63.32％ to 73.42％, showing an upward trend (χ2trend=6.124, P=0.013). Conclusion The prevalence of HAIs in this hospital remained generally stable from 2018 to 2022. However, lower respiratory tract infections and high-risk departments, including neurosurgery, ICUs, and oncology, remain priorities for infection prevention and control. Continuous surveillance, targeted interventions, rational antimicrobial use, and improved microbiological testing are essential to further reduce the risk of HAIs.
Objective To understand the implementation of hand hygiene among medical staff in key departments in Guizhou Province during the diagnosis and treatment process, in order to lay the foundation for establishing a reasonable hand hygiene management strategy and further improve the compliance rate of hand hygiene in our province. Methods From September 1st to 30th, 2021, on-site investigations were conducted on the orthopedic, comprehensive ICU, respiratory, infectious disease, pediatric outpatient and emergency departments, and hemodialysis rooms of 35 medical institutions in Guizhou Province. The implementation of hand hygiene by medical staff during diagnosis and treatment was observed, and the consumption of hand hygiene products in each surveyed department was counted. Results A total of 35 hospitals (20 secondary hospitals and 15 tertiary hospitals) were included in this study. Hand hygiene was observed 24 386 times, and 20 977 times were actually performed, of which 17 956 times were correctly performed. The overall compliance rate of hand hygiene among medical personnel in the province was 86.02％, and the overall accuracy rate was 85.60％. According to the analysis of hand hygiene timing, the highest compliance rate (95.04％) was observed after contact with the patient's blood or body fluids, while the lowest compliance rate (82.35％) was observed after contact with the patient's surrounding environment. According to professional analysis, the compliance rate of nurses' hand hygiene (86.80％) was higher than that of doctors (85.41％). According to hospital level analysis, the compliance rate of hand hygiene in tertiary hospitals (89.72％) was higher than that in secondary hospitals (83.56％).In the comprehensive ICU, the daily hand hygiene product consumption per bed was significantly higher in secondary hospitals than in tertiary hospitals, while no significant differences were observed between the two hospital levels in the remaining departments. Conclusion There is still room for improvement in the hand hygiene compliance of medical personnel in Guizhou Province, and there are significant differences in compliance rates among different hand hygiene timing, professional categories, hospital levels, and departments. Managers should implement targeted interventions for high-risk and low compliance areas, optimize resource allocation, and continuously improve hand hygiene quality.
