Objective To evaluate the bactericidal efficacy of didecyldimethylammonium bromide applied by different methods on different material carriers, and to provide evidence for choosing disinfectants according to the surface material characteristics in practical disinfection applications. Methods Carrier immersion disinfection tests and carrier spray disinfection tests were conducted to assess the killing effects of didecyldimethylammonium bromide against Staphylococcus aureus and Escherichia coli on stainless steel sheets, cloth sheets, and filter paper sheets. Results Using a 250 mg/Ldidecyldimethylammonium bromide disinfectant solution, immersion for 1.5 min achieved an average killing log value >3.00 for Staphylococcus aureus on stainless steel sheets; immersion for 3 min achieved an average killing log value >3.00 for Staphylococcus aureus on filter paper sheets. Immersion for 3 min resulted in average killing log value >3.00 for Escherichia coli on both stainless steel sheets and filter paper sheets. Using a 500 mg/L didecyldimethylammonium bromide disinfectant solution, spray application for 3 min achieved an average killing log value >3.00 for Staphylococcus aureus on stainless steel sheets; spray application for 6 min achieved an average killing log value >3.00 for Staphylococcus aureus on filter paper sheets; spray application for 3 min achieved an average killing log value >3.00 for Escherichia coli on stainless steel sheets. The average killing log values in all other groups were <3.00. The difference in the killing effect of the disinfectant on the same type of bacteria on three carriers was statistically significant (P<0.05). Conclusion The indicator bacteria of stainless steel sheet can be effectively killed by the immersion method and spray method at the concentration of didecyl dimethyl ammonium bromide in this study. The filter paper sheet needs to be disinfected for a longer time, and the cloth sheet cannot be effectively disinfected.
Objective To evaluate the stability of trihalomethanes (THMs) standard working series solutions stored in sealed headspace bottles, and to clarify the applicable storage period, in order to improve detection efficiency and reduce the cost of repeated preparation. Methods The THMs standard working series solutions were measured using headspace-gas chromatography (HS-GC, ECD detection) at different storage times (0, 7, 14, 21, 28, 35, 42 days). A calibration curve was established with mass concentration (1-80 μg/L) as the horizontal axis and peak area as the vertical axis, and the accuracy and applicability of the method were verified using a national standard quality control sample (GSB 07-1982—2005). Results After being stored in a sealed headspace bottle, protected from light, and refrigerated at 4℃ for 42 days, disinfectants such as chloroform, bromodichloromethane, dibromochloromethane, and bromoform maintained good linearity (r=0.999 2-0.999 8) within the range of 1-80 μg/L. Using this set of calibration curves to measure the GSB 07-1982—2005 quality control sample, the measured values for the four compounds were all within the allowable range. Conclusion Under the conditions of being stored in a sealed headspace bottle, protected from light, and refrigerated at 4℃, the THMs standard working series solutions (1-80 μg/L) can be stably stored for at least 42 d.
Objective To investigate the microbial contamination status in sewage from some hospitals and urban sewage treatment plants in Nanjing and Xuzhou, Jiangsu Province, and to analyze the drug resistance of Klebsiella pneumoniae in sewage and its resistance to commonly used sewage disinfectants. Methods Sewage samples before and after treatment were collected on site from hospitals and urban sewage treatment plants to detect pathogen contamination, isolate and identify Klebsiella pneumoniae, and conduct drug sensitivity tests. The resistance of Klebsiella pneumoniae to chlorine containing disinfectants, chlorine dioxide disinfectants, and compound potassium monopersulfate disinfectants was evaluated using minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Results Among the 33 wastewater sample, 7, 12, and 16 strains of staphylococcus aureus. Psedomonas aeruginosa, and Klebsiella pneumon were detected, respectively. The detection proportions of pathogenic bacteria in hospital and wastewater treatmen plants in Nanjing and Xuzhou were 25.7%, 11.4%, 40.0% and 22.9%, respectively. The detection rates of Klebsiella pneumoniae in 23 samples of hospital sewage before and after treatment were 70.0% and 7.7%, respectively, with a statistically significant difference ($\chi^{2}$=9.673, P=0.006). Five strains of Klebsiella pneumoniae and three strains of Klebsiella pneumoniae were detected in five samples before and after sewage treatment in urban sewage treatment plants. Among the 16 isolated strains of Klebsiella pneumoniae, 13 strains had MIC or MBC higher than the standard strain for chlorine containing disinfectants, and only 2 strains had MIC or MBC higher than the standard strain for chlorine dioxide disinfectants; All isolates had MIC and MBC values equal to or lower than the standard strain for the compound monopersulfate potassium disinfectant. Conclusion The investigated sewage is contaminated with pathogenic bacteria such as Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae. After disinfection treatment, some Klebsiella pneumoniae in the sewage still have resistance to drugs and disinfectants, indicating the need to strengthen the management of disinfection work, and scientifically and reasonably use disinfectants to reduce the risk of pathogen transmission.
Objective To evaluate the surface disinfection and sterilization effect of imported and domestic positive pressure bio-protective hood (PPBH) after vaporized hydrogen peroxide fumigation, for providing a basis for the safe and effective reuse of such equipment in medical and biosafety laboratories. Methods A simulated field test was conducted in a dedicated vaporized hydrogen peroxide fumigation disinfection chamber, using 350 g/L hydrogen peroxide to disinfect and sterilize two types of fully loaded PPBH. The disinfection effect was verified by placing Bacillus stearothermophilus bacterial tablets, and the sterilization results were observed after incubation. Results Three repeated tests showed that after a standard disinfection cycle, the biological indicator culture results at 35 sampling points inside and outside the disinfection chamber and on the hood were all negative, with both positive and negative control results being valid. Conclusion Vaporized hydrogen peroxide fumigation can effectively inactivate microorganisms on the surface and complex parts of two types of PPBH, achieving satisfactory sterilization effect. This method can provide a reliable technical solution for the safe reuse of high-value personal protective equipment.
Objective To understand the drug resistance status of carbapenem-resistant Serratia marcescens (CRSM) and risk factors for infection. Methods A retrospective survey method was employed to investigate and analyze the drug resistance and infection risk factors of Serratia marcescens clinically isolated. Results Among 69 strains of Serratia marcescens, 19 CRSM strains were detected, with a detection rate of 27.54%. The resistance rate of CRSM strains to β-lactams and cephalosporins reached 100%, while the resistance rate to sulfamethoxazole-trimethoprim, minocycline, and amikacin was≤5.26%. Multivariate analysis results showed that ICU admission and hospital stay duration >30 days were independent risk factors for CRSM infection. Conclusion The detection rate of CRSM strains in Serratia marcescens clinically isolated from this hospital is high, and the drug resistance is severe. Therefore, surveillance of drug-resistant strains should be strengthened.
Objective To investigate the current status of phacoemulsification handle reprocessing in domestic hospitals, and to identify major issues in the reprocessing procedure, so as to provide scientific evidence for improving the quality of phacoemulsification handle reprocessing. Methods A Delphi method was used to construct a survey questionnaire, and three rounds of expert consultation were conducted to form the final version of the questionnaire. Using stratified sampling, 64 hospitals were selected from 18 provinces (cities) in six major geographical regions of China, and a questionnaire survey was conducted on the current status of phacoemulsification handle reprocessing in these hospitals. Results 11 hospitals (17.19%) did not preprocess the ultrasonic emulsification handpiece; 19 hospitals (29.69%) and 12 hospitals (18.75%) chose tap water and saline solution as preprocessing fluids, respectively. Only Twenty-nine hospitals disassembled the ultrasonic emulsification handpiece before cleaning as required; thirty-nine hospitals (60.94%) used cleaning agents; and only forty-one hospitals (64.06%) used purified water or distilled water throughout the entire cleaning process. Twelve hospitals (18.75%) did not disinfect the ultrasonic emulsification handpiece. Only thirty-four hospitals (53.13%) used a pressure air gun during the drying process. And only eight hospitals (12.50%) placed the ultrasonic emulsification handpiece lumen vertically in the sterilizer during the sterilization process. Conclusion There are many irregularities in the reprocessing procedures of ultrasonic emulsification handpieces in domestic hospitals. Relevant management departments should take improvement measures based on the identified issues to reduce the risk of infection in intraocular surgery.
Objective To analyze the clinical distribution and drug resistance characteristics of Streptococcus pneumoniae infection in children at Women and Children’s Hospital of Ningbo University, and to provide epidemiological evidence for effective prevention and management of Streptococcus pneumoniae infection. Methods BacT/Alert 3D blood culture instrument was used for blood culture, and VITEK-MS mass spectrometer and VITEK 2-COMPACT analyzer were used for strain identification and drug sensitivity testing. Results A total of 159 strains of Streptococcus pneumoniae were isolated, of which 79.24% were children under 5 years old. The department with the highest detection rate was the respiratory department (34.59%), followed by the pediatric intensive care department (30.18%). The main source of specimens is the respiratory tract (77.98%), followed by blood (13.20%). The resistance rates of Streptococcus pneumoniae to vancomycin, linezolid, telimycin, amoxicillin, and quinolone drugs were all 0; The resistance rates of ertapenem and chloramphenicol were both less than 10%; The resistance rates of cefotaxime, ceftriaxone, and meropenem ranged from 25.5% to 44.4%; The resistance rates of tetracycline, penicillin, and compound sulfamethoxazole were relatively high, at 77.9%, 46.6% to 62.2%, and 67.1%, respectively; The resistance rate of erythromycin was as high as 97.5%. Conclusion Children under 5 years old are at high risk of pneumococcal infection, and antibiotics should be selected reasonably based on drug sensitivity results in clinical practice. Cefotaxime, cefotaxime, and meropenem should not be used alone for the treatment of Streptococcus pneumoniae infection. It is recommended to use these drugs in combination with linezolid or vancomycin.
Objective To investigate the current status of the reprocessing of ophthalmic instruments five years after the promulgation of the Guidelines for Ophthalmic Surgery Management, Infection Control, Disinfection and Sterilization in China and the Three Health Industry Standards for Hospital Disinfection Supply Centers. Methods Convenience sampling was used to select 116 secondary and above hospitals in the Sichuan Chongqing Region as research objects. A self-made questionnaire survey was conducted to investigate the current status of quality management, pre-treatment, cleaning, disinfection, packaging, sterilization and other reprocessing processes for ophthalmic instruments in centralized management, training, and specialized post settings. Results Not all ophthalmic instruments had been included in centralized management, with low specialized positions and weak training in specialized knowledge; There were deficiencies in pre-processing, cleaning equipment, use of cleaning agents, final rinsing, disinfection methods, packaging materials, sterilization methods, and other aspects. Conclusion Hospitals at all levels should establish a comprehensive infection prevention and control system for ophthalmic instruments based on the latest guidelines and industry standards.
Objective To explore the clinical distribution characteristics and drug resistance features of methicillin-resistant Staphylococcus aureus (MRSA), and to provide a reference basis for the rational selection of antimicrobial agents and the prevention and control of MRSA infections in clinical settings. Methods A retrospective analysis was conducted on MRSA strains isolated from various types of specimens submitted by inpatients in a hospital from January 2016 to December 2021. Their clinical distribution data and drug sensitivity test results were collected, and the drug resistance was compared with that of methicillin-sensitive Staphylococcus aureus (MSSA) isolated during the same period. Results A total of 609 MRSA strains were isolated, mainly from sputum (43.5%), pus (15.8%), and wound and wound secretion (10.7%); the departments of origin were mainly intensive care units (16.3%), neurosurgery (14.1%), and otolaryngology (6.9%). The majority of MRSA-isolated patients were aged 61 to 70 years (22.0%), and the isolation rate in males (63.4%) was higher than that in females (36.6%). The resistance rates of MRSA to rifampin, tigecycline, daptomycin, linaclotide, vancomycin, and teicoplanin were all <5%, and the resistance rates to other antimicrobial agents were significantly higher than those of MSSA (P<0.05). Analysis of MRSA resistance in different specimen sources showed that the resistance rates of MRSA from pus to gentamicin, moxifloxacin, and levofloxacin (4.2%, 12.5%, 12.6%) were significantly lower than those from sputum (14.0%, 43.0%, 43.1%) and blood (14.7%, 35.3%, 36.7%) (P<0.05). Conclusion MRSA has a wide clinical distribution, mainly affecting elderly patients and males, with significantly higher resistance rates than MSSA; MRSA strains isolated from sputum and blood have higher resistance rates.
Objective To investigate the current status of knowledge, attitude, and practice regarding occupational protection among nurses in central sterile supply departments (CSSDs) in Shandong Province, and to analyze the influencing factors, for providing a basis for formulating targeted intervention measures. Methods From June to October 2022, a cross-sectional survey was conducted using a self-designed questionnaire among CSSD nurses from 7 secondary hospitals and 8 tertiary hospitals in Shandong Province. Results A total of 385 questionnaires were collected. The scores for knowledge, attitude, and practice were (8.08±2.306), (29.69±6.297), and (6.28±1.242), respectively. Multivariate linear regression analysis revealed that hospital level was an influencing factor for knowledge (P<0.05); hospital level and professional title were influencing factors for attitude (P<0.05); and hospital level, knowledge, and attitude were influencing factors for practice (P<0.05). Conclusion CSSD nurses have a relatively positive attitude towards occupational protection, but their knowledge and practice need improvement. Nursing managers should construct a hierarchical training system based on different characteristics of nurses, and promote the implementation of occupational protective behaviors by enhancing knowledge and improving attitude.
Objective To understand the hygiene status of hotels in Wanzhou District, Chongqing, and to identify health hazards in public places, so as to provide scientific basis for strengthening hotel hygiene management. Methods In 2021, 18 hotels (6 each of three-star and above, three-star and below, and express hotels) were randomly selected in Wanzhou District. Their hygiene quality of indoor air, public supplies and utensils, and cooling water in cooling tower were tested and evaluated according to relevant national standards. Results A total of 620 samples were collected in this monitoring, with a total qualified rate of 88.06%. The qualified rates for three-star and above, three-star and below, and express hotels were 93.64%, 83.16%, and 86.17%, respectively, with significant differences ($\chi^{2}$=12.111, P=0.002). The qualified rate of indoor air was 80.61%, and that of public supplies and utensils was 89.40%, with significant differences between the two ($\chi^{2}$=5.975, P=0.015). Among public supplies and utensils, towels had the lowest qualified rate (78.24%), with the main unqualified indicators being total bacterial count and pH value. The qualified rate of cooling water in cooling tower for Legionella pneumophila detection was 90.91%. Conclusion The overall hygiene status of hotels in Wanzhou District is good, but some places have problems such as air microbial pollution, incomplete disinfection of public supplies, and pH value exceeding standards. Supervision and monitoring should be strengthened, disinfection procedures should be standardized, and focus should be placed on the hygiene quality of towels and the risk of Legionella contamination in cooling water.
Objective To understand the distribution and antimicrobial resistance characteristics of pathogenic bacteria in children with respiratory tract infections in Northeast Sichuan, and to provide evidence for rational clinical drug use. Methods Sputum samples from 1,086 children aged 0-12 years with respiratory tract infections admitted to Guangyuan Mental Health Center from January 2021 to December 2022 were collected for pathogenic bacteria isolation and identification, as well as antimicrobial susceptibility testing. The relationship between age, gender, region, season, and infection characteristics was analyzed. Results A total of 11 species of pathogenic bacteria were detected in the 1,086 specimens, mainly including Pseudomonas aeruginosa (79.0%), Escherichia coli (56.4%), Klebsiella pneumoniae (54.1%), and Staphylococcus aureus (52.2%). The antimicrobial susceptibility results showed that Gram-negative bacteria exhibited varying degrees of resistance to cefradine, oxacillin, and penicillin. Reduning had inhibitory effects on most pathogenic bacteria except Acinetobacter baumannii. The detection rate of pathogenic bacteria was not associated with the gender of the children (P>0.05), but was closely related to age and season (P<0.05); the detection rate was the highest in infants aged 0-3 years (61.01%), with peaks in summer (June-August) and winter (December-February). Conclusion The distribution of pathogenic bacteria in respiratory tract infections in children in Northeast Sichuan is widespread, mainly Gram-negative bacteria, which exhibit varying degrees of resistance to commonly used antibiotics. Based on the local aetiological characteristics and current antimicrobial resistance status, infection prevention and control measures should be strengthened according to different age groups and seasonal characteristics, and antimicrobial drugs should be reasonably selected.
Objective To construct an infection control model deeply integrated with clinical practice, and to explore the value of this model in the standardized prophylactic administration of perioperative antibiotics, for providing reference for the rational use of antibiotics. Methods Patients undergoing Class I incision surgery from January 2023 to December 2024 were selected as the research subjects to construct an infection control model deeply integrated with clinical practice. A comprehensive evaluation was conducted on the perioperative use of antibacterial drugs before and after the implementation of this model. Results A total of 14 769 patients undergoing Class I incision surgery were included, including 7 560 cases (51.2%) before the implementation of the model and 7 209 cases (48.8%) after implementation. After the implementation of the model, with the increase of patient age, the elevation of surgical level, and the shortening of surgical duration, the rationality rate of antimicrobial prophylaxis (27.4% vs. 26.6%), medication duration (99.7% vs. 98.4%), medication variety (99.8% vs. 98.8%) and administration timing (99.8% vs. 99.4%) all increased compared to before implementation (P<0.05); The average length of hospital stay was significantly shortened (P<0.05); There was no significant change in the infection rate at the surgical site (P>0.05). Conclusion The infection control model deeply integrated with clinical practice can effectively standardize the use of perioperative antibiotics for prevention and strengthen subject responsibility; which can also promote interdisciplinary collaboration, and integrate infection prevention and control measures throughout the entire diagnosis and treatment process, so as to achieve precise infection prevention and control.
