Objective To evaluate the contamination status of dental unit waterlines (DUWL) and compare the comprehensive efficacy of different disinfectants on biofilm removal from waterlines. Methods The contamination status of DUWL was analyzed by the qualified rates of water quality testing at different time periods (morning, noon, and evening) and under different water supply modes. After disinfection with different chemical agents, the disinfection efficacy and biofilm removal effect were evaluated by scanning electron microscopy. Results No significant difference was observed between the two water supply modes (reverse osmosis filtration and electrolyzed oxidizing water) (P>0.05). Among the different sampling time periods, the lowest qualified rate was found at 8:00 a.m., and the highest contamination rate was detected in the effluent from high-speed handpieces. All three disinfectants showed certain efficacy against biofilms, with sodium hypochlorite exhibiting the best disinfection effect. Conclusion For pipelines without established biofilm on the inner wall, continuous disinfection with hydrogen peroxide or electrolyzed oxidizing water can effectively inhibit biofilm formation. For established stubborn biofilms, sodium hypochlorite at higher concentrations shows superior efficacy. Therefore, a combination of regular pulse disinfection and routine continuous disinfection is recommended in clinical practice to achieve both inhibition and removal of biofilms.
Objective To evaluate the effectiveness of surface cleaning and disinfection on comprehensive dental treatment units in the outpatient dental department of a general hospital using adenosine triphosphate (ATP) bioluminescence detection and ultraviolet (UV)-fluorescence labeling method. Methods Ten treatment units were randomly selected, and 12 fixed points on each unit were marked with fluorescent dye. ATP bioluminescence assay was performed before and after terminal cleaning and disinfection to record relative light units (RLU). After disinfection, the marked points were examined with a UV flashlight to record cleaning efficacy. The ATP results after disinfection were compared, and the correlation between the two methods was analyzed. Results Before disinfection, only 4 of 120 points had RLU<100, indicating severe contamination. After disinfection, RLU values decreased significantly, with only 13 points showing RLU≥100, mainly on the rinsing bowl surface and the side panel of the operator’s table. The qualified rates between ATP bioluminescence and UV-fluorescence visual inspection showed no significant difference (89.17％ vs 92.50％, P>0.05), and the results were strongly positively correlated (Phi correlation coefficient=0.816 9, P<0.000 1). Conclusion Combining UV-fluorescence labeling with ATP bioluminescence detection offers advantages of effectiveness, sustainability, low cost, and intuitive operation, and is recommended as a routine approach for monitoring disinfection efficacy on dental treatment units.
Objective To comprehensively understand the microbial contamination status of pharmaceutical water systems, microorganisms isolated from the water systems were collected for strain identification and population analysis, aiming to preliminarily establish a microbial library for the water system and to provide a basis for the quality control of pharmaceutical water. Methods Microorganisms detected from water for injection and those detected from purified water that failed the microbial limit test over four consecutive quarters in 2021 were isolated and purified, and then identified using the VITEK 2 Compact automatic microbial biochemical identification system. Based on the identification results, the number of microorganisms detected in each area (Areas A-H) of the pharmaceutical company at different quarters of 2021 was statistically analyzed, and the distribution characteristics of the collected microorganisms at the genus and species levels across different seasons were characterized. Results A total of 64 Gram-negative bacterial strains and 40 Gram-positive bacterial strains were isolated and identified. In 2021, higher numbers of contaminated microorganisms were detected in Area B in the second quarter, Area D in the third quarter, and Area E in the third quarter, warranting increased attention. The five most frequently detected genera were Acinetobacter, Staphylococcus, Sphingomonas, Bacillus, and Ralstonia. Population analysis revealed that the dominant species within each genus were Acinetobacter baumannii, Staphylococcus epidermidis, Bacillus cereus, Ralstonia pickettii, and Sphingomonas paucimobilis, respectively. Conclusion The establishment of a microbial library for the pharmaceutical water system can provide guidance for the operation, maintenance, and disinfection of the water system, and plays an important role in drug quality control and microbiological traceability investigation.
Objective To evaluate the bacterial barrier effectiveness of the physical bacterial barrier system in multi-dose eyedrop bottles under extreme conditions simulating post-opening usage, specifically for the drug solution channel and the air return channel. Methods An in vitro controlled experimental design was adopted in this study, and the drug solution channel was challenged by immersing the dropper tip in a suspension of Pseudomonas aeruginosa and simulating the dispensing process. The air return channel was challenged by placing the eyedrop bottles in an aerosol environment containing Bacillus atrophaeus spores and simulating the dispensing operation. Results In both challenge tests, the culture medium in conventional eyedrop bottles became turbid, indicating microbial growth. In contrast, the medium in all 30 multi-dose eyedrop bottles equipped with the physical bacterial barrier system remained clear, with no detectable growth. Conclusion Under the extreme test conditions, the physical bacterial barrier system in multi-dose eyedrop bottles demonstrates effective bacterial barrier performance for both the drug solution channel and the air return channel, ensuring the sterility of the ophthalmic solution during use.
Objective To investigate the current status of hand hygiene compliance during key steps of vaginal delivery and to identify its influencing factors. Methods A covert, non-participatory observation method was employed to monitor hand hygiene performance among 94 delivery-room staff from two hospitals across six critical procedural moments. A structured questionnaire was also administered to collect demographic and occupational data. Results A total of 1,826 hand hygiene opportunities were observed, with an overall compliance rate of 67.31％. The highest adherence was observed "before aseptic procedures" (85.29％), while the lowest was "after glove removal" (37.82％). Multivariate logistic regression analysis revealed that an average daily delivery volume of≥5 cases (OR=3.124, 95％CI: 1.694-5.758), inadequate hand hygiene facilities (OR=2.878, 95％CI: 1.543-5.367), lack of specialized training within the past year (OR=2.542, 95％CI: 1.321-4.892), and insufficient supervisory assessment (OR=2.219, 95％CI: 1.164-4.228) were independent risk factors for poor compliance (all P<0.05). Conclusion Hand hygiene compliance during vaginal delivery remains suboptimal, with the post-glove-removal step being the most critical gap. Targeted interventions—including enhanced training, improved facility availability, and strengthened oversight—should be prioritized to address these identified risk factors.
Objective To investigate the pathogen distribution characteristics of urinary tract infections (UTI) following ureteral stent placement and to construct a predictive model for infection risk. Methods A retrospective analysis was conducted on 339 patients who underwent ureteral stent placement at our hospital from January 2022 to January 2024. Patients were divided into infection group (n=86) and non-infection group (n=253) based on postoperative UTI occurrence. The pathogen distribution was analyzed. Univariate analysis was performed on clinical data, and Lasso regression, univariate and multivariate logistic regression were used to identify risk factors. A nomogram predictive model was constructed, and its predictive performance was evaluated using the receiver operating characteristic (ROC) curve. Results The incidence of postoperative UTI was 25.36％(86/339). A total of 103 pathogenic strains were isolated, with Gram-negative bacteria (52.43％) and Gram-positive bacteria (34.95％) being predominant. Multivariate logistic regression identified diabetes history (OR=2.445, 95％CI: 1.410-4.241), stone size (OR=2.104, 95％CI: 1.322-3.349), residual stones after stenting (OR=2.061, 95％CI: 1.179-3.602), surgical duration≥60 min (OR=1.640, 95％CI: 1.144-2.353), postoperative ureteral stent retention≥4 weeks (OR=2.321, 95％CI: 1.119-4.812), and hospitalization duration (OR=2.675, 95％CI: 1.407-5.088) as independent risk factors (all P<0.05). The AUC of the predictive model was 0.768, and the Hosmer-Lemeshow test yielded P=0.477. Conclusion The pathogens of UTIs following ureteral stent placement are predominantly Gram-negative and Gram-positive bacteria. Diabetes history, larger stone size, residual stones after stenting, prolonged surgical duration, postoperative stent retention≥4 weeks, and extended hospitalization duration are associated with increased risk of postoperative UTI. The constructed predictive model provides a valuable reference for identifying high-risk patients and guiding clinical interventions.
Objective To investigate the relationship between hand hygiene compliance of delivery room nursing staff and the incidence of puerperal genital tract infections, so as to provide evidence for optimizing infection prevention and control strategies in obstetric settings. Methods A total of 264 parturients who delivered in the delivery ward of our hospital between September 2022 and August 2025, along with 16 full-time nursing staff on duty throughout the study period, were enrolled. In accordance with the World Health Organization's "Five Moments for Hand Hygiene" guidelines, continuous dynamic monitoring of hand hygiene compliance was conducted. The entire study period was divided into six consecutive equal-length observation phases (6 months per phase). The first two phases served as the baseline period without targeted interventions, and the subsequent four phases constituted the continuous intervention period. Data on overall hand hygiene compliance rate and compliance rate at the critical moment (before aseptic procedures) were collected for each phase, and the incidence of puerperal genital tract infections was documented simultaneously. Time series correlation analysis, multilevel models, and binary logistic regression were employed to explore the relationship between hand hygiene compliance and infection risk. Results During the study period, the overall hand hygiene compliance rate increased from 62.38％ to 90.15％, and the compliance rate at the critical moment (before aseptic procedures) rose from 58.21％ to 87.42％; meanwhile, the incidence of genital tract infections decreased from 13.64％ to 2.22％. Correlation analysis showed an extremely strong negative correlation between the overall compliance rate and the infection rate in the same period (r=-0.986, P<0.001). Multilevel model analysis indicated that the compliance rate of nursing staff on day shifts was 10.26％ higher than that on night shifts (95％CI: 6.38-14.14), and those with a working tenure of≤10 years had significantly lower compliance (95％CI: -12.06 to -5.44). Multivariate logistic regression showed that poor hand hygiene compliance (OR=4.250, 95％CI: 1.948-9.273), premature rupture of membranes>12 h (OR=3.473, 95％CI: 1.656-7.285), episiotomy (OR=2.601, 95％CI: 1.376-4.918), and labor duration>10 h (OR=2.255, 95％CI: 1.260-4.035) were independent risk factors for genital tract infections (all P<0.05). Conclusion There is a significant negative correlation between hand hygiene compliance of delivery room nursing staff and the incidence of puerperal genital tract infections. Improving hand hygiene compliance, especially the implementation rate before aseptic procedures, may effectively reduce the risk of infection. Greater emphasis should be placed on improving hand hygiene behaviors among nursing staff on night shifts and with low professional seniority.
Objective To investigate the current status of hand hygiene knowledge, attitude, and practice (KAP) among healthcare workers in obstetrics and gynecology departments, and to identify its influencing factors. Methods A cross-sectional survey was conducted among 173 healthcare workers recruited via convenience sampling from a tertiary hospital between December 2025 and February 2026. Data were collected using a self-designed, specialty-specific hand hygiene KAP questionnaire and a demographic and influencing factors inventory. Univariate analysis and multiple linear regression were employed to identify determinants of the total KAP score. Results A total of 173 valid questionnaires were returned. The mean scores for the knowledge, attitude, and practice dimensions were 89.36±12.57, 65.28±7.14, and 58.74±11.36, respectively. The practice dimension had the lowest scoring rate (69.11％), with the sub-dimension of "hand hygiene during specific obstetric procedures" scoring particularly low (62.52％). Multiple linear regression revealed that the frequency of hand hygiene training in the past year (β=0.277, P<0.001), the implementation of departmental hand hygiene management policies (β=-0.288, P<0.001), and the availability of hand hygiene facilities (β=-0.220, P<0.001) were the most significant independent factors associated with the total KAP score. Professional title (β=0.164, P=0.005), working years (β=0.150, P=0.008), and educational level (β=0.117, P=0.025) were also independently and positively correlated with the total score. Conclusion The implementation of hand hygiene practices among obstetrics and gynecology HCWs is suboptimal, particularly during specific high-risk procedures. Comprehensive intervention strategies should target modifiable factors, including inadequate facilities, insufficient training, and weak supervision mechanisms.
Objective To explore the mediating effect of standardized disinfection operations of operating room nurses on the relationship between air purification effect and surgical site infections (SSIs). Methods A total of 206 patients who underwent surgery in the Department of Burns and skin surgery of our hospital from January 2022 to December 2024 were enrolled. A self-designed questionnaire was used to collect data, and indicators of air purification efficacy as well as the occurrence of SSIs within 30 days postoperatively (90 days for patients with implants) were recorded. Pearson correlation analysis was performed to examine correlations, and the Bootstrap method was applied to test the mediating effect. Results A total of 198 valid questionnaires were included, with an effective rate of 96.17％. The standardized disinfection procedures of operating room nurses were negatively correlated with airborne particle count, particle concentration at the filter inlet, particle concentration at the filter outlet, self-cleaning time, sedimentation bacterial count, and SSI (r=-0.716,-0.389,-0.394,-0.793,-0.693,-0.670, all P<0.05), and positively correlated with filtration efficiency, pressure difference between the clean room and adjacent areas, and pressure difference between the corridor and the outdoor environment (r=0.694, 0.233, 0.477, all P<0.05). A significant mediating effect of nurses' standardized disinfection procedures on the relationship between air purification effect and SSI was observed, with an effect size of 0.361 (P<0.05). Conclusion The standardized disinfection procedures performed by operating room nurses exert an indirect mediating effect between air purification efficacy and SSI. Clinical practice should emphasize standardized disinfection training to reduce the risk of surgical site infections.
Objective To analyze the factors influencing hand hygiene compliance among outpatient nurses during peak hours and to propose targeted countermeasures for hand disinfection. Methods From October 2024 to May 2025, 326 outpatient nurses from three medical institutions (two general hospitals and one community hospital) were enrolled. A combination of cross-sectional survey and on-site covert observation was employed, supplemented by semi-structured interviews for qualitative exploration. A self-designed hand hygiene knowledge questionnaire was used to assess nurses' cognitive level, and hand hygiene performance during peak hours was recorded with reference to the World Health Organization (WHO) Hand Hygiene Guidelines. Univariate analysis and multivariate generalized estimating equation (GEE) were applied to identify influencing factors of compliance, and interview findings were integrated to explore underlying barriers. Results The mean raw score of hand hygiene knowledge among the 326 nurses was 23.23±3.60, corresponding to a percentage score of 82.97±12.86. The overall hand hygiene compliance rate during outpatient peak hours was 74.48％. Multivariate GEE analysis revealed that community hospital setting and patient flow>15 patients/hour were independent risk factors for decreased compliance (P<0.05), while working years>5 years, knowledge score≥85.7, convenient access to hand disinfectant, and receiving training within the past six months were protective factors (P<0.05). Semi-structured interviews identified heavy workload, unreasonable facility layout, and monotonous training formats as the primary practical barriers to hand hygiene implementation. Conclusion Hand hygiene compliance among outpatient nurses during peak hours is influenced by multiple factors, including institution type, workload, knowledge level, accessibility of hand disinfectants, and training frequency. Comprehensive strategies—including optimizing facility layout, implementing scenario-based training, and strengthening supervisory feedback—are recommended to improve adherence.
Objective To investigate the current status of disinfection practices in medical institutions in Chongqing, so as to identify weak links in hospital disinfection, and provide a scientific basis for improving hospital infection prevention and control. Methods From 2018 to 2022, three medical institutions at different levels (one primary, one secondary, and one tertiary hospital) in Chongqing were selected as sentinel hospitals for regular surveillance of disinfection and sterilization efficacy. The monitored items included hands of healthcare workers (hygienic handwashing and surgical hand antisepsis), environmental surfaces, operating room air, endoscopes, steam sterilizers, and hospital sewage. Data were analyzed using the $\chi^{2}$ test and Fisher's exact test. A P-value of <0.05 was considered statistically significant. Results A total of 2 266 samples were collected from the three sentinel hospitals, of which 2 123 met the qualified criteria, yielding an overall qualification rate of 93.7％. No statistically significant differences were observed across different years ($\chi^{2}$=7.649, P=0.105) or among hospital levels ($\chi^{2}$=3.450, P=0.178). However, the qualification rates varied significantly across different monitoring items ($\chi^{2}$=92.484, P<0.001). The highest qualification rate was observed for steam sterilizers (97.8％), while the lowest was for hospital sewage (78.4％). Conclusion Weak links exist in the disinfection practices of the three sentinel hospitals in Chongqing. Hospital sewage was the primary concern in the primary hospital, while hygienic handwashing was the major issue in the secondary and tertiary hospitals. Targeted control measures should be implemented to improve the qualification rates.
