15 October 2025, Volume 42 Issue 10
  
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    Experimental Study
  • DONG Fang, FANG Ye-zhen, LIU Shi-chuan, WU Ai-ping, LI Ya, CEN Bin
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    Objective To establish a biosafety laboratory contamination identification technology so as to observe its application value. Methods The MC0 gene fragment of Mengo virus was synthesized as a quality control sample, and the human β-actin and GAPDH gene were used as a unified indicator for contamination identification. A real-time quantitative PCR detection method was established to identify, detect, and evaluate the application of contaminants in biosafety laboratories. Results Quantitative PCR was performed on 417 laboratory smear samples. In the laboratory environment, there was a statistically significant difference in the positive rate of nucleic acid detection between work surfaces, sample placement surfaces, and blood collection window surfaces (P<0.05). Among them, the blood collection window surface was the most contaminated, with a positive rate as high as 72%; the positive rates on various surfaces of laboratory instruments and equipment ranged from 50% to 60%. Conclusion The quantitative PCR detection method established in this study exhibits good linearity, high sensitivity, and good specificity, which can effectively identify potential contamination points in the laboratory for guiding the laboratory cleaning and disinfection procedures.

  • MA Zhi-jie, YU Xiao-fan, YAO Zhuo-ya, SONG Jing-hua, SHA Man, WANG Juan
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    Objective To evaluate the effects of different air disinfection methods on the air quality and the disinfection effect of stored endoscopes in endoscopic repositories. Methods The endoscopic repositories of Gastrointestinal Endoscopy Center of our hospital were selected for the study. The experimental group used an air sterilization station to continuously and dynamically disinfect endoscopic repositories, while the control group used routine timed air disinfection. Both groups were monitored for PM0.5 concentration and air bacterial count before air disinfection and at 1, 6 and 12 h after air disinfection. At the same time, 20 stored endoscopes were randomly selected for microbial culture. Results Compared with PM0.5 concentration and air bacterial count before air disinfection, there were statistically significant differences in PM0.5 concentration and air bacterial count 1 h after air disinfection in both group (P<0.05). At 6 and 12 h of air disinfection, PM0.5 concentration and air bacterial count in the repositories of the experimental group were lower than those in the control group, and the differences were statistically significant (P<0.01). PM0.5 concentration and air bacterial count in the repositories of the experimental group were both lower and had a small fluctuation range. The control group showed a significant increase over time in PM0.5 concentration and airborne bacterial count in the storage repository. After 12 h of air disinfection, the qualified rate of biological culture in endoscopes stored in the repositories of the experimental group was still 100%, while that of the control group was 98.33%. Conclusion Using the air sterilization station for continuous dynamic air disinfection can effectively improve air quality, increase the effect of air disinfection, and guarantee the safe storage of sterilized endoscopes.

  • GUO Jin-zhi, LIU Xiao-jie, WANG Yan-qiu
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    Objective To investigate the physicochemical properties of a novel compound potassium monopersulfate disinfectant and to provide references for its disinfection applications. Methods Physicochemical testing techniques were used to investigate and observe the relevant physicochemical properties of this novel disinfectant containing potassium monopersulfate compound salt, including the effective component content, pH, and metal corrosivity. Results The novel compound potassium monopersulfate disinfectant was a white powder with an active oxygen content of 2.87%. After preparing a disinfectant solution with a concentration of 1 000 mg/L and leaving it for 1 h, the active oxygen content reached a peak of 49.7 mg/L; within 3 days, the active oxygen content could be maintained at over 90% of the initial concentration. The pH range of the disinfectant solution with a concentration of 1 000-6 000 mg/L was 2.43-3.00. 3 types of disinfectants showed moderate corrosion to aluminum, carbon steel, and copper wafers, but had essentially no corrosion to stainless steel wafers. Conclusion The compound potassium monopersulfate disinfectant shows stable physicochemical properties. The decrease in effective components in the solution is related to its preparation concentration and storage time, and it exhibits corrosivity to metals.

  • LI Xiang, LING Peng, NING Yong-zhong, JIANG Bo, XING Yi
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    Objective To observe the germicidal effect of a high-energy pulsed ultraviolet disinfection equipment and to provide basis for practical disinfection applications. Methods Carrier quantitative germicidal test method was used to observe the germicidal effect of a high-energy pulse ultraviolet disinfection equipment. Results The high-energy pulse ultraviolet disinfection equipment was equipped with a xenon lamp tube, emitting ultraviolet intensity of 1.28 mW/cm2 at a vertical distance of 1 m. After irradiation for 5 min at a vertical distance of 1 m from the lamp, the killing log values for Staphylococcus aureus and Escherichia coli on the carrier were 3.05 and 3.40, respectively; after irradiation for 5 min, the killing log value for Candida albicans on the carrier was 2.30. Conclusion The high-energy pulsed ultraviolet disinfection equipment has certain killing effect against common bacterial propagules, but its killing effect against fungi is slightly inferior.

  • WANG Xiao-lei, ZHANG Wei, SHEN Yi-ming
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    Objective To observe the disinfection effect of potassium monopersulfate disinfectant powder and to provide data support for practical disinfection applications. Methods The suspension quantitative sterilization test method was used to observe the disinfection effect of a certain potassium monopersulfate disinfectant powder. Results When treated with a disinfectant solution containing potassium monopersulfate at a concentration of 200 mg/L for 10 min, the killing logarithmic values of Escherichia coli and Pseudomonas aeruginosa in suspension were both >5.00; when treated for 20 min, the killing logarithmic value of Staphylococcus aureus in suspension was >5.00, and the killing logarithmic value of Candida albicans was >4.00. When treated with a disinfectant solution containing 1 000 mg/L potassium monopersulfate for 60 min, the killing logarithmic value of Bacillus subtilis var. niger spores in suspension was >5.00. When treated with a disinfectant solution containing 500 mg/L potassium monopersulfate for 20 min, and the killing logarithmic value of poliovirus in suspension was >4.00. Conclusion The potassium monopersulfate disinfectant powder has good disinfection effect, and has practical disinfection application prospects.

  • CHEN Jing, SUI Rui, SHENG Yan, HUANG Xiao-feng
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    Objective To evaluate the level of air microbial contamination and the effect of different intervention measures in dental clinics of a hospital. Methods Through on-site sampling using air microbial sampler and bacterial quantitative culture methods, the level of air microbial contamination and the intervention effect in a hospital’s dental clinics were evaluated. Results Before diagnosis and treatment, the total bacterial count in the air of each dental clinic ranged from 349-410 cfu/m3, and increased to 853-1 476 cfu/m3 2 h after the start of diagnosis and treatment. After operating the ultraviolet circulating air purification and disinfection machine for 60 min, the total bacterial count decreased to 234-480 cfu/m3, with a reduction rate of 67.5% to 73.7%. After the end of diagnosis and treatment, ultraviolet disinfection lamps were used for disinfection for 60 min, and the bacterial extinction rate in the air was 92.3% to 96.6%. Conclusion Both air purification and disinfection machine and ultraviolet disinfection lamps can significantly reduce the level of air microorganisms in dental clinics.

  • Application Research
  • ZHANG Zhao-wen, FAN Jun-hua, WANG Yan, ZHOU Yi-bin, WANG Zhou-yun, CHUN Ya-li, YAN Bing-qing, JI Xiao-fan, ZHU Ren-yi
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    Objective To understand the current status of disinfection quality in childcare agencies in some districts of Shanghai, and to provide a basis for improving the quality of disinfection work in childcare agencies. Methods On-site sampling and testing methods were used to monitor and analyze the disinfection quality of childcare agencies in three districts in the southwest of Shanghai. Results From 2016 to 2023, a total of 1 092 childcare agencies under the jurisdiction of Minhang District, Xuhui District, and Songjiang District in Shanghai were sampled and monitored, with an average overall qualified rate of 72.62%. 83.28% of childcare agencies failed only in 1 category of sample, and 76.59% of the staff failed in hand hygiene. There was a significant difference in the qualified rate of childcare agencies in different jurisdictions (X2=29.929, P<0.05), with the highest qualified rate of 80.39% in Xuhui District and the lowest qualified rate of 61.20% in Songjiang District. The qualified rate of public childcare agencies was 76.32%, while that of private childcare agencies was 65.98%, with a significant difference (X2=13.483, P<0.05). Conclusion Among childcare agencies in the three districts in the southwest of Shanghai, the disinfection quality in central urban areas (Xuhui District) is better, and the supervision and management of hygiene quality in suburban (Songjiang District) childcare agencies should be strengthened.

  • LI Tao, ZHU Ting-ting, LIU Gang-jian, ZHANG Qi, ZHANG Liu-bo
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    Objective To understand the current situation of the use of rigid sterilization containers in hospitals and the control of sealing performance related to safe use, and to propose further research directions and improvement measures for the identified problems. Methods Survey and evaluation was conducted on the sealing performance of rigid sterilization containers in use in 36 domestic hospitals through questionnaire surveys and on-site sealing instrument testing. Results A total of 2 369 rigid sterilization containers were surveyed in 36 hospitals. Filter paper-type rigid sterilization containers accounted for 63.23%, with 36.98% having been used for 5 to 10 years, and only 6.63% having been used for more than 10 years. Among the 46 rigid sterilization containers tested on-site, the failure rate of seal testing was 26.08%, with the failure rate reaching 52.63% for those used for 5 to 10 years. Conclusion Filter paper-type rigid sterilization containers have a simple structure that makes them easier to test, and their service life and sealing performance testing and control deserve attention. Due to factors such as cleaning and space, rigid sterilization containers have not yet become the preferred choice for sterilization packaging materials for medical devices. The results of this survey can serve as a reference for promoting the development of safe use operating specifications and related control measures for rigid sterilization containers.

  • CHEN Zhi-qiang, ZHANG Yan-jun, MA Xiu-zhen, TAN Jin-yan, XUE Chen, JIANG Qian-qian, ZHAO Yue-xiu, HUANG Yi, LI Yi
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    Objective To analyze the positive rate of cerebrospinal fluid culture, pathogen distribution, and drug resistance in patients with post-craniotomy intracranial infection (PCII), and to provide evidence for the accurate prevention and control of PCII and the spread of multidrug-resistant organisms. Methods A cross-sectional study was conducted, and patients with PCII admitted to a level-A tertiary hospital in Shanghai from January 2015 to December 2021 were selected as the research subjects. Relevant infection data of the patients were retrospectively collected to analyze the positive rate of cerebrospinal fluid culture, composition of pathogens, and detection rate of multidrug-resistant organisms. Results Among the 228 enrolled patients, 85 were positive for cerebrospinal fluid culture, with a positive rate of 37.28%. The pathogens detected in cerebrospinal fluid cultures were mainly Gram-positive bacteria, accounting for 64.66%. The distribution of pathogens was dominated by coagulase-negative Staphylococci, accounting for 41.35%, of which the detection rate of methicillin-resistant strains were 67.35%. The most common Gram-negative bacteria were Acinetobacter baumannii and Klebsiella pneumoniae, accounting for 8.27% and 6.02%, respectively. The detection rates of carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP) were 90.91% and 62.50%, respectively. Conclusion The positive rate of cerebrospinal fluid culture in patients with PCII is relatively low, and the pathogens are mainly coagulase-negative Staphylococci. However, intracranial infections caused by CRAB and CRKP are currently major challenges for nosocomial infection prevention and control in patients undergoing craniotomy.

  • MAO Lu, YANG Jin, HU Shi-hang
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    Objective To explore the value of cluster management strategy based on “key point control theory” in improving the quality of infection prevention and control in operating rooms. Methods A randomized controlled study design was used, and 300 patients who underwent surgical treatment from January 2022 to December 2024 were included as observation subjects and divided into two groups using random number method. The control group (n=150) received routine disinfection management, while the study group (n=150) adopted a bundle disinfection management program guided by the key point control theory. The qualified rate of disinfection, infection control effect, and nursing safety indicators were compared between the two groups, and the degree of nursing quality improvement was evaluated. Results The qualified rate of disinfection in key areas (shadowless lamps, object surfaces, air, incubators, and hands of medical staff) in the study group was significantly higher than that in the control group, and the postoperative infection rate was significantly lower (P<0.05). The incidence of nursing risks in the study group was lower than that in the control group, especially in terms of prevention and control of intraoperative complications and equipment management, which were significantly improved. In addition, the study group achieved better performance in dimensions such as nursing quality scores, team comprehensive ability, and patients’ satisfaction (P<0.05). Conclusion The combination of “key point control theory” and cluster management can systematically optimize the infection prevention and control process in operating rooms, significantly improve the qualified rate of disinfection, reduce the infection rate and nursing risks, and enhance the standardization of nursing management, team collaboration efficiency, and patients’ satisfaction.

  • SUN Yong-ning, LI Jie
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    Objective To understand the distribution, drug resistance, and risk factors of multidrug-resistant organisms (MDROs) in diabetic foot ulcer infections. Methods A retrospective analysis was conducted to examine and analyze the pathogen specimens submitted from patients with diabetic foot ulcer infections in a hospital. Results Among the etiological specimens submitted from 323 patients with diabetic foot ulcers, a total of 414 strains of pathogens were isolated (128 strains from the mild group and 286 strains from the severe group). Among them, there were 134 strains of multidrug-resistant organisms (MDROs), with a detection rate of 32.37%. The top three types of detected pathogens were Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. Extended-spectrum β-lactamase-producing Escherichia coli was sensitive to imipenem, and methicillin-resistant Staphylococcus aureus was sensitive to vancomycin. Factors such as osteomyelitis, invasive procedures, and more than two hospitalizations were identified as independent risk factors for MDROs in diabetic foot ulcer infections. Conclusion The detection rate of MDROs in pathogens causing diabetic foot infections is high, and the risk factors are clear. Preventive and control measures should be strengthened for high-risk factors.

  • JIN Chun-xiang, YANG Hua-fen, HUA Li, PANG Xin-yan, WU Cui, SHEN Zi-huan
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    Objective To explore the distribution of pathogens in hospital-acquired pneumonia (HAP) in pediatric inpatients, so as to analyze influencing factors, and to construct and validate a predictive model. Methods A total of 260 pediatric patients admitted to our hospital from June 2021 to January 2024 were selected as the study subjects, and they were divided into the HAP group (n=20) and the control group (n=240) based on whether they developed HAP. The risk factors affecting HAP were analyzed, and a predictive model was constructed and validated. Results The incidence of HAP in this study was 7.69%, with Acinetobacter baumannii, Klebsiella pneumoniae, and Candida albicans being the main pathogens. Logistic regression analysis showed that factors such as age <5 years, complicating congenital heart disease, immune deficiency, pre-hospital antibiotic abuse, use of steroid medications, history of recurrent infections, length of stay ≥14 d, and ≥5 hospitalizations within 3 months were high-risk factors for the development of HAP in hospitalized pediatric patients (P<0.05). The risk model predicted the risk of HAP in hospitalized pediatric patients with an AUC of 0.879 (0.802-0.956), a sensitivity of 84.73%, and a specificity of 76.49%. Conclusion The HAP risk predictive model constructed in this study has high predictive accuracy and can effectively identify high-risk pediatric patients.

  • ZHU Yi, ZHAO Xia, PAN Ying-ying, ZHUANG Jian-wen, ZOU Li-na, LUO Meng-jia, HUANG Yu-rong
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    Objective To understand the trend of changes in the prevalence of nosocomial infections among inpatients and to provide evidence for improving nosocomial infection management and prevention and control levels. Methods A cross-sectional survey method was used to analyze the prevalence of nosocomial infections among inpatients in a hospital from 2011 to 2022. Results A total of 9 249 inpatients were actually surveyed in the hospital, with an actual survey rate of 99.12% and an average prevalence of nosocomial infections of 2.02%. The sites of nosocomial infections were mainly lower respiratory tract infections, accounting for 31.37%. Among the pathogens causing nosocomial infections, Gram-negative bacteria accounted for 58.77%. The antibiotic usage rate among inpatients was 28.05%, with therapeutic antibiotics accounting for 83.85%. The pathogen testing rate was 70.45%, and the pathogen testing rate before antibiotic use showed a trend of increasing year by year. Conclusions The prevalence of nosocomial infections among inpatients in this hospital is within the national control standards. The pathogen testing for antibiotic use and therapeutic antibiotic use is relatively effective, and close attention should be paid to the monitoring and management of drug-resistant bacterial infections.

  • CAO Dan-na, HUANG Yu-cheng, CHEN Qun-ying
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    Objective To understand the clinical distribution and drug resistance of pathogenic bacteria cultured in ascites of our general surgery department, and to provide a basis for rational drug use in clinical practice. Methods The pathogenic bacteria were isolated from the patient’s ascites, and the strains were identified using a fully automated microbiological analyzer. Then, drug sensitivity tests and confirmation tests for extended spectrum β-lactams (ESBLs) were conducted. Results A total of 1 390 pathogenic bacteria and 72 types of bacteria were isolated from ascites for 10 consecutive years. The top three bacterial composition ratios were Escherichia coli (57.99%), Pseudomonas aeruginosa (8.56%), and Streptococcus pyogenes (5.25%). The positive rate of ESBLs in 806 strains of Escherichia coli was 53.4%, and the positive rate of ESBLs in 40 strains of Klebsiella pneumoniae was 40.0%. Escherichia coli and Klebsiella pneumoniae had high resistance rates to commonly used antibiotics, among which they were more sensitive to piperacillin/tazobactam and to bramycin. Conclusion The main pathogen causing ascites in patients with general surgery in this hospital is Escherichia coli. For infections caused by ESBLs producing strains, piperacillin/tazobactam and cefotentin should be the first choice, followed by carbapenems.

  • SU Guan-min, LIU Wen-jie, WANG Sai, DONG Fei, CHEN Lu, YANG Bin
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    Objective To understand the management, layout, washing and disinfection processes, and hygiene status of medical fabric washing institutions under normalized epidemic prevention and control, and to provide scientific basis for optimizing the supervision of washing institutions. Methods On-site investigation and sampling testing were used to investigate and analyze the disinfection status of some medical fabric washing institutions in Shandong Province. Results There was no statistically significant difference in the overall implementation rate of standard specifications between hospital laundry rooms and socialized washing institutions (X2=1.348, P=0.246), but there were statistically significant differences in the implementation rates of management and functions, data management and preservation (P<0.05). The overall qualified rate of disinfection quality of personnel environmental hygiene samples was 79.47%. There were statistically significant differences (P<0.05) in the qualified rates of air, object surfaces, and staff hands between hospital laundry rooms and socialized washing institutions; The overall qualified rate of clean fabrics was 73.06%, and there was a statistically significant difference (P<0.05) in the qualified rates between hospital laundry rooms and socialized washing institutions. Conclusion The implementation rate of standard specifications for hospital laundry rooms is low, and the qualified rate of environmental hygiene and clean fabrics in socialized washing institutions is also low. Therefore, it is necessary to strengthen the supervision of standard implementation in hospital laundry rooms, enhance the disinfection training and hygiene monitoring of the personnel environment and clean fabrics in socialized washing institutions, so as to ensure that medical fabrics do not cause nosocomial infections.