Epidemiological characteristics of ventilator-associated pneumonia in neurosurgery:A 10-year surveillance study in a Chinese tertiary hospital

Background Ventilator-associated pneumonia(VAP)is a significant and common health concern.The epidemiological landscape of VAP is poorly understood in neurosurgery patients.This study aimed to explore the epidemiology of VAP in this population and devise targeted surveillance,treatment,and control efforts.Methods A 10-year retrospective study spanning 2011 to 2020 was performed in a large Chinese tertiary hospital.Surveillance data was collected from neurosurgical patients and analyzed to map the demographic and clinical characteristics of VAP and describe the distribution and antimicrobial resistance profile of leading pathogens.Risk factors associated with the presence of VAP were explored using boosted regression tree(BRT)models.Results Three hundred ten VAP patients were identified.The 10-year incidence of VAP was 16.21 per 1000 ventilation days.All-cause mortality was 6.1%.The prevalence of gram-negative bacteria,fungi,and gram-positive bacteria among the 357 organisms isolated from VAP patients was 86.0%,7.6%,and 6.4%,respectively;most were multidrug-resistant organisms.Acinetobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa were the most common pathogens.The prevalence of carbapenem-resistant A.baumannii,P.aeruginosa,and K.pneumoniae was high and increased over time in the study period.The BRT models revealed that VAP was associated with number of days of ventilator use(relative contribution,47.84±7.25),Glasgow Coma Scale score(relative contribution,24.72±5.67),and tracheotomy(relative contribution,21.50±2.69).Conclusions Our findings provide a better understanding of the epidemiology of VAP and its risk factors in neurosurgery patients.

Distribution and risk factors of hand, foot, and mouth disease in Changchun, northeastern China

Hand,foot,and mouth disease(HFMD)is a public health problem,and there have been increasing numbers of outbreaks in China's Mainland since 2008.Over17,000 HFMD cases have been reported in Changchun between 2008 and 2011.This study characterized the temporal and spatial distribution of the disease and identified the risk factors for HFMD.The main findings were as follows:(i)there were significant differences in HFMD incidence among age groups,with 86.8%of reported cases in children younger than 5 years old,and boys showed a higher incidence than girls(\6 years);(ii)The disease affected the whole region and spanned a large geographic area,but there was a higher incidence in urban areas(median=242 per 10,000 persons)and urban–rural border areas(median=135 per 10,000 persons),compared with rural areas(median=75 per 10,000 persons);and(iii)the incidence of HFMD in Changchun was significantly associated with the distance to the nearest freeway,GDP per capita,and the type of township.