Ocular injury resulting in eye removal at a large tertiary care center in China

AIM:To investigate the risk factors for eye removal following ocular trauma at a major ophthalmology department in China.METHODS:A retrospective study of patients who underwent eye removal surgery following ocular trauma was completed.Clinical outcomes were consulted in detail through the hospital’s computed medical data system.Patients’information including age,gender,cause of ocular trauma,affected eye,and education level was collected and recorded in a standardized database.Chi-squared test,Student’s t-test,Fisher’s exact test,and bivariate correlation analysis were used for statistical comparisons.RESULTS:The present study included 1675 removal eyes from 1674 patients over the 20-year period.Patients included 80.5%males and 19.5%females,with mean age of 38y.The majority of the patients(70.7%)were blue-collar workers(physical laborers),and 1098 patients(65.6%)did not receive high school education.Work-related injuries were the most common reason for eye removal(n=739,44.1%),of which 441 cases(59.7%)were related to metal/nail wounds.The most frequent injury type in males was work-related injuries(49.7%),whereas the most frequent injury type in females was home-related injuries(25.8%).CONCLUSION:Work-related injuries are a leading cause of severe ocular injury resulting in eye removal.In addition,men and undereducated patients are more likely to undergo eye removal surgery following ocular trauma.This study identified multiple high-risk factors leading to eye removal following ocular trauma,which is of great importance for preventing severe eye injuries.

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study

In many traditional Chinese medicine （TCM） hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections （nBSIs） are an important cause of morbidity and mortality. A retrospective sur- veillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions Escherichia coli （25.5%） was the most common Gram-negative and coagulase-negative staphylococcus （CONS） （14.1%） was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsie/la pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glyco- peptide were the most frequently used for nBSI therapy. Only about one-third of patients （157/482） received appro- priate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score 〉4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.