BACKGROUND Intensive care unit(ICU)patients are critically ill and have low immunity.They will undergo various trauma medical procedures during diagnosis and treatment.The use of high-dose hormones and broad-spectrum ...BACKGROUND Intensive care unit(ICU)patients are critically ill and have low immunity.They will undergo various trauma medical procedures during diagnosis and treatment.The use of high-dose hormones and broad-spectrum antibiotics will increase the incidence of nosocomial infection in ICU patients.Therefore,it is necessary to explore the causes of nosocomial infection in ICU and provide basis for the prevention and control of nosocomial infection in ICU.AIM To explore major pathogens of nosocomial infection in ICUs,methods of detection and drug resistance trends.METHODS Risk factors of multidrug-resistant infection were analyzed to provide a basis for clinical rational use of antimicrobial drugs in the ICU.These findings were used to standardize rational use of antimicrobial agents.BD PhoenixTM100 automatic bacterial identification analyzer was used to for cell identification in specimens collected from the ICU between January 2016 and December 2019.Drug sensitivity tests were carried out and drug resistance trends were analyzed using the optical disc diffusion method.Odds ratios and corresponding 95%CI of independent variables were calculated using a logistic regression model.Backward elimination(trend=0.1)was used as an inclusion criterion for multivariate analysis.All data were analyzed using SPSS version 22.0,and P<0.05 was considered statistically significant.RESULTS We collected 2070 samples from ICU patients between January 2016 and December 2019.Sample types comprised sputum(1139 strains,55.02%),blood(521 strains,25.17%),and drainage fluid(117 strains,5.65%).A total of 1051 strains of major pathogens,including Acinetobacter baumannii,Escherichia coli(E.coli),Pseudomonas aeruginosa(P.aeruginosa),Klebsiella pneumoniae(K.pneumoniae)and Staphylococcus aureus,were detected,with a detection rate of 35.97%(378/1051).Most of these strains were resistant to antibiotics.Detection rate of E.coli was 21.79%(229/1051),and it was generally sensitive to many antimicrobial drugs.Detection rate of P.aeruginosa was 24.74%(260/1051),and showed low sensitivity to most antibiotics.Detection rate of K.pneumoniae was 9.42%(99/1051),which was generally resistant to multiple antimicrobial drugs and resistant forms.K.pneumoniae was resistant to imipenem for approximate 4 years,and showed a 19.9%(19/99)and 20.20%(20/99)rate of meropenem resistance.Logistic analysis showed that mechanical ventilation and ureteral intubation were risk factors for multidrug-resistant bacterial infections.CONCLUSION This study showed a high incidence of ICU infections.Mechanical ventilation and urine tube intubation were risk factors for infection with multidrug-resistant bacteria.展开更多
Objective:To systematically evaluate the risk factors for multidrug-resistant organisms(MDROs)infection in patients with diabetic foot ulcer(DFU).Methods:The quality assessment of outcome measures was performed by sea...Objective:To systematically evaluate the risk factors for multidrug-resistant organisms(MDROs)infection in patients with diabetic foot ulcer(DFU).Methods:The quality assessment of outcome measures was performed by searching the Web of Science,Embase library,PubMed,Cochrane Library databases and screening the literature on the risk factors of MDROs infection in DFU patients according to the inclusion and exclusion criteria,and meta-analysis was performed using revman5.3 analysis software.Results:13 literature was retrieved,involving in 1715 patients.A total of 15 risk factors were included in the analysis and the meta-analysis showed that Previous hospitalization(OR=2.61,95%CI[1.51,4.52],P=0.0006),Previous antibiotic use(OR=2.17,95%CI[1.24-3.78],P<0.01),Type of diabetes(OR=2.44,95%CI[1.29-4.63],P<0.01),Nature of ulcer(OR=2.16,95%CI[1.06-4.40],P=0.03),Size of ulcer(OR=2.56,95%CI[1.53-4.28],P<0.01),Osteomyelitis(OR=3.50,95%CI[2.37-5.17],P<0.01),Peripheral vascular disease(OR=2.37,95%CI[1.41-3.99],P<0.01),and Surgical treatment(OR=4.81,95%CI[2.95-7.84],P<0.01)were closely associated with MDROs infection in DFU patients.Conclusions:The risk factors of MDROs infection in patients with DFU were previous hospitalization,previous antibiotic use,type of diabetes,nature of ulcer,size of ulcer,osteomyelitis,peripheral vascular disease,and surgical treatment.This study is conducive to early detection of MDROs infection in high-risk groups and timely comprehensive treatment to delay the development of the disease.展开更多
You,like all members of human communities,play several roles.At school you are a student,after school you may be on a sports team,at home you are part of a family.Organisms in a natural community also play different r...You,like all members of human communities,play several roles.At school you are a student,after school you may be on a sports team,at home you are part of a family.Organisms in a natural community also play different roles within their ecosystem.An organism’s role within an ecosystem depends on how it obtains its food.Plants and animals obtain their food in very different ways,so they have very different roles in an ecosystem.The way in which an organism obtains food also affects its interactions with other organisms in the ecosystem.展开更多
This study examined the spatiotemporal dynamics of colored dissolved organic matter(CDOM) and spectral slope(S), and further to analyze its sources in three productive water supplies(Eagle Creek, Geist and Morse reser...This study examined the spatiotemporal dynamics of colored dissolved organic matter(CDOM) and spectral slope(S), and further to analyze its sources in three productive water supplies(Eagle Creek, Geist and Morse reservoirs) from Indiana, USA. The results showed that he absorption coefficient aCDOM(440) ranged from 0.37 m–1 to 3.93 m–1 with an average of 1.89 ± 0.76 m–1(±SD) for the aggregated dataset, and S varied from 0.0048 nm–1 to 0.0239 nm–1 with an average of 0.0108 ± 0.0040 nm–1. A significant relationship between S and aCDOM(440) can be fitted with a power equation(S = 0.013 × aCDOM(440)–0.42, R2 = 0.612), excluding data from Geist Reservoir during high flow(12 April 2010) and the Morse Reservoir on 25 June 2010 due to a T-storm achieves even higher determination coefficient(R2 = 0.842). Correlation analysis indicated that aCDOM(440) has strong association with inorganic suspended matter(ISM) concentration(0.231 < R2 < 0.786) for each of the field surveys, and this trend followed the aggregated datasets(R2 = 0.447, p < 0.001). In contrast, chlorophyll-a was only correlated with aCDOM(440) in summer and autumn(0.081 < R2 < 0.763), indicating that CDOM is mainly from terrigenous sources in early spring and that phytoplankton contributed during the algal blooming season. The S value was used to characterize CDOM origin. The results indicate that the CDOM source is mainly controlled by hydrological variations, while phytoplankton originated organic matter also closely linked with CDOM dynamics in three productive reservoirs.展开更多
Cyanopolyynes (H[C≡C]n-CN or HC2n+1N, where n = 1, 2, 3, …, n) are commonly observed in the interstellar medium (ISM) as well as in the envelopes of carbon-rich stars. These linear molecular structures can be well d...Cyanopolyynes (H[C≡C]n-CN or HC2n+1N, where n = 1, 2, 3, …, n) are commonly observed in the interstellar medium (ISM) as well as in the envelopes of carbon-rich stars. These linear molecular structures can be well described with a one-dimensional conduction model, which considers the scattering processes of electrons through the charge transfer conduction bridge of the H[C≡C]n-molecular wire containing the CN group as an electron-acceptor terminal unit. Therefore, our results using this model enable a better understanding of the longest molecules observed in interstellar space and provide new insight into why these particular cyanopolyynes reach a maximum length, such as is observed from astronomical experimental spectral data and cosmological chemical models. Dipole moments and geometrical parameters of these cyanopolyynes were obtained from ab initio molecular orbital calculations using the restricted Hartree-Fock approach and 6-311G* basis set, in order to obtain the inner resistance as a new parameter of chemical reaction feasibility for this molecular series. Using this last molecular parameter, we have been able to analyze the possibility of identifying long molecular species that can be found under local thermodynamic equilibrium in some ISM such us HC25H, HC27H, and HC29N, which have not been observed at present.展开更多
Objective Contact precautions,especially the initiation of isolation,are important measures to prevent and control multidrug-resistant organisms(MDROs).However,the implementation in clinical practice remains weak.This...Objective Contact precautions,especially the initiation of isolation,are important measures to prevent and control multidrug-resistant organisms(MDROs).However,the implementation in clinical practice remains weak.This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection,and determine the factors that affect the implementation of isolation measures.Methods A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1,2018.The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected.Then,the issuance of isolation orders was retrospectively analyzed.Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation.Results The overall issuance rate of isolation orders was 61.21%,which increased from 33.12%to 75.88%(P<0.001)after the implementation of the multidisciplinary collaborative intervention.The intervention(P<0.001,OR=0.166)was a promoting factor for the issuance of isolation orders,in addition to the length of stay(P=0.004,OR=0.991),department(P=0.004),and microorganism(P=0.038).Conclusion The isolation implementation remains far lower than policy standards.Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors,thereby promoting the standardized management of MDROs,and providing reference for further improving the quality of hospital infection management.展开更多
基金Supported by Drug resistance trend analysis and prevention and control of main pathogens in tertiary hospitals of Hebei Provincial Department of health,No.20210845Analysis of drug and drug resistance trend and prevention and control of pathogens in major general hospitals of Baoding science and technology support plan project,No.17zf79.
文摘BACKGROUND Intensive care unit(ICU)patients are critically ill and have low immunity.They will undergo various trauma medical procedures during diagnosis and treatment.The use of high-dose hormones and broad-spectrum antibiotics will increase the incidence of nosocomial infection in ICU patients.Therefore,it is necessary to explore the causes of nosocomial infection in ICU and provide basis for the prevention and control of nosocomial infection in ICU.AIM To explore major pathogens of nosocomial infection in ICUs,methods of detection and drug resistance trends.METHODS Risk factors of multidrug-resistant infection were analyzed to provide a basis for clinical rational use of antimicrobial drugs in the ICU.These findings were used to standardize rational use of antimicrobial agents.BD PhoenixTM100 automatic bacterial identification analyzer was used to for cell identification in specimens collected from the ICU between January 2016 and December 2019.Drug sensitivity tests were carried out and drug resistance trends were analyzed using the optical disc diffusion method.Odds ratios and corresponding 95%CI of independent variables were calculated using a logistic regression model.Backward elimination(trend=0.1)was used as an inclusion criterion for multivariate analysis.All data were analyzed using SPSS version 22.0,and P<0.05 was considered statistically significant.RESULTS We collected 2070 samples from ICU patients between January 2016 and December 2019.Sample types comprised sputum(1139 strains,55.02%),blood(521 strains,25.17%),and drainage fluid(117 strains,5.65%).A total of 1051 strains of major pathogens,including Acinetobacter baumannii,Escherichia coli(E.coli),Pseudomonas aeruginosa(P.aeruginosa),Klebsiella pneumoniae(K.pneumoniae)and Staphylococcus aureus,were detected,with a detection rate of 35.97%(378/1051).Most of these strains were resistant to antibiotics.Detection rate of E.coli was 21.79%(229/1051),and it was generally sensitive to many antimicrobial drugs.Detection rate of P.aeruginosa was 24.74%(260/1051),and showed low sensitivity to most antibiotics.Detection rate of K.pneumoniae was 9.42%(99/1051),which was generally resistant to multiple antimicrobial drugs and resistant forms.K.pneumoniae was resistant to imipenem for approximate 4 years,and showed a 19.9%(19/99)and 20.20%(20/99)rate of meropenem resistance.Logistic analysis showed that mechanical ventilation and ureteral intubation were risk factors for multidrug-resistant bacterial infections.CONCLUSION This study showed a high incidence of ICU infections.Mechanical ventilation and urine tube intubation were risk factors for infection with multidrug-resistant bacteria.
基金National Natural Science Foundation of China(81973614)。
文摘Objective:To systematically evaluate the risk factors for multidrug-resistant organisms(MDROs)infection in patients with diabetic foot ulcer(DFU).Methods:The quality assessment of outcome measures was performed by searching the Web of Science,Embase library,PubMed,Cochrane Library databases and screening the literature on the risk factors of MDROs infection in DFU patients according to the inclusion and exclusion criteria,and meta-analysis was performed using revman5.3 analysis software.Results:13 literature was retrieved,involving in 1715 patients.A total of 15 risk factors were included in the analysis and the meta-analysis showed that Previous hospitalization(OR=2.61,95%CI[1.51,4.52],P=0.0006),Previous antibiotic use(OR=2.17,95%CI[1.24-3.78],P<0.01),Type of diabetes(OR=2.44,95%CI[1.29-4.63],P<0.01),Nature of ulcer(OR=2.16,95%CI[1.06-4.40],P=0.03),Size of ulcer(OR=2.56,95%CI[1.53-4.28],P<0.01),Osteomyelitis(OR=3.50,95%CI[2.37-5.17],P<0.01),Peripheral vascular disease(OR=2.37,95%CI[1.41-3.99],P<0.01),and Surgical treatment(OR=4.81,95%CI[2.95-7.84],P<0.01)were closely associated with MDROs infection in DFU patients.Conclusions:The risk factors of MDROs infection in patients with DFU were previous hospitalization,previous antibiotic use,type of diabetes,nature of ulcer,size of ulcer,osteomyelitis,peripheral vascular disease,and surgical treatment.This study is conducive to early detection of MDROs infection in high-risk groups and timely comprehensive treatment to delay the development of the disease.
文摘You,like all members of human communities,play several roles.At school you are a student,after school you may be on a sports team,at home you are part of a family.Organisms in a natural community also play different roles within their ecosystem.An organism’s role within an ecosystem depends on how it obtains its food.Plants and animals obtain their food in very different ways,so they have very different roles in an ecosystem.The way in which an organism obtains food also affects its interactions with other organisms in the ecosystem.
基金Under the auspices of National Aeronautics and Space Administration of US(NASA)(No.NNG06GA92G)National Natural Science Foundation of China(No.41171293)
文摘This study examined the spatiotemporal dynamics of colored dissolved organic matter(CDOM) and spectral slope(S), and further to analyze its sources in three productive water supplies(Eagle Creek, Geist and Morse reservoirs) from Indiana, USA. The results showed that he absorption coefficient aCDOM(440) ranged from 0.37 m–1 to 3.93 m–1 with an average of 1.89 ± 0.76 m–1(±SD) for the aggregated dataset, and S varied from 0.0048 nm–1 to 0.0239 nm–1 with an average of 0.0108 ± 0.0040 nm–1. A significant relationship between S and aCDOM(440) can be fitted with a power equation(S = 0.013 × aCDOM(440)–0.42, R2 = 0.612), excluding data from Geist Reservoir during high flow(12 April 2010) and the Morse Reservoir on 25 June 2010 due to a T-storm achieves even higher determination coefficient(R2 = 0.842). Correlation analysis indicated that aCDOM(440) has strong association with inorganic suspended matter(ISM) concentration(0.231 < R2 < 0.786) for each of the field surveys, and this trend followed the aggregated datasets(R2 = 0.447, p < 0.001). In contrast, chlorophyll-a was only correlated with aCDOM(440) in summer and autumn(0.081 < R2 < 0.763), indicating that CDOM is mainly from terrigenous sources in early spring and that phytoplankton contributed during the algal blooming season. The S value was used to characterize CDOM origin. The results indicate that the CDOM source is mainly controlled by hydrological variations, while phytoplankton originated organic matter also closely linked with CDOM dynamics in three productive reservoirs.
文摘Cyanopolyynes (H[C≡C]n-CN or HC2n+1N, where n = 1, 2, 3, …, n) are commonly observed in the interstellar medium (ISM) as well as in the envelopes of carbon-rich stars. These linear molecular structures can be well described with a one-dimensional conduction model, which considers the scattering processes of electrons through the charge transfer conduction bridge of the H[C≡C]n-molecular wire containing the CN group as an electron-acceptor terminal unit. Therefore, our results using this model enable a better understanding of the longest molecules observed in interstellar space and provide new insight into why these particular cyanopolyynes reach a maximum length, such as is observed from astronomical experimental spectral data and cosmological chemical models. Dipole moments and geometrical parameters of these cyanopolyynes were obtained from ab initio molecular orbital calculations using the restricted Hartree-Fock approach and 6-311G* basis set, in order to obtain the inner resistance as a new parameter of chemical reaction feasibility for this molecular series. Using this last molecular parameter, we have been able to analyze the possibility of identifying long molecular species that can be found under local thermodynamic equilibrium in some ISM such us HC25H, HC27H, and HC29N, which have not been observed at present.
基金supported by the National Natural Science Foundation of China(No.71473098).
文摘Objective Contact precautions,especially the initiation of isolation,are important measures to prevent and control multidrug-resistant organisms(MDROs).However,the implementation in clinical practice remains weak.This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection,and determine the factors that affect the implementation of isolation measures.Methods A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1,2018.The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected.Then,the issuance of isolation orders was retrospectively analyzed.Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation.Results The overall issuance rate of isolation orders was 61.21%,which increased from 33.12%to 75.88%(P<0.001)after the implementation of the multidisciplinary collaborative intervention.The intervention(P<0.001,OR=0.166)was a promoting factor for the issuance of isolation orders,in addition to the length of stay(P=0.004,OR=0.991),department(P=0.004),and microorganism(P=0.038).Conclusion The isolation implementation remains far lower than policy standards.Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors,thereby promoting the standardized management of MDROs,and providing reference for further improving the quality of hospital infection management.
