Urgent call for attention to diabetes-associated hospital infections

In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.

Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections

Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue.Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment.Microbes have evolved numerous mechanisms to effectively evade host intrinsic and adaptive immune attacks to persistently localize in the host,such as drug-resistant bacteria,biofilms,persister cells,intracellular bacteria,and small colony variants(SCVs).Moreover,microbial-mediated dysregulation of the bone immune microenvironment impedes the bone regeneration process,leading to impaired bone defect repair.Despite advances in surgical strategies and drug applications for the treatment of bone infections within the last decade,challenges remain in clinical management.The development and application of tissue engineering materials have provided new strategies for the treatment of bone infections,but a comprehensive review of their research progress is lacking.This review discusses the critical pathogenic mechanisms of microbes in the skeletal system and their immunomodulatory effects on bone regeneration,and highlights the prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections.It will inform the development and translation of antimicrobial and bone repair tissue engineering materials for the management of bone infections.

Klebsiella pneumoniae infections after liver transplantation:Drug resistance and distribution of pathogens,risk factors,and influence on outcomes

BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.

Preoperative blood markers and intra-abdominal infection after colorectal cancer resection

BACKGROUND Colorectal cancer(CRC)has one of the highest morbidity and mortality rates among digestive tract tumors.Intra-abdominal infection(IAI)is a common postoperative complication that affects the clinical outcomes of patients with CRC and hinders their rehabilitation process.However,the factors influencing abdominal infection after CRC surgery remain unclear;further,prediction models are rarely used to analyze preoperative laboratory indicators and postoperative complications.AIM To explore the predictive value of preoperative blood markers for IAI after radical resection of CRC.METHODS The data of 80 patients who underwent radical resection of CRC in the Anorectal Surgery Department of Suzhou Hospital affiliated with Anhui Medical University were analyzed.These patients were categorized into IAI(n=15)and non-IAI groups(n=65)based on whether IAI occurred.Influencing factors were compared;general data and laboratory indices of both groups were identified.The relationship between the indicators was assessed.Further,a nomogram prediction model was developed and evaluated;its utility and clinical applic-ability were assessed.RESULTS The risk factors for IAI after radical resection of CRC were neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and carcinoembryonic antigen(CEA)levels.NLR was correlated with PLR and SII(r=0.604,0.925,and 0.305,respectively),while PLR was correlated with SII(r=0.787).The nomogram prediction model demonstrated an area under the curve of 0.968[95%confidence interval(CI):0.948-0.988]in the training set(n=60)and 0.926(95%CI:0.906-0.980)in the validation set(n=20).The average absolute errors of the calibration curves for the training and validation sets were 0.032 and 0.048,respectively,indicating a good model fit.The decision curve analysis curves demonstrated high net income above the 5%threshold,indicating the clinical practicality of the model.CONCLUSION The nomogram model constructed using NLR,PLR,SII,and CEA levels had good accuracy and reliability in predicting IAI after radical resection of CRC,potentially aiding clinical treatment decision-making.

Role of vitamin D in COVID-19 and other viral infections

Vitamin D is a steroid hormone that is naturally produced in the body or obtained through dietary sources,primarily under the influence of UVB radiation.This essential nutrient has a vital role in numerous physiological processes,encom-passing immune function,cell growth,differentiation,insulin regulation,and cardiovascular well-being,along with its pivotal role in sustaining the delicate equilibrium of calcium and phosphate concentrations in the body.Moreover,vitamin D reinforces mucosal defense and bolsters the immune system through immunomodulation,making it a critical component of overall health.Numerous studies have unveiled the profound connection between vitamin D and the predisposition to respiratory tract infections,including well-known viruses such as influenza and the novel severe acute respiratory syndrome coronavirus 2.Vita-min D deficiency has been consistently linked to increased severity of coronavirus disease 2019(COVID-19)and a heightened risk of mortality among afflicted individuals.Retrospective observational studies have further substantiated these findings,indicating that levels of vitamin D are linked with both the occurrence and severity of COVID-19 cases.Vitamin D has its influence on viral infections th-rough a multitude of mechanisms,such as promoting the release of antimicrobial peptides and fine-tuning the responses of the immune system.Additionally,vitamin D is intertwined with the intricate network of the renin–angiotensin system,suggesting a potential impact on the development of complications related to COVID-19.While further clinical trials and extensive research are warranted,the existing body of evidence strongly hints at the possible use of vitamin D as a valuable tool in the prophylaxis and management of COVID-19 and other viral infectious diseases.

Meiotic transcriptional reprogramming mediated by cell-cell communications in humans and mice revealed by scATACseq and scRNA-seq

Meiosis is a highly complex process significantly influenced by transcriptional regulation.However,studies on the mechanisms that govern transcriptomic changes during meiosis,especially in prophase I,are limited.Here,we performed single-cell ATAC-seq of human testis tissues and observed reprogramming during the transition from zygotene to pachytene spermatocytes.This event,conserved in mice,involved the deactivation of genes associated with meiosis after reprogramming and the activation of those related to spermatogenesis before their functional onset.Furthermore,we identified 282 transcriptional regulators(TRs)that underwent activation or deactivation subsequent to this process.Evidence suggested that physical contact signals from Sertoli cells may regulate these TRs in spermatocytes,while secreted ENHO signals may alter metabolic patterns in these cells.Our results further indicated that defective transcriptional reprogramming may be associated with non-obstructive azoospermia(NOA).This study revealed the importance of both physical contact and secreted signals between Sertoli cells and germ cells in meiotic progression.

Prediction of cell-cell communication patierns of dorsal root ganglion cells:single-cell RNA sequencing data analysis

Dorsal root ganglion neurons transmit peripheral somatic information to the central nervous system,and dorsal root ganglion neuron excitability affects pain perception.Dorsal root ganglion stimulation is a new approach for managing pain sensation.Knowledge of the cell-cell communication among dorsal root ganglion cells may help in the development of new pain and itch management strategies.Here,we used the single-cell RNA-sequencing(scRNA-seq)database to investigate intercellular communication networks among dorsal root ganglion cells.We collected scRNA-seq data from six samples from three studies,yielding data on a total of 17,766 cells.Based on genetic profiles,we identified satellite glial cells,Schwann cells,neurons,vascular endothelial cells,immune cells,fibroblasts,and vascular smooth muscle cells.Further analysis revealed that eight types of dorsal root ganglion neurons mediated proprioceptive,itch,touch,mechanical,heat,and cold sensations.Moreover,we predicted several distinct forms of intercellular communication among dorsal root ganglion cells,including cell-cell contact,secreted signals,extracellular matrix,and neurotransmitter-mediated signals.The data mining predicted that Mrgpra3-positive neurons robustly express the genes encoding the adenosine Adora2b(A2B)receptor and glial cell line-derived neurotrophic factor family receptor alpha 1(GFRα-1).Our immunohistochemistry results confirmed the coexpression of the A2B receptor and GFRα-1.Intrathecal injection of the A2B receptor antagonist PSB-603 effectively prevented histamine-induced scratching behaviour in a dose-dependent manner.Our results demonstrate the involvement of the A2B receptor in the modulation of itch sensation.Furthermore,our findings provide insight into dorsal root ganglion cell-cell communication patterns and mechanisms.Our results should contribute to the development of new strategies for the regulation of dorsal root ganglion excitability.

Identification of an immune-related gene signature for predicting prognosis and immunotherapy efficacy in liver cancer via cell-cell communication

BACKGROUND Liver cancer is one of the deadliest malignant tumors worldwide.Immunotherapy has provided hope to patients with advanced liver cancer,but only a small fraction of patients benefit from this treatment due to individual differences.Identifying immune-related gene signatures in liver cancer patients not only aids physicians in cancer diagnosis but also offers personalized treatment strategies,thereby improving patient survival rates.Although several methods have been developed to predict the prognosis and immunotherapeutic efficacy in patients with liver cancer,the impact of cell-cell interactions in the tumor microenvir-onment has not been adequately considered.AIM To identify immune-related gene signals for predicting liver cancer prognosis and immunotherapy efficacy.METHODS Cell grouping and cell-cell communication analysis were performed on single-cell RNA-sequencing data to identify highly active cell groups in immune-related pathways.Highly active immune cells were identified by intersecting the highly active cell groups with B cells and T cells.The significantly differentially expressed genes between highly active immune cells and other cells were subsequently selected as features,and a least absolute shrinkage and selection operator(LASSO)regression model was constructed to screen for diagnostic-related features.Fourteen genes that were selected more than 5 times in 10 LASSO regression experiments were included in a multivariable Cox regression model.Finally,3 genes(stathmin 1,cofilin 1,and C-C chemokine ligand 5)significantly associated with survival were identified and used to construct an immune-related gene signature.RESULTS The immune-related gene signature composed of stathmin 1,cofilin 1,and C-C chemokine ligand 5 was identified through cell-cell communication.The effectiveness of the identified gene signature was validated based on experi-mental results of predictive immunotherapy response,tumor mutation burden analysis,immune cell infiltration analysis,survival analysis,and expression analysis.CONCLUSION The findings suggest that the identified gene signature may contribute to a deeper understanding of the activity patterns of immune cells in the liver tumor microenvironment,providing insights for personalized treatment strategies.

Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

Spontaneous Infection of Ascites Fluid at the National and University Hospital Hubert Koutoukou Maga in Cotonou: Prevalence and Associated Factors

Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated with it in the largest hospital in Cotonou. Methods: This was a retrospective descriptive and analytical study conducted from January 2013 to July 2019, at the National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) in Cotonou, Benin. All patients followed in the University Clinic of Hepato-Gastroenterology and diagnosed with SAFI were included. Results: Eighty-two patients were included, predominantly males (69.5%), with a mean age of 51.5 ± 14.5 years. Among them, 32 had SAFI, i.e., a prevalence of 39%. Of the 32 cases of SAFI, the culture of ascites fluid was positive in 6 cases (18.7%). The most frequent germ found in SAFI was Escherichia coli (5 patients, 83.3%). The factors associated with SAFI in this study were: abdominal pain (p = 0.004), increased bilirubinemia (p = 0.009), decreased prothrombin level 20 (p = 0.001). Conclusion: SAFI was common in cirrhotic patients in the department. Certain clinical and paraclinical factors were associated with it, as was the severity of cirrhosis. Early diagnosis and aetiological management of cirrhosis could reduce its frequency.

Reinfection and Risk Factors of SARS-CoV-2 during an Omicron Wave 2022 in Shanghai

Multiple waves of coronavirus disease 2019(COVID-19) outbreaks have affected numerous countries worldwide. The first case of SARS-CoV-2 reinfection was reported in Hong Kong in August 2020^([1]), leading to increased interest in the effectiveness of natural immunity acquired from primary infection. While data reports vary across countries, all findings indicate that prior SARS-CoV-2 infection provides substantial protection against reinfection^([2]). However, natural immunity from infection with previous non-Omicron or early Omicron sub-lineages offers lower levels of protection against Omicron reinfection, with rates below 60%^([3]) and approximately 75%[4], respectively.

Countermeasures to reduce the risk of infections at the 2024 Olympic and Paralympic Games—A balancing act

The Olympic and Paralympic Games are a global celebration of athletic dedication and achievement,bringing together athletes and spectators from around the world.However,such large gatherings present public health challenges for the Organizing Committees and local governments.As highlighted by the coronavirus disease 2019(COVID-19)pandemic,these events are associated with an increased risk of transmission of infections,which can significantly impact the health and well-being of athletes and attendees.Prioritizing the health and safety of athletes,officials and spectators is fundamental to ensure the successful hosting of the Games.Therefore,it is essential to design and implement comprehensive countermeasures to mitigate the risk of an infectious disease outbreak among participants but also to the residents of the host city.

A case of Rickettsia felis infection-induced encephalitis in a pregnant woman

Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.

Timing of hepatectomy following the Omicron variant infection for vaccinated-patients:A retrospective cohort study

Many previous studies suggested that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection elevated the risk of morbidity and 90-day mortality after operation, especially pulmonary complications [1–7]. Uncertainty about perioperative safety puts off the progress of elective surgery [8]. The Omicron variant has recently become the dominant variant causing prevalence in several countries [9]. Although a high rate of patients with Omicron presented asymptomatic status [10], it is still unclear whether Omicron infection would raise the risk of postoperative complications.

The Place of Nursing Theory in the Management of Post-Operative Infections in a Hospital Environment: Case of Cibitoke District Hospital

Introduction: Post-operative infections, such as surgical site infections (SSIs), are a significant concern in healthcare settings. Nurses play a crucial role in the prevention and management of these infections. The use of nursing theory could contribute to the prevention of SSIs. The aim of this study was to evaluate the role of nursing theory in the management of surgical site infections (SSIs) in a hospital environment. Method: A cross-sectional study was conducted using descriptive and analytical methods to assess the role of nursing theory in the management of Post-operative infections (POI) in a hospital setting in October 2023. The study population consisted of nurses working in the Surgery, Emergency, and Maternity units at Cibitoke District Hospital. A sample size of 71 nurses working full or part time in the Surgery were invited to participate in this study. A questionnaire was used to collect the data, and SPSS version 21.0 software was used for analysis. Results: The study found that nursing theory did not have any statistically significant place in the management of POI (p-value = 0.523). However, the results showed that experience was the only significant factor influencing the management of POI (p-value = 0.004). This is explained by the analysis of the net effects of the explanatory variable where we noticed that those who had more experience were more likely to manage post-operative infections. The participants’ knowledge regarding nursing theory in the management was poor as they scored less than 30% in all the variables used to measure their knowledge. Conclusion: The study revealed that nurses’ knowledge of nursing theories and their applications in the management of SSIs was poor. Continuing professional development, curriculum review, and in-service training were highly recommended.

Caspase-11 mediated inflammasome activation in macrophages by systemic infection of A.actinomycetemcomitans exacerbates arthritis

Clinical studies have shown that Aggregatibacter actinomycetemcomitans(A.actinomycetemcomitans)is associated with aggressive periodontitis and can potentially trigger or exacerbate rheumatoid arthritis(RA).However,the mechanism is poorly understood.Here,we show that systemic infection with A.actinomycetemcomitans triggers the progression of arthritis in mice anti-collagen antibody-induced arthritis(CAIA)model following IL-1βsecretion and cell infiltration in paws in a manner that is dependent on caspase-11-mediated inflammasome activation in macrophages.The administration of polymyxin B(PMB),chloroquine,and anti-CD11b antibody suppressed inflammasome activation in macrophages and arthritis in mice,suggesting that the recognition of lipopolysaccharide(LPS)in the cytosol after bacterial degradation by lysosomes and invasion via CD11b are needed to trigger arthritis following inflammasome activation in macrophages.These data reveal that the inhibition of caspase-11-mediated inflammasome activation potentiates aggravation of RA induced by infection with A.actinomycetemcomitans.This work highlights how RA can be progressed by inflammasome activation as a result of periodontitis-associated bacterial infection and discusses the mechanism of inflammasome activation in response to infection with A.actinomycetemcomitans.

Ethnobotanical Study of Medicinal Plants Used for Treating Urinary Tract Infections in N’Djamena (Chad)

Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.

Thoracic spine infection caused by Pseudomonas fluorescens:A case report and review of literature

BACKGROUND The clinical incidence of spinal infection is gradually increasing,and its onset is insidious,easily leading to missed diagnosis and misdiagnosis,which may lead to serious complications such as nervous system dysfunction,spinal instability and/or deformity,and cause a huge burden on society and families.Early identification of the causative agent and precision medicine will greatly reduce the suffering of patients.At present,the main pathogenic bacteria that cause spinal infection are Staphylococcus aureus,Streptococcus,Pneumococcus,Escherichia coli,and Klebsiella.There are no reports of spinal infection caused by Pseudomonas fluorescens.CASE SUMMARY We report a 32-year-old female patient with spinal infection.She presented with flank pain,initially thought to be bone metastases or bone tuberculosis,and had a family background of tumors.Her clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine infection.Histopathology of the lesion showed inflammation,tissue culture of the lesion was negative several times,and the possible pathogen-Pseudomonas fluorescens was found after gene sequencing of the lesion.The patient recovered completely after a full course of antibiotic treatment.CONCLUSION This report increases the range of pathogens involved in spinal infections,highlights the unique advantages of gene sequencing technology in difficult-todiagnose diseases,and validates conservative treatment with a full course of antibiotics for spinal infections without complications.

Risk Factors Recurrence of Spontaneous Ascitic Fluid Infection (Slai) in Cirrhotic Patients

Introduction: After an episode of spontaneous infection of ascitic fluid (ISLA). The recurrence of ISLA at one year is greater than 70%. We studied the risk factors associated with the occurrence of recurrence. Patients and methods: this was a retrospective, descriptive and analytical study of patient files, hospitalized in the department for 12 months, the choice of the sample was of convenience. Results: We have 1347 patient files collected including 389 cases of cirrhosis. We had 37 files of cirrhotic patients with ISLA including 28 cures without recurrence of ISLA, 08 files of patients with recurrence of ISLA and 03 excluded, i.e. a hospital prevalence of recurrence of 0.6% and a prevalence in cirrhotic patients of 23.5%. The most common antecedents were: hospital contact recent (35.3%), the concept of iterative ascites punctures (32.3%), the presence of HCC (29.4%), hepatic encephalopathy (20.6%) and digestive hemorrhage (14.7%). In univariate analysis, recent digestive bleeding was associated with an increased risk of recurrence (OR 7.2, 95% CI 0.96 - 67.1). HBV (62.5%) is the main etiology of cirrhosis. The PNN rate at 250 - 499 mm3 (62.5%), the protein level 3 (75%). Patients on secondary prophylaxis with NORFLOXACIN were 25%. Recurrence of ISLA was treated with CEFTRIAXONE 2 g/24 hours. Conclusion: Recurrence of ISLA is serious, the predictive factors for recurrence are, hospital contact recent, the concept of iterative ascites punctures, the presence of HCC, the presence of hepatic encephalopathy and digestive bleeding.

The Impact of Optimizing Details in the Operating Room on the Level of Knowledge, Attitude, and Practice of Hospital Infection Prevention and Control by Surgeons, as Well as the Effectiveness of Infection Control

Objective: This paper aims to explore the impact of optimizing details in the operating room on the level of knowledge, attitude, and practice of hospital infection prevention and control by surgeons, as well as the effectiveness of infection control. Methods: From January 2022 to June 2023, a total of 120 patients were screened and randomly divided into a control group (routine care and hospital infection management) and a study group (optimizing details in the operating room). Results: Significant differences were found between the two groups in the data of surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, infection rates, and nursing satisfaction, with the study group showing better results (P Conclusion: The use of optimizing details in the operating room among surgeons can effectively improve surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, reduce infection occurrence, and is worth promoting.