Hepatitis C virus(HCV)infection is highly prevalent among patients on hemodialysis(HD).The prevalence of HCV infection in HD patients varies markedly from country to country.Some factors are especially related to thes...Hepatitis C virus(HCV)infection is highly prevalent among patients on hemodialysis(HD).The prevalence of HCV infection in HD patients varies markedly from country to country.Some factors are especially related to these high prevalence rates,such as blood transfusions and length of dialysis time. Nosocomial routes of transmission including the use of contaminated equipment and patient-to-patient exposure is considered more important.Several prophylactic measures have been suggested to avoid infection by HCV in the HD environment.展开更多
Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the...Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the ward,the nursing log and the hospitalization medical record of correlative patients were consulted.SARS-CoV in serum specimen from SARS patient was detected by PCR.Results The room where SARS outbreak occurred was on the 13th floor of the 16-story main ward building.There were 6 beds in the room,living with 6 female patients(aged 45-67)who were all hospitalized due to type2 diabetes.On March 24,2003,Patient 1 began to have a fever and cough,chest X-ray showed pneumonia.Five and six days later,Patient 2 and Patient 3 began to have a fever,respectively.Finally,all of these 3 patients died.Their beds were all at the same side of the room,and the other 3 patients at the opposite side were not infected.Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR.The daughter-in-law of Patient 1who accompanied Patient 1 by the bedside several days,mainly near the window,upwind of Patient 1,was not infected.Medical staff,family members and visitors of the 6 patients were not infected.Conclusions This outbreak was not transmitted by aerosol.The distance droplets travels could be up to 3.43 meters.Droplet spread has direction,and the droplets direction of propagation is closely related with the wind direction and speed.Those at the downwind position of SARS patients were susceptible to be infected.Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.展开更多
Promoting biosafety regulations and techniques supports human health and protects individuals and groups from harmful incidents.Particular attention should be paid to those potential infectious hazards associated with...Promoting biosafety regulations and techniques supports human health and protects individuals and groups from harmful incidents.Particular attention should be paid to those potential infectious hazards associated with blood and other bodily fluids,especially those highly transmitted infectious diseases,such as human immunodeficiency virus(HIV),one of the largest global health threats.Ensuring innovative and adaptive screening and laboratory techniques to reduce the possibility of HIV transmission are integral to managing the disease.We review here the evolution and success of blood screening techniques for HIV,along with current issues that still need to be addressed.Published academic articles and media reports about nosocomial HIV transmission events since 1981 were reviewed to identify current blood screening and transfusion safety trends across the globe,along with specific recommendations from the Chinese perspective.Although most initial screening was limited only to antibody and antigen testing,newer screening tests(such as nucleic acid testing),coupled with risk-based screening of donors,have led to reduced risk of HIV transmission and continues to reduce the“window period,”when an HIV-positive individual may test negative though they have been infected.Further examination of current guidelines and regulations across the globe are discussed,in order to understand where critical gaps in screening may exist.Through examination of this data,it is evident that huge strides have been made since the beginning of the epidemic;however improved technical training of staff and streamlined testing guidelines could help promote efficient screening of HIV,while also supporting those providing care.展开更多
Healthcare workers(HCWs)are at high risk of occupational exposure to the new pandemic human coronavirus,SARSCoV-2,and are a source of nosocomial transmission in airborne infectious isolation rooms(AIIRs).Here,we perfo...Healthcare workers(HCWs)are at high risk of occupational exposure to the new pandemic human coronavirus,SARSCoV-2,and are a source of nosocomial transmission in airborne infectious isolation rooms(AIIRs).Here,we performed comprehensive environmental contamination surveillance to evaluate the risk of viral transmission in AIIRs with 115 rooms in three buildings at the Shanghai Public Health Clinical Center,Shanghai,during the treatment of 334 patients infected with SARS-CoV-2.The results showed that the risk of airborne transmission of SARS-CoV-2 in AIIRs was low(1.62%,25/1544)due to the directional airflow and strong environmental hygiene procedures.However,we detected viral RNA on the surface of foot-operated openers and bathroom sinks in AIIRs(viral load:55.00–3154.50 copies/mL).This might be a source of contamination to connecting corridors and object surfaces through the footwear and gloves used by HCWs.The risk of infection was eliminated by the use of disposable footwear covers and the application of more effective environmental and personal hygiene measures.With the help of effective infection control procedures,none of 290 HCWs was infected when working in the AIIRs at this hospital.This study has provided information pertinent for infection control in AIIRs during the treatment of COVID-19 patients.展开更多
Background Identification of hospitalized carbapenem-resistant Enterobacteriaceae （CRE）-positive patient is important in preventing nosocomial transmission.The objective of this study was to illustrate the implement...Background Identification of hospitalized carbapenem-resistant Enterobacteriaceae （CRE）-positive patient is important in preventing nosocomial transmission.The objective of this study was to illustrate the implementation of proactive infection control measures in preventing nosocomial transmission of CRE in a healthcare region of over 3200 beds in Hong Kong between October 1,2010 and December 31,2011.Methods The program included active surveillance culture in patients with history of medical tourism with hospitalization and surgical operation outside Hong Kong within 12 months before admission,and ＂added test＂ as an opportunistic CRE screening in all fecal specimens submitted to the laboratory.Outbreak investigation and contact tracing were conducted for CRE-positive patients.Serial quantitative culture was performed on CRE-positive patients and the duration of fecal carriage of CRE was analyzed.Results During the study period,a total of 6533 patients were screened for CRE,of which 76 patients were positive （10 from active surveillance culture,65 from ＂added test＂,and 1 secondary case from contact tracing of 223 patients with no nosocomial outbreak）,resulting in an overall rate of CRE fecal carriage of 1.2％.The median time of fecal carriage of CRE was 43 days （range,13-119 days）.Beta-lactam-beta-lactamase-inhibitors,cephalosporins,and fluoroquinolones were associated significantly with high fecal bacterial load when used 90 days before CRE detection,while use of cephalosporins,carbapenems,and fiuoroquinolones after CRE detection are significantly associated with longer duration of carriage.The duration of fecal carriage of CRE also correlates significantly with the initial fecal bacterial load （Pearson correlation：0.53; P=0.02）.Conclusion Proactive infection control measures by enhanced surveillance program identify CRE-positive patients and data obtained are useful for the planning of and resource allocation for CRE control.展开更多
Background:Severe fever with thrombocytopenia syndrome virus(SFTSV)is a tick-borne bunyavirus that could cause a severe hemorrhagic fever termed SFTS with a high fatality rate of up to 30%.Importantly,SFTSV is frequen...Background:Severe fever with thrombocytopenia syndrome virus(SFTSV)is a tick-borne bunyavirus that could cause a severe hemorrhagic fever termed SFTS with a high fatality rate of up to 30%.Importantly,SFTSV is frequently transmitted from person-to-person and patients’blood or excreta are considered as the risk factors for transmission of SFTSV.However,the mechanism of person-to-person transmission of SFTSV is still elusive.Methods:In this study,wild-type(WT)C57BL/6 J mice and a lethal SFTSV mouse model IFNAR−/−A129 mice were utilized to evaluate whether SFTSV could be transmitted via oral or ocular routes.C57BL/6 J mice were inoculated with cell-cultured SFTSV via oral and ocular inoculation.IFNAR−/−A129 mice were inoculated with cell-cultured SFTSV or SFTSV infected mouse acute sera via oral and ocular inoculation.Results:We found that SFTSV antibody positive rates in C57BL/6 J mice were 70%(7/10)and 30%(3/10)in the oral inoculation group and ocular inoculation group,respectively on day 21 post SFTSV inoculation.The mortality rates of IFNAR−/−mice with oral and ocular inoculation of cell-cultured SFTSV were 100%and 83.33%(5/6),respectively on day 6 post inoculation.The mortality rates of IFNAR−/−mice with oral and ocular inoculation of SFTSV infected mouse acute serum were 100%and 66.67%(4/6),respectively on day 9 post inoculation.Conclusions:Together,our results show that SFTSV can be transmitted effectively through oral and ocular mem-brane,suggesting exposure to SFTS positive excreta may be a high-risk factor of nosocomial transmission of SFTSV in hospitals and/or families.Family members and healthcare workers should be protected properly during taking care of SFTS patients to prevent SFTSV nosocomial infection.展开更多
文摘Hepatitis C virus(HCV)infection is highly prevalent among patients on hemodialysis(HD).The prevalence of HCV infection in HD patients varies markedly from country to country.Some factors are especially related to these high prevalence rates,such as blood transfusions and length of dialysis time. Nosocomial routes of transmission including the use of contaminated equipment and patient-to-patient exposure is considered more important.Several prophylactic measures have been suggested to avoid infection by HCV in the HD environment.
文摘Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the ward,the nursing log and the hospitalization medical record of correlative patients were consulted.SARS-CoV in serum specimen from SARS patient was detected by PCR.Results The room where SARS outbreak occurred was on the 13th floor of the 16-story main ward building.There were 6 beds in the room,living with 6 female patients(aged 45-67)who were all hospitalized due to type2 diabetes.On March 24,2003,Patient 1 began to have a fever and cough,chest X-ray showed pneumonia.Five and six days later,Patient 2 and Patient 3 began to have a fever,respectively.Finally,all of these 3 patients died.Their beds were all at the same side of the room,and the other 3 patients at the opposite side were not infected.Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR.The daughter-in-law of Patient 1who accompanied Patient 1 by the bedside several days,mainly near the window,upwind of Patient 1,was not infected.Medical staff,family members and visitors of the 6 patients were not infected.Conclusions This outbreak was not transmitted by aerosol.The distance droplets travels could be up to 3.43 meters.Droplet spread has direction,and the droplets direction of propagation is closely related with the wind direction and speed.Those at the downwind position of SARS patients were susceptible to be infected.Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.
基金This research was supported by the National Science and Technology Major Project on Prevention and Treatment of Major Infectious Diseases Including AIDS and Viral Hepatitis from the National Health Commission of the People's Republic of China(2018ZX10721102).
文摘Promoting biosafety regulations and techniques supports human health and protects individuals and groups from harmful incidents.Particular attention should be paid to those potential infectious hazards associated with blood and other bodily fluids,especially those highly transmitted infectious diseases,such as human immunodeficiency virus(HIV),one of the largest global health threats.Ensuring innovative and adaptive screening and laboratory techniques to reduce the possibility of HIV transmission are integral to managing the disease.We review here the evolution and success of blood screening techniques for HIV,along with current issues that still need to be addressed.Published academic articles and media reports about nosocomial HIV transmission events since 1981 were reviewed to identify current blood screening and transfusion safety trends across the globe,along with specific recommendations from the Chinese perspective.Although most initial screening was limited only to antibody and antigen testing,newer screening tests(such as nucleic acid testing),coupled with risk-based screening of donors,have led to reduced risk of HIV transmission and continues to reduce the“window period,”when an HIV-positive individual may test negative though they have been infected.Further examination of current guidelines and regulations across the globe are discussed,in order to understand where critical gaps in screening may exist.Through examination of this data,it is evident that huge strides have been made since the beginning of the epidemic;however improved technical training of staff and streamlined testing guidelines could help promote efficient screening of HIV,while also supporting those providing care.
基金supported by the Special National Project on investigation of basic resources of China(Grant 2019FY101500)the National Natural Science Foundation of China(Grants 81861138003 and 31930001)supported an Australian Research Council(ARC)Australian Laureate Fellowship(FL170100022)。
文摘Healthcare workers(HCWs)are at high risk of occupational exposure to the new pandemic human coronavirus,SARSCoV-2,and are a source of nosocomial transmission in airborne infectious isolation rooms(AIIRs).Here,we performed comprehensive environmental contamination surveillance to evaluate the risk of viral transmission in AIIRs with 115 rooms in three buildings at the Shanghai Public Health Clinical Center,Shanghai,during the treatment of 334 patients infected with SARS-CoV-2.The results showed that the risk of airborne transmission of SARS-CoV-2 in AIIRs was low(1.62%,25/1544)due to the directional airflow and strong environmental hygiene procedures.However,we detected viral RNA on the surface of foot-operated openers and bathroom sinks in AIIRs(viral load:55.00–3154.50 copies/mL).This might be a source of contamination to connecting corridors and object surfaces through the footwear and gloves used by HCWs.The risk of infection was eliminated by the use of disposable footwear covers and the application of more effective environmental and personal hygiene measures.With the help of effective infection control procedures,none of 290 HCWs was infected when working in the AIIRs at this hospital.This study has provided information pertinent for infection control in AIIRs during the treatment of COVID-19 patients.
文摘Background Identification of hospitalized carbapenem-resistant Enterobacteriaceae （CRE）-positive patient is important in preventing nosocomial transmission.The objective of this study was to illustrate the implementation of proactive infection control measures in preventing nosocomial transmission of CRE in a healthcare region of over 3200 beds in Hong Kong between October 1,2010 and December 31,2011.Methods The program included active surveillance culture in patients with history of medical tourism with hospitalization and surgical operation outside Hong Kong within 12 months before admission,and ＂added test＂ as an opportunistic CRE screening in all fecal specimens submitted to the laboratory.Outbreak investigation and contact tracing were conducted for CRE-positive patients.Serial quantitative culture was performed on CRE-positive patients and the duration of fecal carriage of CRE was analyzed.Results During the study period,a total of 6533 patients were screened for CRE,of which 76 patients were positive （10 from active surveillance culture,65 from ＂added test＂,and 1 secondary case from contact tracing of 223 patients with no nosocomial outbreak）,resulting in an overall rate of CRE fecal carriage of 1.2％.The median time of fecal carriage of CRE was 43 days （range,13-119 days）.Beta-lactam-beta-lactamase-inhibitors,cephalosporins,and fluoroquinolones were associated significantly with high fecal bacterial load when used 90 days before CRE detection,while use of cephalosporins,carbapenems,and fiuoroquinolones after CRE detection are significantly associated with longer duration of carriage.The duration of fecal carriage of CRE also correlates significantly with the initial fecal bacterial load （Pearson correlation：0.53; P=0.02）.Conclusion Proactive infection control measures by enhanced surveillance program identify CRE-positive patients and data obtained are useful for the planning of and resource allocation for CRE control.
文摘目的利用AFLP分型和分子标记了解我院鲍曼不动杆菌(Acinetobacter baumannii.AB)菌株亲缘性和传播途径。方法应用PCR方法,对17种内酰胺酶基因、6种氨基糖苷类修饰酶基因、耐消毒剂和磺胺基因、整合子遗传标记(整合酶基因)、Tn21/Tn501转座子遗传标记(汞离子还原酶基因)进行检测;采用扩增片段长度多态性(Amplified Fragment Length Polymorphism,AFLP)进行AB菌分型;对检测结果作样本聚合分析讨论菌株亲缘性并根据临床资料研究AB的传播途径。结果27株AB不仅TEM、OXA-23群、ADC等内酰胺酶基因携带率高,而且包括aac(3)-Ⅰ、aa(c6′)-Ⅰ、an(t3″)-Ⅰ氨基糖苷类修饰酶编码基因,qacE△1-sul1耐消毒剂和磺胺基因,Ⅰ类整合酶基因携带率高。多基因聚合分析发现存在至少3个克隆。AFLP分型发现耐药菌是由同一个克隆进化而来。结论医院的ICU病房已经成为耐药AB菌发生、进化、传播的核心环节。加强ICU的管理工作是防止院内耐药AB菌流行的重要手段。而控制抗生素的使用,可以使AB菌的耐药性逐步减弱。
基金This study was supported by the National Natural Sci-ence Funds of China(81971939 and 31570167)the Fundamental Research Funds for the Central Universities(2042021kf0046).
文摘Background:Severe fever with thrombocytopenia syndrome virus(SFTSV)is a tick-borne bunyavirus that could cause a severe hemorrhagic fever termed SFTS with a high fatality rate of up to 30%.Importantly,SFTSV is frequently transmitted from person-to-person and patients’blood or excreta are considered as the risk factors for transmission of SFTSV.However,the mechanism of person-to-person transmission of SFTSV is still elusive.Methods:In this study,wild-type(WT)C57BL/6 J mice and a lethal SFTSV mouse model IFNAR−/−A129 mice were utilized to evaluate whether SFTSV could be transmitted via oral or ocular routes.C57BL/6 J mice were inoculated with cell-cultured SFTSV via oral and ocular inoculation.IFNAR−/−A129 mice were inoculated with cell-cultured SFTSV or SFTSV infected mouse acute sera via oral and ocular inoculation.Results:We found that SFTSV antibody positive rates in C57BL/6 J mice were 70%(7/10)and 30%(3/10)in the oral inoculation group and ocular inoculation group,respectively on day 21 post SFTSV inoculation.The mortality rates of IFNAR−/−mice with oral and ocular inoculation of cell-cultured SFTSV were 100%and 83.33%(5/6),respectively on day 6 post inoculation.The mortality rates of IFNAR−/−mice with oral and ocular inoculation of SFTSV infected mouse acute serum were 100%and 66.67%(4/6),respectively on day 9 post inoculation.Conclusions:Together,our results show that SFTSV can be transmitted effectively through oral and ocular mem-brane,suggesting exposure to SFTS positive excreta may be a high-risk factor of nosocomial transmission of SFTSV in hospitals and/or families.Family members and healthcare workers should be protected properly during taking care of SFTS patients to prevent SFTSV nosocomial infection.
