Colonization of multidrug-resistant Gram-negative bacteria increases risk of surgical site infection after hemorrhoidectomy: a cross-sectional study of two centers in southern China.

PURPOSE: The present study aims to determine the rectoanal colonization rate and risk factors for the colonization of present multidrug-resistant bacteria (MDRBs). In addition, the relationship between MDRB colonization and surgical site infection (SSI) following hemorrhoidectomy was explored. METHODS: A cross-sectional study was conducted in the Department of Colorectal Surgery of two hospitals. Patients with hemorrhoid disease, who underwent hemorrhoidectomy, were included. The pre-surgical screening of multidrug-resistant Gram-negative bacteria (MDR-GNB) colonization was performed using rectal swabs on the day of admission. Then, the MDRB colonization rate was determined through the rectal swab. Logistic regression models were established to determine the risk factors for MDRB colonization and SSI after hemorrhoidectomy. A p-value of < 0.05 was considered statistically significant. RESULTS: A total of 432 patients met the inclusion criteria, and the MDRB colonization prevalence was 21.06% (91/432). The independent risk factors for MDRB colonization were as follows: patients who received ≥ 2 categories of antibiotic treatment within 3 months (odds ratio (OR): 3.714, 95% confidence interval (CI): 1.436-9.605, p = 0.007), patients with inflammatory bowel disease (IBD; OR: 6.746, 95% CI: 2.361-19.608, p < 0.001), and patients with high serum uric acid (OR: 1.006, 95% CI: 1.001-1.010, p = 0.017). Furthermore, 41.57% (37/89) of MDRB carriers and 1.81% (6/332) of non-carriers developed SSIs, with a total incidence of 10.21% (43/421). Based on the multivariable model, the rectoanal colonization of MDRBs (OR: 32.087, 95% CI: 12.052-85.424, p < 0.001) and hemoglobin < 100 g/L (OR: 4.130, 95% CI: 1.556-10.960, p = 0.004) were independently associated with SSI after hemorrhoidectomy. CONCLUSION: The rectoanal colonization rate of MDRBs in hemorrhoid patients is high, and this was identified as an independent risk factor for SSI after hemorrhoidectomy.

Evaluation of the quality of COVID-19 prevention and control by a novel comprehensive evaluation model in a tertiary general hospital: a prospective observational study.

BACKGROUND: Prevention and control (P&C) of Corona Virus Disease 2019 (COVID-19) is still a critical task in most countries and regions. However, there are many single evaluation indexes to assess the quality of COVID-19 P&C. It is necessary to synthesize the single evaluation indexes reasonably to obtain the overall evaluation results. METHODS: This study was divided into three steps. Step 1: In February 2020, the improved Delphi method was used to establish the quality evaluation indexes system for COVID-19 P&C. Step 2: in March 2020, the CRITIC method was used to adjust the Order Relation Analysis (G1) method to obtain the subjective and objective (S&O) combination weights. The comprehensive evaluation value was obtained using the weighted Efficacy Coefficient (EC) method, weighted TOPSIS method, weighted rank-sum ratio (RSR) method, and weighted Grey Relationship Analysis (GRA) method. Finally, the linear normalization method was used to synthesize the evaluation values of different evaluation methods. Step 3: From April 2020 to May 2021, this evaluation method was used to monitor and assess COVID-19 P&C quality in critical departments prospectively. The results were reported to the departments monthly. RESULT: A quality evaluation indexes system for COVID-19 P&C was established. Kendall's consistency test shows that the four evaluation method had good consistency (χ2 = 43.429, P<0.001, Kendall's consistency coefficient = 0.835). The Spearman correlation test showed that the correlation between the combined evaluation results and the original method was statistically significant(P < 0.001). According to the Mann-Kendall test, from March 2020 to May 2021, the mean value of COVID-19 P&C quality in all critical departments showed an upward trend (P < 0.01). CONCLUSIONS: The combined comprehensive evaluation method based on the S&O combined weight was more scientific and comprehensive than the single weighting and evaluation methods. In addition, monitoring and feedback of COVID-19 P&C quality were helpful for the improvement of P&C quality.

[Seroepidemiological Survey on Echinococcosis among Children in Ningxia Hui Autonomous Region in 2012].

According to the population structure, a stratified cluster sampling was carried out in 22 counties/ cities/disticts of Ningxia Hui Autonomous Region from June to August 2012. Serum anti-echinococcus IgG was detected by ELISA. Among 22995 sampled children from 91 primary schools, the sero-positive rate was 2.9%. The rate in males and females was 2.8%(333/11 840) and 3.0%(337/11 155), respectively (χ2 = 0.88, P > 0.05). Higher serum positive rate occurred in Yuanzhou District (10.6%, 169/1602), Yanchi County (9.1%, 74/810), and Zhongning County (7.1%, 96/1350) (χ2 = 1826.51, P < 0.05). The rate in rural schools (3.1%, 371/11 963) was higher than that of urban ones (2.7%, 368/13,834) (χ2 = 4.30, P < 0.05), and higher in Hui nationality (3.3%, 302/9,127) than that of Han nationality (2.7%, 368/13,834) (χ2 = 8.17, P < 0.05). The highest positive rate was found in the group of 7 to 9 years (3.2%, 180/5 662) and of 12 years (3.3%, 254/7,694) (χ2 = 4.11, P < 0.05).

[Development and forensic application of a pentaplex X-STR loci typing system].

A fluorescent multiplex PCR that simultaneously amplifies five X-chromosomal short tandem repeat (X-STR) loci (DXS6803, DXS981, DXS6809, DXS6789 and DXS7132)was set up to study their polymorphic nature and to determine its use in kinship tests for forensic cases. PCR products were analyzed using capillary electrophoresis and ABI prism 3100 Genetic Analyzer with GeneMapper ID 3.1 Analysis Software. The pentaplex system gave satisfactory results as its sensitivity, reproducibility and unambiguous genotyping. About 20 ng DNA was routinely used, although 0.25 ng DNA was sufficient for allele typing. The results demonstrate that the multiplex system of the five X-STR loci provides a fast technology for forensic identification and paternity testing. The X-STR pentaplex system can complement the analysis of AS-STR and Y-STR efficiently, especially in complex cases of kinship testing.

Development of a five ChX STRs loci typing system.

We investigated the polymorphism of five X-chromosomal short tandem repeat markers (ChrX STRs) loci (DXS7132, DXS981, DXS6803, DXS6809, and DXS6789) and their value for forensic applications. A fluorescent multiplex polymerase chain reaction (PCR) for amplifying five ChrX STRs loci in the same PCR reaction was set up. A total of 827 unrelated individuals of the Han nationality in China were tested. The results show that the five loci in the multiplex system provide high polymorphism information for forensic identification and paternity testing, particularly for difficult paternity-deficient cases.