ObjectiveTo research on the types of pathogenic bacteria in wound infection and analyze the effectiveness of long-term use of nano-silver dressing in the treatment of pressure ulcers, in order to provide references for the management of pressure ulcer wound. MethodsFifty-five patients (60 wounds) with stage Ⅲ-Ⅳ pressure ulcer wound treated in all departments between September 2011 and August 2015 were chosen to be our study subjects. Under overall intervention, all the wounds were assessed by the same method, cleansed and debrided, after which nano-silver antimicrobial dressing was used to intervene until the wound healed or the end of 8 weeks. The wounds which were not healed were treated with wet dressing therapy until wound healing. The detection rate of pathogenic bacteria before intervention and 2, 4 and 8 weeks after intervention, change of pressure ulcer healing score and the rate of wound healing were observed. ResultsBefore the intervention, 12 kinds of pathogenic bacteria were detected, including mainly Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and coagulase negative Staphylococci. The detection rate of pathogenic bacteria was 92.73% (51/55). With the use of nano-silver dressing during different time periods, the detection rate of pathogenic bacteria and the total score of pressure ulcer were lowered by varying degrees (P<0.01). Four and 8 weeks after intervention, wound bed improved significantly and the detection rate of pathogenic bacteria decreased faster. The healing rate during the intervention period was 23.64% (13/55). ConclusionThe incidence of pressure ulcer wound infection is high. The use of nano-silver wound dressing can effectively remove pathogenic bacteria and promote wound healing.
Objective To review the research progress of new antibacterial hydrogels in the treatment of infected wounds in the field of biomedicine, in order to provide new methods and ideas for clinical treatment of infected wounds. Methods The research literature on antibacterial hydrogels at home and abroad was extensively reviewed in recent years, and the antibacterial hydrogels for the treatment of infected wounds were classified and summarized. Results Antibacterial hydrogels can be divided into three categories: inherent antibacterial hydrogels, antibacterial agent release hydrogels, and environmental response antibacterial hydrogels. The advantages and disadvantages of antibacterial materials, antibacterial mechanism, antibacterial ability, and biocompatibility were discussed respectively. Inherent antibacterial hydrogels have the characteristics of wide source, low cost, and simple preparation, but their antibacterial ability is relatively weak. New antimicrobial substances are added to antibacterial agent release hydrogels, such as antimicrobial peptides, metal ions, graphene materials, etc., providing a new therapeutic strategy for alternative antibiotic therapy. On the basis of the antibacterial material, environmental promoting factors such as photothermal effect, pH value, and magnetic force are added to the environmental response antibacterial hydrogels, which synergically enhances the antibacterial ability of the hydrogel, improves the precise regulation function and bionic effect of the hydrogel. ConclusionThe selection of a variety of materials, the addition of a variety of antibacterial agents, and the effect of various promoting factors make composite hydrogels show multiple characteristics. The development of antibacterial hydrogels that can effectively address practical clinical applications remains a significant challenge. In the future, expanding the application range of antibacterial hydrogels, constructing drug-loaded hydrogels, and developing intelligent hydrogels are still new areas that need to be explored and studied.
Carbapenemase producing Enterobacteriaceae (CPE) has emerged as a significant global public health challenge and placing infected patients at risk of potentially untreatable infections. When resistance to carbapenems occurs, there are often few alternative treatments available. Numerous international guidelines have performed systematic and evidence review to identify new strategies to prevent the entry and spread of CPE in healthcare settings. Several key strategies have been shown to be highly effective. Firstly a new strategy that is proven to be effective is the early identification of the CPE carrier patients through active surveillance cultures. While waiting for the screening results, suspected CPE carriers will be put on preemptive isolation in single room and healthcare worker will at the same time practice contact precautions. The active surveillance culture and prompt preemptive isolation will limit the entry and spread of CPE from getting into hospital. Secondly, it is of utmost importance to incorporate enforcement of the basic infection prevention and control best practices in the hospital including, full compliance to hand hygiene, appropriate use of personal protective equipment, execute antibiotic stewardship program to control abuse of antibiotics, effective environmental cleaning and decontamination, staff education and feedback, as well as surveillance of healthcare-associated infections. Such a holistic approach has been shown to be effective in inhibiting CPE from gaining foothold in the hospital.
ObjectiveTo study the influence of myxobacteria metabolites NX52 and NX83 on the proliferation of colorectal carcinoma cells and investigate its probable mechanism. MethodsThe human colorectal carcinoma cell lines HT-29, SW480, and SW1463 were respectively treated with the two metabolites (NX52 and NX83) at different concentrations (0.1 mg/mL, 1.0 mg/mL, and 10.0 mg/mL), the cells of negative control were treated without metabolite. The proliferation inhibition was examined by methyl tthiazolyl tetrazolium assay. The cell morphology character was compared by inverted microscope, and the apoptosis of cell was analyzed by flow cytometry. ResultsTwo kinds of metabolites NX52 and NX83 had time-dose inhibitory effects on proliferation of human colorectal carcinoma cells HT-29, SW480, and SW1463 (P < 0.05). The metabolite NX83 had more obvious proliferation inhibition in the colorectal carcinoma cells as compared with the metabolite NX52 (P < 0.05). After 48 h, the apoptosis rate of the metabolite NX83 for SW1463 cell was observably increased as compared with the negative control group (P < 0.01). ConclusionsThe two kinds of metabolites NX52 and NX83 from myxobacteria could kill colorectal carcinoma cells in vitro. The possible mechanism might be induced by apoptosis of tumor cells.
Medical institutions of China still face two challenges in hospital infections currently: one challenge is from infection, including infectious diseases, multidrug-resistant bacteria healthcare-associated infection (HAI), and classic HAI; the another challenge comes from the management of HAI in medical institutions, such as lack of full-time staff and insufficient capacity, inadequate infection control organizations, insufficient awareness of infection control among medical staff, and unbalanced development. To cope with these severe challenges, we must do the following three aspects: establishing the discipline of HAI, and improving people’s infection control ability through human-orienting; improving the management organization and system of HAI; improving the awareness of infection control among all medical staff, carrying out scientific and orderly infection prevention and control work in accordance with the law, and adhering to evidence-based infection control.
摘要:目的: 探討在闌尾切除術中應用抗菌薇喬縫線以減少闌尾切口感染的可能性。 方法 : 將我院2007年4月至2009年3月所有闌尾切除術病例1425例隨機分為抗菌薇喬縫線組和絲線組,比較其切口感染發生率。 結果 : 統計中按闌尾未穿孔、闌尾穿孔以及總計分別計算切口感染率,在抗菌微喬線組感染率分別為017%、072%、028%,絲線組分別為154%、781%、267%,兩組間分別予以X2檢驗,其〖WTBX〗P 值均小于001,具有顯著性差異。 結論 : 縫線是輔助產生切口感染的一個危險因素,在闌尾切除術中使用抗菌薇喬縫線可以顯著降低切口感染率。Abstract: Objective: To investigate the application of Coated VICRYL Plus Antibacterial suture in order to reduce the possibility of infection of appendectomy incision. Methods : Hospital from April 2007 to March 2009 appendectomy patients in all 1425 cases were randomly divided into Coated VICRYL Plus Antibacterial suture group and silk group,compared to the incidence of incision infection. Results : The statistics are not in accordance with perforated appendicitis, perforated appendicitis, as well as calculation of the total, respectively, incision infection, the infection rate in the Coated VICRYL Plus Antibacterial suture group were 017%, 072%, 028%, silk group were 154%, 781%, 267% between the two groups separately X2 test, the P value of less than 001, with a significant difference. Conclusion : The suture is to assist the incision produced a risk factor for infection in appendectomy,Coated VICRYL Plus Antibacterial suture can be used in a significant reduction in incision infection rates.
5–20 wt% trimethoxysilylpropyl octadecyldimethyl ammonium chloride (QAS) was used to modify Poly (ε-caprolactone) (PCL)-gelatin hybrid to fabricate non-leaching antibacterial nanofiber membranes (PG-Q) by electrospinning. The results from scanning electron microscopy (SEM) and transmission electron microscopy (TEM) indicated that the QAS leaded to phase separation between the QAS and PCL. Hydrophilic test demonstrated that the PG-Q nanofiber membranes had hydrophobic surface, which was help for peeling off the dressing from the wound. Additionally, the physical and chemical cross-linking between the QAS/PCL and QAS/gelatin were confirmed by Fourier transform infrared (FTIR), which were good for long lasting antibacterial effect. The PG-Q membranes also showed excellent cell-biocompatibility. Furthermore, compared with pure PCL nanofiber membrane, the PG-Q nanofiber membranes, especially PG-Q15 (QAS: 15 wt%) and PG-Q20 (QAS: 20 wt%), showed a considerable increase in the bacteriostatic rate of S. aureus and P. aeruginosa (more than 99% after 12 h). Therefore, electrospinning non-leaching antibacterial nanofiber membranes could be an optimal choice for antibacterial wound dressing.
ObjectiveThe antibacterial properties of porous medical implant materials were reviewed to provide guidance for further improvement of new medical implant materials.MethodsThe literature related to the antibacterial properties of porous medical implant materials in recent years was consulted, and the classification, characteristics and applications, and antibacterial methods of porous medical implant materials were reviewed.ResultsPorous medical implant materials can be classified according to surface pore size, preparation process, degree of degradation in vivo, and material source. It is widely used in the medical field due to its good biocompatibility and biomechanical properties. Nevertheless, the antibacterial properties of porous medical implant materials themselves are not obvious, and their antibacterial properties need to be improved through structural modification, overall modification, and coating modification.ConclusionAt present, coating modification as the mainstream modification method for improving the antibacterial properties of porous medical materials is still a research hotspot. The introduction of new antibacterial substances provides a new perspective for the development of new coated porous medical implant materials, so that the porous medical implant materials have a more reliable antibacterial effect while taking into account biocompatibility.
ObjectiveTo analyze the drug-resistant phenotype and genotype characteristics of carbapenem-resistant Enterobacteriaceae (CRE) in a traditional Chinese medicine hospital from 2016 to 2018, to provide guidance for clinical rational drug use and effective anti-infection treatment.MethodsA total of 2 901 Enterobacteriaceae bacteria strains isolated from January 2016 to December 2018 were selected, and CRE strains were screened by microdilution test and Kirby-Bauer methods. CRE strains with successful seed preservation and detailed clinical data were selected for carbapenemase phenotype confirmation test, drug-resistant gene amplification, and sequencing comparison.ResultsThe 101 CRE strains collected between 2016 and 2018 were mainly Klebsiella pneumonia (73.27%, 74/101) and Escherichia coli (14.85%, 15/101), and the specimens were mainly from sputum (63.37%, 64/101) and catheter urine (11.88%, 12/101). The phenotypic test results of carbapenemase showed that 94 strains were positive in modified Hodge test, with a positive rate of 93.07%, 96 strains were positive in Carba NP test, with a positive rate of 95.05%, and 98 strains were positive in modified carbapenem inactivation method test, with a positive rate of 97.03%. Drug-resistant genes were detected in 92 (91.01%) of the 101 CRE strains, sequencing results showed that 66 (65.35%) carried blaKPC-2 gene, 4 (3.96%) carried blaKPC-19 gene, 9 (8.91%) carried blaNDM-1 gene, and 13 (12.87%) carried blaNDM-5 gene. No CRE strains carrying two resistance genes were detected. Among them, Klebsiella pneumoniae strains mainly carried blaKPC-2 gene (82.43%, 61/74), and Escherichia coli strains mainly carried blaNDM-5 gene (86.67%, 13/15), which were consistent with the main epidemic genotype in China.ConclusionsIn recent three years, the CRE strains in this hospital mainly included Klebsiella pneumoniae with blaKPC-2 gene and Escherichia coli with blaNDM-5 gene. According to the results of this test, we can reasonably select antimicrobial agents in combination with the drug sensitivity report from the microbial laboratory, so as to delay the growth of drug-resistant strains and prevent hospital transmission of multidrug-resistant bacteria.
Objective To investigate predictive value of procalcitonin (PCT) and C-reactive protein (CRP) levels for spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis ascites. Methods The clinical data of 140 patients with liver cirrhosis ascites treated in our hospital from January 2012 to January 2016 were retrospectively analyzed. According to the presence of SBP, these patients were divided into SBP group and non-SBP group. The clinical data were compared between these two groups. The receiver operating characteristic (ROC) curve was constructed to assess their sensitivities and specificities of PCT and CRP for diagnosis of SBP. Results The PCT and CRP levels of the SBP group were significantly higher than those of the non-SBP group (P<0.05). The differences of serum ALT, AST and white cell count between the SBP group and the non-SBP were not statistically significant (P>0.05). The ROC curve analysis showed that the area under the ROC curve of PCT and CRP were 0.895 and 0.926, their corresponding cut-off value 2.1 μg/L and 24.8 mg/L, the sensitivities were 86.9% and 89.5%, the specificities were 85.1% and 83.5%, respectively. Conclusion Abnormally elevated PCT and CRP levels might have an important detective value for SBP in patients with liver cirrhosis ascites.