ObjectiveTo explore the risk factors, pathophysiological mechanism, pathogenic bacteria distribution, diagnosis, and treatment of postoperative intra-abdominal infection, and to provide a theoretical basis for further understanding the mechanism and treatment of postoperative intra-abdominal infection.MethodThe related literatures in PubMed, CNKI, WanFang, and other databases were searched to summarize the research progress of postoperative intra-abdominal infection.ResultsPostoperative intra-abdominal infection was associated with a variety of risk factors, and timely identification and control were conducive to the prevention of intra-abdominal infection. Postoperative intra-abdominal infection had a complex pathophysiological mechanism, mainly involving changes in the immune system, which provided a target for immunotherapy. Pathogenic bacteria were widely distributed in postoperative intra-abdominal infection, and the problem of drug resistance was also a big problem nowadays. In the treatment of postoperative intra-abdominal infection, comprehensive treatment measures should be taken to control the infection, in which the control of the source of infection was the basis and played a key role.ConclusionsThe treatment of postoperative intra-abdominal infection needs to be more individualized and refined, and comprehensive treatment measures such as controlling the source of infection, nutrition therapy, organ function support, and so on, should be taken. Immunotherapy is a new potential treatment measure.
The morbidity and mortality of pulmonary infection are high among infectious diseases worldwide. Rapid and accurate etiological diagnosis is the key to timely and effective treatment. Metagenomic next-generation sequencing (mNGS) technology has brokenthrough the limitations of traditional pathogenic microorganism detection methods and improved the detection rate of pathogens. In this paper, the application and advantages of mNGS technology in the diagnosis of bacteria, fungi, viruses and mixed infections in the lungs are analyzed, and the challenges and breakthroughs in RNA detection, wall breaking of firmicutes and host DNA clearance are described, in order to achieve targeted and accurate etiological diagnosis through mNGS, so as to effectively treat pulmonary infections.
ObjectiveTo analyze the clinical characteristics, risk factors, and drug resistance of pathogenic bacteria in patients with blood stream infections (BSI) after orthopedic surgery, so as to provide reference and basis for clinical diagnosis and treatment.MethodsA retrospective analysis was made on the clinical data of 6 348 orthopedic patients admitted for surgery between January 2017 and December 2019. There were 3 598 males and 2 750 females. Their age ranged from 18 to 98 years, with an average of 66 years. The data of patients were collected, and the risk factors of BSI were analyzed by univariate analysis and logistic regression analysis. The distribution of BSI pathogenic bacteria, the results of drug sensitivity test, the incidence of BSI in patients after orthopedic surgery in different years, and the common sites of BSI secondary infection were summarized.ResultsBSI occurred in 106 (1.67%) of 6 348 patients after orthopedic surgery. There were 71 cases (66.98%) of secondary infection. The mortality of postoperative BSI patients was 1.89%, and the difference was significant when compared with that of non-postoperative BSI patients (0.24%) (χ2=5.313, P=0.021). The incidences of BSI in 2017, 2018, and 2019 were 1.18%, 1.53%, and 2.17%, respectively, showing an increasing trend year by year (trend χ2=6.610, P=0.037). Statistical analysis showed that the independent risk factors for BSI after orthopedic surgery (P<0.05) included the trauma, length of hospital stay≥14 days, emergency surgery, postoperative leukocyte counting<4×109/L, level of hemoglobin≤90 g/L, albumin≤30 g/L, the time of indwelling ureter>24 hours, use of deep vein catheter insertion, and merging other site infection. Blood culture showed 56 strains (52.83%) of Gram-positive bacteria, 47 strains (44.34%) of Gram-negative bacteria, and 3 strains (2.83%) of fungi. The top three pathogenic bacteria were coagulase negative Staphylococci (CNS; 36 strains, 33.96%), Escherichia coli (16 strains, 15.09%), and Staphylococcus aureus (15 strains, 14.15%). The detection rates of extended-spectum β-lactamases producing strains of Escherichia coli and Klebsiella pneumoniae were 56.25% (9/16) and 44.44% (4/9), respectively. The detection rates of methicillin-resistant strains in Staphylococcus aureus and CNS were 46.67% (7/15) and 72.22% (26/36), respectively.ConclusionPostoperative BSI in orthopedic patients is caused by multiple factors. Preventive measures should be taken according to related risk factors and perioperative risk assessment should be strengthened. Staphylococcus and Escherichia coli are the most common pathogenic bacteria in BSI after orthopedic surgery. The infection rate and drug-resistant bacteria are increasing year by year. Therefore, drug resistance monitoring should be strengthened.
Objective To explore the characteristics and influencing factors of bloodstream infection in patients with acute pancreatitis (AP), understand the characteristics of infectious pathogens, and provide references for formulating prevention and control measures for bloodstream infection in patients with AP. Methods The clinical data of patients with AP admitted to Sichuan Provincial People’s Hospital between January 2019 and February 2025 were retrospectively collected. Multivariate logistic regression analysis was employed to identify the influencing factors of bloodstream infection, and the characteristics of related pathogens was analyzed. Results A total of 1510 patients with AP were included, of whom 52 were complicated with bloodstream infections, with an infection rate of 3.44%. Multivariate logistic regression analysis revealed that gender [odds ratio (OR)=2.062, 95% confidence interval (CI) (1.045, 4.070)], hyperlipidemia [OR=0.207, 95%CI (0.077, 0.554)], and central venous catheterization [OR=4.093, 95%CI (1.765, 9.493)] were influencing factors for bloodstream infections (P<0.05). Among the pathogens identified in patients with AP complicated by bloodstream infections, Gram-negative bacteria accounted for the highest proportion (48.1%), with the main bacteria being Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. Conclusions Gender, hyperlipidemia, and central venous catheterization are influencing factors for AP complicated with bloodstream infection. For with AP, it is necessary to strictly evaluate the indications for central venous catheterization and implement corresponding prevention and control measures to reduce the risk of infection.
