Search

BackgroundCentral catheter bloodstream infections (CRBSI) is a major cause of healthcare-associated infections. However, few factors are generally accepted and some studies have conflicting finding about some factors, possibly caused by limitation associated with an individual study. This study was to identify risk factors for CRBSI in intensive care units.MethodsWe searched the PubMed, Cochrane Library, Web of science and EMBASE databases and the 4 top Chinese-language databases, including WanFang data, China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM) as of July 2023. Case control and cohort studies were included. Two authors independently screened the literature and evaluated the quality of the studies using the Newcastle-Ottawa scale (NOS). The pooled effect size was estimated using the odds ratio (OR), and the corresponding 95% confidence interval (CI) was calculated. The Cochrane Q (χ2) and I2 tests were used to assess heterogeneity among studies, and each risk factor was tested for its robustness using fixed- or random-effects models.FindingsA total of 32 studies enrolled, among which eleven factors were identified, they were divided into two categories: modifiable and unmodifiable factors. Modifiable factors: duration of catheterization (≥ 5d) (OR: 2.07, 95%CI: 1.41-3.03), duration of catheterization (≥ 7d) (OR: 3.62, 95%CI: 2.65-4.97), duration of catheterization (≥ 14d)(OR: 4.85, 95%CI: 3.35-7.01), total parenteral nutrition (OR: 2.27,95%CI: 1.56-3.29), use of multiple-lumen catheters(OR: 3.41, 95%CI: 2.27-5.11), times of tube indwelling (OR: 3.50, 95%CI: 2.93-4.17), length of ICU stay (OR: 4.05, 95%CI: 2.41-6.80), the position of indwelling(OR: 2.41, 95%CI: 2.03-2.85); Unmodifiable factors: APACHEII scores (OR: 1.84, 95%CI: 1.54-2.20), Age≥ 60 years old (OR: 2.19, 95%CI: 1.76-2.73), the extensive use of antibiotic (OR: 3.54, 95%CI: 1.65-7.61), Diabetes mellitus (OR: 3.06, 95%CI: 2.56-3.66), Immunosuppression (OR: 2.87, 95%CI: 2.08-3.95).ConclusionsEffective interventions targeting the above modifiable factors may reduce the risk of developing CRBSI in ICU and improve the clinical outcome of patients. Further prospective studies are needed to confirm these findings.

In this work, the thermo-sensitive materials N-isopropylacrylamide (NIPAM) and acrylic acid (AA) were crosslinked with carboxymethyl cellulose (CMC) (CMC/P (NIPAM-co-AA)) via a free radical polymerization method for the removal of U(VI) from aqueous solution. The L16 (45) orthogonal experiments were designed for the optimization of the synthesis condition. The chemical structures of the crosslinking hydrogel were confirmed by FTIR spectroscopy. The microstructural analyses were conducted though scanning electron microscopy (SEM) to show the pore structure of the hydrogel. The adsorption performance of the CMC/P (NIPAM-co-AA) hydrogel for the uptake of U(VI) from simulated wastewater was also investigated. The adsorption reached equilibrium within 1 h. Under the reaction of pH = 6 and a temperature of 298 K, an initial concentration of U(VI) of 5 mg·L−1, and 10 mg of the CMC/P(NIPAM-co-AA) hydrogel, the maximum adsorption capacity was 14.69 mg g−1. The kinetics fitted perfectly with the pseudo-second-order model, and the isotherms for the composite hydrogel adsorption of U(VI) was in accordance with the Langmuir model. The chemical modification confirmed that the acylamino group played an important role in uranium adsorption. The desorption and reusability study revealed that the resolution rate was still available at approximately 77.74% after five alternate heating cycles at 20 and 50 °C of adsorption-desorption.

Background Sarcopenia, a syndrome of progressive and generalised loss of skeletal muscle, which can increase the risk of postoperative complications of colorectal cancer, but its association with postoperative surgical site infections in colorectal cancer is still inconclusive. Objective To evaluate the association of abdominal CT-assessed sarcopenia with postoperative surgical site infections in patients undergoing colorectal cancer surgery. Methods Three hundred and twenty-eight colorectal cancer patients underwent radical surgery in Gastrointestinal Surgery, the First Affiliated Hospital of University of South China between July 2019 and December 2021 were selected. Clinical data were retrospectively collected through the electronic medical record system. Sarcopenia was diagnosed by the L3 skeletal muscle index (L3 SMI) assessed using abdominal CT. Surgical site infection was assessed using the Diagnostic Criteria of Nosocomial Infection (Trial) . Multivariate Logistic regression was applied to explore the influencing factors of postoperative surgical site infection. Results The incidence of surgical site infection in sarcopenia group was higher than that in non-sarcopenia group〔27.3% (12/44) vs 12.3% (35/284) 〕 (P