Objective To preliminarily understand the equipment configuration and information system function improvement of the microbiology laboratory for etiological submission before antibiotic treatment in Chinese medical institutions, and provide a scientific basis for further targeted action work on the rate of etiological submission before antibiotic treatment. Methods A network questionnaire was released in “Sentinel Hospital Information Reporting System of National Hospital Infection Management Professional Quality Control Center” between March 1 and June 21, 2022. The second-level and above hospitals were investigated. Results A total of 783 hospitals were included, of which 765 (97.7%) hospitals had been equipped with microbiology laboratory equipment to varying degrees, and the allocation rate of tertiary hospitals was higher than that of secondary hospitals (P<0.05). The top three items of common pathogenic test were aerobic (98.3%), bacterial smear (97.6%) and fungal smear (95.1%), and the last three items were streptococcus pneumoniae urine antigen (20.4%), silver hexamine staining (19.0%) and gene sequencing (8.9%). The comparison of relevant information system and function improvement among hospitals of different levels showed that tertiary hospitals were superior to secondary hospitals (P<0.05). In different regions, except for the allocation rate of nosocomial infection information monitoring system and rational drug use monitoring system (P>0.05), other relevant systems and functional improvement of hospitals in eastern, central and western regions, the differences were statistically significant (P<0.05). The number of hospitals that could obtain the indicators of “etiological submission rate of inpatients before antibiotic treatment”“etiological submission rate related to hospital infection diagnosis”“etiological submission rate before combined use of key drugs” were 698 (89.1%), 474 (60.5%) and 337 (43.0%), respectively. Among the factors affecting the implementation of special actions, 454 hospitals (58.0%) thought that the information system was not fully functional, 341 hospitals (43.6%) thought that the etiology testing project was not fully carried out, and 148 hospitals (18.9%) thought that the microbiology laboratory testing ability was insufficient. Conclusion All kinds of hospitals at all levels in China, especially specialized and secondary hospitals, need to further improve the configuration of equipment and information system functions in the microorganism laboratory related to aetiology inspection, strengthen the support for microbial inspection, and strengthen information management, monitoring and analysis.
ObjectiveTo explore the association between preoperative, perioperative parameters, especially estimated glomerular filtration rate (eGFR) and postoperative atrial fibrillation (POAF) after modified extended Morrow procedure.MethodsA total of 300 hypertrophic obstructive cardiomyopathy (HOCM) patients who underwent modified extended Morrow procedure in our hospital from January 2012 to March 2018 were collected. There were 197 (65.67%) males and 103 (34.33%) females with an average age of 43.54±13.81 years. Heart rhythm was continuously monitored during hospitalization. The patients were divided into a POAF group (n=68) and a non-POAF group (n=232). The general data, perioperative parameters and echocardiographic results were collected by consulting medical records for statistical analysis. Univariate and multivariate logistic regression models were used to analyze the risk factors for POAF.ResultsOverall incidence of POAF during hospitalization was 22.67% (68/300). Compared with patients without POAF, patients with POAF were older, had higher incidence of chest pain and syncope, lower level of preoperative eGFR, higher body mass index and heart function classification (NYHA), larger preoperative left atrial diameter and left ventricular end diastolic diameter, and longer ventilator-assisted time, ICU stay and postoperative hospital stay. Age, heart function classification (NYHA)≥Ⅲ, hypertension, syncope history and eGFR were independent risk factors for POAF. Receiver operating characteristic curve analysis showed that the area under the curve of eGFR was 0.731 (95%CI 0.677-0.780, P<0.001), and the sensitivity and specificity were 82.4% and 57.8%, respectively.ConclusionIncreased age, high preoperative heart function classification (NYHA), hypertension, preoperative syncope history and decreased eGFR are independent risk factors for POAF in HOCM patients who underwent surgical septal myectomy. Preoperative decreased eGFR can moderately predict the occurrence of POAF after modified extended Morrow procedure.