Epidemiological and Population Characteristics of Seroprevalence of TTIs Among Voluntary Blood Donors — Guangzhou City, Guangdong Province, China, 2014–2023

Feifeng Li^1,2; Junmou Xie^1,2; Wenbo Gao^1,2; Fenfang Liao^1,2; Haojian Liang^1,2; Rongsong Du^1,2; Zhongping Li^1,2; Yongmei Nie^1,2; Yongshui Fu³; Ru Xu^1,2; Shijie Li^1,2; Hao Wang^1,2; Huaqin Liang^1,2,#

1. Insitute of Blood Transfusion and Hematology, Guangzhou Blood Center, Guangzhou Medical University, Guangzhou City, Guangdong Province, China;

2. The Key Medical Laboratory of Guangzhou, Guangzhou City, Guangdong Province, China;

3. Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou City, Guangdong Province, China.

^# Corresponding authors: Huaqin Liang, lianghuaqin11@163.com.

Transfusion-transmitted infections (TTIs) pose significant public health challenges. Screening potential blood donors for HBV, HCV, HIV, and Treponema pallidum (TP), along with ongoing monitoring of epidemiological data on TTIs among donors, is essential to ensure blood safety. This study conducted a retrospective analysis of the seroprevalence of HBsAg, anti-HCV, anti-HIV, and anti-TP among 3,111,265 blood donation events in Guangzhou from 2014 to 2023, investigating their relationships with demographic characteristics such as gender, age, and donation status. The findings indicated that the overall seroprevalence of TTIs among blood donations was 866.21 per 100,000, demonstrating a declining trend over the ten-year period. Seroprevalence rates of transfusion-transmissible diseases also exhibited a downward trend across various demographic groups. Notably, male donors, first-time donors, and older donors demonstrated higher seroprevalence rates for TTIs. While the overall seroprevalence rate of transfusion-transmissible diseases among blood donors remains relatively low, significant disparities exist among different demographic groups. It is necessary of sustained TTIs monitoring among blood donors to guide public health interventions and donor screening practices.

无偿献血者输血传播感染的流行病学和人群特征 — 广州市，广东省，中国，2014-2023年

李飞奉^1,2；谢君谋^1,2；高文博^1,2；廖芬芳^1,2；梁浩坚^1,2；杜荣松^1,2；李仲平^1,2；聂咏梅^1,2；付涌水³；许茹^1,2；黎世杰^1,2；王淏^1,2；梁华钦^1,2,#

1. 中国输血协会，广州血液中心，广州市，广东省，中国；

2. 广州医科大学输血与血液病研究所，广州市，广东省，中国；

3. 广州市第一人民医院，广州医科大学，广州市，广东省，中国。

^# 通信作者：梁华钦，lianghuaqin11@163.com。

输血传播感染（TTIs）仍然是一个重要公共卫生问题。对潜在献血者进行 HBsAg、HCV、HIV和梅毒（TP） 筛查，及监测献血者TTIs的流行病学数据，对血液安全有重要意义。本研究回顾性分析了广州2014年至2023年间3,111,265次血液检测中的HBsAg、抗-HCV、抗-HIV和抗-TP的血清流行率及趋势，和其与性别、年龄、献血次数等人口统计学特征的关系。研究发现，献血者中TTIs的总体血清流行率为866.21/100000，十年以来献血者输血传播疾病的血清流行率呈下降趋势。不同人群献血者的输血传播性疾病的血清流行率呈下降趋势。男性献血者、初次献血者和老年献血者TTIs的血清流行率更高。献血者中输血传播感染的血清流行率较低，不同人群TTIs的血清流行率有差异。建议对献血者TTIs进行流行病学的持续监测，以指导公共卫生干预和献血者筛查。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.133

Prevalence of Salmonella enterica Serotype 4,[5],12:i:- from Human Sources: Antimicrobial Resistance, Genotypic Diversity and Emergence of Carbapenem Resistance — China, 2017–2023

Huiying Sun¹; Zhigang Cui¹; Xiaoli Du¹; Fenxia Fan¹; Bowei Sun¹; Baowei Diao¹; Haijian Zhou¹; Biao Kan¹; Meiying Yan^1,#

1 National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

^# Corresponding author: Meiying Yan, yanmeiying@icdc.cn.

Salmonella 4,[5],12:i:-, a globally emerging pathogen with multidrug resistance (MDR), is spreading in China. Nationwide data on the antimicrobial resistance (AMR) and genomic characteristics of Salmonella 4,[5],12:i:- from human sources in China are scarce. This study aimed to characterize the prevalence, genetic diversity, and AMR profiles of Salmonella 4,[5],12:i:- in China. All information, including geographical data, antimicrobial susceptibility test results, and whole-genome sequences, was extracted from the Chinese Pathogen Identification Network database from 2017 to 2023. Antimicrobial resistance phenotypes of 2,736 human-derived isolates were determined, and genomic analysis was applied to assess their genetic heterogeneity. Additionally, resistance genes were detected. Salmonella 4,[5],12:i:- strains exhibited varying levels of resistance to the tested antibiotics, with an overall resistance rate of 98.83%, MDR rate of 87.98%, and cefotaxime resistance of 25.91%. An increasing trend was observed for resistance to key antibiotics and AMR determinants from 2020–2023. Whole-genome analysis revealed five clades with high genetic diversity (A–E), with 97.33% belonging to ST34. Clade D carried a significant proportion of ESBL genes. Moreover, we identified 15 meropenem-resistant isolates primarily harboring widely distributed plasmids containing multiple resistance genes including bla_NDM-5 and bla_OXA-10. Salmonella 4,[5],12:i:- is highly sporadic in China but remains phylogenetically linked to the prevalent MDR clone with a distinct resistance profile worldwide. The emergence of elevated resistance to third-generation cephalosporins and sharp rise in carbapenem resistance, coupled with the detection of plasmid-mediated resistance determinants, suggests the evolution of endemic MDR clones circulating within China. These findings emphasize the need for enhanced surveillance, stricter regulations on antibiotic use in agriculture, comprehensive risk factor surveys, and targeted interventions to prevent outbreaks.

人源鼠伤寒沙门菌单相变种Salmonella 4,[5],12:i:-的流行：耐药性、遗传多样性和碳青霉烯类耐药性的出现 — 中国，2017–2023年

孙慧颖¹；崔志刚¹；杜小莉¹；樊粉霞¹；孙博威¹；刁保卫¹；周海健¹；阚飙¹；闫梅英^1,#

1. 传染病预防控制所，中国疾病预防控制中心，北京，中国。

^# 通信作者: 闫梅英，yanmeiying@icdc.cn。

鼠伤寒沙门菌单相变种 (Salmonella 4,[5],12:i:-)，作为一种全球新兴的多重耐药病原菌，正在我国传播。但关于该病原体在我国人群感染的全国范围的耐药性和基因组特征报道很少。因此，本研究旨在描述鼠伤寒沙门菌单相变种在中国人源菌株中的流行、遗传多样性和耐药谱。菌株所涉及的所有信息，包括地理信息、药物敏感性试验结果和全基因组序列，均来自2017年至2023年中国致病菌识别网数据库。共对2736株人源分离株进行了药物敏感性测试，获得其耐药表型，并利用基因组学分析揭示其遗传多样性。此外，还对菌株携带耐药基因进行了检测。鼠伤寒沙门菌单相变种对所测试的抗生素表现出不同程度的耐药性，总体耐药率为98.83%，多重耐药率为87.98%，对头孢噻肟的耐药率为25.91%。2020-2023年期间，菌株对关键抗生素的耐药性和耐药基因携带率呈上升趋势。全基因组分析显示，我国鼠伤寒沙门菌单相变种具有高度遗传多样性，可分为A-E五个流行谱系，其中，97.33%的菌株属于序列型ST34， 谱系D携带了高比例的ESBL基因。此外，研究还发现了15株对美罗培南耐药的鼠伤寒沙门菌单相变种，它们主要携带了广泛分布的包含bla_NDM-5和bla_OXA-10在内的多种耐药基因的多药耐药质粒。鼠伤寒沙门菌单相变种在中国高度散发，具有独特的耐药特征，但在系统发育上仍与全球流行的多耐药克隆有关。第三代头孢菌素耐药性升高、碳青霉烯类耐药性急剧上升和质粒介导耐药基因出现的现象，表明中国流行的鼠伤寒沙门菌单相变种多耐药克隆发生了演变。该研究结果强调了进一步加强监测、更严格监管农业中抗生素使用、进行全面风险因素调查和采取针对性防控措施防止暴发发生的必要性。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.134

Assessment of Disinfection Efficacy on Bacterial Contamination of Hospital Surfaces, China， 2007 - 2022

Baoying Zhang^1,2;  Hongyang Duan^1,2; Jiaqi Wang ³;  Liubo Zhang²; Jin Shen^1,2#

1. China CDC Key Laboratory of Environment and Population Health, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China;

2.  National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China;

3.  Peking University People's Hospital, Beijing, China.

^# Corresponding author: Shen Jin, shenjin@nieh.chinacdc.cn.

To monitor the dynamics of bacterial contamination on hospital surfaces and assess the effectiveness of disinfection procedures for controlling bacterial contamination in hospitals and protecting patient safety. This survey was conducted in sentinel hospitals across 31 provincial-level administrative divisions (PLADs) in China from 2007 to 2022. Surface samples were collected from each site before and after disinfection. Bacterial concentrations were measured using the pour plate method, while pathogenic bacteria were isolated and identified using selective media. The overall qualified rate for total plate count was 85.7% (41,474/48,367). Pathogenic bacteria were detected in 577 (5.2%) of the 14,665 samples. Significant differences were observed in the qualified rate of total plate count (χ²=14.627, P<0.05) and the positive rate of pathogenic bacteria (χ²=266.700, P<0.05) among primary, secondary, and tertiary hospitals. Significant differences were also found in the qualified rate of total plate count among four environmental classes (χ²=775.700, P<0.05) and seventeen departments (χ²=1606.000, P<0.05). The qualified rate of total plate count after disinfection (89.5%) was higher than before disinfection (81.8%), while the positive rate of pathogenic bacteria after disinfection (3.8%) was lower than before disinfection (4.3%). Routine disinfection significantly reduces microbial contamination levels on hospital surfaces. Microbiological monitoring of hospital surfaces is a valuable tool for assessing environmental contamination and the effectiveness of disinfection procedures.

医院物体表面细菌污染的消毒效果评价 — 中国，2007–2022

张宝莹^1,2；段弘扬^1,2；王佳奇³；张流波²；沈瑾^1,2,#

1. 中国疾病预防控制中心环境与人群健康重点实验室，传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心环境与健康相关产品安全所，北京，中国；

2.  中国疾病预防控制中心环境与健康相关产品安全所，北京，中国；

3. 北京大学人民医院，北京，中国。

^# 通信作者：沈瑾，shenjin@nieh.chinacdc.cn。

监测医院物体表面细菌污染的动态变化并评价消毒效果，以控制医院细菌污染以及保障人群安全。2007年–2022年，在中国31个省份的哨点医院开展调查。每个采样点在消毒前后采集物体表面样本。采用倾注法检测细菌总数，采用选择性培养基分离培养和鉴定病原性细菌。结果显示细菌总数合格率为85.7%（41,474/48,367）。在14,665份物体表面样本中，577份（5.2%）检测出病原性细菌。一级、二级和三级医院的细菌总数合格率（χ²=14.627，P<0.05）和病原性细菌阳性率（χ²=266.700，P<0.05）有统计学差异。四类环境（χ²=775.700，P<0.05）和十七个科室（χ²=1606.000，P<0.05）的细菌总数合格率也存在统计学差异。消毒后的细菌总数合格率（89.5%）高于消毒前（81.8%），消毒后的病原性细菌阳性率（3.8%）低于消毒前（4.3%）。表明常规消毒显著降低了医院物体表面的微生物污染水平。医院物体表面微生物监测是评估环境污染和消毒效果的有效工具。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.135

Trends in Life Expectancy of HIV-Infected Patients Receiving Antiretroviral Therapy — China, 2013–2023

Lai Wei^1,2; Hanlu Jia¹; Yunxia Geng^1,3; Zhihui Dou¹; Decai Zhao¹; Xiumin Gan¹; Yan Zhao^1,#

1. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China;

2. Beijing Center for Disease Prevention and Control, Beijing, China;

3. Office of General Administration, Chinese Center for Disease Control and Prevention, Beijing, China.

^# Corresponding author: Yan Zhao, zhaoyan@chinaaids.cn.

Life expectancy (LE) is a key indicator for comprehensively evaluating population health status and healthcare service quality. With the increasing accessibility and optimization of antiretroviral therapy (ART) worldwide, mortality rates among human immunodeficiency virus (HIV)-infected patients have declined significantly, with their LE gradually approaching that of the general population. Recent studies have further identified that increasing LE exacerbates HIV aging. In China, ART coverage reached 92.8% by 2022, with all-cause mortality decreasing to 2.7%. However, comprehensive analyses of LE among Chinese HIV-infected patients remain scarce. Based on data from China's nationwide ART cohort, we conducted a continuous cross-sectional study analyzing changes in LE among HIV-infected patients receiving ART in China from 2013 to 2023. Our findings revealed that LE at age 20 years increased from 30.2 years in 2013 to 45.7 years in 2023, though with significant variations across different subpopulations. This study provides vital evidence of improved health outcomes for the HIV population.

接受抗反转录病毒治疗的HIV感染者的期望寿命趋势 — 中国， 2013–2023年

魏来^1,2；贾瀚璐¹；耿云霞^1,3；豆智慧¹；赵德才¹；甘秀敏¹；赵燕^1,#

1. 性病艾滋病预防控制中心，中国疾病预防控制中心，北京，中国；

2. 北京市疾病预防控制中心，北京，中国；

3. 办公室，中国疾病预防控制中心，北京，中国。

^# 通信作者：赵燕, zhaoyan@chinaaids.cn。

期望寿命（Life expectancy, LE）是综合评价人群健康状况和医疗卫生服务质量的核心指标。随着抗反转录病毒治疗（Antiretroviral therapy, ART）在全球范围内的可及性提升和方案优化，人类免疫缺陷病毒（HIV）感染者的死亡率显著下降，其期望寿命逐渐接近普通人群水平。最新研究进一步表明，期望寿命的延长加剧了HIV感染人群的老龄化进程。截至2022年，中国ART覆盖率已达92.8%，全因死亡率下降至2.7%，但目前仍缺乏对中国HIV感染者期望寿命的系统分析。基于国家HIV感染者ART队列数据，本研究采用连续横断面设计分析了2013至2023年中国接受ART的HIV感染者期望寿命变化趋势。结果显示，HIV感染者20岁时的期望寿命从2013年的30.2岁提升至2023年的45.7岁，但不同亚群间仍存在显著差异。该研究为HIV感染者健康结局的改善提供了重要证据。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.136

Impact of Comprehensive Strategy on Mortality in Heterosexually Transmitted HIV-Infected Individuals — Liangshan Prefecture, Sichuan Province, China, 2008–2024

Ruiying Liang^1,2; Fangfang Chen^3,#; Yan Zhao¹; Ju Wang⁴; Decai Zhao¹; Jiejun Yu¹; Houlin Tang¹; Jian Li¹; Zhongfu Liu^1,#

1. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China;

2. Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China;

3. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

4. Liangshan Prefecture Center for Disease Control and Prevention, Xichang City, Sichuan Province, China.

^# Corresponding author: Fangfang Chen, chenfangfang@chinaaids.cn; Zhongfu Liu, liuzhongfu@chinaaids.cn.

A comprehensive strategy, that integrated universal HIV testing, real-time patient tracking, and enhanced antiretroviral therapy (ART) within a poverty-alleviation framework, was implemented to curb HIV epidemic in Liangshan Prefecture. This study aimed to quantify its impact on HIV treatment coverage and mortality among hetersexual HIV infected individuals. Data on heterosexually transmitted HIV infected individuals in Liangshan from 2008 to 2024 were extracted from China's HIV/AIDS Comprehensive Response Information Management System (CRIMS) database. Cox proportional hazards model was used to estimate the effectiveness of comprehensive strategy on mortality. Interrupted time series analysis was applied to examine trends and changes in treatment coverage and mortality before and after the comprehensive strategy. Subgroup analysis examined variations across different populations. Among 37,034 eligible HIV infected individuals, 7302 deaths occurred. Not receiving ART was the strongest risk factor for mortality (HR: 17.74). Comprehensive strategy led to a 21.62% immediate increase and a 1.48% annual increase in treatment coverage, accompanied by a 0.47% decline in mortality per year (95% CI: -0.73, -0.21). By 2024, the observed mortality rate was 4.89% lower than the expected level (95 % CI: -8.02, -1.75), representing an 81.2% reduction. Reductions were greatest among males, residents of key counties, and patients at HIV infection stage. Comprehensive strategies in Liangshan significantly improved treatment coverage and reduced mortality among heterosexual HIV infected individuals. Further efforts are needed to promote early diagnosis, rapid ART initiation and tailored care support for advanced disease. The comprehensive model offers an adaptable template for high-burden, resource-limited settings.

综合策略的实施对异性性传播HIV感染者死亡率的影响 — 凉山州，四川省，中国，2008–2024年

梁瑞英^1,2；陈方方^3,#；赵燕¹；王菊³；赵德才¹；虞接军¹；汤后林¹；李健¹；刘中夫^1,#

1. 性病艾滋病预防控制中心，中国疾病预防控制中心，北京，中国；

2. 北京市朝阳区疾病预防控制中心, 北京，中国；

3. 传染病溯源预警与智能决策全国重点实验室，性病艾滋病预防控制中心，中国疾病预防控制中心，北京，中国；

4. 凉山州疾病预防控制中心，西昌市，四川省，中国。

^# 通信作者：陈方方，chenfangfang@chinaaids.cn；刘中夫，liuzhongfu@chinaaids.cn。

在凉山州实施的综合策略包括普遍HIV检测、实时患者追踪和加强抗病毒治疗（ART），结合健康扶贫战略达到遏制HIV流行的目的。本研究旨在量化该策略对异性性传播HIV感染者的治疗覆盖率和病死率的影响。利用艾滋病综合防治信息系统（CRIMS）中2008-2024年凉山州异性性传播HIV感染者的数据，通过Cox比例风险模型评估综合策略对死亡的有效性。应用中断时间序列（ITS）方法，检验综合策略实施前后治疗覆盖率和病死率的趋势及变化。通过亚组分析评估不同人群之间结局的差异。共37034 名符合资格的 HIV 感染者，其中7302 例死亡。未接受ART是死亡的最强风险因素（风险比 HR 为 17.74）。综合策略使治疗覆盖率立即提高了 21.62%，且每年增加 1.48%，同时病死率每年下降 0.47%（95% CI：-0.73, -0.21）。到 2024 年，观察到的病死率比预期水平低 4.89%（95% CI：-8.02, -1.75），这意味着死亡率降低了 81.2%。在男性、居住在重点县及处于 HIV 感染阶段的患者中，病死率降幅最大。凉山州实施综合策略显著提高了异性性传播 HIV 感染者的治疗覆盖率，并降低了病死率。建议未来继续促进早期诊断和快速启动ART，关注晚期疾病患者，提供个性化护理支持。这种综合模式为高负担、资源有限的地区提供了一个可供借鉴的模板。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.138