If there's always a chance that things will go bad, no matter how small that chance, it will always happen – Murphy's Law.

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Murphy's Law plays out in reality in all sorts of unexpected ways and angles. And this time in Changning Maternal and Child Health Hospital, it was manifested as an explosive nosocomial infection.

Almost a month ago, children in the NICU of Changning Maternal and Child Health Hospital developed unexplained high fever, severe pathological jaundice and respiratory distress syndrome. In the past month, 24 children have developed the disease, and three of them have died due to the rapid progression of respiratory distress syndrome.

Thirteen days ago, the Changning Maternal and Child Health Hospital notified pregnant women who came to the hospital for temporary prenatal checkups, asking them to undergo prenatal checkups in other hospitals and make appointments with the remaining five hospitals in the city. At the same time, intensive disinfection of the NICU and neonatal wards began.

Seven days ago, the Changning Maternal and Child Health Hospital officially reported the cases of unnatural deaths of children in the hospital to the Changning Municipal Health Commission and the Provincial Health Commission. However, the causative organism has not been found.

Three days ago, all departments of the Changning Maternal and Child Health Hospital, except for the emergency obstetrics department, ceased operations. The whole hospital has entered the emergency response mechanism.

Two days ago, the Changning Maternal and Child Health Hospital began to refer stable children and mothers to other hospitals. The Provincial Health Commission dispatched an expert group to investigate.

In all fairness, even as a fellow medical worker, Sun Lien felt an uncontrollable anger at the slow and inefficient operation of the Changning Maternal and Child Health Hospital.

"They...... How dare they ......" Sun Lien scolded in front of Qian Hongjun in a gaffe, "These bastards!"

"Now you know why Dean Song lost his temper so much, right?" Qian Hongjun did not reprimand the Changning Maternal and Child Health Hospital for neglecting and despising the work of the hospital with Sun Lien, but said solemnly to Sun Lien, "If you run into the clean room alone knowing that there is a risk of infection, if you are not careful, this accident in the Maternal and Child Health Hospital will fall on our heads! If it weren't for the fact that it didn't cause any serious consequences, and Lao Liu took the blame for you, you kid would have been fired a long time ago!"

Sun Lien was shocked when he heard this, and he said seriously to Qian Hongjun, "I know it's wrong. ”

Qian Hongjun looked Sun Lien up and down, and nodded after a long time, "I know that Liu Tangchun, that old fox, will not be wrong." He must have his plans to protect you. Qian Hongjun then sighed, "You have to remember that there is no trivial matter in the hospital, no trivial matter for patients, and no trivial matter in life!" He changed his tone and dragged Sun Lien out of the bathroom, "Do you know how big the incident in Changning Maternal and Child Health Hospital is this time?"

Sun Lien shook his head honestly, he didn't really care about this issue. At present, he is most concerned about what kind of illness his cousin has - from Qian Hongjun's description, his symptoms seem to be very similar to the symptoms of hospital infection that broke out in the maternal and child health hospital.

"The team of experts from the Ministry of Health has arrived in Changning. Qian Hongjun shook off the water in his hands, found an alcohol gel disinfectant bottle in the corridor, squeezed some and rubbed it on his hand for a while, "The person in charge of the Changning Municipal Health Commission is estimated to be suspended for inspection, the director of the maternal and child health hospital is bound to be suspended, and there are still people who will be held criminally responsible if the hospital infection department does not do well." The top three brands can't be kept...... Doctors, nurses, and midwives in maternal and child health hospitals have to suffer. ”

How important the name of a tertiary hospital is, probably people in the non-medical industry can't understand. Only medical personnel who have experienced the top three examinations and reviews know how hard-won this title is.

The total number of inpatient beds should be more than 501, and there should be at least 13 departments including emergency department, internal medicine, surgery, gynecology, pediatrics, traditional Chinese medicine, etc., and 11 clinical auxiliary departments such as pharmacy, examination, blood transfusion, and operating room. There are 1.03 health technicians per bed and at least 0.4 nurses per bed...... There are a total of eight major items and six specific requirements, which were gathered into a full score of 1,000 points after the meeting. A hospital must score more than 900 points in the examination to be recognized as a tertiary hospital.

Up to now, among the 34 provincial-level administrative regions in the country, 31 provincial-level administrative regions have carried out the hospital classification evaluation, and there are only 722 third-class hospitals in 334 prefecture-level administrative regions and 2876 county-level administrative districts.

In a few days, there will be only 721.

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"We can talk about these issues later. Sun Lien couldn't help it, he tugged on Qian Hongjun's sleeve and asked, "What kind of disease does my cousin have?" Is it related to the infectious disease that broke out in the Changning Maternal and Child Health Hospital?"

Qian Hongjun patted his head, "I forgot about this stubble." He nodded towards Sun Lien, "It has been confirmed, it is cytomegalovirus infection, and the results of the autopsy examination are consistent with those of Changning Maternal and Child Health Hospital." The child has been given ganciclovir treatment. ”

Cytomegalovirus? Sun Lien heard a term that he was quite familiar with. In microbiology, cytomegalovirus is known for its special name, the fact that it causes the enlargement of infected cells, and the fact that it also has large intranuclear inclusions. As a typical herpes virus, it replicates slowly in cells and generally takes 30~40 days to multiply for one round.

Thirty...... By forty days?Sun Lien frowned, which was not quite consistent with the symptoms of his cousin's illness. He was only four days old, where is the time for CMV to replicate and multiply?

"CMV doesn't progress so fast, right?" Sun Lien hesitated, "If it's CMV, wouldn't it take about a month to multiply?"

Qian Hongjun shook his head at Sun Lien, and said with contempt, "You emergency doctors, that's it, your vision is too limited!"

Sun Lien was criticized inexplicably, and the most infuriating thing was that he couldn't talk back - he really didn't understand how the virus, which was not very fast, and the hidden infection rate of more than 95% in the Chinese adult population broke out in his cousin.

"Intrauterine infection!" Qian Hongjun hated iron and knocked on Sun Lien's head, I don't know if it was because he hadn't knocked on the head of the head for a long time, after knocking twice, Qian Hongjun paused and knocked again, "Mother-to-child transmission, intrauterine infection." The mother may have been infected with the virus during the prenatal checkup, and the child itself was born prematurely, so it was infected explosively!"

Neonatal cytomegalovirus infection itself is one of the most common congenital infections in clinical practice. However, the chance of congenital infection caused by intrauterine infection is not very high, only about 7% to 10%. And not every newborn infected with CMV will be so critically ill. In fact, most newborns infected with CMV do not have severe symptoms – many children will have the same insidious infection as their mothers.

However, if the infection of pregnant women during pregnancy is combined with premature babies, the results will be different. CMV itself attacks the liver and lungs, resulting in severe hepatitis and respiratory distress syndrome. Sadly, both the jaundice of hepatitis and the hypoxic and retraction symptoms of respiratory distress syndrome are consistent with neonatal jaundice and atelectasis caused by surfactant insufficiency in premature infants.

After more than 10 days of delay, the child's jaundice does not improve, and the breathing difficulties persist, doctors may consider CMV infection. Subsequent immunological tests also take time and equipment to perform. For many children diagnosed with CMV infection, it is common for the onset to delay a week or two from onset to diagnosis.

There are no obvious clinical manifestations, the onset is insidious, and the diagnosis is difficult. Therefore, CMV infection in newborns is very susceptible to death due to untimely treatment. The three children in the Changning Maternal and Child Health Hospital died because the optimal treatment time was delayed.

From this point of view, Wang Tian is lucky. Xiao Wang Tian was also very lucky. Through autopsies of the three deceased children, doctors proved that CMV infection is raging at the Changning Maternal and Child Health Hospital. This only gave Ningyuan Fourth Central Hospital a warning, and after receiving Xiao Wangtian, it immediately carried out relevant examinations for cytomegalovirus infection.

"In the past, the statistics of cases were based on clinical diagnosis, so most children were not treated at the optimal treatment period. Qian Hongjun planned to completely reassure Sun Lien, so he said a few extra words when explaining, "That's why there will be a 30% mortality rate." This data can't be applied to your cousin. However, it is difficult to say whether there will be any subsequent damage. We'll just have to wait and see. ”

Sun Lien also understood this truth, and he nodded at Qian Hongjun gratefully, "I'm much more relieved, thank you, Director Qian." ”

"Thank you is not sincere. Qian Hongjun rubbed his bald head again, "Tonight, our department's supper, Director Sun, do you want to solve it?" Qian Hongjun smiled like an old fox, "Lao Liu is angry with me, your Director Sun is a big family now." ”

"It should be, it should be. Sun Lien didn't know how much Liu Tangchun knew, and how much he told Qian Hongjun. However, the hard work of pediatrics, coupled with the fact that people are really interested in their cousins, should be thanked. "Okay, I'll have someone deliver a batch of takeaways and deliver them directly to the NICU nurses' station, right?"

"That's a good feeling. Qian Hongjun nodded, and then instructed, "Don't order something that tastes too big, it won't have a good impact." ”

Sun Lien pondered for a moment and turned on his mobile phone, "Fifty servings of sweet soy milk, plus fifty servings of fritters...... Director Qian, it's all vegetarian, okay?

Qian Hongjun was shocked when he heard this, "Why are you engaged in such a big battle?" Isn't it the end of buying some fruit?" He glared at Sun Lien, "Fifty servings of soy milk fritters, on average, two and a half servings per person, you are all rice buckets when we are pediatric doctors?"