Antimicrobial central venous catheters are discussed as a device to reduce catheter-related infections. Previously we have reported a study with 223 adult surgical patients randomized to receive either a rifampicin-miconazole-loaded Central Venous Catheter (CVC) (n=118) or a standard CVC (n=105). The antimicrobial CVC was shown to reduce catheter colonization (CC) and catheter-related local infection (CRI) significantly even at long-term catheterization. Here, we present further evaluation of the study focusing on possible benefits for high-risk patients. Subgroup analyses showed a pronounced reduction of CC and CRI in male, overweight and oncology patients. Important covariates were skin colonization for CC and oncological disease for CRI. Odds ratio (OR) for reducing CC was 0.076 (95% CI: 0.016-0.360) and CRI was reduced from 26% to 2.3% (p=0.001) in the cancer subgroup. Ex vivo long-term antimicrobial activity of modified catheters exceeded 4 weeks.
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First, the occurrence of vegetable pests and diseases in recent years, China's rapidly expanding area of ​​vegetables, growing variety, cultivation methods, multiple cropping index, in particular, a large number of planting protected areas and off-season vegetables, making most of the annual production of vegetables can be broken to a large extent The balance of the ecosystem of the original vegetable crops has resulted in an increase in the number of vegetable pests and diseases. At present, there are more than 200 kinds of pests and diseases of vegetables reported in China. Among them, there are more than 70 kinds of diseases that occur year round, and there are more than 50 kinds of insect pests. Almost any kind of vegetables can be infected by pests and diseases. In addition, due to the increase in the number of vegetables, the expansion of protected areas, the variety of cultivation methods, the back-season cultivation, and frequent international exchanges, some of the original pests and diseases have gradually increased to become the main pests and diseases; As a result, the resistance of pests has become stronger and stronger, which has brought great difficulties in control. Second, the main problems in the prevention of pests and diseases As the current control of vegetable pests and diseases is still dominated by chemical agents, so the problem of chemical pesticide pollution is serious. Many vegetable farmers cannot correctly identify pests and diseases, lack basic knowledge of plant protection and integrated pest control techniques, and rely on, misuse, and unreasonable use of chemical pesticides are common. The principle of "prevention as the mainstay and comprehensive prevention and control" is not well understood. There are often phenomena such as hitting "insurance drugs", "taking medicine behind the horses," playing "cheap drugs," playing "highly toxic poisons," and using the wrong drugs. The pesticides that affect the quality and safety of pollution-free vegetable products are mainly insecticide pesticides (70%), of which organophosphorus insecticides are the main pesticides, especially high-toxicity, high-residue organophosphate insecticides. Some vegetable farmers have blindly pursued their effects and used iridfos-methyl, methamidophos, dicofol, carbofuran, and even highly toxic, highly toxic, and high-residue pesticides that were banned such as 1059 and 1605, causing excessive pesticide residues in vegetables and human and animal poisoning incidents. Occurrences, a series of problems such as the destruction of the ecological environment, the development of resistance to diseases and insects, and the increase in production costs. Third, the pollution-free control strategy of vegetable pests and diseases Because any control method is not a panacea, relying on a single method to prevent diseases and insect pests have a certain one-sidedness, so implement the "prevention-based, comprehensive prevention and control" plant protection policy to control pests and diseases, is Key strategies for the production of phytotoxic vegetables. In comprehensive prevention and control, we must take agricultural control as the basis, timely and in response to local conditions, and rationally use chemical prevention, biological control, physical control, and other measures to achieve economic, safe, and effective control of insect pests. (a) Plant quarantine The first thing to understand is the quarantine objects in the region. For example, Liriomyza sativae, Hübner, tomato canker, cucumber scab, and potato nematode are all quarantine objects of current vegetable crops. Regardless of where the introduction of vegetable seedlings, it should be quarantined by the relevant departments to ensure that it does not bring in dangerous pests and diseases. In particular, vegetable seedlings should not be introduced from infected areas to prevent the spread of infectious diseases and insect pests. (2) Agricultural control Agricultural control refers to the use of agricultural management methods and cultivation techniques to create environmental conditions suitable for the growth and development of vegetables and the survival and breeding of beneficial organisms that are not conducive to the occurrence of pests and diseases, to avoid the occurrence of pests or to reduce pests and diseases. 1. Choose disease resistant varieties. Under the premise of choosing the varieties that are marketable and suitable for local planting, high-yield, high-quality, pest-resistant and stress-tolerant varieties should be selected. At the same time, it is necessary to grasp the cultivation characteristics of the varieties so that they can be improved. Pay attention to the resistance performance and changes of the varieties. Once the resistance is lost, the varieties should be updated in time. 2. Select the production base. The production site has good ecological conditions, no source of pollution from industrial and mining enterprises, and is far from hospitals, garbage, and major traffic arteries to protect the air and irrigation water. The base vegetable fields must be selected for convenient drainage, irrigation, deep, loose, fertile loam or sandy soil. And meet the requirements of soil environmental quality. 3. The rotation is down. Do not dictate that we should rationally arrange the layout of cornucopias and different types of vegetables and different resistant varieties. 4. Disinfection. 1 seed disinfection. According to the main diseases and insect pests in the area, choose suitable disinfection methods, such as sun drying, soaking in warm soup, and dry heat sterilization. 2 bed disinfection. Thoroughly clean the pastoral area, select the pastoral soil without the disease and pest source, and decompose farmyard fertilizers according to local conditions; the seedbed can also use the solar energy, steam, etc. for high temperature disinfection. 3 shed disinfection. Before planting, mix DDV emulsifiable concentrate with sawdust, mix and ignite proportionately with sulfur powder, seal for 24 hours, colonize completely after releasing air, or use 5% chlorothalonil smoke agent before and during planting, 80 g/mu, tightly smoked Smoke disinfection, etc., can control a variety of diseases and insect pests, frame can be used formalin disinfection, but also can be used high temperature stuffy shed. 4 Fertilizer disinfection. High-temperature composting and fermentation can be used to kill germs, eggs and pests in fertilizers. 5. Breeding disease-free strong seedlings. The use of nutritious seedlings to raise the temperature in the cold season to promote the development of the root system, enhance the resistance to disease; gauze covering the seedbed to reduce the incidence of pests. 6. Water and fertilizer management. Maintain appropriate proportions of nitrogen, phosphorus, and potassium fertilizers, increase the application of organic fertilizers, and pay attention to the application of trace elements and fertilizers to enhance the overall resistance of vegetables. 7. Ecological regulation. Improve cultivation methods, strengthen management, and control the ecological conditions of greenhouses and greenhouses. Such as improving the soil, deep plowing, close planting, ground cover, deep sorghum, micro-irrigation or submerged irrigation and ventilation and humidity, high temperature stuffy shed and other measures to reduce the occurrence of pests and diseases. 8. Grafting for roots. It can prevent soil-borne diseases such as wilt disease, verticillium wilt, bacterial wilt, and nematode diseases, and it can also prevent warts and alkalis. Radicle cutting induction rooting technology can also prevent soil-borne diseases. 1. Facilities protection. Keep insecticidal nets at ventilation openings or doors and windows of facilities, cover plastic film, insect nets, and shade nets in summer to avoid rain, shade, and pests. 2. Temptation. Use the repellency of pests to control. Such as black light can kill more than 300 kinds of pests; frequency vibration type insecticidal lamp can trap and kill pests, but also to protect natural enemies; hanging yellow sticky board or yellow oil board trap and kill aphids, whitefly and spotted fly, etc.; sweet and sour liquid trapping Nocturnal insect pests; Ground cover or covered silver ash film or silver gray mesh, hanging silver ash film can repel pests. 3. Ozone control. The use of ozone generators in protected areas regularly releases ozone to control pests and diseases. (4) Biological control 1. Natural enemies of insects. If Trichogramma is used to control Lepidoptera pests, such as Pieris rapae, Plutella xylostella, Spodoptera litura, Brassica juncea, and Helicoverpa armigera, the grasshopper can prey on lepidopterous pest eggs and newly hatched larvae such as aphids, whiteflies, and leafhoppers. The reed bumblebee controls whiteflies; predatory spiders and cockroaches prevent cockroaches; and ladybugs, flies, and carnivores are also predatory natural enemies. 2. Microbial control. Bacillus thuringiensis (TB), Beauveria bassiana, Metarhizium anisopliae can control Plutella xylostella and Pieris rapae. Insect viruses such as beet moth nuclear polyhedrosis virus can control Spodoptera exigua, and cotton bollworm nuclear polyhedrosis virus can control cotton bollworm and tobacco. The greenworm, diamondback moth and cabbage worm particles can control Plutella xylostella and Pieris rapae respectively. The protozoa such as avermectin antibiotics and microsporidia can also kill insects. 3. Biological agents. Agricultural antibiotics such as agricultural anti-120 and polyoxin can prevent damping-off, downy mildew, powdery mildew, fusarium wilt, black spot, and epidemic diseases; jinggangmycin can prevent and control bacterial wilt, blight, and sheath blight. Streptomycin for agricultural control of soft rot and bacterial spot disease; Gingfengmycin, Bo ~ 10 (wuyimycin) neomycin and other agricultural antibiotics to prevent various diseases; Cucumber mosaic virus health vaccine S32 and tobacco mosaic Viral vaccine N14 prevents viral diseases; plant-derived pesticides such as azadirachtin, triterpene alcohol solution can reduce the harm of Plutella xylostella, Spodoptera exigua, Bemisia tabaci, etc.; matrine, bitter buckwheat, nicotine, vegetables, etc. The pests have a certain preventive and therapeutic effect; rice bran, kasik, and CPT are also effective in controlling vegetable pests. (5) Chemical control Pollution-free vegetables are not chemical pesticides. The use of chemical pesticides is an effective means to control pests and diseases of vegetables. In particular, disease prevention and pest outbreaks are effective prevention and control measures. The key is to use drugs scientifically and rationally. To prevent and treat pests and diseases, we must also reduce pollution, and control pesticide residues in vegetables within the allowable range. 1. The correct choice of agents. According to the types of pests and diseases and the nature of pesticides, different fungicides and insecticides are used to prevent and treat the disease. All pesticides used must be registered by the Ministry of Agriculture's pesticide inspection authority. Do not use pesticides that have not been registered and have no production licenses, especially those that have no name, no drug name, and no description. 2. It is forbidden to use highly toxic and high residue pesticides. Among common pesticides, highly toxic pesticides such as iron toxin, phorate-containing, parathion and thiote; high-toxic pesticides such as chlorfloxacin, protected cotton, phosphorus, phosphorus, thiophene, long-term Phosphorus, chlorfenulfuron, carbofuran (carbofuran), methyl parathion, trithiophos, toxaprop-en, pyrimiphos, methamidophos, phosphoamine, methomyl, methyl- Killing of P, Phosphorus, Methyl-methyl-parathion, Methyl-isosalt-phos, chlorfenone, endosulfan, omethoate, etc. is prohibited on vegetables. Some pesticides such as DDT, BHC, Lindane, Toxaphene, Chlordane, Heptachlor, Endosulfan (Saidan, Shuodan, Handan), dicofol, etc., although the acute toxicity is not high, but due to the stable nature, after spraying Long-term residue on the crop or in the soil, not easy to decompose, is one of the important causes of environmental pollution, but also prohibit the use of vegetables. In addition, the insecticide carp had been found to have a carcinogenic effect in the early 1980s and could not be used on vegetables. 3. Use non-toxic, non-residue or low toxicity, low residue pesticides. 1 Select biological pesticides or biochemical pesticides. Such as BT, 8010, Beauveria bassiana, Caifengling, insect viruses, Tianba, Tianli 2, etc. 2 Select specific insect growth regulator pesticides. Such as: anti-Tai Bao, card dead grams, diflubenzuron, diflubenzuron, Nongmengte and so on. 3 Select high efficiency, low toxicity and low residual pesticides. Such as: trichlorfon, phoxim, clotris, thiophanate methyl, metalaxyl and so on. (4) Moderately toxic and low-residue pesticides, such as dichlorvos, dimethoate, immediate extinction, Uranus, and Enkeson, were selected when devastating pests caused devastating losses. 4. Grasp the timing of application. According to the rule of disease and insect pests, identify the weak links and apply pesticides in time to receive a multiplier effect. 5. Look at the weather application. Generally should be carried out on a sunny day without wind, and the temperature has a certain influence on the efficacy. Therefore, according to the weather conditions, the flexible application of pesticides. 6. Strictly observe the guidelines for the safe use of pesticides. 1 Strictly grasp the safety interval. The safety intervals of various pesticides are different, generally 7 days in summer and 10 days in winter. 2 strictly according to the provisions of pesticides. Observe the scope of use of pesticides, the object of control, the amount of drug used, and the time limit for drug use, etc., and do not change blindly. 3 Comply with pesticide safety practices. Pesticides should be stored in a safe place. Applicants should wear rubber gloves. Seeds that are mixed with herbs should be sown with a machine. The applicators must protect themselves from the body. During the operation, smoking, drinking, and eating are forbidden; Eyes should be wiped and the daily application time should not exceed 6 hours. In case of adverse reactions, immediately remove contaminated clothing, shoes, gloves, mouthwash, hands, face, and skin, and then go to the hospital for treatment.