Historically, Yichun City has borne the highest burden of Hemorrhagic Fever with Renal Syndrome (HFRS) in China, with incidence exhibiting marked fluctuations between 2005 and 2023. Despite this, HFRS-weather associations in Yichun remain poorly characterized. We analyzed weekly time-series data on HFRS cases and meteorological factors (mainly temperature, humidity, and precipitation) from 2005 to 2023 using random forest models to identify optimal lags, distributed lag non-linear models, and generalized additive models. We identified a symmetric unimodal relationship for temperature (peak risk at 13.66 °C; RR = 1.77, 95% CI: 0.92-3.39), a right-skewed pattern for relative humidity, and a distinct inverse J-shaped pattern for precipitation. Lag-response analysis indicated that the strongest associations occurred at 26 weeks for temperature, 12 weeks for relative humidity, and 16 weeks for precipitation. Temperature showed complex delayed responses with both protective and risk-increasing phases (~ 4-6 months), while precipitation and humidity primarily exhibited protective effects. Formal interaction testing revealed no statistically significant two-way or three-way interactions among meteorological variables (all P > 0.05), indicating that each factor operates independently rather than synergistically. These findings offer actionable evidence for designing targeted, climate-informed HFRS prevention strategies in Yichun and similar high-burden regions.

BACKGROUND:To compare the adherence and efficacy between the 0 - 7 - 21-day and the 0 - 1 - 6-month hepatitis B virus (HBV) vaccination schedules among people who use drugs (PWUD) in China. RESEARCH DESIGN AND METHODS:A randomized controlled trial was conducted in 1261 HBV-susceptible PWUD from compulsory isolated detoxification centers (CIDCs) and methadone maintenance treatment (MMT) clinics in Xi'an. A 20 µg per-dose vaccine was used. HBV surface antibody (anti-HBs), surface antigen, and core antibody were tested at months 7, 15, and 22 after the first dose. RESULTS:Third-dose coverage was significantly higher in the 0 - 7 - 21-day group (74.40%) than in the 0 - 1 - 6-month group (51.58%, p < 0.001), mainly driven by participants from CIDCs (77.75% vs. 45.69%). Anti-HBs positive rates at months 7, 15, and 22 among participants who completed all three doses were significantly higher for the 0 - 1 - 6-month schedule (90.71%, 76.82%, and 67.35%) than for the 0 - 7 - 21-day schedule (74.23%, 49.40%, and 40.95%; all p < 0.001). HBV infection incidence was similar between schedules, but significantly different between vaccinees and non-vaccinees (p = 0.018). CONCLUSIONS:The 0 - 7 - 21-day schedule substantially enhances three-dose completion in PWUD, but induces a notably weaker anti-HBs response and persistence. Schedules should be selected based on the management models for PWUD and their individual characteristics. CLINICAL TRIAL REGISTRATION:Chinese Clinical Trial Registry (ChiCTR1900022403).

China recently updated its colorectal cancer (CRC) screening guidelines, lowering the recommended initiation age from 45 to 40 years for the general population in response to the rising burden and earlier onset. This study evaluates the cost-effectiveness of earlier initiation and identifies the optimal screening strategy. A Markov model was developed to compare 48 screening strategies, combining different starting ages, methods (fecal immunochemical test [FIT], multitarget stool DNA [MT-sDNA] test, methylated Septin 9 [mSEPT9] test, computed tomography colonography [CTC], or colonoscopy), and frequencies, from the healthcare system perspective. Incremental cost-effectiveness ratios (ICERs) were calculated based on quality-adjusted life-years (QALYs), with willingness-to-pay thresholds set at one- and three-time China's per-capita gross domestic product (GDP). The results show that all screening strategies are cost-effective compared with non-screening under the three-time GDP threshold, with nearly half found to be cost-saving. Starting annual FIT screening at age 40 is the most cost-effective under both thresholds, with an ICER of US$5381/QALY and reductions of 5.5% in CRC cases and 7.4% in CRC-related deaths compared with the second-best strategy of starting at age 45. Starting 10-yearly colonoscopy screening at age 40 may be optimal, but only under very low thresholds. Both MT-sDNA and mSEPT9 tests would become the optimal options only if their costs were substantially reduced. The findings are highly robust across sensitivity analyses. This study supports the updated recommendation to lower the CRC screening initiation age for average-risk individuals and identifies annual FIT screening as the optimal strategy in the current context of China.

Addressing social determinants is critical to achieving the End TB Strategy targets. However, the impact of tuberculosis (TB) programmatic indicators amenable to short-term interventions on TB incidence remains underexplored. We aimed to identify modifiable social determinants and evaluate their impact on TB incidence in different risk-specific areas. We compiled individual-level surveillance data on reported pulmonary TB (PTB) cases and county-level data on 12 social determinants between 2011 and 2018 across 108 counties in Shaanxi Province, China. A Bayesian spatiotemporal model quantified associations between PTB incidence rate and social determinants. Model-estimated relative risks (RRs; x-axis) and their annual percentage change (APC; y-axis) were integrated to construct an RR–APC plane diagram for classifying different risk-specific counties. Counterfactual analysis estimated potential reduction in PTB incidence rate if the referral and tracing percentage for PTB patients and suspected cases or the percentage of PTB cases confirmed bacteriologically in these counties were increased to 2018 provincial benchmarks. Five social determinants were significantly associated with PTB incidence rate. A 1

Early-stage (0–3) cardiovascular–kidney–metabolic (CKM) syndrome populations require urgent cardiovascular disease (CVD) prevention. Chronic inflammation, insulin resistance, and visceral adiposity are three core interactive CVD pathogenic pathways, while current biomarkers fail to integrate all three. This study aimed to explore the association of the novel three-dimensional composite index CTI–CVAI with incident CVD and its predictive value in Chinese adults with CKM stages 0–3. This nationwide prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020), including 6728 participants aged ≥ 45 years with CKM stages 0–3. CTI–CVAI was calculated by combining the C-reactive protein–triglyceride–glucose index (CTI) and Chinese visceral adiposity index (CVAI). Cox regression, restricted cubic spline, survival analysis, ROC curves, and reclassification analysis were used to evaluate its value. Subgroup and multiple sensitivity analyses, including competing-risks models, were conducted to assess the robustness of the results. During a median follow-up of 9 years, the overall CVD incidence was 23.83

BackgroundRelatively little is known about long COVID (LC) in China, particularly regarding the effects of recent Omicron sub-lineages. Therefore, we systematically assessed the prevalence and risk factors for developing LC.MethodsThis retrospective cohort study included COVID-19 patients who had been hospitalized at two hospitals in Changzhi, China, between December 15, 2022 and April 30, 2024. All patients were interviewed via telephone ≥ 3 months after discharge. The follow-up study was conducted between July 18 and August 20, 2024. Logistic regression models were used to analyze risk factors for developing long COVID.ResultsA total of 2,765 patients (1,407 male [50.9%]; median [IQR] age 70.0 [59.0–78.0] years) were successfully evaluated by telephone; 458 (16.6%) self-reported long COVID symptoms. The most common symptom was fatigue (4.9%), followed by muscle weakness (3.9%), sleep difficulties (3.0%), brain fog (2.8%) and cough (2.5%). Severe COVID-19 patients had a higher risk of LC than non-severe patients (OR = 1.275, 95% CI: 1.036–1.570). In subgroup analyses stratified by follow-up time, overweight patients (OR = 1.564; 95% CI: 1.052–2.326), patients with ≥ 7 acute-phase symptoms (OR = 1.275; 95% CI: 1.064–1.528), and farmer (OR = 1.439, 95% CI: 1.047, 1.976) had a higher risk of LC, whereas individuals who received immunosuppressant therapy had a lower risk (OR = 0.691, 95% CI: 0.504, 0.948). In addition, aged ≥ 50 years (OR = 2.441, 95% CI: 1.175–5.072) and underweight status (OR = 2.183; 95% CI: 1.115–4.273) were associated with a higher risk of muscle weakness.ConclusionThis study provides valuable insights into LC after discharge, with 16.6% of discharged patients reporting symptoms. It is essential to monitor at-risk individuals according to identified risk factors for public health efforts.

BACKGROUND:Varicella remains a major public health concern in China, where the vaccine is self-paid, leading to delayed and inequitable coverage. Recent policy reforms aim to unify vaccine management and compensation, yet the public health impact of improved vaccination timeliness remains unclear. This study assessed the long-term benefits of optimising varicella vaccination timeliness and coverage in a resource-limited setting in western China, using Shaanxi province as a representative example. METHODS:A dynamic age-structured compartmental model was developed to simulate varicella transmission from 2017 to 2054, calibrated with surveillance data and real-world vaccination records from a provincial immunisation information system. Three scenarios were compared: (1) maintaining current vaccination coverage and timeliness; (2) improving timeliness only; and (3) improving both coverage and timeliness to National Immunisation Programme (NIP) levels. Primary outcomes included annual varicella incidence and cumulative varicella-related deaths over 30 years (2025-2054). Sensitivity analyses assessed the robustness of results. FINDINGS:According to immunisation system data, varicella vaccine coverage in the 2017 birth cohort was 60.8% for the first dose and 41.9% for the second, with only 14.7% and 0.7% of children receiving the first and second doses on schedule, respectively. Over a 30-year projection period, model simulations indicated that improving vaccination timeliness alone would reduce cumulative varicella cases by 67.7% and deaths by 69.1% compared with the status quo. Simultaneous improvements in coverage and timeliness further decreased cumulative cases by 89.3% and deaths by 90.8%, leading to near elimination of childhood varicella by 2031. These findings remained robust across sensitivity analyses. CONCLUSION:Optimising varicella vaccination timeliness and coverage could substantially reduce disease burden in resource-limited settings. Incorporating the vaccine into the NIP could yield the greatest benefits, while improving timeliness under a more integrated management framework may represent a feasible interim policy direction for varicella control in China and similar settings.

BackgroundUnderstanding the persistence of long COVID (LC) among discharged patients with Omicron infection remains limited.MethodsThe study used a retrospective longitudinal cohort to evaluate the dynamic trajectory of LC after hospital discharge and to identify factors associated with new-onset and persistent LC following Omicron infection. Patients admitted to Heping Hospital Affiliated to Changzhi Medical College and Changzhi People’s Hospital for coronavirus disease 2019 between 15 December 2022 and 30 April 2024 were included. The first follow-up was conducted from 18 July to 20 August 2024, and the second from 9 May 2025 to 13 June 2025.ResultsOf the 3,777 discharged patients, 1,922 [median (IQR) age, 70.0 (59.0–78.0) years; 968 male individuals (50.4%)] who completed both follow-up visits were included in the final analysis. The median (IQR) time from discharge to the second follow-up was 727 (688–854) days. At the second follow-up, 292 patients (15.2%) were diagnosed with LC, including 121 (6.3%) with persistent LC and 171 (8.9%) with new-onset LC. The most common symptoms were muscle weakness, sleep difficulties, fatigue, cough, and dyspnea at rest. Notably, the proportions of muscle weakness, sleep difficulties, cough, arthralgia, and palpitations increased significantly, whereas brain fog decreased significantly from 2.8% at the first follow-up to 0.4% at the second follow-up. Overall, antiviral treatment (OR = 1.503; 95% CI: 1.063–2.126), female sex (OR = 3.729; 95% CI: 1.145–12.147), being a farmer as an occupation (OR = 4.695; 95% CI: 2.188–10.101), and BMI < 18.5 kg/m2 (OR = 5.291; 95% CI: 1.115–25.000) were associated with increased new-onset LC susceptibility, whereas having one or more complications was associated with decreased new-onset LC susceptibility (OR = 0.329; 95% CI: 0.125–0.865).ConclusionOmicron-infected patients report a persistent burden of symptoms consistent with the WHO definition of LC after discharge. These findings provide valuable information on the dynamic trajectory of long-term health outcomes in patients infected with Omicron. However, the non-specific nature of the symptoms should be considered when interpreting these findings.

BACKGROUND AND AIM:Colorectal cancer (CRC) is a significant global health burden, and screening can greatly reduce CRC incidence and mortality. Previous studies investigated the economic effects of CRC screening. We performed a systematic review to provide the cost-effectiveness of CRC screening strategies across countries with different income levels. METHODS:We searched relevant scientific databases (PubMed, Embase, Ovid, Web of Science, Scopus) from January 1, 2010, to December 31, 2023. We selected English-language studies related to model-based economic evaluations of CRC screening strategies. Information such as the characters of screening tests, model characteristics, and key cost-effectiveness findings were collected. The net monetary benefit approach was used to compare the outcomes of various strategies. RESULTS:A total of 56 studies were identified, including 46 from high-income countries (HICs), 6 from upper-middle-income countries (UMICs), and 4 from lower-middle-income countries (LMICs). Most annual fecal occult blood tests and fecal immunochemical tests were cost-saving, and colonoscopy every 10 years was cost-saving. Other strategies involving multitarget fecal FIT-DNA detection, computed tomography colonography, and flexible sigmoidoscopy were cost-effective compared with no screening. Newer strategies such as magnetic resonance colonography every 5 years, annual urine metabolomic tests, and fecal bacterial biomarkers were cost-effective compared with no screening. CONCLUSION:In our updated review, we found that common CRC screening strategies and magnetic resonance colonography continued to be cost-effective compared with no screening. Areas for further development include accurately modeling the natural history of colorectal cancer and obtaining more evidence from UMICs and LMICs.

BACKGROUND:The human papillomavirus (HPV) vaccine has been approved for use in Chinese males in 2025. We aimed to assess HPV vaccination preferences and willingness-to-pay (WTP) among men who have sex with men (MSM) in China using a discrete choice experiment (DCE). METHODS:A cross-sectional survey was conducted from October 31 to November 30, 2023, among MSM aged 15-45 years in China, recruited offline and online. Data were collected using a self-administered online questionnaire. The DCE assessed preferences for seven HPV vaccination attributes: prevention of HPV-related cancers, prevention of genital warts, duration of vaccine protection, number of doses, vaccination cost, vaccination site, and service opening hours. Random parameters logit (RPL) and latent class analysis (LCA) models were applied to analyse preferences, estimate marginal WTP for each attribute, and predict uptake for various vaccination scenarios. FINDINGS:The median age of the 7457 participants was 28 years (interquartile range: 25-35 years). In the RPL model, vaccine efficacy against genital warts was the most influential attribute (48.8 %, 95 % CI: 47.1-50.6 %), followed by vaccination cost (17.1 %, 15.7-18.4 %). LCA identified two subgroups: a "high-income/knowledge, low-sexual activity" group (49.2 %) and a "low-income/knowledge, high-sexual activity" group (50.8 %). Both groups prioritised vaccine efficacy, protection duration, and cost, and also favoured MSM-friendly clinics. The "high-income/knowledge, low-sexual activity" group valued genital wart prevention most (49.7 %) and preferred single-dose schedules and extended service hours, whereas the "low-income/knowledge, high-sexual activity" group prioritised cost (26.3 %). Under a potentially realistic scenario (9-valent HPV vaccination with feasible service-related attributes), both groups' WTP exceeded the current market price of the full-course vaccination (CNY 3993), with a higher predicted uptake in the former group (96.2 % vs. 50.8 %). CONCLUSION:This study underscores a high acceptance of HPV vaccination among Chinese MSM, emphasising the pivotal role of HPV knowledge, economic considerations, and service delivery preferences in shaping vaccination decisions.

Catheter-associated urinary tract infections (CAUTIs) are one of the most common types of healthcare-associated infections (HAIs). Current studies mainly focus on risk factors, but the method to control them is unresolved. We aim to give an overview of the epidemiology of CAUTIs and explore the effects of bundle intervention on intensive care unit (ICU) inpatients. A multi-center, double-blind, retrospective study was conducted in eight Xiamen medical centers over six months; we recruited ICU inpatients with indwelling urinary catheters (UC) > = 48 h. Data were analyzed using Chi-Square and student’s t-test. With bundle interventions, the CAUTI rate in ICUs decreased from 3.84 to 1.31 per 1000 UC days. The UC utilization was significantly reduced after bundles (71.29–62.70

Background: The World Health Organization (WHO) targets a 65% reduction in hepatitis Brelated deaths by 2030 compared to 2015 to eliminate viral hepatitis as a major public health threat. It is unknown whether and how China can achieve this target despite significant intervention achievements. We aimed to predict the hepatitis B-related deaths in China and identify key developments needed to achieve the target. Methods: An age- and time-dependent dynamic hepatitis B virus (HBV) transmission compartmental model was developed to predict the trend of hepatitis B-related deaths under base-case and subsequent scenarios from 2015 to 2040. In base-case scenario, we assumed the diagnosis and treatment (D&T) rate would reach 72% in 2030, as proposed by WHO. Subsequent scenarios were set based on the results of base-case and one-way sensitivity analysis. Results: Compared with 2015, hepatitis B-related deaths would be reduced by 23.89% in 2030 and 51.79% in 2040, respectively, and the WHO's impact target of 65% reduction would not be achieved until 2038 at the earliest under base-case scenario. HBV clearance rate and current treatment effectiveness were the most sensitive parameters that significantly influenced the decline of hepatitis B-related deaths from 2015 to 2040. In the subsequent scenario, when D&T rate improving to 90% by 2030, with the current treatment effectiveness and HBV clearance rate being optimized from 2016, the WHO's impact target would be achieved in 2038. Increasing the clearance rate further from 2% to 2.8% during 2016-2030 linearly, the impact target would be achieved on time. Conclusions: It is difficult for China to achieve the WHO's impact target of 65% reduction in hepatitis B-related deaths by 2030 even we assumed the D&T rate would reach 72% in 2030 and beyond. A comprehensive scale-up of available strategies, especially innovative drugs and technologies will ensure that China achieves the target on schedule. (c) 2025 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Objectives: The study aims to investigate whether bathing with 2% chlorhexidine gluconate (CHG) re-duces the incidence of surgical site infection (SSI) in patients undergoing routine pancreatic surgery. Methods: A randomized controlled trial was conducted at a large-volume pancreatic centre between 1 January 2021 and 31 December 2022. Patients undergoing clean-contaminated pancreatic surgery were enrolled and randomized into an intervention arm (bathing with a 2% CHG wipe) and a control arm (routine care, soap, and water). The primary outcome was the incidence of SSI after pancreatic surgery within 30 days. Results: Overall, 614 patients (intervention arm, 311; control arm, 303) were included in intention-to-treat analysis. In tollal, 8.8% (54/614) patients developed SSL. The incidence of SSI in the intervention arm was 6.8% (21/311) and 10.9% (33/303) in control arm, and the difference did not reach the level of statistical sig-nificance (p 0.070). The time to SSI was significantly extended when patients were in the intervention arm (log-rank test. p 0.047). The intervention did not significantly reduce the incidence of healthcare-associated infection, hospital-acquired pneumonia, and bloodstream infection. No adverse events were observed. However, in the per-protocol analysis among 519 patients, the intervention arm showed a significantly lower incidence of overall SSI than that of those in the control arm (21/272, 7.7% vs. 33/242, 13.4%, p 0.036). Discussion: Bathing with 2% CHG could potentially reduce the incidence of SSI for the patients scheduled to undergo pancreatic surgery for which further well-designed clinical trials are warranted. Wen-Sen Chen, Clih Microbiol Infect 2025:31:825 (c) 2025 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights arq reserved, including those for text and data mining. Al training, and similar technologies

Expanding tuberculosis preventive treatment (TPT) for high-risk populations with latent tuberculosis infection (LTBI) is a key component of the End TB Strategy. However, the high-risk population size is small, which may have limited impact on reducing TB incidence. We aimed to evaluate the health impact and cost-effectiveness of expanding TPT to key community-level population We developed a dynamic transmission model incorporating the effect of TPT and seasonal variations in TB incidence. The model was calibrated by monthly pulmonary tuberculosis (PTB) case data during 2011–2018 from Shaanxi province, China, and validated by data in 2019. We first assessed the TB epidemic trend for seven expanding TPT strategies and sought the optimal TPT strategy that can reach the target of the End TB Strategy by 2035. Then, we calculated the incremental cost-effectiveness ratios (ICER) of this optimal TPT strategy with five TPT regimens (isoniazid monotherapy with two different durations, rifampin monotherapy, and combinations of isoniazid with rifampin or rifapentine) over 2025–2050, compared with no TPT, from a health system perspective. A willingness-to-pay threshold of US 36,378 (three times the per-capita gross domestic product of Shaanxi province in 2023) was used. The optimal TPT strategy is implementing TPT for all WHO-recommended populations and individuals with LTBI aged ≥ 50 at the community level (starting in 2025 with full coverage within 1 year), which could reduce the PTB incidence rate to 1.83/100,000 by 2035, meeting the WHO target of a 90

BACKGROUND:Emerging evidence suggests that metabolic syndrome (MetS) contributes to cancer development, but the causal relationship remains unclear. This study aimed to explore the potential causal associations between MetS and 50 types of cancer (including the main cancer subtypes) using bidirectional Mendelian randomization (MR) analysis. METHODS:Genome-wide association study (GWAS) data were downloaded from the IEU-GWAS database and CNCR-CTGLAB. We investigated the causal associations between MetS and cancer via the inverse variance-weighted (IVW) method. We used sensitivity analyses, including Cochran's Q, MR-PRESSO, and MR-Egger intercept tests, to verify the reliability of the MR results. The P-value of the IVW analysis was adjusted for the false discovery rate (FDR) to avoid false-positive results. RESULTS:The results of the IVW analysis revealed that genetically predicted MetS was positively associated with an increased risk of 11 types of cancers (P-FDR < 0.05, odds ratio [OR] = 1.23-3.01), including squamous cell lung cancer, lung cancer, endometrial cancer, endometrial cancer (endometrioid histology), endometrial cancer (non-endometrioid histology), rectal cancer, hepatic cancer, colorectal cancer, non-follicular lymphoma cancer, primary lymphoid and hematopoietic malignant neoplasm cancer, and thyroid cancer. Genetically predicted MetS was negatively associated with the risk of prostate cancer (P-FDR < 0.05, OR = 0.87). The sensitivity analyses revealed no heterogeneity or horizontal pleiotropy (P > 0.05) in the MR Egger intercept and MR-PRESSO tests, confirming the robustness of the results. Moreover, there were no reverse causalities between these cancers and MetS. CONCLUSION:Our study revealed a positive causal relationship between genetically predicted MetS and lung cancer, lung squamous cell carcinoma, endometrial cancer, colorectal cancer, hepatic cancer, non-follicular lymphoma cancer, primary lymphoid and hematopoietic malignant neoplasm cancer, and thyroid cancer, and a negative causal relationship between genetically predicted MetS and prostate cancer, which provides important insights into the cancer prevention, treatment, and long-term health management of MetS.

Background: While hepatitis B virus (HBV) infection in children has declined dramatically in China due to the vaccination strategy for newborns, HBV infection in high-risk adults is receiving an increasing attention. The number of people who use drugs (PWUD) in China is huge, but their status of HBV infection and vaccination is less reported, especially from large samples. The related knowledge can help decision makers develop the further strategy of HBV prevention and control. Methods: A seroepidemiological survey was conducted in all four compulsory isolated detoxification centers (CIDCs) and all eight methadone maintenance treatment (MMT) clinics located in Xi'an, China. All PWUD who were undergoing detoxification or treatment in these settings were included. A questionnaire was designed to obtain the information of HBV vaccination history of participants, and sociodemographic and behavioral data of participants were obtained from the registration records of their respective CIDCs or MMT clinics. Results: A total of 4705 PWUD participated in the survey. Positive rates of HBsAg (current infection) and HBsAg or anti-HBc (current/past infection) were 5.50% and 58.02%, notably higher than those reported for the general adult population in the same province during the same period. As age increased, the anti-HBc positive rate increased with statistically significant trend. The all-negative for HBsAg, anti-HBc, and anti-HBs accounted for 28.82%. Only 18.49% were identified by the questionnaire as having received HBV vaccine. The logistic regression found that compared with identified vaccinated PWUD, those unsure if having been vaccinated and those identified non-vaccinated had a significantly higher HBV current/past infection rate, with an increasing trend. Conclusion: PWUD are a high-risk adult group of HBV infection in China. Of them, more than half have not received HBV vaccine, and a significant portion are susceptible to HBV. Catch-up vaccination is need for this population to prevent and control HBV transmission.

Background Catheter-associated urinary tract infections (CAUTIs) are the most common type of healthcare-associated infections (HAIs). Current studies mainly focused on the risk factors, but the method to control is unresolved. We aimed to give an overview of the epidemiology of CAUTIs and to explore the bundles intervention effect in intensive care unit (ICU) inpatients. Methods A multi-center, double blind, prospective study was conducted in eight Xiamen’s medical centers during six months, We recruited ICU inpatients who had indwelling urinary catheters > = 48h. Data were analyzed using Chi-Square and student's t-test. Results With bundle interventions, the CAUTIs rate in ICUs was decreased from 3.84 to 1.31 per 1000 urinary catheter days. The urinary catheter utilization was significantly decreased after bundles (71.29–62.70%), the average duration of indwelling urinary catheters was significantly decreased as well (7,035 days vs 6,884 days). CAUTIs in patients over 60 years old were found a significantly reduction after bundles. There were 45 causative organisms detected from 36 cases of CAUTIs, including 12 multidrug-resistant bacteria. Conclusions Bundles have been shown to reduce the risk of CAUTIs in patients with indwelling catheters in the ICU, especially in the elderly. It also significantly reduces the use of Carbapenem. Therefore, CAUTI bundles are recommended to clinicians.