Antimicrobial resistance profiles and genome characteristics of Klebsiella isolated from the faeces of neonates in the neonatal intensive care unit.

Introduction. Klebsiella spp. are important bacteria that colonize the human intestine, especially in preterm infants; they can induce local and systemic disease under specific circumstances, including inflammatory bowel disease, necrotizing enterocolitis and colorectal cancer.Hypothesis. Klebsiella spp. colonized in the intestine of the neonates in the neonatal intensive care unit (NICU) may be associated with disease and antibiotic resistance, which will be hazardous to the children.Aim. Our aim was to know about the prevalence, antimicrobial resistance and genome characteristics of Klebsiella spp. in neonate carriers.Methodology. Genome sequencing and analysis, and antimicrobial susceptibility testing were mainly performed in this study.Results. The isolation rates of Klebsiella spp. strains were 3.7% (16/436) in 2014 and 4.3% (18/420) in 2021. Cases with intestinal-colonized Klebsiella spp. were mainly infants with low birth weights or those with pneumonia or hyperbilirubinemia. According to the core-pan genomic analysis, 34 stains showed gene polymorphism and a sequence type (ST) of an emerging high-risk clone (ST11). Eight strains (23.5%) were found to be resistant to 2 or more antibiotics, and 46 genes/gene families along with nine plasmids were identified that conferred resistance to antibiotics. In particular, the two strains were multidrug-resistant. Strain A1256 that is related to Klebsiella quasipneumoniae subsp. similipneumoniae was uncommon, carrying two plasmids similar to IncFII and IncX3 that included five antibiotic resistance genes.Conclusion. The prevention and control of neonatal Klebsiella spp. colonization in the NICU should be strengthened by paying increased attention to preventing antimicrobial resistance in neonates.

The Maternal-Fetal Risk Factors of Hypertensive Disorders of Pregnancy and its Effects on Infant Complete Blood Count and Coagulation Factors.

Objective: Our aim was to analyze the risk factors of hypertensive disorders of pregnancy (HDP) and explore its influence on fetal risk factors, infant's blood cells and markers of inflammation. Methods: A total of 123 patients with HDP were in the HDP group, and 121 healthy pregnant women were selected as the control group. The general clinical data of the participants were recorded. Statistics of maternal and infant outcomes, delivery methods, routine blood lab results and coagulation factors of the newborn were recorded. Univariate analysis and multi-factor analysis were used to explore the risk factors for HDP. Results: The overall incidence of poor maternal outcomes in the HDP group was higher than in the control group. The incidence of premature delivery; postpartum hemorrhage; coagulopathy; placental abruption; heart failure and hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome was significantly higher in the HDP group than in the control group (P < .05). The cesarean section rate in the HDP group was significantly higher than in the control group (P < .05). The overall incidence of poor outcomes in fetuses and newborns in the HDP group was higher than in the control group. The incidence of infant low birth weight, intraventricular hemorrhage (IVH), neonatal respiratory distress syndrome (NRDS), asphyxia and all-cause neonatal death were higher than in the control group (P < .05). The incidence of small gestational age (SGA), fetal distress and intrauterine death in the HDP group were higher than in the control group (P < .05). In the HDP group, neonatal white blood cells (WBC), neutrophils (NEUT) and platelets (PLT) were significantly lower than in the control group (P < .05), while hemoglobin (Hgb) and hematocrit (Hct) were higher (P < .05). Conclusions: HDP endangers the health of mother and infant; Age, body mass index (BMI) (>24 kg/m2), parity, history of hypertension, family history of hypertension and other factors may be involved in the occurrence and development of HDP.

Pan-cancer analysis of the prognostic and immunological role of nucleophosmin/nucleoplasmin 3 (NPM3) and its potential significance in lung adenocarcinoma.

Background: Nucleophosmin/nucleoplasmin 3 (NPM3), a member of the NPM protein family, is widely expressed in various human tissues. Although previous studies identified elevated NPM3 expression in several cancers, a systematic pan-cancer analysis remains lacking. In this study, we conducted a comprehensive analysis of NPM3 to determine its role in tumorigenesis and tumor development. Methods: Using data from The Cancer Genome Atlas (TCGA) and various bioinformatics analysis tools, we conducted a pan-cancer analysis of NPM3. Additionally, we collected gene expression and clinical data from 890 patients with lung adenocarcinoma (LUAD) from TCGA and the Gene Expression Omnibus database. We performed Cox regression analyses to explore the independent prognostic value of NPM3 expression in LUAD and plotted a nomogram to predict patient survival. We also used real-time quantitative polymerase chain reaction (RT-qPCR) to examine the expression levels of NPM3 in seven pairs of LUAD and paraneoplastic tissue samples. Results: NPM3 expression was significantly increased in 20 types of cancer and was associated with poor prognosis in five types (P < 0.05). NPM3 expression was negatively correlated with DNA methylation and positively correlated with copy number variation. NPM3 was also significantly associated with immune cell infiltration in various cancers. Cox regression analyses revealed that NPM3 expression could serve as an independent prognostic marker of LUAD. Moreover, our nomogram demonstrated good predictive ability for the prognosis of patients with LUAD. Finally, the high expression of NPM3 in LUAD was verified using RT-qPCR. Conclusion: NPM3 is a promising biomarker for predicting pan-cancer prognosis and immunotherapeutic efficacy.