Analysis of Differences in Neonatal Sepsis Caused by Streptococcus Agalactiae and Escherichia Coli.

BACKGROUND: Streptococcus agalactiae (GBS) and Escherichia coli (E. coli) are the main pathogenic bacteria in neonatal sepsis. Therefore, the clinical characteristics, nonspecific indicators, and drug susceptibilities of these two bacteria were studied. METHODS: In total, 81 and 80 children with sepsis caused by GBS and E. coli infection, respectively, admitted to the neonatal department of our hospital between May 2012 and July 2023, were selected, and the clinical characteris-tics of the two groups were analyzed. Nonspecific indicators and drug sensitivity test results were analyzed retrospectively. RESULTS: Birth weight, tachypnea, groan, tachycardia or bradycardia, and the incidence of complications, such as pneumonia, respiratory failure, and purulent meningitis, were higher in the GBS group than in the E. coli group. The children were born prematurely, and the mother had a premature rupture of membranes. The incidence of jaundice, abdominal distension, atypical clinical manifestations, and complications of necrotizing enterocolitis was lower than of the E. coli group, and the differences were statistically significant (p < 0.05). The WBC, NE#, NE#/LY#, hs-CRP, and PCT of the GBS group were higher than those of the E. coli group, whereas the MPV, D-D, and FDP levels were lower than those in the E. coli group. The differences were all statistically significant (p < 0.05). The 81-bead GBS had high resistance rates against tetracycline (95%), erythromycin (48.8%), and clindamycin (40%), and no strains resistant to vancomycin, linezolid, penicillin, or ampicillin appeared, whereas 80 strains of E. coli were more resistant to penicillin and third-generation cephalosporins, with the higher resistance rates to ampicillin (68.30%), trimethoprim/sulfamethoxazole (53.6%), and ciprofloxacin (42.90%). Resistance rates to carbapenems and aminoglycosides were extremely low. CONCLUSIONS: Both GBS and E. coli neonatal sepsis have specific clinical characteristics, especially in terms of clinical manifestations, complications, non-specific indicators, and drug resistance. Early identification is important for clinical diagnosis and treatment.

Pathogenic Characteristics and Genomic Analysis of a Rare Serotype Salmonella enterica Serovar Moualine Isolated from the Blood.

BACKGROUND: Salmonella is composed of a wide variety of serovars that cause human self-limited gastrointestinal illnesses or invasive infections. Most of the Salmonella strains of clinical isolates belong to the A - F group. In December 2012, a case of invasive infection was caused by a rare Salmonella, Salmonella enterica serovar Moualine (S. Moualine), identified as 047 outside of groups A - F, which was easily missed or misreported. The goal is to ex-plore clinical symptoms and therapies of blood infection caused by S. Moualine and to provide theoretical basis and molecular level date for Salmonella research by analyzing pathogenic characteristics and genome information of S. Moualine. METHODS: The S. Moualine genome was sequenced using a PacBio RS II platform and Illumina HiSeq 4000 platform and analysis for serotyping serovars, ST types, the characterization of antibiotic resistance, virulence and phylogeny. RESULTS: The clinical symptoms were mainly irregular recurrent fever, lasting 1 - 3 weeks, with mild gastrointestinal symptoms. The genome size of S. Moualine was 4,611,151 bp, the serotype was 047 (+), Hy (+), H1,6 (+), and multilocus sequence typing analysis was ST3038. S. Moualine contains the majority of virulence genes. Interestingly, S. Moualine also harbors the rck and Typhi colonization factor (tcf) genes, which may play a role in invasive infection. S. Moualine encodes 17 Salmonella pathogenicity islands and is potentially dangerous to human health. Both phenotypic and genomic characterizations have demonstrated that S. Moualine generally showed low antimicrobial resistance potential. CONCLUSIONS: There were few reports on S. Moualine. According to clinical symptoms and genetic analysis, S. Moualine was predicted to be a highly virulent bacteria and was also potentially dangerous to health of humans. This study highlights that the transparency of global surveillance genomic data could accelerate the understanding of the virulence and antimicrobial resistance makeup of a previously unknown threat.

Antimicrobial Resistance, Genetic Diversity and Virulence Genes of Salmonella Typhimurium Isolated in Infant with Acute Diarrhea in Fuzhou, China, 2015 - 2017.

BACKGROUND: S. Typhimurium was the dominant serovar in an infant in Fuzhou, China. There have been few comprehensive studies on Salmonella typhimurium in infants in China. METHODS: We conducted a retrospective study on 30 Salmonella typhimurium from 3,200 fecal samples of infants with acute diarrhea from 2015 to 2017. Thirty S. Typhimurium strains were tested for antimicrobial susceptibility and characterized for virulence genes. Pulsed-field gel electrophoresis (PFGE) was also applied for comparison of genetic relatedness. RESULTS: All of the strains harbored misL, orfL, pipD, prgH, sifA, sopB, sitC, spiC, and invA genes. The other three gene distributions in the strains are different. Strains subtyped into 4 virulotypes (VP1-VP4), the most common virulence profile was VP3, accounting for 63.3% of the strains. The resistance to ciprofloxacin and ceftriaxone was 26.7%. The proportion of MDR isolates is approximately 90.0%. Sixteen different antimicrobial resistance patterns were observed and the most frequent resistance type was antibiotype 13 (resistance to streptomycin, tetracycline, amoxicillin), occurring in 43.3% of the isolates. Regarding PFGE, 30 isolates of S. Typhimurium showed genetic diversity, while no predominant PFGE patterns were observed in S. Typhimurium. Moreover, no correlation between virulence profiles or antibiotic patterns and PFGE clusters was observed. With one exception, VP1 which harbors pefA showed more diversity than the other virulence profiles among PFGE profiles. CONCLUSIONS: Our study provided valuable information on virulence gene content, antibiotic resistance, and genetic diversity of S. Typhimurium isolated from infant with acute diarrhea in Fuzhou, China.

Non-Typhoidal Salmonella Infections Among Children in Fuzhou, Fujian, China: A 10-Year Retrospective Review from 2012 to 2021.

Purpose: Non-typhoidal salmonella (NTS) infection is a leading cause of acute gastroenteritis in children. Recently, NTS infections have increased, especially those associated with Salmonella Typhimurium, which has become a global problem because of its high level of drug resistance. Diseases caused by NTS serotypes vary considerably. We summarised NTS infections among children in Fuzhou, Fujian, China, from 2012 to 2021, and synthesised studies indicating the clinical symptoms, laboratory test results, and drug resistance associated with S. Typhimurium and non-S. Typhimurium to enhance the knowledge of these infections and improve their diagnoses and treatment. Patients and Methods: Between January 2012 and December 2021, 691 children with NTS infections confirmed by positive culture test results were recruited from Fujian Children's Hospital and Fujian Maternity and Child Health Hospital. Clinical demographic data of each case were collected from the electronic medical records and analysed. Results: A total of 691 isolates were identified. The number of NTS infections increased significantly in 2017 and increased sharply during 2020 and 2021, especially S. Typhimurium greatly increased and was the dominant serotype (58.3%). S. Typhimurium infection was commonly occurred in children younger than 3 years and most of them were gastrointestinal infection, while non-S. Typhimurium more often observed in older children and associated with extra-intestinal infection. The rate of multidrug-resistant S. Typhimurium was significantly higher than that of non-S. Typhimurium, especially during the last 2 years of this study (2020 and 2021). Conclusion: S. Typhimurium was the dominant serotype and greatly increased among children in Fuzhou city. There are significant differences in clinical symptoms, laboratory test results, and drug resistance between S. Typhimurium and non-S. Typhimurium. More attention should be paid on S. Typhimurium. Long-term high-quality surveillance and control measures should be conducted to prevent salmonella infections and drug resistance.

Molecular Epidemiology of Group B Streptococcus Isolates from Pregnant Women with Premature Rupture of Membranes in Fuzhou, China.

Objective: This study investigated the molecular epidemiology of Group B Streptococcus (GBS) in pregnant women with premature rupture of membranes (PROM) in Fuzhou region of China as a source of clinical reference. Methods: GBS isolates were obtained from pregnant women with PROM. All isolates were genotyped, serotyped, and tested for drug-resistance and virulence genes using PCR and DNA sequencing. Antibiotic susceptibility testing was performed using the Vitek® 2 automated system. Results: Among the 140 GBS isolates, seventeen sequence types (STs) were identified, of which ST19 (20.0%) was the most prevalent, followed by ST862, ST10, and ST12. Three clonal complexes (CC19, CC10 and CC1) were identified. The predominant serotype was III (45.7%), followed by V (23.6%), Ib (18.6%), Ia (7.1%), and II (3.6%). The prevalence of multidrug resistance was 72.8% (102/140). All isolates were susceptible to penicillin G, ampicillin, quinupristin, linezolid, vancomycin, and tigecycline. The majority of isolates were resistant to erythromycin (70.0%), clindamycin (72.1%), and tetracycline (81.4%), and 28.6% of isolates were resistant to levofloxacin and moxifloxacin. Of the 98 erythromycin-resistant strains, mreA, ermB, mefA, mefE, ermA, and ermTR were detected in 100%, 70.4%, 49.0%, 22.4%, 13.3%, and 9.2%, respectively. No linB was detected among 101 clindamycin-resistant strains. Of the 114 tetracycline-resistant strains, tetM, tetK, tetL and tetO were detected in 52.6%, 61.4%, 7.9%, and 23.7%, respectively. Regarding virulence genes, all strains carried rib and hylB, followed by scpB (98.6%), and bca (80.7%), whereas only one strain carried bac. Conclusion: ST19/III and ST862/III were the most prevalent GBS subtypes. Penicillin G remains a first-line antibiotic for intrapartum antibiotic prophylaxis and treatment of GBS infections. The prevalence of resistance to clindamycin, erythromycin, and tetracycline is high among GBS isolates in the Fuzhou region. ST862 and ST651 are emerging animal origin STs in human infections, and may become potential zoonotic threats.

A multiomics comparison between endometrial cancer and serous ovarian cancer.

BACKGROUND: Endometrial carcinoma (EC) and serous ovarian carcinoma (OvCa) are both among the common cancer types in women. EC can be divided into two subtypes, endometroid EC and serous-like EC, with distinct histological characterizations and molecular phenotypes. There is an increasing awareness that serous-like EC resembles serous OvCa in genetic landscape, but a clear relationship between them is still lacking. METHODS: Here, we took advantage of the large-scale molecular profiling of The Cancer Genome Atlas(TCGA) to compare the two EC subtypes and serous OvCa. We used bioinformatics data analytic methods to systematically examine the somatic mutation (SM) and copy number alteration (SCNA), gene expression, pathway activities, survival gene signatures and immune infiltration. Based on these quantifiable molecular characterizations, we asked whether serous-like EC should be grouped more closely to serous OvCa, based on the context of being serous-like; or if should be grouped more closely to endometroid EC, based on the same organ origin. RESULTS: We found that although serous-like EC and serous OvCa share some common genotypes, including mutation and copy number alteration, they differ in molecular phenotypes such as gene expression and signaling pathway activity. Moreover, no shared prognostic gene signature was found, indicating that they use unique genes governing tumor progression. Finally, although the endometrioid EC and serous OvCa are both highly immune infiltrated, the immune cell composition in serous OvCa is mostly immune suppressive, whereas endometrioid EC has a higher level of cytotoxic immune cells. Overall, our genetic aberration and molecular phenotype characterizations indicated that serous-like EC and serous OvCa cannot be simply treated as a simple "serous" cancer type. In particular, additional attention should be paid to their unique gene activities and tumor microenvironments for novel targeted therapy development.