Efficacy of Rg1-Oil Adjuvant on Inducing Immune Responses against Bordetella bronchiseptica in Rabbits.

Bordetella bronchiseptica (B. bronchiseptica) is an obligately aerobic, oxidase- and catalase-positive, nonfermentative Gram-negative coccobacillus. This study is aimed at examining the immune effects of Rg1, Rg1 plus oil, and other common adjuvants on inactivated B. bronchiseptica vaccine in rabbits. The mechanism underlying the adjuvant effect of Rg1 plus oil on the vaccine was also explored. Rg1 (100 µg) plus oil significantly improved the immune effect of B. bronchiseptica vaccine at both the humoral and cellular levels. Rg1-oil adjuvant increased the levels of IL-2 and IL-4 in rabbits after immunization. Rg1 (100 µg) plus oil also significantly increased TLR2 expression and downregulated NF-κB in splenocytes. Rg1-oil adjuvant may increase the levels of IL-2 and IL-4 via upregulating TLR2, thereby enhancing the immune effect of B. bronchiseptica vaccine. In conclusion, Rg1 plus oil could be used as a potential vaccine adjuvant for rabbit B. bronchiseptica vaccine.

Klebsiella pneumoniae Isolates from Meningitis: Epidemiology, Virulence and Antibiotic Resistance.

Klebsiella pneumoniae (KP) resistance to broad-spectrum cephalosporin (BSC) in meningitis is important because of limited therapeutic options. To investigate the antibiotic resistance, virulence and epidemiology of KP in meningitis, we conducted a retrospective study for 33 non-metastatic isolates, including primary meningitis (n = 20) and post-craniotomy meningitis (n = 13) collected from 1999 to 2013. BSC resistance was found in 9 (27.3%) isolates, all from post-craniotomy meningitis, harboring bla SHV-5 (n = 6), bla CMY-2 (n = 2), bla DHA-1 (n = 2), and bla TEM-1B (n = 1). Positive virulence factors were hypermucoviscosity (n = 22), larger bacterial size (n = 24), virulent capsule serotypes (n = 24, K2, 11; K1, 5; K57, 3; K5, 2; K20, 2 and K54, 1), rmpA (n = 23), rmpA 2 (n = 20), aerobactin gene (n = 22) and high-grade serum resistance (n = 23, 69.7%). Higher mouse lethality (LD50 < 106) was found in 16 isolates (48.5%). Post-craniotomy isolates were significantly less virulent than primary meningitis isolates, except for similar serum resistance capability. The pulsotype and sequence typing (ST) results were diverse. A minor cluster with pulsotype C and ST23 (n = 5) was identified in primary meningitis isolates. In conclusion, virulence factors and BSC resistance corresponded to about 70% and 30% of KP meningitis isolates respectively. BSC remains appropriate for treating primary meningitis, whereas meropenem is indicated for post-craniotomy meningitis empirically.

Port-A-Cath implantation using percutaneous puncture without guidance.

BACKGROUND: The implantation of a Port-A-Cath (PAC) is a common surgical procedure usually done under guidance with techniques such as fluoroscopy, ultrasound, or intravenous electrocardiography. PAC implantation without guidance avoids radiation exposure and decreases time, expense, and complexity. The purpose of this study was to analyze the success rate, and operation-related and postoperative complications of PAC implantation without intraoperative guidance. METHODS: Between July 2004 and June 2007, 1,070 PACs were implanted in 1,025 patients receiving chemotherapy. All PACs were placed via the subclavian vein by percutaneous puncture. The catheter length was precalculated for each patient. Postoperative chest radiography was immediately performed to check the catheter position. All data on outcome of the implantations were reviewed retrospectively. RESULTS: The catheter tip was correctly placed at the cavoatrial junction without complications in 1,055/1,070 (98.6%) of the implants. Surgery-related complications occurred in 15 (1.4%) implantations: 9 malposition, 3 pneumothorax, 2 hematoma, and 1 catheter kinking. Two patients underwent PAC removal due to hematoma with subsequent wound infection in one and catheter occlusion by kinking in the other. There were 86 (8.0%) postoperative complications that resulted in PAC removal: catheter occlusion in 24 (2.2%), pocket infection in 22 (2.1%), catheter rupture in 11 (1.0%), venous thrombosis in 9 (0.8%), port exposure in 9 (0.8%), catheter fracture in 6 (0.6%), infraclavicular pain in 3 (0.3%), catheter migration in 1 (0.1%), and extraportal injection in 1 (0.1%). CONCLUSIONS: PACs can be safely and accurately placed using percutaneous puncture of the subclavian vein without intraoperative guidance.