Application of Targeted Coronary Angiography in the Diagnosis of Sudden Cardiac Death.

OBJECTIVES: To diagnose coronary artery stenosis by using the postmortem computed tomography angiography (PMCTA), and to explore the diagnostic value of PMCTA in sudden cardiac death. METHODS: Six death cases were selected, and the contrast medium iohexol was injected under high pressure through femoral artery approach with 5F pigtail catheter to obtain coronary image data and then the data was analyzed. The results of targeted coronary imaging and coronary artery calcium score (CaS) were compared with the results of conventional autopsy and histopathological examination. RESULTS: The autopsy and histopathological examination of cases with coronary artery stenosis obtained similar results in targeted coronary angiography, with a diagnostic concordance rate of 83.3%. Targeted coronary angiography could effectively show coronary artery diseases, and the CaS was consistent with the results of conventional autopsy and histopathological examination. CONCLUSIONS: Targeted coronary angiography can be used as an effective auxiliary method for conventional autopsy in cases of sudden cardiac death.

[A study of in vitro activity of daptomycin against 2679 Gram-positive cocci].

OBJECTIVE: To evaluate the in vitro activity of daptomycin against 2679 Gram-positive cocci. METHODS: A total of 2679 non-duplicate Gram-positive cocci isolates were collected from 17 teaching hospitals during January, 2010 and December, 2011. The minimal inhibitory concentrations (MICs) of daptomycin and other anti-microbial agents against 4 Gram-positive cocci were determined by micro-broth dilution method and agar dilution respectively. The data of drug susceptibility were analyzed by WHONET5.6 software. RESULTS: Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRSCoN) detection rates were 45.8% and 84.2%, respectively. The susceptibility rates of sulfamethoxazole, chloramphenicol, erythromycin, tetracycline, clindamycin and rifampicin against MRSA were 93.1%, 85.5%, 13.8%, 26.6%, 63.2% and 50.0%, respectively. The susceptibility rates of daptomycin, vancomycin and linezolid against MRSA and MRSCoN were all 100.0%. The daptomycin MIC50 and MIC90 of MRSCoN and MRSA were 0.5 mg/L. The high level gentamicin resistance rate of 513 Enterococci isolates was 56.9%. The susceptibility rates of chloramphenicol and tetracycline were 76.0% and 44.1%, respectively. The susceptibility rates of tigecycline and daptomycin reached 100.0%. The MIC50 and MIC90 of daptomycin against 17 vancomycin-resistant Enterococci (VRE) were both 2 mg/L. The susceptibility rates of daptomycin against Streptococcus pneumoniae and ß-hemolytic Streptococcus were 100.0%. The prevalence of penicillin-nonsusceptible Streptococcus pneumoniae (PNSSP) was 63.1%. The MIC50 and MIC90 of daptomycin against PNSSP were 0.125 mg/L and 0.25 mg/L, respectively according to the breakpoint of oral penicillin. The MIC50 and MIC90 daptomycin against ß-hemolytic Streptococci were 0.008 mg/L and 0.032 mg/L. CONCLUSIONS: Daptomycin have excellent in vitro activity against common Gram-positive cocci, including multi-drug resistant bacteria. It may be a good choice for clinicians to treat drug-resistant Gram-positive cocci.