An analysis of differences in Carbapenem-resistant Enterobacterales in different regions: a multicenter cross-sectional study.

OBJECTIVE: This study aimed to explore the characteristics of carbapenem-resistant Enterobacterales (CRE) patients in the intensive care unit (ICU) in different regions of Henan Province to provide evidence for the targeted prevention and treatment of CRE. METHODS: This was a cross-sectional study. CRE screening was conducted in the ICUs of 78 hospitals in Henan Province, China, on March 10, 2021. The patients were divided into provincial capital hospitals and nonprovincial capital hospitals for comparative analysis. RESULTS: This study involved 1009 patients in total, of whom 241 were CRE-positive patients, 92 were in the provincial capital hospital and 149 were in the nonprovincial capital hospital. Provincial capital hospitals had a higher rate of CRE positivity, and there was a significant difference in the rate of CRE positivity between the two groups. The body temperature; immunosuppressed state; transfer from the ICU to other hospitals; and use of enemas, arterial catheters, carbapenems, or tigecycline at the provincial capital hospital were greater than those at the nonprovincial capital hospital (P < 0.05). However, there was no significant difference in the distribution of carbapenemase strains or enzymes between the two groups. CONCLUSIONS: The detection rate of CRE was significantly greater in provincial capital hospitals than in nonprovincial capital hospitals. The source of the patients, invasive procedures, and use of advanced antibiotics may account for the differences. Carbapenem-resistant Klebsiella pneumoniae (CR-KPN) was the most prevalent strain. Klebsiella pneumoniae carbapenemase (KPC) was the predominant carbapenemase enzyme. The distributions of carbapenemase strains and enzymes were similar in different regions.

Assessment of geothermal resource potential in Changbaishan utilizing high-precision gravity-based man-machine interactive inversion technology.

As one of the clean energy sources, geothermal resources have no negative impact in changing the climate. However, the accurate assessment and precise identification of the potential geothermal resource is still complex and dynamic. In this paper, ~2,000 large-scale high-precision gravity survey points are conducted in the north of the Tianchi caldera, Changbaishan. Advanced data processing technologies can provide straightforward information on deep geothermal resources (Hot source, caprock, geothermal reservoir and geothermal migration pathway). Upwards continuation and the technologies decode two dome shaped low and gentle anomalies (-48 × 10-5 m/s2-65 m/s2) and a positive gravity gradient anomaly (0.4 × 10-7 m/s2-1.6 × 10-5 m/s2) in large-scale high-precision gravity planar. According to two point five dimensional man-machine interactive inversion technology and the research on petrophysical parameters, the density of the shied-forming basalts in the two orthogonal gravity sections is 2.58 g/cm3. The relatively intermediate to high density (2.60-2.75 g/cm3) represents geothermal reservoir, and low density (low to 2.58 g/cm3) is the geothermal migration pathway. In addition, large-scale high-precision gravity planar with a solution of about 1/50,000 indicate that the north of the Tianchi caldera exits the sedimentary basin and uplift mountain geothermal system.

Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series.

Objective: To investigate the application effect of extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) caused by Pneumocystis jirovecii pneumonia (PJP) after kidney transplantation. Methods: This is a case series on 10 kidney transplant recipients with severe ARDS caused by PJP at the People's Hospital of Zhengzhou, who were enrolled as the case group. A total of 17 cases of PJP diagnosed with severe ARDS without ECMO were selected as the control group. The timing and mode of ECMO support and treatment complications were summarized. The primary aim of this study was mortality and secondary was imaging and complications. Results: The enrolled patients' oxygenation index before the start of ECMO ranged from 25 to 92, and the time from admission to the start of ECMO was 1-17 days, with an average of 5.56 days. In the case group, one patient died of hemorrhagic shock due to abdominal hemorrhage, but the other nine patients were successfully weaned from ECMO. Of these patients, one died due to sepsis following weaning. The survival rate in the case group was 80.0% (8/10), and the survival rate in the control group was 35.29% (6/17). The vein-vein ECMO support time in the nine successfully weaned patients in the case group ranged from 131 to 288 h, with an average of 215.5 h. Of the eight patients who survived, deterioration of renal function after transplantation occurred in two patients, but no fatal complications occurred. Conclusion: Overall, Patients with severe ARDS caused by postoperative PJP infection following kidney transplantation have a poor prognosis. The mortality was lower in patients who were treated with ECMO compared to standard care.

SOFA Score Can Effectively Predict the Incidence of Sepsis and 30-Day Mortality in Liver Transplant Patients: A Retrospective Study.

INTRODUCTION: This study aims to evaluate the early predictive value for postoperative sepsis and 30-day mortality in liver transplant patients using sequential organ failure assessment (SOFA). METHODS: A total of 96 liver transplant patients were enrolled into this study from February 2015 to June 2018. The general information, biochemical findings, and postoperative 30-day mortality of these patients were statistically analyzed. RESULTS: The SOFA scores, C-reactive protein (CRP), and procalcitonin (PCT) at postoperative day (POD) 3, 5, and 7 were significantly higher in the sepsis group than in the non-sepsis group, and the differences were statistically significant. Receiver operating characteristic (ROC) curve showed that SOFA scores at POD 1, 3, 5, and 7 had higher sensitivity and specificity in predicting the incidence of sepsis within 30 days. The difference in 30-day survival rate between patients with SOFA scores of > 5 and patients with SOFA scores of ≤ 5 at POD 1-7 was statistically significant (P < 0.05). CONCLUSION: SOFA scores at POD 1-7 can effectively predict the incidence of sepsis and 30-day mortality in liver transplant patients on the basis of CRP and PCT.