الملخص
Objective To understand the distribution of frequently isolated pathogenic bacteria from clinical speci-mens and their antimicrobial resistance changes in Hunan Province from 2012 to 2021,and to provide scientific evi-dence for the formulation and evaluation of antimicrobial clinical administration policies.Methods Species identifi-cation,selection of quality control strains and antimicrobial susceptibility testing agents were conducted according to the technical scheme of the China Antimicrobial Resistance Surveillance System(CARSS).Duplicate strains were excluded based on the principle of counting the first strain in each case.Statistical analysis was performed by WHO-NET 5.6 software.The the variations in constituent ratio and resistance rate of strains were analyzed with linear trend test,and the magnitude of change was described with Pearson correlation coefficient.Results From 2012 to 2021,the number of clinically isolated bacteria in the analysis increased from 82 759 to 312 914,with Gram-negative bacteria accounting for 69.5%-72.4%.The major Gram-positive bacteria were Staphylococcus aureus,Staphylo-coccus epidermidis,Streptococcus pneumoniae,Enterococcus faecalis and Enterococcus faecium,and the major Gram-negative bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii and Enterobacter cloacae.Isolation rate of Gram-positive bacteria increased yearly(r=0.022,P=0.001).Isolation rate of methicillin-resistant Staphylococcus aureus(MRSA)decreased from 34.3%to 24.8%.Isolation rates of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were less than 3%and 2%,respectively,presenting a downward trend.The detection rate of penicillin-resistant Streptococcus pneumoniae(PRSP)decreased from 5.6%to 1.0%.Except cefoperazone sulbactam,resistance rates of Escherichia coli to other tested antimicrobial agents showed decreasing trends(r<0,P=0.001).Isolation rates of third-generation cephalo-sporin-resistant Escherichia coli(CTX/CRO-R-EC)and carbapenem-resistant Escherichia coli(CREC)decreased year by year(from 70.5%to 45.3%,and 12.2%to 2.0%,respectively).Resistance rates of Klebsiella pneumo-niae to imipenem and meropenem have increased year by year,reaching 9.1%and 11.0%respectively in 2021,while isolation rate of carbapenem-resistant Pseudomonas aeruginosa(CRPA)decreased from 28.5%to 15.0%.Resistance rates of Acinetobacter baumannii to most antimicrobial agents were 40%-60%,and remained relatively stable.Isolation rate of carbapenem-resistant Acinetobacter baumannii(CRAB)ranged from 39.5% to 59.6%.Conclusion The clinical isolation rates of most important special antimicrobial-resistant bacteria have been decrea-sing year by year,while the resistance rate of Klebsiella pneumoniae to carbapenem agents gradually increased.Antimicrobial stewardship as well as the prevention and control of healthcare-associated infection on specific antimi-crobial-resistant bacteria should continue to be implemented in the future.The coverage and quality of antimicrobial resistance surveillance in H unan Province should continue to be improved.
الملخص
Objective To understand the distribution and antimicrobial resistance changes of bacteria isolated from pleural and peritoneal effusion in Hunan Province,and provide reference for correct clinical diagnosis and rational antimicrobial use.Methods Data reported by member units of Hunan Provincial Antimicrobial Resistance Survei-llance System from 2012 to 2021 were collected.Bacteria antimicrobial resistance surveillance method was imple-mented according to technical scheme of China Antimicrobial Resistance Surveillance System(CARSS),and WHO-NET 5.6 software was used to analyze the data of bacteria isolated from pleural and peritoneal effusion as well as antimicrobial susceptibility testing results.Results From 2012 to 2021,a total of 28 934 bacterial strains were iso-lated from specimens of pleural and peritoneal effusions from member units of Hunan Provincial Antimicrobial Re-sistance Surveillance System,with 5 752 strains from pleural effusion and 23 182 from peritoneal effusion.The top five bacteria isolated from pleural effusion were Escherichia coli(n=907,15.8%),Staphylococcus aureus(n=535,9.3%),Klebsiella pneumoniae(n=369,6.4%),Staphylococcus epidermidis(n=452,7.9%),and Staphy-lococcus haemolyticus(n=285,5.0%).The detection rate of methicillin-resistant Staphylococcus aureus(MR-SA)from pleural effusion was 24.3%-39.2%,and that of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 58.8%-77.1%.The top five bacteria isolated from peritoneal effusion were Escherichia coli(n=8 264,35.6%),Klebsiella pneumoniae(n=2 074,9.0%),Enterococcus faecium(n=1 458,6.3%),Staphylo-coccus epidermidis(n=1 383,6.0%),and Pseudomonas aeruginosa(n=1 152,5.0%).The detection rate of MRSA from peritoneal effusion was 22.1%-52.4%,which presented a decreasing trend(P=0.004).The detec-tion rate of MRCNS was 60.4%-79.4%.The resistance rates of Enterobacterales from peritoneal effusion to ce-fazolin,cefuroxime,ceftriaxone and cefepime all showed decreasing trends(all P<0.05).Vancomycin-,linezo-lid-,and teicoplanin-resistant Staphylococcus strains were not found in pleural and peritoneal effusions.The resis-tance rates of Enterococcus faecium to most tested antimicrobial agents were higher than those of Enterococcus fae-calis.The resistance rates of Enterobacterales to imipenem and meropenem were ≤8.5%.The resistance rates of non-fermentative Gram-negative bacilli to imipenem and meropenem were ≤43.3%.Conclusion The data structure of Hunan Antimicrobial Resistance Surveillance System for pleural and peritoneal effusions from 2012 to 2021 is relatively complete.The constituent and antimicrobial susceptibility of isolated pathogenic bacteria vary in different years.
الملخص
Objective To understand the distribution and changes in antimicrobial resistance of clinically isolated Pseudomonas aeruginosa(P.aeruginosa)in the member hospitals of Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021.Methods Antimicrobial susceptibility testing by disk diffusion or automa-ted instrument was performed on clinical isolates.Testing results were determined according to the standards of 2022 edition from American Clinical Laboratory Standards Institute(CLSI).Statistical analysis was performed by WHONET 5.6 software.Data were analyzed by trend test(Cochran-armitage)and Chi-square test with SPSS.Results A total of 176 441 strains of P.aeruginosa were surveilled by Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021.99.4%of the strains were isolated from hospitalized patients,and about 70%of the strains were isolated from respiratory specimens.8.4%of P.aeruginosa were from children(0-17 years old),91.6%were from adults.Antimicrobial susceptibility testing results showed that P.aeruginosa was most sensitive to polymyxin B over 10 years,with a resis-tance rate of less than 6%.Resistance rates to piperacil-lin,piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,imipenem,amikacin,gentamicin,tobramycin,cip-rofloxacin,levofloxacin,and polymyxin B all showed downward trends.A total of 29 920 carbapenem-resistant P.aeruginosa(CRPA)strains were detected.The average isolation rate of CRPA in this province was 18.0%over 10 years.CRPA detection rate from adult was 18.5%,higher than that from children(12.3%),and both showing downward trends.Conclusion The resistance rate of clinically isolated P.aeruginosa in Hunan Province to most commonly used antimicrobial agents is decreasing.
الملخص
Objective To understand the epidemiology of clinically isolated Acinetobacter baumannii(A.bauma-nnii)in Hunan Province.Methods Bacterial antimicrobial resistance surveillance was carried out according to the requirements of the technical program of National Antimicrobial Resistance Surveillance System.Clinical data of Acinetobacter spp.reported to Hunan Provincial Antimicrobial Resistance Surveillance System by multiple centers in Hunan Province from 2012 to 2021 were summarized and analyzed with reference to the standards of the American Clinical and Laboratory Standards Institute.Results A total of 169 438 strains of Acinetobacter spp.were detected during the 10-year period,with the detection rate of A.baumannii being the highest(82.74%).70 923 strains(53.63%)of carbapenem-resistant A.baumannii(CRAB)and 58 149 strains(43.97%)of carbapenem-sensitive A.baumannii(CSAB)were detected respectively.Both CRAB and CSAB were detected most frequently in the age group>70 years,which were 34.44%and 32.02%,respectively.The percentage of CRAB and CSAB detected in the intensive care unit were 34.80%and 11.31%,respectively.CRAB and CSAB were mainly isolated from spu-tum/bronchoalveolar lavage fluid,followed by pus/secretion,urine,and blood.The resistance rates of CRAB to commonly used antimicrobial agents didn't change much during the 10-year period.Resistance rates of CRAB to ceftazidime and cefepime were both>84%,to ampicillin/sulbactam and piperacillin/tazobactam were both>82%,to aminoglycosides and quinolones were both>59%,to minocycline and polymyxin B were 15.9%-25.0%and 1.3%-6.9%,respectively.CSAB were sensitive to commonly used antimicrobial agents.Conclusion The isolation rate of CRAB is high and there is no significant change in resistance to commonly used antimicrobial agents.
الملخص
Caveolin-1 (CAV-1) is related to inflammation, oxidative damage, and immunity. In order to obtain a series of dibenzoylmethane halophenols with strong anti-inflammatory and antioxidant effects targeting CAV-1, twenty-nine target compounds were therefore synthesized by Baker-Ventaraman rearrangement and demethylation reaction, starting from the substituted benzoyl chloride and o-hydroxyacetophenone, and their interactions with CAV-1 were investigated by BLI technique. Their in vitro anti-inflammatory and antioxidant properties were also evaluated. The results showed that compounds A6, A17, A18, and A29 not only specifically bind to CAV-1, but also present strong anti-inflammatory and antioxidant effects. These results suggest that this class of compounds can affect the signaling pathways related to inflammation and oxidative stress by directly acting on CAV-1. In particular, these compounds exhibit the most significantly inhibitory effects on IL-1β and COX-2 release. IL-1β plays a key regulatory role in the development of arthritis. Therefore, it is worth expecting for the application of such compounds in the prevention and treatment of arthritis.
الملخص
Objective:To investigate the relationship between NOD-like receptor pyrin domain containing 3(NLRP3)/cysteine aspartate-specific protease(Caspase)-1 signaling pathway and esophageal inflammation by observing the effect of Xuanfu Daizhe Tang on the composition of inflammatory body and the expression of relevant inflammatory factors in rats with reflux esophagitis (RE), so as to explain the mechanism of Xuanfu Daizhe Tang in treating RE. Method:Sixty healthy male Wistar rats were randomly divided into four groups:the normal control group, the model control group, the Xuanfu Daizhe Tang group (9.89 g·kg-1) and the positive control group (omeprazole enteric-coated tablets+mosapride, 2.58 mg·kg-1), with 15 rats in each group. Except for the blank control group, the remaining rats were operated by " 4.2 mm pyloric clip+2/3 gastric fundus ligation" to establish models. Since the 8th day after the operation, the rats were given corresponding drugs twice a day for 14 days. The arterial blood and esophageal tissues were taken out at the 15th day after the intervention. The pathological morphology of esophagus was observed by naked eyes and under light microscopy. The secretion of cytokines Caspase-1 and interleukin(IL)-1β in serum was detected by enzyme linked immunosorbent assay(ELISA). The expressions of NLRP3, Caspase-1 and IL-1β in esophagus were detected by Western blot. Result:Compared with the normal group, the injury of esophageal mucosa in the model group was the most serious. Compared with the normal group, the levels of Caspase-1 and IL-1β in serum and the expression of NLRP3 protein in esophageal tissue of the model group were significantly increased (PPβ in serum of rats, and down-regulate the expressions of NLRP3, Caspase-1 and IL-1β protein in esophageal tissue (P0.05, PConclusion:Xuanfu Daizhe Tang can regulate the expressions of NLRP3 and Caspase-1, and reduce the content of IL-1β, suggesting that it may antagonize esophageal inflammatory response, reduce esophageal inflammatory injury and treat RE by inhibiting the activation of NLRP3/Caspase-1 signaling pathway.
الملخص
Objective To investigate the effect of moxifloxacin(MXF)on inflammatory reaction of mice abdominal peritoneal macrophage induced by LPS.Methods The level of TLR4、SPHK1 and NF-κB mRNA was determined by realtime-PCR;The relative levels of TLR4、SPHK1 and NF-κB were determined by Western blot.TNF-αand IL-1 se-creted by macrophages were detected by ELISA.Results At low and medium concentration(8,16 mg/L)of the MXF have inhibitory effect on the increasing of TLR 4,SPHK1,NF-κB expression level and cell supernatant of TNF-αand IL-1 in LPS stimulation of mice peritoneal macrophages.High concentration(64 mg/L)of the MXF promoted the role of inflammation.Conclusions The MXF of low and medium concentrations can inhibit the inflammatory response in LPS stimulation of mice peritoneal macrophages,and high concentration of the MXF showed contrary effects.
الملخص
Objective To explore the retrograde contamination of drainage bag outlets,and provide basis for the formulation of related guideline for healthcare-associated infection(HAI)management. Methods On October 14,2016,with sterile manipulation,urine,5% glucose solution,glucose normal saline,sterile water,and 0.9% nor-mal saline were injected into anti-reflux drainage bags(anti-reflux group)and common drainage bags(common group)respectively,entrances of bags were sealed and bags were hung in two ways:outlets were 10 cm away from the ground(suspended group)and touched the ground(ground-touching group)respectively,specimens were col-lected from bag outlets to perform bacterial culture every 3 days,a total of 10 times of cultures were performed,re-trograde contamination of drainage bag outlets was observed dynamically.Results Retrograde contamination rate of drainage bag outlets of anti-reflux group was significantly lower than common group(7.7% vs 46.0%,P=0.000);suspended group was significantly lower than ground-touching group(17.9% vs 35.8%,P=0.000). Retrograde contamination rates of outlets of drainage bags filled with different properties of liquid were as follows:urine (54.3%)>5% glucose solution(34.5%)>glucose normal saline(24.3%)>0.9% normal saline(10.8%)>ste-rile water(10.5%),pairwise comparison showed a significant difference(P=0.000).The initial occurrence time of contamination in anti-reflux group and common group was on the 13thday and 7thday respectively,two group was significantly different on the 7thday(P=0.041). There was a medium intensity correlation between the types of drainage bags and liquid properties(PearsonC=0.5).Conclusion Different types of drainage bags,retention time,and liquid property can impact retrograde contamination of drainage bag outlets,regular urine culture during the use of drainage bags should be paid attention in clinical practice,so as to use antimicrobial agents rationally and guide replacement time of drainage bags.
الملخص
<p><b>OBJECTIVE</b>To investigate the relationship of gene polymorphisms of inflammattion related cytokines with incidence of diffuse large B-cell lymphoma(DLBCL) in Gansu Han population.</p><p><b>METHODS</b>The gene polymorphism of inflammation-related cytokines were detected by high-resolution melting(HRM) curve.</p><p><b>RESULTS</b>The homozygous CC genotype carrying IL-1RA rs4251961 gene locus was related with the risk of DLBCL in comparison with homozygous TT, the OR was 0.83 of homozygous CC, 95% CI=0.697-0.997,P<0.05), while the C allele of IL-1RA rs4251961 gene locus significantly correlated with the high incidence of diffuse large B-cell lymphoma compared with T allele(OR=8.83, 95% CI=1.909-40.813,P<0.01).</p><p><b>CONCLUSION</b>The minor allele C of IL-1RA rs4251961 gene locus significantly relates with the susceptibility to DLBCL.</p>
الملخص
<p><b>OBJECTIVE</b>To study the roles of IL-4, IL-5 and IgE in childhood cough variant asthma (CVA).</p><p><b>METHODS</b>The IL-4 and IL-5 levels in peripheral blood mononuclear cell (PBMC) and the serum IgE levels were determined using ELISA in children with CVA in the acute stage (n=21) and in the convalesce stage (n=9). The samples from 30 children with acute bronchial asthma and from 30 healthy children were used as controls.</p><p><b>RESULTS</b>The levels of PBMC IL-4 (91.57 +/- 12.19 ng/L) and IL-5 (13.28 +/- 0.31 ng/mL) in children with CVA in the acute stage were significantly higher than those in the convalesce stage (74.68 +/- 11.54 ng/L, 6.53 +/- 0.28 ng/mL) and also higher than those in the healthy controls (70.32 +/- 18.16 ng/L, 5.29 +/- 0.36 ng/mL) (P < 0.01). The levels of serum IgE in children with CVA in the acute stage (279.6 +/- 41.3 KU /L) were strikingly higher than those in the convalesce stage (153.8 +/- 37.5 KU/L) (P < 0.01). The levels of serum IgE in children with CVA either in the acute stage or in the convalesce stage were significantly higher than those in healthy controls (90.6 +/- 44.8 KU /L) (P < 0.01). There were no significant differences in the levels of IL-4, IL-5 and IgE between children with acute CVA and acute asthma.</p><p><b>CONCLUSIONS</b>A combined determination of PBMC IL-4 and IL-5 and serum IgE may be valuable for the diagnosis and the outcome evaluation of CVA. IL-4 and IL-5 may play a role in the pathogenesis of CVA. It is speculated that CVA may have similar pathogenesis to bronchial asthma since acute CVA patients have similar IL-4, IL-5 and IgE levels to children with acute bronchial asthma.</p>