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Objective@#To examine whether presepsin level can serve as a distinguishing marker between G- bacteria and G+ bacteria, fungal infection in sepsis patients.@*Methods@#A prospective observation study was conducted on the consecutive patients with positive bacterial cultures in intensive care unit (ICU) from June 2017 to November 2018. The patients were divided into the G- group, G+ group and fungal group. Blood samples were collected upon admission to measure the levels of presepsin and procalcitonin (PCT).@*Results@#(1) Of the 156 patients met the inclusion criteria. 96 (62% G- rods, 25 (16%) G+ microbes, and 35 (22%) fungi were detected. (2) Presepsin concentrations were significantly higher in the G- group compared with the G+ and fungal groups (P = 0.000). (3) Presepsin level has a higher accuracy in differentiating G- sepsis from Gram+ and fungal sepsis than PCT level [area under the curve (AUC): 0.809 vs 0.712]. The AUC value of a combination of presepsin and PCT level was significantly larger than that of presepsin level alone in differentiating G- sepsis from Gram+ and fungal sepsis (AUC: 0.866 vs 0.809).@*Conclusions@#In contrast to PCT, presepsin is a good discriminative biomarker in different infections.
ABSTRACT
Objective To examine whether presepsin level can serve as a distinguishing marker between G-bacteria and G+ bacteria,fungal infection in sepsis patients.Methods A prospective observation study was conducted on the consecutive patients with positive bacterial cultures in intensive care unit (ICU) from June 2017 to November 2018.The patients were divided into the G-group,G+ group and fungal group.Blood samples were collected upon admission to measure the levels of presepsin and procalcitonin (PCT).Results (1) Of the 156 patients met the inclusion criteria.96 (62％ G-rods,25 (16％) G+ microbes,and 35 (22％) fungi were detected.(2) Presepsin concentrations were significantly higher in the G-group compared with the G+ and fungal groups (P =0.000).(3) Presepsin level has a higher accuracy in differentiating G-sepsis from Gram+ and fungal sepsis than PCT level [area under the curve (AUC):0.809 vs 0.712].The AUC value of a combination of presepsin and PCT level was significantly larger than that of presepsin level alone in differentiating G-sepsis from Gram+ and fungal sepsis (AUC:0.866 vs 0.809).Conclusions In contrast to PCT,presepsin is a good discriminative biomarker in different infections.
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Objective To investigate the hallux nail flap with the tibia lateral diamond shaped flap of the second phalange,joints,tendon combined tissue combination reengineering the surgical methods and clinical effects of thumb.Methods From May,2010 to February,2015,thcrc had fifteen cases of the thumb defect on Ⅱ-Ⅳ degree of the patients in our hospital,and we took anastomosis vascular pedicle of the hallux nail flap and thumb reconstruction with a second phalange with the tibia lateral diamond shaped flap,joint,and tendon composite tissue combination to reconstruct the thumb.The provided district of the second metatarsal was amputated to repair the ligaments between metatarsal bones.And we took the second toe bone nail flap covering the hallux toe area wound in anterograde shift.Results 15 cases of thumb reconstruction survived.The patients were followed-up for 6 to 30 months,the shape of the reconstructed thumb was closed to the contralateral thumb.The thumb to the finger and the palm function was good,two-point discrimination of the finger pulp were 0.6-1.0 cm.According to the upper limb function of the Chinese Medical Association Hand Surgery Society,the upper limb partial function of the evaluation trial standard:excellent in 11 cases,good in 4 cases.The district was recovered well,normal walking and running function were not restricted.Long term follow-up showed no blisters formation and skin ulceration.No nail deformity,good growth.Conclusion The hallux nail flap with the tibia lateral diamond shaped flap of the second phalange,joints,tendon combined tissue combination to reconstruct the thumb of the defect on Ⅱ-Ⅳ degree can restore good function and feeling,but also to have beautiful appearance.It is an effective method for reconstruction of thumb defect on Ⅱ-Ⅳ degree.
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OBJECTIVE To investigate the distribution and drug resistance status to pathogens from urinary tract and offer scientific evidence for reasonable usage of antibiotics.METHODS Totally 389 isolates derived from infected urinary tract in mountain area of western Hubei Province from 2002 to 2005 were identified and antibiotic susceptibility test was performed.RESULTS Escherichia coli accounted for 66.1% ranking the first.The isolates were all susceptible to imipenem and vancomycin.The ratio of ESBLs in E.coli and Klebsiella pneumoniae was 23.7% and 25.9%,respectively.CONCLUSIONS The drug resistance rate in isolates derived from infected urinary tract of patients in mountain area was lower than in plain region of Hubei Province.
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OBJECTIVE To explore occurrence, distribution,and resistance profile of ?-lactamases in clinical isolates of Enterobacter cloacae for rational use of antibiotics in clinic. METHODS Susceptibility test to 13 antibiotics was also performed through disk diffusion test.ESBLs were conformed according to NCCLS.DIDST test was adopted to detect AmpC ?-lactamases in E.cloacae isolates. RESULTS Among 78 isolates collected,13(14.9%) produced AmpC ?-lactamases,24(27.6%) produced ESBLs,10(11.5%) produced both ?-lactamases.These produced(?-lactamases) strains resisted to almost all ?-lactams,except for imipenem.The ?-lactamases producers possessed seriously multi-and cross-drug resistance. CONCLUSIONS ESBLs and AmpC ?-lactams are the main mechanism of E.cloacae resistance to antibiotic.