Determinantes sociales de la salud y prevención de infecciones de transmisión sexual en estudiantes de una institución educativa del Perú / Social determinantsof health and prevention of sexually transmitted infections in students of an educational institution in Perú

Objetivo: Establecer la relación entre los determinantes sociales de la salud y prevención de infecciones de transmisión sexual en estudiantes de una Institución Educativa del Perú. Material y métodos: Estudio descriptivo, con enfoque cuantitativo, nivel correlacional y diseño no experimental, donde se contó con una muestra de 144 estudiantes, evaluados mediante un instrumento como el cuestionario estructurado, validado y con un nivel alto de confiabilidad. Resultados: Evidenciaron que la prevención de ITS mostró una relación significativa con las dimensiones biológico, estilo de vida y el sistema sanitario, donde el p valor alcanzado fue de 0,000, así como una correlación positiva media, donde los coeficientes obtenidos fueron 0,500, 0.485 y 0,434 respectivamente. Conclusiones: Predominó una relación significativa, así como una correlación positiva considerable entre las variables evaluadas, por lo mismo que se contó con un p valor de 0.000 y un coeficiente de 0,642 correspondientemente

Objective: To establish the relationship between the social determinants of health and the prevention of sexually transmitted infections in students of an educational institution in Peru. Material and method:descriptive study, with a quantitative approach, correlational level and non-experimental design, where there was a sample of 144 students, evaluated using an instrument such as the structured questionnaire, validated and with a high level of reliability. Results:Showed that STI prevention showed a significant relationship with the biological, lifestyle and health system dimensions, where the p value achieved was 0.000, as well as a mean positive correlation, where the coefficients obtained were 0.500, 0.485 and 0.434 respectively. Conclusions: A significant relationship predominated, as well as a considerable positive correlation between the variables evaluated, for the same reason that there was a p value of 0.000 and a coefficient of 0.642 respectively

Resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario en pacientes ambulatorios / Antimicrobial resistance of Enterobacteriaceae causing urinary tract infection in ambulatory patients / Resistência antimicrobiana de Enterobacteriaceae causadora de infecção do trato urinário em pacientes ambulatoriais

Las infecciones del tracto urinario son consideradas un problema de salud a nivel hospitalario y comunitario por el aumento de bacterias resistentes a los antibióticos. Objetivo: Analizar el patrón de susceptibilidad y resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario. Métodos: Se aplicó una investigación descriptiva de diseño documental. La población fue de 672 registros de urocultivos positivos, recopilados de la base de datos del Laboratorio San Pablo en el periodo 2021-2022. Para su tabulación y análisis los datos obtenidos fueron procesados en el Software SPSS versión 25.0. Resultados: Las ITU se presentan con mayor frecuencia en el género femenino 86,5%. El grupo etario con más afección es la edad adulta 50,4%. El agente etiológico con mayor incidencia fue Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. La producción de BLEE como mecanismo de resistencia predominaron en las cepas de E.coli y Klebsiella spp. Se encontró un mayor porcentaje de resistencia para Ampicilina y SXT. Los antibióticos con mejor sensibilidad destacaron nitrofurantoína, fosfomicina. Conclusión: La especie con mayor aislamiento, implicada en la etiología de infecciones urinarias sigue siendo E.coli con una sensibilidad alta para nitrofurantoína y fosfomicina.

Urinary tract infections are considered a health problem at hospital and community level due to the increase of antibiotic resistant bacteria. Objective: To analyze the pattern of susceptibility and antimicrobial resistance of Enterobacteriaceae causing urinary tract infection. Methods: A descriptive research of documentary design was applied. The population was 672 records of positive urine cultures, collected from the San Pablo Laboratory database in the period 2021-2022. For tabulation and analysis, the data obtained were processed in SPSS software version 25.0. Results: UTIs occur more frequently in females 86.5%. The age group with the highest incidence was adulthood 50.4%. The etiological agent with the highest incidence was Escherichia coli 75.74%, Citrobacter Freundii 8.93%, Klebsiella spp 6.10%. The production of BLEE as a mechanism of resistance predominated in the strains of E.coli and Klebsiella spp. A higher percentage of resistance was found for Ampicillin and SXT. The antibiotics with the best sensitivity were nitrofurantoin and fosfomycin. Conclusion: The species with the highest isolation, implicated in the etiology of urinary tract infections, continues to be E.coli with a high sensitivity to nitrofurantoin and fosfomycin.

As infecções do trato urinário são consideradas um problema de saúde a nível hospitalar e comunitário devido ao aumento de bactérias resistentes aos antibióticos. Objetivo: Analisar o padrão de suscetibilidade e resistência antimicrobiana das Enterobacteriaceae causadoras de infecções do trato urinário. Métodos: Foi aplicada uma metodologia de investigação documental descritiva. A população foi de 672 registros de culturas de urina positivas, coletados do banco de dados do Laboratório San Pablo no período de 2021-2022. Para tabulação e análise, os dados obtidos foram processados no software SPSS versão 25.0 Resultados: As ITUs ocorreram com maior frequência no sexo feminino 86,5%. A faixa etária com maior incidência foi a adulta 50,4%. O agente etiológico com maior incidência foi a Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. A produção de BLEE como mecanismo de resistência predominou em E. coli e Klebsiella spp. Foi encontrada uma maior percentagem de resistência para a ampicilina e o SXT. Os antibióticos com melhor sensibilidade foram a nitrofurantoína e a fosfomicina. Conclusão: A espécie com maior isolamento, implicada na etiologia das infecções do trato urinário, continua a ser a E. coli com uma elevada sensibilidade à nitrofurantoína e à fosfomicina.

Vacinas passado e futuro ­ Reflexões para discussão / The past and future of vaccines ­ Reflections for discussion

Neste artigo de opinião, apresento uma breve história do desenvolvimento de vacinas, comentando sobre as formas clássicas de produção de vacinas utilizando o próprio agente infeccioso. Em seguida, abordo as vacinas virais, discutindo seus benefícios e dificuldades e a questão dos sorotipos virais, bem como as vacinas bacterianas e seu relativo sucesso. Apresento nossos estudos sobre doença cardíaca reumática e o desenvolvimento de uma vacina contra infecções estreptocócicas. Também discuto plataformas vacinais, especialmente os sucessos alcançados com vacinas de vetores virais não replicantes e, acima de tudo, o grande êxito das vacinas de RNA mensageiro (mRNA). As vacinas de mRNA tornaram-se possíveis somente após os avanços obtidos com a substituição de nucleotídeos que reduziam a ação da imunidade inata. Serão todas as vacinas desenvolvidas a partir de mRNA no futuro? Em seguida, abordo a questão das vias de administração de vacinas, seja por via subcutânea, intradérmica, intramuscular ou nasal. Exponho dados do meu laboratório sobre o desenvolvimento de uma vacina de instilação nasal que induziu uma resposta de proteção da mucosa, prevenindo a infecção e, consequentemente, a transmissão do SARS-CoV-2. Posteriormente, discuto quais vacinas futuras poderiam ser desenvolvidas para além das doenças infecciosas agudas. Por fim, discuto as vantagens do desenvolvimento de vacinas seguras, eficazes e de uso múltiplo, bem como a forma de torná-las acessíveis à população mundial, promovendo a equidade em saúde.

In this opinion article, I provide a brief history of vaccine development, commenting on the classic ways of producing vaccines using the infectious agent itself. I address viral vaccines, discussing their benefits and challenges and the issue of viral serotypes, as well as bacterial vaccines and their relative success. I present our studies on rheumatic heart disease and the development of a vaccine against streptococcal infection. I also discuss vaccine platforms, highlighting the success achieved with non-replicating viral vector-based vaccines and, especially, with messenger RNA (mRNA) vaccines. mRNA vaccines only became possible after the advances provided by the replacement of nucleotides that reduced the action of the innate immune system. Will all vaccines be made from mRNA in the future? Then, I address the issue of vaccine administration routes, whether subcutaneously, intradermally, intramuscularly, or intranasal. I present data from my laboratory on the development of an intranasal vaccine that induced a protective mucosal response, preventing infection and, consequently, the transmission of SARSCoV- 2. I discuss which future vaccines could be developed beyond acute infectious diseases. Finally, I discuss the advantages of developing safe, effective, multiple-use vaccines and how to make them accessible worldwide by promoting health equity.

Uso de antimicrobianos en la unidad de cuidados intensivos de un hospital público de Loreto / Use of antimicrobials in the intensive care unit of a Loreto public hospital

RESUMEN Introducción. El uso inapropiado de antimicrobianos en las unidades de cuidados intensivos (UCI) contribuye a la resistencia bacteriana. Objetivo. El propósito del presente estudio fue medir el uso y tipo de antimicrobianos en los pacientes hospitalizados en la Unidad de Cuidados Intensivos del Hospital Regional de Loreto (HRL). Métodos. Estudio de tipo descriptivo. Revisamos 120 historias clínicas en pacientes de UCI-HRL desde enero a junio 2023. Resultados. La mayoría de los pacientes usaron antimicrobianos (74,2%), indicados por shock séptico (42,7%), de 1 a 3 antimicrobianos (93,2%), con terapia de 1 a 3 días (45%). Del total de antimicrobianos usados, la mayor proporción fueron bactericidas 89 (90,4%), de la familia de cefalosporinas (33,1%) y carbapenémicos (23,5%); los fármacos más empleados fueron ceftriaxona (26,5%) y meropenem (21,1%) por vía intravenosa (90,4%). Conclusión. La mayor proporción de pacientes hospitalizados usan antimicrobianos de la familia de cefalosporinas y carbapenémicos.

ABSTRACT Introduction. Inappropriate use of antimicrobials in the Intensive Care Unit (ICU) contributes to bacterial resistance. Objective. The purpose of the present study was to measure the use and type of antimicrobials in patients hospitalized in the Intensive Care Unit of the Loreto Regional Hospital (HRL). Methods. Descriptive study. We reviewed 120 medical records in ICU-HRL patients from January to June 2023. Results. Most patients used antimicrobials (74.2%), indicated for septic shock (42.7%), 1 to 3 antimicrobials (93.2%), with therapy of 1 to 3 days (45%). Of the total number of antimicrobials used, the greatest proportion were bactericides 89 (90.4%), from the cephalosporin family (33.1%) and carbapenemics (23.5%); the most commonly used drugs were ceftriaxone (26.5%) and meropenem (21.1%) by the intravenous route (90.4%). Conclusion. The highest proportion of hospitalized patients use antimicrobials of the cephalosporin and carbapenemics family.

Relationship between IL-1Ra gene polymorphism and the natural outcome of asymptomatic bacterial vaginosis / 安徽医科大学学报

Objective To investigate the relationship between interleukin 1 receptor a(IL-1Ra)gene polymorphism and different outcomes in asymptomatic bacterial vaginosis(aBV)patients with the aim of grouping and managing aBV patients.Methods In study on the natural attribution of aBV patients,all patients were enrolled and a sam-ple of venous blood and vaginal lavage fluid were separately frozen.After 4 months at the end of the clinical study,patients who completed the study were divided into three groups based on clinical outcomes:self-healing,progres-sive,and unchanged.The IL-1Ra gene polymorphism,the concentration of IL-1 β and IL-1Ra were tested,and the differences in the above indicators among three groups of patients with different outcomes were compared.Results 1 014 Chinese Han female patients were enrolled,and 984 patients completed clinical follow-up and obtained clini-cal outcome data.13 specimens were unusable during testing,with a total of 971 specimens completed the test.IL-1Ra gene was detected in all patients,with three genotypes:A1/A1,A1/A2,and A2/A2.Most population had a genotype of A1/A1,with the rarest genotype being A2/A2.No rare genotype of female was found.The frequency of A2 alleles in the progression group was significantly higher than that in the self-healing group(P＜0.05).IL-1 βand IL-1Ra were detected in all vaginal lavage fluid samples.Compared with the progression group,IL-1 β in the self-healing group was significantly lower(P＜0.05).When carrying the A2 allele,IL-1 β in progression group was relatively low,while the level of IL-1Ra was relatively high.The values of the unchanged group were middle.Con-clusion The polymorphism characteristics of the IL-1Ra gene in aBV patients are related to the IL-1Ra content in vaginal secretions.Carrying allele A2 is related to the elevation of IL-1Ra,the decrease of IL-1 β in vaginal secre-tions.Carrying allele A2 may affect the clinical outcome of aBV by some potential mechanism.

The value of serum LBP and CXCL-10 in the differential diagnosis of acute upper respiratory tract bacterial infection in children and its influencing factors / 国际检验医学杂志

Objective To investigate the differential diagnostic value of serum lipopolysaccharide binding protein(LBP)and serum CXC chemokine ligand-10(CXCL-10)in children with acute upper respiratory tract bacterial infection and its influencing factors.Methods A total of 90 children with acute upper respiratory tract infection admitted to the hospital from July 2021 to June 2022 were enrolled in the study as the study group,and 40 healthy children who underwent physical examination in the hospital during the same period were enrolled as the healthy group.According to the results of sputum bacterial culture,the study group was divided into bacterial infection group(51 cases)and non-bacterial infection group(39 cases).The serum levels of LBP and CXCL-10 were detected by using enzyme-linked immunosorbent assay.Receiver operating charac-teristic(ROC)curve was used to evaluate the value of serum LBP and CXCL-10 in the differential diagnosis of acute upper respiratory tract bacterial infection in children.Multivariate Logistic regression was used to ana-lyze the influencing factors of acute upper respiratory tract bacterial infection in children.Results The serum levels of LBP and CXCL-10 in the study group were higher than those in the healthy group(P＜0.05).The se-rum levels of LBP and CXCL-10 in the bacterial infection group were higher than those in the non-bacterial in-fection group(P＜0.05).The area under curves(AUCs)of serum LBP and CXCL-10 alone and in combina-tion for the diagnosis of acute upper respiratory tract bacterial infection in children were 0.779(95％CI:0.724-0.822),0.843(95％CI:0.796-0.898),0.906(95％CI:0.852-0.959),respectively.Compared with the non-bacterial infection group,the bacterial infection group had significantly higher proportions of family members with smoking,iron deficiency,and calcium deficiency,annual average times of antibacterial drug use,and serum LBP and CXCL-10 levels(P＜0.05).Logistic multivariate regression analysis showed that the av-erage annual use of antibiotics ≥2 times(OR=2.305,95％CI:1.483-3.582),LBP≥104.26 ng/mL(OR=2.573,95％CI:1.446-4.578)and CXCL-10≥112.98 pg/mL(OR=1.208,95％CI:0.110-1.314)were the influencing factors of acute upper respiratory tract bacterial infection in children(P＜0.05).Conclusion The elevated serum LBP and CXCL-10 levels are closely related to acute upper respiratory tract bacterial infection in children,which can be used as indicators for the differential diagnosis of acute upper respiratory tract bacte-rial infection,and the combination of the two has higher diagnostic efficiency.

Clinical Features of Traditional Chinese Medicine Syndrome Elements in Patients with Multi-Drug Resistant Bacterial Pneumonia:A Retrospective Analysis of 126 Cases / 广州中医药大学学报

Objective To explore the distribution of traditional Chinese medicine(TCM)syndrome elements in patients with multi-drug resistant bacteria-infected pneumonia.Methods Clinical data of 126 patients with multi-drug resistant bacteria-infected pneumonia admitted to the intensive care unit of Lung Disease Centre of Qingdao Hospital of Traditional Chinese Medicine from May 2020 to July 2022 were retrospectively collected.The clinical data included the patients'gender,age,underlying diseases,history of bad additions of smoking and alcohol,multi-drug resistant bacteria,and the information of four diagnostic methods of TCM,etc.The disease-nature syndrome elements in patients with drug-resistance to various strains of drug-resistant bacteria were extracted,and then deficiency-excess syndrome differentiation was carried out.Results(1)A total of 201 strains of multi-drug resistant bacteria were detected in 126 patients with multi-drug resistant bacterial pneumonia.The main pathogenic species were Gram-negative bacteria,and the proportion accounted for 95.52%(192/201),which was significantly higher than that of Gram-positive bacteria[4.48%(9/201)],with a statistically significant difference(χ2 = 166.612,P＜0.001).Klebsiella pneumoniae accounted for the highest percentage of 23.38%in the gram-negative bacterium.(2)A total of 12 syndrome elements were extracted from the 126 patients.The excess syndrome elements were predominated by phlegm and heat,and the deficiency syndrome elements were predominated by yin deficiency.There was no statistically significant difference in the distribution of yin deficiency,blood deficiency,heat,phlegm,fluid-retention and damp syndrome elements among patients with different strains of drug-resistant bacterial infection(P＞0.05).(3)Of the 126 patients,62 cases(49.21%)had simple excess syndrome,one case(0.79%)had simple deficiency syndrome,and 63 cases(50.00%)had concurrent deficiency-excess syndrome.Among the 126 patients,there were 19 cases of single syndrome element,41 cases of concurrent two-syndrome element,49 cases of concurrent three-syndrome element,16 cases of concurrent four-syndrome element,and one case of concurrent five-syndrome element.And the combined syndrome element of phlegm-heat-yin deficiency occurred most frequently for 26 times.Conclusion Gram-negative bacteria are the primary infectious pathogens for the patients with multi-drug resistant bacterial infections,and the TCM syndrome elements of the patients are characterized by the concurrence of deficiency and excess and simple excess syndrome,mainly manifesting as phlegm,heat,and yin deficiency.

Risk Prediction of SBP in Patients with Primary Liver Cancer Complicated with Ascites / 昆明医科大学学报

Objective To explore the influencing factors of spontaneous bacterial peritonitis in patients with primary liver cancer complicated with ascites and establish a prediction model.Methods A total of 292 patients with primary liver cancer complicated with ascites who were hospitalized for the first time in the Third People's Hospital of Kunming from January 2012 to December 2021 were selected as the study objects.General data,etiological indicators,serological indicators and complications of these subjects were collected.Then they were divided into the infection group(n = 114)and the control group(n = 178)according to whether spontaneous bacterial peritonitis(SBP)was complicated.Univariate and multivariate logistic regression were used to analyze the influencing factors of SBP in patients with primary liver cancer complicated with ascites.Finally,ROC curves were constructed to more intuitively represent the individual and combined predictive value of these targets.Results Am-ong 292 hepatocellular carcinoma patients with ascites,there were 235 males(80.48%)and 57 females(19.52%),among which 114 patients with SBP were in the infection group and 178 patients without SBP were in the control group.The results of univariate analysis showed that compared with the control group,the levels of WBC,neutrophils,prothrombin time,total bilirubin,albumin,CD3,CD4,CD8,CD4/CD8 ratio,CD19 procalcitonin,serum amyloid A,hypersensitive C-reactive protein,sodium,chlorine,alcohol consumption,shock,hepatorenal syndrome,hepatic encephalopathy,massive ascites in the infection group had statistically significant difference(P<0.05).Multi-factor analysis revealed that CD8,CD4/CD8 ratio were protective factors for SBP in patients with liver cancer ascites,CD19,procalcitonin,serum amyloid A,and massive ascites were risk factors for SBP in patients with ascites.ROC curve construction showed that serum amyloid A,CD8,CD4/CD8 ratio,CD19,procalcitonin,massive ascites area under curve(AUC)of massive ascites were 0.724,0.637,0.653,0.820,0.705,0.686,respectively.Conclusion CD8,CD4/CD8 ratio,CD19,procalcitonin,serum amyloid A,and a large volume of ascites are significant factors contributing to the development of spontaneous bacterial peritonitis(SBP)in patients with hepatocellular carcinoma ascites.The predictive value of combination is substantial,demonstrating a level of accuracy in forecasting SBP occurrence

Effects of bacterial lysates on immune function in elderly mice with pulmonary fibrosis / 中华老年医学杂志

Objective:To investigate the correlation between immune function and age-related pulmonary fibrosis, as well as the potential impact of bacterial lysates on this condition.Methods:Twenty-four healthy male C57BL/6 mice, aged 24, were randomly divided into three groups: a control group(Group N), a pulmonary fibrosis group(Group M), and a pulmonary fibrosis+ bacterial lysis product intervention group(Group P). Mice in Groups M and P were intratracheally injected with bleomycin(5 mg/kg)to induce a mouse pulmonary fibrosis model, while mice in Group N were injected with saline.After modeling, mice in Group P were orally administered 0.4 ml of a bacterial lysis product once a day.After 28 days, lung tissue and blood samples were collected for analysis.Pathological changes in lung tissue were assessed using hematoxylin and tosin staining(HE)and Masson staining and the Ashcroft score.The expression of CD4+ and CD8+ in lung tissue was evaluated using immunohistochemistry.The levels of serum interferon-γ(INF-γ), interleukin-3(IL-13), and immunoglobulin A(IgA)protein were measured using Enzyme-linked Immuno Sorbent Assay(ELISA). The levels of INF-γ and IL-13 mRNA in lung tissue were determined using Real-Time Quantitative Transcription PCR(RT-qPCR). Additionally, the protein expression levels of matrix metalloprotein-9(MMP-9)and tissue inhibitor of metalloproteincise 1(TIMP-1)in lung tissue were assessed using blot analysis.Results:The degree of lung fibrosis was significantly reduced in mice in group P compared with group M when treated with bacterial lysis products.Group M showed a significant decrease in the expression of CD4+ T cells and an increase in the expression of CD8+ T cells( P<0.05)compared to group N. Additionally, the content of IgA was decreased( P<0.05)in group M. On the other hand, group P showed a significant increase in the expression of CD4+ T cells and a decrease in the expression of CD8+ T cells( P<0.05)compared to group M. Furthermore, the content of IgA was elevated( P<0.05)in group P. After bacterial lysis product intervention, mRNA and protein expression levels of IFN-γ were elevated( P<0.05), while mRNA and protein expression levels of IL-13 were reduced( P<0.05). Moreover, protein expression of MMP-9 and TIMP-1 was significantly up-regulated in group M compared with group N( P<0.05), and decreased after bacterial lysis product intervention( P<0.05). Conclusions:It is well-known that immune mechanisms play a crucial role in the development of pulmonary fibrosis.The use of bacterial lysates has been found to effectively regulate immune balance and mitigate the severity of pulmonary fibrosis in elderly mice.

Small intestinal bacterial overgrowth in patients with rosacea: prevalence and clinical features / 中华皮肤科杂志

Objective:To investigate the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with rosacea, and to analyze the relationship between breath test results and the occurrence of rosacea.Methods:Patients with rosacea were enrolled from the outpatient department of Xiangya Hospital from March 2022 to June 2023. The methane-hydrogen breath test was used to detect intestinal levels of methane and hydrogen in all patients to investigate the prevalence of SIBO. The basic information, clinical symptoms and severity, quality of life scores, gastrointestinal symptoms, and past medical history of the patients were collected. Statistical analysis was carried out by using the chi-square test, nonparametric test and multivariate logistic regression models to investigate the relationship between SIBO and the occurrence of rosacea.Results:A total of 116 patients with rosacea completed the methane-hydrogen breath test. They were aged 18 to 56 years (median [ Q1, Q3]: 25 [22, 33] years), and included 7 males (6.0%) and 109 females (94.0%) ; there were 43 cases (37.1%) of erythematotelangiectatic rosacea, and 73 (62.9%) of papulopustular rosacea. As the breath test showed, 94 patients were diagnosed with SIBO (81.0%, 95% CI: 72.7% - 87.7%) based on the breath tests, 84 showed positive hydrogen breath test results (72.4%, 95% CI: 63.3% - 80.3%), and 47 had positive methane breath test results (40.5%, 95% CI: 31.5% - 50%). Among the 67 patients with moderate to severe erythema, 33 (49.3%) showed positive methane breath test results, and 14 of 49 (28.6%) patients with mild erythema showed positive methane breath test results, with a rate difference of 20.7% ( P = 0.025, 95% CI: 13.9% - 27.5%) ; there were no significant differences in the positive rates of SIBO and hydrogen breath test results between the patients with moderate to severe erythema and those with mild erythema (both P > 0.05). No significant differences were observed in the age, gender, clinical subtypes, severity of papulopustules, flushing and burning sensation, or rosacea quality of life index scores between the SIBO-positive and -negative groups, between hydrogen-positive and -negative groups, and between methane-positive and -negative groups (all P > 0.05). Multivariate logistic regression analysis showed that methane positivity on breath test was associated with the severity of erythema in rosacea ( OR = 2.495, 95% CI: 1.102 - 5.649, P < 0.05) . Conclusions:The prevalence of SIBO was relatively high in the patients with rosacea. However, only the positive rate of methane breath test differed between the rosacea patients and non-rosacea controls, and there was some correlation between methane positivity on breath test and increased severity of rosacea erythema.

Analysis of current status and risk factors of multidrug-resistant bacteria wound infections in patients with autoimmune bullous diseases / 中华皮肤科杂志

Objective:To investigate the current status of multidrug-resistant bacteria (MDRO) wound infections in patients with autoimmune bullous diseases (AIBDs), and to analyze their risk factors.Methods:A retrospective study was conducted, and inpatients with AIBDs accompanied by wound infections were collected from Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2020 to December 2022. A descriptive analysis was carried out to analyze the basic characteristics of these patients and pathogenic characteristics of MDRO. Univariate and binary logistic regression models were used to analyze independent risk factors for MDRO infections in patients with AIBDs. Differences between the MDRO infection group and common bacterial infection group were analyzed by using t test, Mann-Whitney U test and chi-square test. Results:Totally, 271 patients with AIBDs accompanied by wound infections were included, including 159 males (58.7%) and 112 females (41.3%), and 142 patients (52.4%) were aged over 60 years. Most patients with AIBDs were diagnosed with pemphigus vulgaris (131 cases, 48.3%), or bullous pemphigoid (99 cases, 36.5%). Bacterial culture was positive in all the patients, and 74 (27.3%) were infected with MDRO; a total of 108 strains of MDRO were detected, with relatively high detection rates of Staphylococcus (82 strains, 75.9%) and Enterobacter (15 strains, 13.9%). Significant differences were observed between the MDRO infection group and the common bacterial infection group in the duration of hospitalization, involved body surface area, proportions of patients self-modificating drug dosage, proportions of patients topically using antibiotic ointments, proportions of patients using immunosuppressants, duration of glucocorticoid use, maximum dose of glucocorticoids and the first albumin level at admission (all P < 0.05), while there were no significant differences in the gender, age, proportions of patients at first hospitalization, types of AIBDs, duration of education, body mass index, disease duration, proportions of smoking patients, proportions of drinking patients, proportions of patients with comorbid chronic diseases, surgical history, prevalence of hypoalbuminemia, prevalence of mucosal involvement, proportions of patients receiving topical glucocorticoids, proportions of patients using biological agents, duration of antibiotic use, and the first total protein level at admission between the two groups (all P > 0.05). Logistic regression analysis showed that the use of topical antibiotic ointments, use of immunosuppressants, maximum dose of glucocorticoids, and self-modification of drug dosage were independent risk factors for MDRO infections (all P < 0.05) . Conclusions:The patients with AIBDs were prone to develop MDRO infections in wounds, and Staphylococcus infections were the most common. The use of topical antibiotic ointments, use of immunosuppressants, high dose of glucocorticoids, and self-modification of drug dosage may increase the risk of infections in patients with AIBDs.

Clinical Distribution,Serotypes and Drug Resistance Analysis of 425 Cases of Invasive Pneumococcal Disease Infectious in Children / 现代检验医学杂志

Objective To analyze the infection distribution,serotypes,and drug resistance of invasive pneumococcal disease(IPD)in children,and provide a reference for the standardized treatment of IPD and the rational use of antibiotics in clinical practice.Methods A total of 425 children with definitive diagnoses of IPD in the Department of Pediatrics,the Affiliated Suzhou Hospital of Nanjing Medical University between March 2019 and November 2022 were selected as the research subjects.Information from the medical records of these children was reviewed,clinical data was collected,serotyping by podoconiosis test on the specimens of Streptococcus pneumoniae strains sent for preservation was determined,and the susceptibility test was performed.Results A sum of 425 children with IPD(with a mean age of 2.16±0.93)were collected in this study.Analysis of clinical infection types showed 189 cases(44.47%)of bacteremia pneumonia,80 cases(18.82%)of simple bloodstream infection,76 cases(17.88%)of septic meningitis,11 cases(2.59%)of infectious pleurisy,9 cases(2.12%)of infective peritonitis,7 cases(1.65%)of bone and joint infection,7 cases(1.65%)of infective endocarditis,and 46 cases(10.82%)of other infections in combination.A total of 14 serotypes were confirmed in this study,with detection rates of 162 cases(38.12%),90 cases(21.18%),42cases(9.88%),38 cases(8.94%),14 cases(3.29%)and 8 cases(1.88%)for serotypes 19F,19A,14,23F,6A,and 6B,respectively.The susceptibility test indicated that the resistance rates of erythromycin and clindamycin were both high,with 95.53%(406/425)and 99.53(423/425),respectively,while the resistance rates of amoxicillin,cefepime,and cefotaxime were all relatively low,with 13.65%(58/425),9.06%(81/425),and 17.18%(73/425),respectively.Comparison between the two groups of cerebrospinal fluid(CSF)isolates and non-CSF isolates showed that the rates of resistance to penicillin were 69.74%and 24.07%(χ2=59.59,P＜0.05),the resistance rates to cefepime were 50.00%and 12.32%(χ2=57.44,P＜0.05),the resistance rates to meropenem were 40.79%and 29.23%(χ2=3.88,P＜0.05),respectively,with statistically significant differences.Conclusion Cultivation identification and drug resistance monitoring of IPD should be strengthened in clinical work.Antibiotics should be effectively used according to the drug susceptibility results to minimize the drug resistance of Streptococcus pneumoniae and improve the efficacy of drug therapy.

Advances in the Mechanism of Phage Resistance to Bacterial Biofilms and Strategies for Its Application / 现代检验医学杂志

Bacterial biofilms(BF)are complex microbial communities formed by bacteria on living or abiotic surfaces.Their formation significantly enhances bacterial virulence and drug resistance and is associated with a high proportion of chronic bacterial infections,posing a serious threat to human health.The ability of traditional antibiotics and commonly used disinfectants to clear biofilms is limited,and an effective new strategy to treat BF is urgently needed.Bacteriophage,as a kind of virus that can infect and lyse bacteria,has high safety and specificity,and is considered as a promising alternative method for the treatment of BF.In this paper,the mechanism of bacteriophage anti-bacterial biofilm and the application strategies based on bacteriophage and its derivatives in the prevention and control of bacteriophage biofilm formation were reviewed,which provided new ideas for the development of efficient bacteriophage anti-bacterial biofilm methods.

Pathogenic bacteria distribution,drug resistance changes and risk factors of death in patients with acute myeloid leukemia complicated with bloodstream infection / 天津医药

Objective To explore the distribution and drug resistance changes of pathogenic bacteria in adult acute myeloid leukemia(AML)with bloodstream infection,and to analyze risk factors of death of patients.Methods Changes of detection rate of pathogenic bacteria and drug resistance rate of main pathogenic bacteria of 85 patients with AML and bloodstream infection 30 months before confirmed diagnosis(pathogenic bacteria detected from January 2017 to June 2019)and 30 months after diagnosis(from July 2019 to December 2021)were compared.According to the prognosis at 6 months after bloodstream infection,patients were divided into the death group(33 cases)and the survival group(52 cases).Logistic regression analysis was used to analyze risk factors of death in patients with AML complicated with bloodstream infection.Results A total of 98 strains of pathogenic bacteria were detected in 85 patients with AML complicated with bloodstream infection,mainly gram-negative bacteria(65/98,66.33%),followed by Gram-positive bacteria(29/98,29.59%)and fungi(4/98,4.08%).The proportion of fungi(all were candida)detected in the last 30 months was more than that in the first 30 months(P<0.05).There were no significant differences in proportions of gram-negative bacteria and gram-positive bacteria and drug resistance rates of Escherichia coli and Staphylococcus aureus between the late 30 months and the first 30 months(P>0.05).Logistic regression analysis showed that the history of antibiotic use within 1 month before confirmed diagnosis and septic shock were independent risk factors for death in patients with AML complicated with bloodstream infection(P<0.05).Conclusion The main pathogens of adults with AML combined with bloodstream infection are gram-negative bacteria.However,candida infection rate has increased in recent years,and patients with antibiotic use before bloodstream infection and complicated with septic shock are prone to poor prognosis.

Immunogenicity, protective efficacy and preliminary protective mechanism of KPC-2, a drug resistance target from Klebsiella pneumoniae / 中华微生物学和免疫学杂志

Objective:To develop a recombinant protein vaccine based on KPC-2, a drug resistance target in Klebsiella pneumoniae, and evaluate its immunogenicity, protective efficacy and mechanism in a mouse model of pneumonia. Methods:KPC-2 was expressed in Escherichia coli and purified using GST affinity chromatography. A recombinant protein vaccine was prepared with KPC-2 and used to immunize New Zealand rabbits through subcutaneous injection. Serum samples were isolated from cardiac blood and Protein G chromatography was used to purify polyclonal antibodies against KPC-2. Opsonophagocytic killing assay was used to assess the bactericidal activity of the polyclonal antibodies in vitro. Female BALB/c mice were immunized three times with the recombinant protein vaccine, and the titers of specific IgG antibodies in serum were measured by indirect ELISA. One week after the last vaccination, the mice were infected with Klebsiella pneumoniae strain SRT through tracheal intubation, and received a single intravenous dose of meropenem (0.1 mg) 1 h later. The protective efficacy of the KPC-2 recombinant protein vaccine was evaluated by comparing the survival rates, bacterial colonization and histopathological changes between vaccine group and adjuvant group as well as the survival rates between meropenem group and normal saline group. Moreover, the protective efficacy of polyclonal antibodies against KPC-2 was evaluated through passive immunization. Results:The level of specific IgG antibodies in serum was significantly higher in the vaccine group than in the adjuvant group ( t=4.325, P<0.05). The survival rate in the vaccine group was also higher than that of the adjuvant group [70% (7/10) vs 10% (1/10), P<0.05]. Furthermore, lung inflammation was less severe and bacterial burden was reduced in the vaccine group as compared with those of the control group ( t=3.127, P<0.05). Both active and passive vaccination strategies demonstrated strong protective efficacy against Klebsiella pneumoniae infection, and had a synergistic effect when used in combination with antibiotic therapy. The polyclonal antibodies against KPC-2 had bactericidal activity in vitro ( t=5.427, P<0.05). Conclusions:The prepared KPC-2 vaccine has better immunogenicity and protective efficacy. It can induce strong humoral immune responses. This study suggest that drug resistance target may be used as a candidate antigen for future vaccine development.

Advances in the study of outer membrane vesicles of gram-negative bacteria in infection and immune regulation / 中华微生物学和免疫学杂志

Outer membrane vesicle (OMV), originating from the outermost membrane of cells, is the extracellular vesicles released by gram-negative bacteria, containing bacterial outer membrane components such as phospholipids, lipopolysaccharide (LPS), outer membrane protein, and bacterial-specific antigens. OMV plays an important role in bacterial physiology and pathogenesis, involving in biofilm formation, horizontal gene transfer, stress and inflammatory responses, and delivery of toxins and other biomolecules. It also plays a vital role in immune regulation and the establishment and maintenance of balanced intestinal microflora. This article provides an overview of the roles of OMV in bacterial infections and immune regulation and the potential application value of OMV in tumor-targeted therapy and new vaccine preparation in the hope to provide new ideas for the prevention and treatment of bacterial infections.

Isolation and toxicity of Xanthomonas oryzae pv. oryzae in rice and a collection of phages against the pathogen

Aims@#The objective of the study was to isolate bacteriophages and conduct a comprehensive analysis of their potential against Xanthomonas oryzae pv. oryzae (Xoo) strains in the Mekong Delta, Vietnam.@*Methodology and results@#Twelve Xoo strains were isolated from rice fields located in the Mekong Delta, Vietnam. Among these strains, three strains Xoo L019, L020 and L024, showed the highest disease index of bacterial blight. Four phages specific to Xoo were isolated from soil, water and leaf samples, and their morphologies were determined. In a test against 12 Xoo strains, phage L541, MLA23 or W41 could infect 10 of the 12 Xoo strains, while phage LBH01 could infect 8 of the 12 Xoo strains. The stability of the phages to pH, organic solvents, UV-A and UV-B was also evaluated.@*Conclusion, significance and impact of study@#The initial characterization of the phages indicates their potential as biocontrol agents against bacterial blight in rice. The study is one of the very first studies about Xoo phages in rice in Vietnam.

Rapid detection of some STD-causing bacteria using the direct flow chip method

Aims@#This study aimed to detect bacterial pathogens that cause sexually transmitted diseases (STD) using multiplex polymerase chain reaction and reverse hybridization.@*Methodology and results@#Thirty urine samples were collected from male patients aged between 20 and 45 in Dohuk City who were suspected of having an STD. The samples were tested for the presence of five main types of bacteria, namely Ureaplasma urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium and Chlamydia trachomatis responsible for causing STDs. Nineteen of the thirty urine samples were positive for at least one of the five species of bacteria, yielding a positive rate of 63.3%. Ureaplasma urealyticum had the highest diagnostic rate of 68.4% among positive samples, while C. trachomatis had the lowest diagnosis rate of 5.2%. Both N. gonorrhoeae and M. hominis had a 15.7% diagnosis rate, while M. genitalium had a 10.5% diagnosis rate. @*Conclusion, significance and impact of study @#Research findings suggest that U. urealyticum was the most common cause of STD, accounting for 68.4% of the positive samples. Conversely, the study identifies C. trachomatis as the least prevalent cause, accounting for only 5.2% of the cases. These noteworthy findings shed light on the prevalence of these bacterial pathogens in sexually transmitted diseases, laying the groundwork for more precise and effective diagnostic and treatment options.

Insights into the diversity of grassland soil bacterial communities associated with four contrasting Köppen climatic zones of India

Aims@#This study investigates the community structure and diversity of terrestrial soil bacterial communities thriving in four contrasting Köppen climatic zones of India using high-throughput sequencing.@*Methodology and results@#Soil samples were collected for metagenomic DNA isolation and PCR amplification using primers targeting the 16S rRNA gene region. Amplicons were subjected to Oxford nanopore sequencing and data analysis. Bacterial species diversity, evenness and richness were highest in a humid sub-tropical climatic zone (HSCZ). Firmicutes were the most abundant phylum in the tropical wet climatic zone (TWCZ), arid climatic zone (ACZ) and humid sub-tropical climatic zone (HSCZ), while Proteobacteria in the mountain climatic zone (MCZ). The predominance of class Alphaproteobacteria, Actinobacteria with genera Bradyrhizobium, Chthoniobacter and Mycobacterium, was observed in MCZ in contrast to class Bacilli with genera Bacillus and Paenibacillus in the rest of the zones. OTU abundance was positively correlated with moisture, TOC (total organic carbon), K, MAP (mean annual precipitation) and negatively correlated with pH, Ca, N, B, Fe, P, Mg and MAT (mean annual temperature). A significant correlation was only observed with Fe against Shannon diversity (H’) in multiple regression analysis. @*Conclusion, significance and impact of study@#The multidirectional relationship between soil, its microbiota and climate is crucial in modulating bacterial community diversity and its survival in terrestrial ecosystems that significantly contribute to ecosystem function. This work mapped the occurrence and distribution of terrestrial soil bacterial communities in contrasting climatic zones for the first time, enabling us to assess the effect of climate in the mentioned Köppen climatic zones.

Genotoxicity evaluation of HMS-01 / 药学实践与服务

Objective To provide a toxicological basis for HMS-01 in future clinical trials, through genotoxicity testing of safety evaluation. Methods The genotoxicity of HMS-01 was evaluated by Bacterial Reverse Mutation Assay （Ames test） with Salmonella typhimurium. Results HMS-01 was non-mutagenic against Salmonella typhimurium at six doses of 20.6, 61.7, 185.2, 555.6, 1666.7, and 5000 μg/dish with （or without） a metabolic activation system. Conclusion HMS-01 was not found to be mutagenic in the dose range of this experiment.