Visual Identification of Trichosporon asahii, a Gut Yeast Associated with Obesity, Using an Enzymatic NIR Fluorescent Probe.

Lipase found in the gut microbiota participates in the digestion and absorption of dietary fats. As such, the gut microbiota is involved in the regulation of the host metabolism, affecting the levels of lipids and free fatty acids, ultimately resulting in obesity. In this study, an enzymatic activatable near-infrared fluorescent probe, DDAO-C6, was developed for visually sensing endogenous lipase from gut microbes. Using DDAO-C6, a cultivated intestinal yeast strain was rapidly identified from human feces that exhibited high lipase expression and was identified as Trichosporon asahii Y2. We then determined that the colonization of the gut of mice with T. asahii Y2 increased lipase activity in the digestive tract and promoted obesity and hyperlipidemia when the mice were fed high fat diets. Above all, the present research resulted in a fluorescence visualization tool for the functional investigation of gut microbiota associated with obesity and disorders of lipid metabolism.

Evaluation of the Japanese Respiratory Society guidelines for the identification of Mycoplasma pneumoniae pneumonia.

BACKGROUND AND OBJECTIVE: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Mycoplasma pneumoniae is one of the major causative pathogens of CAP. Early diagnosis of M. pneumoniae pneumonia is crucial for initiating appropriate antibiotic therapy. The aim of this study was to determine whether the Japanese Respiratory Society (JRS) guidelines on CAP are effective for diagnosing M. pneumoniae pneumonia. METHODS: Between August 2008 and July 2009, adult outpatients with CAP were consecutively enrolled. The aetiology of CAP was determined by culture and real-time polymerase chain reaction (PCR) methods to detect M. pneumoniae, urine antigen tests to detect Streptococcus pneumoniae and Legionella pneumoniae, blood and sputum culture for bacteria and real-time PCR for eight common respiratory viruses. The predictive value of the JRS guidelines for differentiating M. pneumoniae pneumonia from typical bacterial and viral pneumonias was determined. RESULTS: Data from 215 adult CAP outpatients was analyzed. An aetiological diagnosis was made for 105 patients (48.8%), including 62 patients with M. pneumoniae pneumonia, 17 patients with typical bacterial pneumonia and 23 patients with viral pneumonia. According to the JRS criteria for differential diagnosis of atypical pneumonia, 55 of 62 patients were correctly diagnosed with M. pneumoniae pneumonia (sensitivity 88.7%), and 31 of 40 patients with bacterial and viral pneumonia were correctly excluded (specificity 77.5%). CONCLUSIONS: The JRS guidelines on CAP provide a useful tool for the identification of M. pneumoniae pneumonia cases and differentiating these from cases of typical bacterial or viral pneumonia.

High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China.

The resistance rate of 67 Mycoplasma pneumoniae isolates from 356 ambulatory adult patients with respiratory tract infection was 69% (46 of 67). All 46 macrolide-resistant strains harbored point mutations in the 23S ribosomal RNA gene. Patients infected with macrolide-resistant M. pneumoniae required significantly longer durations of antibiotic therapy and had longer time to resolution of fever.

High prevalence of vitamin D deficiency in urban health checkup population.

BACKGROUND: Vitamin D deficiency is documented as a common health problem in the world. Limited data has been found on the prevalence of vitamin D deficiency in Beijing area. AIM: To investigate the prevalence s of vitamin D deficiency in urban Beijing residents and the seasonal and monthly serum 25(OH)D variation in this population. METHODS: This is an urban hospital based cross-sectional study lasting whole 2 years. 5531 (5-101 years old) urban Beijing residents for health checkup are recruited from December 9th, 2011 to December 8th, 2013. Each subject completed a questionnaire designed to quantify intake of vitamin D through food, vitamin D supplements, hours of sun exposure, sunscreen use over the past month. Serum 25(OH)D is statistically analyzed in accordance with gender, age, and time-lines. RESULTS: Vitamin D deficiency (Serum 25(OH)D level ≤20 ng/mL) and sever deficiency (Serum 25(OH)D level ≤ 10 ng/mL) are highly prevalent in this population. The prevalence of vitamin D deficiency is 87.1% and higher prevalence is found in female (89.0%) than male (84.9% P < 0.001). Severe vitamin D deficiency is also higher in female than male (59.3% and 42.7%, respectively, P < 0.001). Female under 20 and over 80 have lower 25(OH)D levels compared to 40-60 years old female (both P < 0.05). Severe vitamin D deficiency are also highly prevalence in this two group (60.9% and 54.1%) compared with 40-60 years old females (43.1%, both P < 0.05). Seasonal variation are also found in this population (P < 0.01). Autumn and summer have the higher 25(OH)D level than winter and spring in both genders (P < 0.001). Winter and spring have higher vitamin D deficiency and Severe deficiency than the other two seasons (P < 0.05). Serum 25(OH)D level peaks in October and troughed in April in both female and male. Lower serum 25(OH)D level are found in April than February (P < 0.05) in both gender. CONCLUSIONS: This is the first time to examine the prevalence of vitamin D deficiency among urban Beijing residents spanning the age spectrum. And Vitamin D deficiency and severe deficiency is found highly prevalent in this population, especially among females under 20 and older than 80 and in winter and spring seasons. Targeted prevention on vitamin D deficiency is urgent for this population.

Severe community-acquired pneumonia caused by adenovirus type 11 in immunocompetent adults in Beijing.

BACKGROUND: Severe community-acquired pneumonia (CAP) due to human adenoviruses (HAdVs) in immunocompetent adults has raised concerns. OBJECTIVE: To describe the clinical, laboratorial, and radiological characteristics of adenovirus pneumonia and detect the type and diversity of human adenoviruses that caused acute respiratory distress syndrome (ARDS) in Beijing. STUDY DESIGN: An etiological study of adult community-acquired pneumonia was carried out prospectively at Beijing Chao-Yang Hospital. A total of 18 cases with laboratory-confirmed adenovirus infections in 487 cases with CAP were observed clinically. The viral type and phylogenetic analysis were tested by polymerase chain reaction (PCR). RESULTS: Patients with adenovirus pneumonia typically reported flu-like symptoms. Some of them developed shortness of breath or severe dyspnea on 6 days after disease onset. The patients with ARDS usually present dyspnea, higher level of serum muscle enzymes and bilateral, mutilobal consolidation and patchy/ground-glass opacities. HAdVs type was detected in 17 samples and all of them belonged to species B (HAdV-11, 7, 3 and 14). Among them, HAdV-11 was most frequently (10/17), followed by HAdV-7 (5/17). Phylogenetic analysis of the partial penton nucleotide confirmed a close relationship with stains circulating in the Beijing region. CONCLUSIONS: Our identification of severe respiratory illness due to adenovirus, especially type 11 may highlight the need for rapid diagnosis and improved surveillance, which may assist with targeted development of antiviral agents or type-specific vaccines.

An uncontrolled open-label, multicenter study to monitor the antiviral activity and safety of inhaled zanamivir (as Rotadisk via Diskhaler device) among Chinese adolescents and adults with influenza-like illness.

BACKGROUND: It is the first multicenter clinical study in China to investigate zanamivir use among Chinese adolescents and adults with influenza-like illness (ILI) since 2009, when inhaled zanamivir (RELENZA(®)) was marketed in China. METHODS: An uncontrolled open-label, multicentre study to evaluate the antiviral activity, and safety of inhaled zanamivir (as Rotadisk via Diskhaler device); 10 mg administered twice daily for 5 days in subjects ≥ 12 years old with ILI. Patients were enrolled within 48 hours of onset and followed for eight days. Patients were defined as being influenza-positive if the real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) test had positive results. RESULTS: A total of 400 patients ≥ 12 years old were screened from 11 centers in seven provinces from March 2010 to January 2011. Three hundred and ninety-two patients who took at least one dose of zanamivir were entered into the safety analysis. The mean age was 33.8 years and 50% were male. Cardiovascular diseases and diabetes were the most common comorbidities. All the reported adverse events, such as rash, nasal ache, muscle ache, nausea, diarrhea, headache, occurred in less than 1% of subjects. Mild sinus bradycadia or arrhythmia occurred in four subjects (1%). Most of the adverse events were mild and did not require any change of treatment. No severe adverse events (SAE) or fatal cases were reported. Bronchospasm was found in a 38 years old woman whose symptoms disappeared after stopping zanamivir and without additional treatment. All the 61 influenza virus isolates (43 before enrollment, 18 during treatment) proved to be sensitive to zanamivir. CONCLUSIONS: Zanamivir is well tolerated by Chinese adolescents and adults with ILIs. There is no evidence for the emergence of drug-resistant isolates during treatment with zanamivir.

Clinical features of pneumonia caused by 2009 influenza A(H1N1) virus in Beijing, China.

BACKGROUND: Data on symptoms and radiographic changes in patients with pandemic 2009 influenza A(H1N1) (A[H1N1]) pneumonia during convalescence have not been reported. METHODS: During October 26, 2009, and January 23, 2010, adult patients with pneumonia with laboratory-confirmed or clinically suspected A(H1N1) infections were observed for clinical characteristics, high-resolution chest CT scan, and lung function test changes during acute and 3-month convalescent phases. RESULTS: Of the 65 case subjects, the median age was 41 (interquartile range [IQR], 28-57) years, 60.0% were men, and 55.4% had at least one underlying medical condition. Sixty-two patients started oseltamivir therapy within a median of 5 (IQR, 4-6) days from the onset of illness, and 31 received IV corticosteroids. ARDS developed in 33 patients, and 24 were treated initially with noninvasive positive pressure ventilation (NPPV). In this group, NPPV was successful in 13 patients (54.2%). Nine patients died at a median of 16 (IQR, 10-24) days after onset of illness. Multivariate Cox regression identified two independent risk factors for death: progressive dyspnea after resolution of fever (relative risk, 5.852; 95% CI, 1.395-24.541; P = .016) and a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score on presentation (relative risk for each point, 1.312; 95% CI, 1.140-1.511; P < .001). At 3-month follow-up of survivors with A(H1N1), ground-glass opacities were still present, although diminished, in 85.7%, and diffusing capacity for carbon monoxide was mildly reduced in 61.5%. CONCLUSIONS: Ground-glass opacities and decreased diffusing capacity were the main abnormalities observed at 3-month follow-up of survivors of A(H1N1).

A new Tn1546 type of VanB phenotype-vanA genotype vancomycin-resistant Enterococcus faecium isolates in mainland China.

VanB phenotype-vanA genotype vancomycin-resistant Enterococcus faecium (VREF) has never been reported in mainland China. We investigated the frequency and molecular characteristics of this strain in a Beijing tertiary hospital. Of 23 vanA genotype VREF clinical isolates, 12 (54.3%) were VanB phenotype-vanA genotype. Mutilocus sequence typing (MLST) analysis revealed that all isolates belong to a single clonal complex (CC78), which has been disseminated worldwide. Based on MLST and pulsed-field gel electrophoresis, 23 isolates were polyclonal dissemination in our hospital. Tn1546-like element structure analysis showed that of 12 VanB phenotype-vanA genotype isolates, 5 had complete deletion of vanY and vanZ accompanying insertion of IS1216V in vanX-vanY intergenic region, 5 had ISEfa4 insertion in orf2-vanR intergenic region, a new Tn1546 structure type, and 2 were identical to VanA phenotype-vanA genotype VREF. Data showed that the deletion of vanY and vanZ genes or ISEfa4 insertion in orf2-vanR intergenic region can partly explain the causes of difference between phenotype and genotype.