Pathogenic characterization of Klebsiella pneumoniae resistant to carbapenems and polymyxin / 中华预防医学杂志

Objective: Analysis and investigation of pathogenic characteristics of polymyxin-and carbapenem-resistant Klebsiella pneumoniae (PR-CRKP). Methods: A total of 23 PR-CRKP strains isolated from clinical specimens from the General Hospital of Southern Theater Command from March 2019 to July 2021 were retrospectively collected, Whole-genome sequencing was performed on 23 PR-CRKP strains, resistance genes were identified by comparison of the CARD and the ResFinder database, high-resolution typing of PR-CRKP strains was analyzed by core genomic multilocus sequencing (cgMLST) and single nucleotide polymorphism (SNP); polymyxin resistance genes were determined by PCR and sequencing. Results: All PR-CRKP strains were KPC-2 producing ST11 types. cgMLST results showed that the evolutionary distance between the PR-CRKP strains and Klebsiella pneumoniae in mainland China was 66.44 on average, which is more closely related than foreign strains; the 23 PR-CRKP strains were divided into 3 main subclusters based on SNP phylogenetic trees, with some aggregation among Clade 2-1 in the isolation department and date. The two-component negative regulatory gene mgrB has seven mutation types including point mutations, different insertion fragments and different insertion positions. Conclusion: The close affinity of PR-CRKP strains indicate the possibility of nosocomial clonal transmission and the need to strengthen surveillance of PR-CRKP strains to prevent epidemic transmission of PR-CRKP.

The clinical observation on acupuncture at Xuanzhong (GB 39) and Ashi points for treatment of orthopedic postoperative pain / 中国针灸

<p><b>OBJECTIVE</b>To compare the therapeutic effects between acupuncture and Bezoxazocine injection in treatment of orthopedic postoperative pain.</p><p><b>METHODS</b>Sixty patients were randomly divided into an acupuncture group and a medication group, 30 cases in each group. The patients in the acupuncture group were treated by acupuncture at Xuanzhong (GB 39) as main point and Ashi points for 30 minutes; the medication group were treated by intramuscular injection of Bezoxazocine injection, 20 mg once, three times per day. Then the pain changes within 48 hours were observed and recorded in two groups.</p><p><b>RESULTS</b>The good rates at 24 hours and 48 hours were 89.2% and 100.0% in the acupuncture group and 81.4% and 96.3% in the medication group, respectively. The analgesic effect of acupuncture was better than that of Bezoxazocine injection (P < 0.05).</p><p><b>CONCLUSION</b>Analgesic effect of acupuncture at Xuanzhong (GB 39) on orthopedic postoperative pain and Ashi points is better than Bezoxazocine injection.</p>