The Efficacy and Safety of High-dose Daptomycin in the Treatment of Complicated Skin and Soft Tissue Infections in Asians.

OBJECTIVE: To compare the efficacy and safety of standard-dose (SD) daptomycin with those of high-dose (HD) daptomycin in complicated skin and soft tissue infections (cSSTIs) in an Asian population. MATERIALS AND METHODS: Patients from three medical centers diagnosed with cSSTIs were screened in the clinical information system. Patients included in the analysis were divided into two groups: those who received daptomycin at doses ≥ 6 mg/kg (HD group) and those receiving 4 mg/kg (SD group). The demographics and clinical treatment information were analyzed. RESULTS: Overall, 155 patients were recruited, including 108 patients in the SD group and 47 patients in the HD group. The rate of healthcare-associated infections was higher in the HD group (61.70% vs. 37.04%), demonstrating a statistically significant difference (P = 0.005). Compared with the SD group, the HD group had statistically significant early clinical stabilization (72.34% vs 52.78%, P = 0.023). The results of the multivariate analysis indicated that HD daptomycin was an independent effector for early clinical stabilization (HR=0.394, P < 0.001). The rate of drug-related adverse events was equally distributed in the HD and SD groups (36.17% vs. 26.85%, P = 0.243). CONCLUSION: Compared with SD daptomycin, HD daptomycin increased the rate of early clinical stabilization in Asian patients with cSSTIs, whereas the incidence of adverse events did not increase.

The combination of decoy receptor 3 and soluble triggering receptor expressed on myeloid cells-1 for the diagnosis of nosocomial bacterial meningitis.

BACKGROUND: Early diagnosis and appropriate antibiotic treatment can significantly reduce mortality of nosocomial bacterial meningitis. However, it is a challenge for clinicians to make an accurate and rapid diagnosis of bacterial meningitis. This study aimed at determining whether combined biomarkers can provide a useful tool for the diagnosis of bacterial meningitis. METHODS: A retrospective study was carried out. Cerebrospinal fluid (CSF) levels of decoy receptor 3 (DcR3) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) were detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: The patients with bacterial meningitis had significantly elevated levels of the above mentioned biomarkers. The two biomarkers were all risk factors with bacterial meningitis. The biomarkers were constructed into a "bioscore". The discriminative performance of the bioscore was better than that of each biomarker, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.842 (95% confidence intervals (CI) 0.770-0.914; p< 0.001). CONCLUSIONS: Combined measurement of CSF DcR3 and sTREM-1 concentrations improved the prediction of nosocomial bacterial meningitis. The combined strategy is of interest and the validation of that improvement needs further studies.

Hyperthermia induces upregulation of connexin43 in the golden hamster neural tube.

BACKGROUND: During early embryonic development, maternal exposure to hyperthermia induces neural tube defects (NTDs). Connexins are essential for the formation of gap junctions and Connexin43 (Cx43) is crucially involved in neural tube development. This study was designed to explore the potential role of Cx43 in NTDs induced by hyperthermia. METHODS: Using PCR, the Cx43 cDNA was screened from the cDNA library of the neural tube from golden hamsters treated with hyperthermia. By Northern blot, the expression of Cx43 in heat-treated and control groups of the golden hamsters at day 8.5 after mating was detected. Finally, by in situ hybridization and RT-PCR, the expression of Cx43 was examined in the neural tube at different time points after heat treatment. RESULTS: Cx43 was stably expressed in heat-treated and control groups of the golden hamsters, whereas the expression was evidently higher in the heat-treated group. Cx43 expression in the neural tube at different time points after heat treatment was significantly higher than in control groups (p < 0.01). Hyperthermia did not induce any mutations in Cx43 cDNA. CONCLUSIONS: Our data provide the first evidence that hyperthermia induces upregulation of Cx43 in the golden hamster neural tube. NTDs caused by hyperthermia may be intimately related with the overexpression of Cx43.