ABSTRACT
Purpose: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is closely related to respiratory tract infection. The aim of this study was to investigate the clinical features and prognostic factors of CRKP-induced pneumonia in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. Methods: A single-centre, retrospective case-control study on COPD patients hospitalized for acute exacerbation and CRKP-induced pneumonia was conducted from January 1, 2016, to December 31, 2022. The mortality rate of acute exacerbation due to CRKP-induced pneumonia was investigated. The patients were divided into the CRKP-induced pneumonic acute exacerbation (CRKPpAE) group and the non-CRKP-induced pneumonic acute exacerbation (non-CRKPpAE) group, and the clinical characteristics and prognostic factors were compared using univariate analysis and multivariate analysis. Results: A total of 65 AECOPD patients were included, composed of 26 patients with CRKPpAE and 39 patients with non-CRKPpAE. The mortality rate of CRKPpAE was 57.69%, while non-CRKPpAE was 7.69%. Compared with non-CRKPpAE, a history of acute exacerbation in the last year (OR=8.860, 95% CI: 1.360-57.722, p=0.023), ICU admission (OR=11.736, 95% CI: 2.112-65.207, p=0.005), higher NLR levels (OR=1.187, 95% CI: 1.037-1.359, p=0.013) and higher D-dimer levels (OR=1.385, 95% CI: 1.006-1.905, p=0.046) were independently related with CRKPpAE. CRKP isolates were all MDR strains (26/26, 100%), and MDR strains were also observed in non-CRKP isolates (5/39, 12.82%). Conclusion: Compared with non-CRKPpAE, CRKPpAE affects the COPD patient's condition more seriously and significantly increases the risk of death.
Subject(s)
Klebsiella Infections , Pneumonia , Pulmonary Disease, Chronic Obstructive , Humans , Carbapenems/pharmacology , Carbapenems/therapeutic use , Klebsiella pneumoniae , Retrospective Studies , Case-Control Studies , Anti-Bacterial Agents/therapeutic use , Klebsiella , Prognosis , Klebsiella Infections/diagnosis , Klebsiella Infections/drug therapy , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/drug therapy , Pneumonia/drug therapy , Risk Factors , Drug Resistance, BacterialABSTRACT
In this work, a simple and sensitive SERS-based miRNA biosensor was constructed based on porous MOFs nanoparticles and efficient subject-object recognition ability. MOFs as a container can package lots of signal probe neutral red (NR) for the advantages of three dimensional structure and porosity. The partially complementary duplex DNA can as a "lock" to lock up the hole for obtaining a weak Raman signal. In the present of miRNA, miRNA just like a "key" to open the duplex structure with the results of releasing NR. At this time, the released NR can be captured by SERS substrate AuNS@CB[7] for the subject-object recognition ability to produce a strong Raman signal which was positive correlation to target miRNA. By this way, the proposed SERS biosensor can achieve sensitively and selectively detect miRNA with a detection limit of 0.562 fM. This MOF-based SERS biosensor also be hopeful application for clinical diagnostics.
