The role of silver nanoparticles alone and combined with imipenem on carbapenem-resistant Klebsiella pneumoniae.

AIMS: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections poses a significant threat to human health, necessitating urgent development of new antimicrobial agents. Silver nanoparticles (AgNPs), which are among the most widely used engineered nanomaterials, have been extensively studied. However, the impact of AgNPs on CRKP and the potential for drug resistance development remain inadequately explored. METHODS AND RESULTS: In this study, broth dilution method was used to determine the minimum inhibitory concentration (MIC) was determined using the broth dilution method. Results indicated MIC values of 93.1 ± 193.3 µg ml-1 for AgNPs, 2.3 ± 5.1 µg ml-1 for AgNO3, and 25.1 ± 48.3 µg ml-1 for imipenem (IMI). The combined inhibitory effect of AgNPs and IMI on CRKP was assessed using the checkerboard method. Moreover, after 6-20 generations of continuous culture, the MIC value of AgNPs increased 2-fold. Compared to IMI, resistance of Kl. pneumoniae to AgNPs developed more slowly, with a higher fold increase in MIC observed after 20 generations. Whole-genome sequencing revealed four nonsynonymous single nucleotide polymorphism mutations in CRKP after 20 generations of AgNP treatment. CONCLUSION: We have demonstrated that AgNPs significantly inhibit CRKP isolates and enhance the antibacterial activity of imipenem against Kl. pneumoniae. Although the development of AgNP resistance is gradual, continued efforts are necessary for monitoring and studying the mechanisms of AgNP resistance.

Epidemiological Characteristics, Antifungal Susceptibility, Risk Factors, and Outcomes of Candida Bloodstream Infection: A Ten-Year Surveillance in a Teaching Hospital in China.

Background: Candida is one of the most important pathogens of hospital-acquired bloodstream infections. Its morbidity and mortality are still high, which is a serious global public problem. Purpose: To investigate the strain distribution, drug susceptibility, clinical characteristics of patients, and risk factors affecting the prognosis of Candida bloodstream infection (BSI). Materials and Methods: We retrospectively collected the clinical data, infection-related indicators, prognosis, strain prevalence and drug susceptibility of 163 patients with Candida BSI in a teaching hospital from January 2012 to December 2022. Univariate and multivariate logistic regression were used to analyze the risk factors affecting the prognosis. Results: In 163 cases of Candida BSI, Candida albicans accounted for 48.47%, and Candida non-albicans accounted for 51.53%. A total of 163 patients with Candida BSI were mainly distributed in intensive care unit (ICU) and emergency department, accounting for 40.49% and 14.72%, respectively. The resistance rate of Candida albicans to fluconazole, itraconazole and voriconazole was less than 10%, and the sensitivity rate of Candida tropicalis to fluconazole, itraconazole and voriconazole was less than 80%. The mortality rate of 163 patients with Candida BSI was 33.13%, with Candida non-albicans higher than that of Candida albicans (p = 0.04). Multivariate analysis showed that hemodialysis (OR = 0.199, 95% CI: 0.059-0.673, P = 0.009), arteriovenous catheters (OR = 0.344, 95% CI: 0.130-0.913, P = 0.032), elevated neutrophil count (OR = 0.409, 95% CI: 0.194-0.862, P = 0.019) and APACHE II score (OR = 0.848, 95% CI: 0.789~0.911, P < 0.001) were independent risk factors for death in patients with candidemia. Conclusion: The blood flow infection rate of Candida non-albicans is increasing, and the mortality rate and resistance to antifungal drugs are higher than that of Candida albicans. Hemodialysis, arteriovenous catheters, elevated neutrophil count and APACHE II score were associated with death in patients with Candida BSI.

Relationship between demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college student: A structural equation analysis.

AIMS: This study aimed to create a structural equation model to evaluate the associations among demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college students. METHODS: A survey was undertaken using a self-administered questionnaire and targeting 2233 students from Eastern China. Structural equation modeling with the bootstrap approach was utilized to estimate the interrelationships and the strength of the associations among measured variables based on the hypothetical model. RESULTS: Among the total participants, 14.7% of the female college students reported having performed breast self-examination. The final structural equation model showed highly satisfactory fitness on indices. Breast self-examination behavior was significantly linked to demographic factors, breast cancer related-knowledge, attitudes, and health education. Health education had the greatest influence on breast self-examination behavior. In addition, breast cancer related-knowledge was significantly associated with demographic factors and health education. Health education and knowledge all significantly affected attitudes towards breast cancer. CONCLUSION: Breast self-examination behavior was influenced by demographic factors, breast cancer related-knowledge, attitudes towards breast cancer, and health education in a sample of female college students in China. Health education was the most important predictor of breast self-examination behavior.