Associations Between ABO Blood Groups and Diseases in the Digestive System and Vein.

Purpose: The ABO blood type system is crucial for human blood transfusions. However, the relationships between ABO blood groups and diseases in the digestive system and vein have not been elucidated. We investigated the relationships between ABO blood groups and diseases in the digestive system and vein in this study. Patients and Methods: A retrospective study on a Chinese population, including 1432 Crohn's disease (CD), 416 ulcerative colitis (UC), 1140 stomach cancer (SC), 841 colorectal cancer (CRC), 384 pancreatic cancer (PC), 520 liver cancer (LC), and 563 venous thrombosis (VT) patients, was performed. Furthermore, 896 healthy subjects were enrolled as normal controls (NC) in this study. The demographic characteristics of patients and NC were compared using the unpaired t-test and χ2 test. Multivariate logistic regression model was used to evaluate the association between ABO blood groups and CD and VT. Results: ABO blood groups distributions in UC, SC, CRC, PC, and LC patients did not differ from that of NC, but CD and VT patients had significant difference of ABO blood group distribution from that of NC (p = 0.015 and p = 0.002, respectively). Patients with CD and VT had considerably lower rates of type O blood (p = 0.011 and p = 0.001, respectively) and significantly higher rates of type AB blood (p = 0.013 and p = 0.022, respectively) than those with NC. Multivariate logistic regression analysis showed the association of CD and VT with non-O blood types was still significant with a higher risk than with blood group O after adjusting for age and gender (OR = 1.355, 95% CI = 1.100-1.670, p = 0.004 and OR = 1.465, 95% CI = 1.131-1.903, p = 0.004, respectively). Conclusion: ABO blood groups distributions in CD and VT patients significantly differed from that of NC. Non-O blood group could be a new predictor for CD and VT.

Nitrate denitrification rate response to temperature gradient change during river bank infiltration.

Nitrate attenuation during river bank infiltration is the key process for reducing nitrogen pollution. Temperature is considered to be an important factor affecting nitrate attenuation. However, the magnitude and mechanism of its impact have not been clear for a long time. In this study, the effects of temperature and temperature gradient on the nitrate denitrification rate were investigated via static batch and dynamic soil column simulation experiments. The results showed that temperature had a significant effect on the denitrification rate. Temperature effects were first observed in denitrifying bacteria. At low temperatures, the microorganism diversity was low, resulting in a lower denitrification rate constant. The static experimental results showed that the denitrification rate at 19 °C was approximately 2.4 times that at 10 °C. The dynamic soil column experiment established an exponential positive correlation between the nitrate denitrification decay kinetic constant and temperature. The affinity of denitrifying enzymes for nitrate in the reaction substrate was ordered as follows: decreasing temperature gradient (30 °C → 10 °C) > zero temperature gradient (10 °C) > increasing temperature gradient condition (0 °C → 10 °C). This study provides a theoretical basis for the biogeochemical processes underlying river bank infiltration, which will help aid in the development and utilization of groundwater resources.

Soil ecoenzyme activities coupled with soil properties and plant biomass strongly influence the variation in soil organic carbon components in semi-arid degraded wetlands.

Wetland degradation can induce alterations in plant biomass, soil properties, and soil ecoenzyme activities, consequently influencing soil organic carbon components. Despite extensive investigations into the relationships among plant characteristics, soil properties, and soil organic carbon components, the enzymatic mechanisms underlying changes in soil organic carbon components, particularly the impact and contribution of ecoenzyme activities, remain poorly understood. This study compared the soil organic carbon components at a depth of 0-20 cm in wetlands in the semi-arid western Songnen Plain under different degradation levels and explored plant biomass, soil properties, and soil ecoenzyme activities. The results showed that the soil total organic carbon, labile organic carbon, and recalcitrant organic carbon contents in the degraded wetlands were generally lower than those in the non-degraded wetlands. Furthermore, the soil nutrient contents and soil ß-1,4-glucosidase, L-leucine aminopeptidase, and acid phosphatase activities were also lower in the degraded wetlands than in the non-degraded wetlands. Vector analysis of enzymatic stoichiometry revealed that wetland degradation did not increase microbial carbon limitation. The soil organic carbon components showed significant positive correlations with plant biomass, soil water content, soil total nitrogen, soil total phosphorus, as well as soil ecoenzyme activities. Variation partitioning analysis revealed that plant biomass, soil properties, soil ecoenzyme activities collectively accounted for 78.5 % variation in soil organic carbon components, among which plant biomass, soil properties, soil ecoenzyme activities, and their interactions explaining 4.2 %, 8.0 %, 7.9 %, and 24.5 % of the variation, respectively. Therefore, the impact of soil ecoenzyme activities and soil properties on soil organic carbon component changes was greater than that of plant biomass, with the interaction of these three factors playing a crucial role in soil organic carbon formation. This study provides a theoretical basis for scientifically evaluating the carbon sink function of degraded wetland soil and preserving the wetland soil carbon pool.

Platelet/Albumin ratio and plateletcrit levels are potential new biomarkers for assessing endoscopic inflammatory bowel disease severity.

BACKGROUND: Endoscopy is currently recognized as the gold standard for assessing inflammatory bowel disease (IBD) severity. However, because the procedure is costly and invasive, endoscopy is not suitable for frequently monitoring intestinal inflammation. In this study, our aim was to identify noninvasive, low cost, and convenient biomarkers for identifying endoscopic IBD activity. METHODS: In total, 246 patients with IBD (131 with Ulcerative colitis (UC) and 115 with Crohn's disease (CD)) and 369 healthy controls were recruited for this retrospective study. IBD activity was evaluated using endoscopic and clinical examinations. The potential of several inflammatory biomarkers, including platelets (PLT), plateletcrit (PCT), albumin (ALB), highly sensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and platelet-to-albumin ratio (PLT/ALB) to assess endoscopic IBD activity was evaluated using receiver operating characteristic (ROC) analyses. RESULTS: PLT/ALB ratio, PLT, ALB, and hs-CRP levels were correlated with Mayo scores in UC patients, while PCT, PLT, fibrinogen (FIB), PLT/ALB ratio, hs-CRP, and ESR levels were correlated with Simple Endoscopic Scores for CD (SES-CD) in CD patients. ROC analyses showed that the area under the curve (AUC) value for the PLT/ALB ratio (0.705) was greater than hs-CRP (0.607) and ESR (0.552) values in UC patients. The AUC value for PCT (0.779) was greater than hs-CRP (0.698) and ESR (0.746) values in CD patients. CONCLUSION: PLT/ALB ratio and PCT biomarkers were the most appropriate of all tested inflammatory biomarkers for assessing endoscopic IBD activity in UC and CD patients, respectively.

B-Cell Lymphoma Producing IgM Anti-B Antibody: A Case Report.

ABO blood group system is the most important blood group system in transfusion and transplantation medicine. Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphomas (NHLs) worldwide. There have been some studies that lymphoma could affect ABO blood group system and thus affect blood transfusion strategy. However, the mechanisms lymphoma affecting ABO blood group system have not been fully elucidated so far. Here, we report a case of a patient who was a 72-year-old Chinese man came to our hospital for medical advice because of cervical lymphadenophathy. The patient was subsequently diagnosed with diffuse large B-cell lymphoma by lymph-node biopsy. His ABO blood group was initially typed as B on November 7, 2020. He was transfusing B type leukocyte poor RBCs (LPR) before we found the patient's ABO blood group discrepancy on December 2, 2020 by forward and reverse typing methods, which the discrepancy was verified by genotyping. The patient began to transfuse O type washed RBCs (WRBC) since then. Compared to transfuse B type leukocyte poor RBCs (LPR), the efficiency of transfusing O type washed RBCs (WRBC) was better. Although hemoglobin level did not greatly improve, indirect bilirubin level evidently decreased. Furthermore, we found B-cell lymphoma affected blood transfusion strategy by producing IgM anti-B antibody in this case. Clinicians should need to be aware of the effect of B-cell lymphoma on blood transfusion strategy.

Selenium distribution in cultivated Argosols and Gleyosols of dry and paddy lands: A case study in Sanjiang Plain, Northeast China.

Distribution pattern of selenium (Se) fractions in soil could influence Se content in crops and thereby intake of Se in human body. In order to investigate the effects of soil types and farming conditions on Se distribution in small-scaled cultivated land developed under the same conditions of climate, topography and parent materials, two types of soils (i.e., Argosols and Gleyosols) from paddy and dry lands in the Sanjiang Plain of Northeast China were selected. Total Se (T-Se) content in Argosols was influenced by organic carbon (Org C) content and pH of bulk topsoil. In Gleyosols, it was mainly affected by Org C content in dry land and pH in paddy land, respectively. In rice root associated topsoil, organic matter associated Se (OM-Se) accounted for 70% of T-Se. Compared with pH (median 6.10) and OM weakly bound Se (OW-Se) (0.14 ± 0.04 mg kg-1) of Argosols, the higher pH (median 6.77) resulted in less OW-Se (0.10 ± 0.04 mg kg-1) of Gleyosols. Vertical distribution of Se in borehole cores within the depth of 0-900 cm was mainly affected by the soil type. Se accumulated mainly within 0-150 cm depth (horizon A, E and B) in Argosols and above 40 cm depth (horizon H), existing prominently as OM strongly bound Se (OS-Se), in Gleyosols. Within the depth of 0-150 cm, various Se fractions for both soils were probably controlled by reductive fixation and complexation of Org C; In the alkaline paddy land, DOM-complexed Se was the main composition of A-Se. The findings of this study could help in understanding the mechanisms of Se distribution and enrichment in soils developed under different formation processes and farming conditions.

Experiments and simulation of co-migration of copper-resistant microorganisms and copper ions in saturated porous media.

Heavy metal (HV) pollutants may migrate to the groundwater environment through leaching, causing groundwater pollution. Compared with surface water pollution, groundwater pollution is complex and hidden. Existing methods for treating HV pollution in the vadose zone have had limited application owing to various problems. In recent years, microorganisms have been used in the field of pollution control and remediation owing to their outstanding adsorption and degradation properties and low cost, but their environmental safety and behavior in porous media are still poorly understood. This study aimed to investigate the migration behavior and mechanisms of copper ions in saturated porous media under the action of copper-resistant microorganisms and to establish a corresponding numerical model to simulate the results. The key parameters of adsorption and migration were determined through batch adsorption and soil column experiments. A one-dimensional soil column was used to conduct a co-migration experiment using copper-resistant microorganisms and Cu2+ in water-saturated quartz sand, and a co-migration mathematical model was constructed. It was found that the existence of microorganisms had an inhibitory effect on the migration of Cu2+ in quartz sand, and Cu2+ promoted the migration of microorganisms, reduced their adsorption, and increased their concentration in the column experiment effluent. The selected solute transport mathematical model had a good fitting effect on the breakthrough curves of copper ion and copper-resistant microorganisms during their co-migration. The results can provide parameters and a theoretical basis for the risk assessment and prevention of HV pollution in the saturated zone or aquifers.

Transfusion-induced platelet antibodies and regulatory T cells in multiply transfused patients.

BACKGROUND: Platelet transfusion refractoriness (PTR) remains a difficult problem in patients requiring long-term platelet supportive care. However, there are little data on the frequency of platelet antibodies in multiply transfused Chinese patients. Moreover, the relationship between peripheral regulatory T cells (Tregs) and PTR remains unclear. METHODS: We retrospectively studied the frequency of alloimmunization against platelet antigens in patients receiving multiple transfusions between 2013 and 2017. Monoclonal antibody solid-phase platelet antibody test (MASPAT) kits were used to screen for platelet antibodies before each platelet transfusion. Peripheral Tregs and CD4+ CD25+ CD127- T cells were detected by flow cytometry, while transforming growth factor-beta (TGF-ß) and interleukin (IL)-17 cytokines were detected by enzyme-linked immunosorbent assay. RESULTS: A total of 399 patients who met the inclusion criteria were enrolled for the analysis of platelet antibodies and refractoriness. Among these patients, 10 (2.5%) were positive for platelet antibodies before transfusion and 47 (11.8%) became antibody-positive during the study period. The number of alloimmunized patients was significantly higher in patients with hematological disease as compared with other disease groups (p < 0.05). Refractoriness and alloimmunization occurred in 77 (19.3%) and 22 (28.6%) patients, respectively. There were no significant differences in CD4+ , CD8+ , and CD4+ CD25+ CD127- T cell numbers and plasma levels of TGF-ß1 and IL-17 between patients with PTR and the control group. CONCLUSIONS: Refractoriness was common in patients undergoing multiple platelet transfusions (19.3%), with alloimmunization observed in 28.6% of patients. However, Tregs in peripheral blood may not play a key role in PTR.

Imaging features of the initial chest thin-section CT scans from 110 patients after admission with suspected or confirmed diagnosis of COVID-19.

BACKGROUND: In December 2019, an outbreak of a novel coronavirus pneumonia, now called COVID-19, occurred in Wuhan, Hubei Province, China. COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread quickly across China and the rest of the world. This study aims to evaluate initial chest thin-section CT findings of COVID-19 patients after their admission at our hospital. METHODS: Retrospective study in a tertiary referral hospital in Anhui, China. From January 22, 2020 to February 16, 2020, 110 suspected or confirmed COVID-19 patients were examined using chest thin-section CT. Patients in group 1 (n = 51) presented with symptoms of COVID-19 according to the diagnostic criteria. Group 2 (n = 29) patients were identified as a high degree of clinical suspicion. Patients in group 3 (n = 30) presented with mild symptoms and normal chest radiographs. The characteristics, positions, and distribution of intrapulmonary lesions were analyzed. Moreover, interstitial lesions, pleural thickening and effusion, lymph node enlargement, and other CT abnormalities were reviewed. RESULTS: CT abnormalities were found only in groups 1 and 2. The segments involved were mainly distributed in the lower lobes (58.3%) and the peripheral zone (73.8%). The peripheral lesions, adjacent subpleural lesions, accounted for 51.8%. Commonly observed CT patterns were ground-glass opacification (GGO) (with or without consolidation), interlobular septal thickening, and intralobular interstitial thickening. Compared with group 1, patients in group 2 presented with smaller lesions, and all lesions were distributed in fewer lung segments. Localized pleural thickening was observed in 51.0% of group 1 patients and 48.2% of group 2 patients. The prevalence of lymph node enlargement in groups 1 and 2 combined was extremely low (1 of 80 patients), and no significant pleural effusion or pneumothorax was observed (0 of 80 patients). CONCLUSION: The common features of chest thin-section CT of COVID-19 are multiple areas of GGO, sometimes accompanied by consolidation. The lesions are mainly distributed in the lower lobes and peripheral zone, and a large proportion of peripheral lesions are accompanied by localized pleural thickening adjacent to the subpleural region.

Antibiotic susceptibilities and genetic variations in macrolide resistance genes of Ureaplasma spp. isolated in China.

Macrolides are widely used for the treatment of Ureaplasma spp. infection. The aim of this study was to investigate possible genetic resistance determinants in Ureaplasma spp. isolates. A total of eleven macrolide- resistant Ureaplasma spp. isolates, recovered from urogenital specimens, were investigated for genetic mechanisms of macrolide resistance. The 23S rRNA operons, as well as L4 and L22 ribosomal protein genes, were amplified and sequenced. Our study identified that the mutation A2066G in the 23S rRNA and four mutations (G361T, A406G, C422T and G196A) in the L22 ribosomal protein, may be responsible for the resistance of Ureaplasma spp. to macrolides, in China.

Detection of Ureaplasma spp. serovars in genital tract of infertile males.

BACKGROUND: The colonization of Ureaplasma species in genital tract is related with male infertility. However, it has been postulated based upon limited study that virulence is related to serotype specificity. The aim of this study was to determine the distribution of Ureaplasma serovars in genital tract of infertile males and analyze their role in male infertility. METHODS: A total of 358 urethral swabs samples were obtained from infertile males. The culture of Ureaplasma species were performed using a commercially available Mycoplasma IST 2 kit. Serovars were determined by real-time polymerase chain reaction (real-time PCR). RESULTS: A total of 92 (25.7%) infertile males were positive for Ureaplasma spp; among them, Ureaplasma parvum (UPA) was detected in 73 (79.3%) isolates, and Ureaplasma urealyticum (UUR) was detected in 19 (20.7%) isolates. Serovars 1, 6, or in combination accounted for 63.0% (46/73) of UPA isolates. Serovar 9 (alone and in combination of other serovars) was the most common serovar in UUR (47.4%, 9/19). Multiple serovars were detected in 21 (22.8%) isolates, and serovars 4, 5, 7, and 12 were not detected in any sample. CONCLUSION: The distribution of 14 Ureaplasma serovars in genital tract of infertile males was identified for the first time by real-time PCR assay. UPA serovars 1 and 6, and UUR serovar 9 are the most common serovars colonization in urogenital tract of infertile males.

Correlation between Ureaplasma spp. sub-group 1 and preterm pre-labour rupture of membranes revealed by an eMLST scheme.

Ureaplasma spp. is gaining recognition as an important pathogen associated with preterm birth (PTB) and preterm pre-labour rupture of membranes (PPROM). The aim of this study was to investigate the clonality of this organism in maternal/neonatal pairs with PTB or pre-labour rupture of membranes (PROM) or PPROM and the association between sub-groups and PPROM. In total, 50 of 93 maternal/neonatal pairs that were diagnosed with PTB, PROM or PPROM were identified with Ureaplasma spp. colonized in the amniotic fluid or umbilical cord or placenta. All 104 clinical Ureaplasma spp. samples (50, 30, and 24 cultured from amniotic fluid, umbilical cord, and placenta, respectively) were included for analysis of the genetic lineages using the eMLST scheme. A total of 34 eSTs were revealed, with two predominant eSTs (eST16 and eST41). Interestingly, six maternal/neonatal pairs displayed eST differences in the above three specimen sources. In addition, phylogenetic analysis showed two genetically significant distant clusters, and cluster I included the most clinical strains. Interestingly, there was a significant difference in the prevalence of sub-group 1 of cluster II between women with PPROM and those with PROM. In conclusion, the distribution of cluster I was predominately higher than that of cluster II in maternal/neonatal pairs. In addition, sub-group 1 was prone to associated PPROM through the specific epidemic clonal lineages.

lncRNA BCAR4 Increases Viability, Invasion, and Migration of Non-Small Cell Lung Cancer Cells by Targeting Glioma-Associated Oncogene 2 (GLI2).

This study aimed to explore the effects of lncRNA BCAR4 on the viability and aggressiveness of non-small cell lung cancer (NSCLC) cells. qRT-PCR was used to determine the expression of BCAR4 and GLI2 downstream genes in NSCLC tissues and cell lines. Chromatin isolation by RNA purification (CHIRP) and Western blot were employed to measure the expression of the GLI2 downstream proteins. Ki-67 expression in nude mice tumors was tested by immunohistochemistry. MTT assay, wound healing assay, and Transwell assay were used to assess NSCLC cell viability and aggressiveness, respectively. Tumor xenograft was conducted to determine the effects of BCAR4 and GLI2 on NSCLC tumorigenesis in vivo. The expression of BCAR4 in NSCLC tissues and cells was significantly higher than the normal level. The overexpression of BCAR4 promoted NSCLC cell viability, migration, and invasion. The suppression of BCAR4 and GLI2 showed the opposite effects. The overexpression of BCAR4 led to an increase in the expression of GLI2 downstream proteins, while the suppression of BCAR4 and GLI2 reduced their expression. In a tumor xenograft assay, the tumors in mice of the BCAR4 group showed the biggest volume, while those in mice of the si-GLI2 group showed the smallest volume. Ki-67 showed much higher levels in the BCAR4 overexpression group but much lower levels in the si-GLI2 group. In summary, the cooperative mechanism of lncRNA BCAR4 and GLI2 might provide a new opportunity for treating NSCLC.

Downregulation of long noncoding RNA PVT1 attenuates paclitaxel resistance in glioma cells.

BACKGROUND: Drug resistance in clinical cancer treatment has become an issue. OBJECTIVE: We focus on abnormally expressed lncRNAs in glioma and investigating the function of PVT1. METHODS: The paclitaxel-resistant glioma cells SHG-44 RE was obtained through screening the SHG 44 cells that were cultured in medium containing a certain concentration of paclitaxel. Cell survival of SHG 44 RE and SHG 44 cells under the treatment of paclitaxel was detected by MTT assay. The aberrant expressed lncRNAs were screened out with microarray analysis. Further qRT-PCR was utilized to validate the expression of lncRNA PVT1 in the two cells. After manipulating the expression of PVT1, cell viability and apoptosis were measured by MTT and flow cytometry respectively. RESULTS: LncRNA PVT1 was overexpressed in glioma cells SHG-44 RE compared with parent SHG-44 cells. Down-regulation of lncRNA PVT1 inhibited the SHG-44 RE cell viability and increased glioma SHG-44 RE cells apoptosis after paclitaxel treatment, suggesting that inhibition of lncRNA PVT1 improved paclitaxel sensibility in human glioma cells. CONCLUSION: Down-regulation of PVT1 could enhance chemosensitivity of paclitaxel, induce apoptosis of glioma cells and noteworthy inhibit glioma cells proliferation. Our findings of PVT1 could contribute to attenuate paclitaxel resistance in clinical medicine.

Selenium (Se) uptake and dynamic changes of Se content in soil-plant systems.

In this study, we collected crop plants and associated soil samples and determined these for selenium (Se) content to analyze the uptake, enrichment, and translocation of Se in the different soil-plant systems of an agricultural production area, elucidate the dynamic mechanisms relating to Se content in plants and soil during different growth periods, and screen plants for high Se enrichment ability. Bioconcentration factor determinations indicated that the grains of rice have the strongest Se enrichment ability, followed by soybean and corn. Translocation factor analysis indicated that the grains of rice and corn have similar low translocation abilities for Se compared with soybean. Within the study area, the Se content in plants was closely related to the soil available Se content and varied considerably among different growth periods and plant organs. This study provides a theoretical basis for the development and utilization of local agricultural products.

TRB3 is elevated in psoriasis vulgaris lesions and mediates HaCaT cells proliferation in vitro.

Psoriasis is a chronic skin disease characterized by abnormal keratinocyte proliferation and differentiation, inflammation, and angiogenesis. Overexpression of tribbles homolog3 (TRB3), which belongs to the tribbles family of pseudokinases, has been found in several human tumors and metabolic diseases, but its role in psoriasis has not been fully clarified. The aim of this study is to investigate the expression of TRB3 in psoriasis and explore its roles in the proliferation of keratinocytes. Twenty-four patients with psoriasis vulgaris were recruited for the study. Diagnosis of psoriasis was based on clinical and histologic examinations. Immunohistochemistry and real-time reverse transcription PCR (RT-PCR) were performed to determine protein and messenger RNA (mRNA) expression of TRB3 in psoriasis lesions. 5-Bromo-2-deoxyUridine (BrdU) incorporation assay were performed for cell proliferation. Cell cycle distribution was assessed by flow cytometry analysis. The levels of TRB3 is elevated in psoriatic lesions compared with psoriatic non-lesions. The HaCat cells expressed the TRB3 gene. We found TRB3 silencing to significantly inhibit HaCat cell proliferation. Furthermore, the specific knockdown of TRB3 slowed down the cell cycle at the gap 0/first gap phase. In conclusion, our data suggest that TRB3 is overexpressed in lesions of patients with psoriasis and may be involved in the abnormal proliferation of keratinocytes. Therefore, TRB3 may be a potential therapeutic target for psoriasis.

Comparative analysis of male and female populations on prevalence and antibiotic resistance of Mycoplasma hominis in China, 2005-2014.

The aim of this study was to estimate the prevalence and antimicrobial resistance rate of Mycoplasma hominis among male and female populations. A total of 67921 individuals were examined. All samples were isolated from patients at an outpatient clinic from January 2005 to December 2014. Species identification and antibiotic susceptibility testing were performed using Mycoplasma IST2. In this study, 523 (0.8%) and 4625 (6.8%) cultures, respectively, were positive for single M. hominis identification and simultaneous identification of both M. hominis and Ureaplasma spp. The results showed that both single and simultaneous identification were more frequent in the female than the male population. Moreover, the highest positive rates of single M. hominis identification were observed in 56-60-year-old males and 61-65-year-old females, and the rates of simultaneous identification were high in males aged >65 years and females aged 15-20 years. Among the seven antibiotics assessed, tetracycline, josamycin, doxycycline and pristinamycin were the most effective, whilst clarithromycin, ciprofloxacin and ofloxacin displayed extremely high resistance rates. Different antimicrobial susceptibility rates were observed between the two sexes, and the resistance rates to ofloxacin showed a significant difference (P<0.05). In conclusion, this study demonstrates that the prevalence of M. hominis varied significantly between the two sexes in the past 10 years and that the optimal antimicrobial therapy strategy should be directed by local susceptibility testing.

Frequent topoisomerase IV mutations associated with fluoroquinolone resistance in Ureaplasma species.

This study aimed to investigate the role of quinolone resistance-determining regions (QRDRs) of DNA gyrase (encoded by gyrA and gyrB) and topoisomerase IV (encoded by parC and parE) associated with fluoroquinolone resistance. A total of 114 Ureaplasma spp. strains, isolated from clinical female patients with symptomatic infection, were tested for species distribution and susceptibility to four fluoroquinolones. Moreover, we analysed the QRDRs and compared these with 14 ATCC reference strains of Ureaplasma spp. serovars to identify mutations that caused antimicrobial resistance. Our study indicated that moxifloxacin was the most effective fluoroquinolone against Ureaplasma spp. (MIC range: 0.125-32 µg ml⁻¹). However, extremely high MICs were estimated for ciprofloxacin (MIC range: 1-256 µg ml⁻¹) and ofloxacin (MIC range: 0.5-128 µg ml⁻¹), followed by levofloxacin (MIC range: 0.5-64 µg ml⁻¹). Seven amino acid substitutions were discovered in GyrB, ParC and ParE, but not in GyrA. Ser-83 → Leu/Trp (C248T/G) in ParC and Arg-448 → Lys (G1343A) in ParE, which were potentially responsible for fluoroquinolone resistance, were observed in 89 (77.2 %) and three (2.6 %) strains, respectively. Pro-462 → Ser (C1384T), Asn-481 → Ser (A1442G) and Ala-493 → Val (C1478T) in GyrB and Met-105 → Ile (G315T) in ParC seemed to be neutral polymorphisms, and were observed and occurred along with the amino acid change of Ser-83 → Leu (C248T) in ParC. Interestingly, two novel mutations of ParC and ParE were independently found in four strains. These observations suggest that amino acid mutation in topoisomerase IV appears to be the leading cause of fluoroquinolone resistance, especially the mutation of Ser-83 → Leu (C248T) in ParC. Moxifloxacin had the best activity against strains with Ser-83 → Leu mutation.

Correlation between Ureaplasma subgroup 2 and genitourinary tract disease outcomes revealed by an expanded multilocus sequence typing (eMLST) scheme.

The multilocus sequence typing (MLST) scheme of Ureaplasma based on four housekeeping genes (ftsH, rpL22, valS, and thrS) was described in our previous study; here we introduced an expanded MLST (eMLST) scheme with improved discriminatory power, which was developed by adding two putative virulence genes (ureG and mba-np1) to the original MLST scheme. To evaluate the discriminatory power of eMLST, a total of 14 reference strains of Ureaplasma serovars and 269 clinical strains (134 isolated from symptomatic patients and 135 obtained from asymptomatic persons) were investigated. Our study confirmed that all 14 serotype strains could successfully be differentiated into 14 eMLST STs (eSTs), while some of them could not even be differentiated by the MLST, and a total of 136 eSTs were identified among the clinical isolates we investigated. In addition, phylogenetic analysis indicated that two genetically significantly distant clusters (cluster I and II) were revealed and most clinical isolates were located in cluster I. These findings were in accordance with and further support for the concept of two well-known genetic lineages (Ureaplasma parvum and Ureaplasma urealyticum) in our previous study. Interestingly, although both clusters were associated with clinical manifestation, the sub-group 2 of cluster II had pronounced and adverse effect on patients and might be a potential risk factor for clinical outcomes. In conclusion, the eMLST scheme offers investigators a highly discriminative typing tool that is capable for precise epidemiological investigations and clinical relevance of Ureaplasma.