Expanding of ST11 Carbapenemase-Producing Klebsiella pneumoniae Subclones in a Chinese Hospital, Shenzhen, China.

BACKGROUND: ST11 is the most prevalent sequence type of clinical Klebsiella pneumoniae in China. METHODS: We investigated the characteristics of the ST11 subclones using core genome multi-locus sequence typing (cgMLST). Ninety-three carbapenemase-producing K. pneumoniae isolates were collected at Shenzhen People's Hospital. Then, whole-genome sequencing and cgMLST were used to discriminate apparent subclones within the ST11 group. RESULTS: We analyzed the prevalence and genetic relationships of these subclones. ST11 and K. pneumoniae carbapenemase (KPC-2) were the predominant genotype and carbapenemase, respectively, in the clinical carbapenemase-producing K. pneumoniae strains. cgMLST scheme genotyping divided the ST11 group into two clades across seven complex types (CTs). CT1313 was the most prevalent subclone. The deletion of galF and a high frequency of SNPs in genes associated with the stress- and SOS-responses were found in CT1291 and CT2405 over time, respectively. CONCLUSION: Our results indicated that the subclones of the ST11 group had different patterns of prevalence. Highly discriminatory genotyping techniques, such as cgMLST scheme, should be used in further molecular epidemiology investigations.

Computer-aided diagnosis expert system for cerebrovascular diseases.

OBJECTIVE: To establish an expert diagnosis system for cerebrovascular diseases (CVDs) and assess accuracy of the diagnosis system. METHODS: An expert diagnosis system for CVDs was established and evaluated using actual clinical cases. RESULTS: An expert diagnosis system for CVDs was established and tested in 319 clinical patients. Diagnosis accordance was obtained in 307 patients (the diagnosis accordance rate was 96.2%). Involved were 223, 7, 23, 54 and 12 patients with cerebral thrombosis, cerebral embolism, transient ischemic attack, cerebral hemorrhage and subarachnoid hemorrhage, respectively; and diagnosis accordance was obtained in 219 (98.2%), 6 (85.7%), 23 (100%), 48 (88.9%) and 11 (91.7%), respectively. CONCLUSION: Overall, the case analysis results support and demonstrate the diagnostic reasoning accuracy of the expert diagnosis system for CVDs. With the expert diagnosis system, medical experts' diagnosis of CVDs can be effectively mimicked and auxiliary diagnosis of CVDs has been preliminarily realized, laying a foundation for increasing the diagnostic accuracy of clinical diagnoses as it pertains to CVDs.