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1.
Medicine (Baltimore) ; 99(19): e19987, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384451

RESUMO

This study aimed to investigate the inner linkage and mechanism of Mycoplasma pneumoniae (MP) infection and Kawasaki disease (KD), as well as the risk factors of outcome in this cohort of patients.A retrospective study was performed in 210 patients diagnosed with KD complicated with community acquired pneumonia (CAP) in Children's Hospital, Zhejiang University School of Medicine from January 2014 to December 2017. They were divided into two groups based on MP infection: MP infection group (n = 97) and non-MP infection group (n = 113). We compared the variables of these two groups based on medical records.The MP infection group had higher ESR than the non-MP infection group. During hospitalization, the non-MP infection group had higher levels of WBC during hospital, LDH, PCT, and lower HB when compared to the MP infection group. No differences were found in the hs-CRP level, N%, PLT, ALT, CKMB, and cytokine levels (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) between MP and non-MP infection group. Likewise, no difference was found in fever duration or hospital stays between them. Totally 19 patients in the infection group had CAA with a rate of 19.59%; and 27 (23.89%) patients had CAA in the non-MP infection group. Unfortunately, no difference was found in CAA rate between the two groups.MP infection may occur simultaneously in children with Kawasaki disease. KD patients with MP infection tended to occur in older population. MP infection may not increase the risk of CAA, which still needs further large-scaled studies to confirm. Clinicians should be alert to KD patients with high level of ESR. MP should be screened and early treatment with macrolides should be given timely.


Assuntos
Sedimentação Sanguínea , Cardiopatias , Macrolídeos/administração & dosagem , Síndrome de Linfonodos Mucocutâneos , Pneumonia por Mycoplasma , Antibacterianos/administração & dosagem , Pré-Escolar , China/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Comorbidade , Citocinas/sangue , Intervenção Médica Precoce/métodos , Feminino , Cardiopatias/etiologia , Cardiopatias/prevenção & controle , Humanos , Lactente , Contagem de Leucócitos/métodos , Contagem de Leucócitos/estatística & dados numéricos , Masculino , Síndrome de Linfonodos Mucocutâneos/sangue , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/epidemiologia , Síndrome de Linfonodos Mucocutâneos/terapia , Pneumonia por Mycoplasma/sangue , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/epidemiologia , Estudos Retrospectivos , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
2.
Int J Infect Dis ; 2020 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-32389850

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is spreading. Here, we summarized the composition of pathogens in fever clinic patients and analyzed characteristics of different respiratory virus infection. METHODS: Retrospectively collected patients with definite etiological results using nasal and pharyngeal swabs in fever clinic. RESULTS: Totally, 1860 patients were screened and 136 patients were enrolled. 72 (52.94%) of them were diagnosed as influenza (Flu) A virus infection. 32 (23.53%) of them were diagnosed as Flu B virus infection. 18 (13.24%) and 14 (10.29%) of them were diagnosed as COVID-19 and respiratory syncytial virus (RSV) infection respectively. COVID-19 group had a higher rate of contact with epidemic area within 14 days and clustering onset than other groups. Fever was the most common symptom in these patients. The ratio of fever and the highest temperature were higher in Flu A virus infection patients than in COVID-19 patients. COVID-19 patients had lower white blood cell count and neutrophil count than Flu A virus and RSV infection group, but higher lymphocyte count than Flu A and B virus infection groups. COVID-19 group (83.33%) had higher rate of pneumonia in chest CT scan than Flu A and B virus infection groups. CONCLUSIONS: Influenza viruses accounted for a large proportion of respiratory virus infection even during the epidemic of COVID-19 in Beijing. No single symptom or laboratory finding was suggestive of specific respiratory virus, however, epidemic history was important for screening of COVID-19.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32334978

RESUMO

BACKGROUND/PURPOSE: As the incidence of fungal infections in China increases, the demand for rapid and accurate diagnosis of mycoses is growing. Yet, information on current diagnostic capacity is scarce. METHODS: An online survey was conducted in February 2018 to collect information on mycology testing from tertiary care hospitals across China. Responses from 348 hospitals were analyzed, and a scoring system was designed and employed to assess the overall diagnostic capacity. RESULTS: Most of the surveyed hospitals did not have separate laboratory space, manpower, or equipment dedicated for fungal testing. Conventional staining methods were widely available (>70%), whereas GMS and fluorescent staining were less common. Fungal identification services were offered mostly with chromogenic medium, morphological characterization or automated identification systems, other than more advanced methods such as MALDI-TOF MS and DNA sequencing. Fungal serology testing was available in 81.1%, with G test being the most often used. Though 91.8% of the respondents had the ability to perform antifungal susceptibility testing for yeasts, less than 13% conducted such testing for molds. The percentage of laboratories participating in External Quality Assessment programs and research was 57.5% and 32.5%, respectively. The average score for the 348 surveyed hospitals was 37.2 (out of a maximum of 89 points), with only 15 hospitals scoring >60, suggesting a general lack of high-quality mycology laboratories. CONCLUSIONS: The overall clinical testing capacity for fungal infection in China is insufficient. More investment and training efforts are warranted to establish centers of excellence and promote access to high-quality diagnostic services.

5.
Medicine (Baltimore) ; 99(16): e19792, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311992

RESUMO

Mycoplasma pneumoniae (MP) is one of the most common pathogens of respiratory infection in children, while Epstein-Barr virus (EBV) infection is usually subclinical in immunocompetent children. Although single MP infection is common enough, MP and EBV coinfection have received little attention. Especially, the pathogenic role of EBV in lung when coinfection with MP, has not been clarified. The purpose of this study was to investigate the impact of EBV on MP pneumonia (MPP) in hospitalized children. We retrospectively reviewed the clinical data of MPP children who underwent screening for EBV by polymerase chain reaction in bronchoalveolar lavage fluid during hospitalization in 2014. Of total 147 patients, 68 patients were in the MP group and 79 were in the MP/EBV coinfection group. We found longer fever duration and higher CRP, IgA, IgG, interleukin-2 (IL-2), percentage of peripheral neutrophils levels, higher incidence of pulmonary consolidation and percentage of refractory MPP in coinfection group, when compared to those in MP group. In ROC curve analysis, IL-2 was useful for differentiating patients with coinfection from those with MP infection. Logistic regression analysis showed that the IL-2 ≥ 3.35 pg/ml (OR = 3.677) was a significant predictor regarding to MP/EBV coinfection. In conclusion, coinfection of EBV and MP poses a higher risk for prolonged symptoms. IL-2 could be used as a good predictor of coinfection.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Pneumonia por Mycoplasma/complicações , Criança , Pré-Escolar , Coinfecção , Citocinas/sangue , Infecções por Vírus Epstein-Barr/sangue , Infecções por Vírus Epstein-Barr/diagnóstico , Feminino , Humanos , Masculino , Pneumonia por Mycoplasma/sangue , Valor Preditivo dos Testes , Estudos Retrospectivos
6.
Artigo em Inglês | MEDLINE | ID: mdl-32306049

RESUMO

BACKGROUND: Durlobactam is a broad-spectrum inhibitor of class A, C and D ß-lactamases. Sulbactam is a generic ß-lactam most commonly used as a ß-lactamase inhibitor in combination with ampicillin; however, it has a unique property in that it has selective intrinsic activity against Acinetobacter baumannii. Currently, there is widespread resistance caused by multiple ß-lactamases including class A carbapenemases and class C and class D enzymes. The addition of durlobactam to sulbactam restores in vitro activity against MDR A. baumannii that possess multiple ß-lactamases. OBJECTIVES: Previously, susceptibility data for sulbactam/durlobactam were limited to isolates from patients in Western countries. This study was undertaken to determine the activity of sulbactam/durlobactam against A. baumannii isolated from patients in mainland China. METHODS: Nine hundred and eighty-two recent A. baumannii clinical isolates were collected from 22 sites across mainland China during 2016-18. The isolates were collected from lower respiratory tract, intra-abdominal, urinary tract and skin and skin structure infections. The in vitro activities of sulbactam/durlobactam and comparators were determined by broth microdilution. RESULTS: The addition of durlobactam restored the activity of sulbactam against the majority of the strains tested. The MIC90 of sulbactam/durlobactam was 2 mg/L for all A. baumannii, compared with 64 mg/L for sulbactam alone. The MIC90 of sulbactam/durlobactam of 2 mg/L remained unchanged for 831 carbapenem-resistant isolates. Colistin was the only comparator with comparable activity (MIC90 = 1 mg/L). CONCLUSIONS: This study demonstrated the potential utility of sulbactam/durlobactam for the treatment of infections caused by A. baumannii in China.

7.
Int J Antimicrob Agents ; : 105981, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32330584

RESUMO

Clostridium difficile infection (CDI) is the leading cause of antibiotic-associated diarrhea worldwide. In order to gain a better understanding about the molecular epidemiology of C. difficile in Beijing, China, we performed molecular typing, antimicrobial susceptibility test, and drug resistance gene sequencing on 174 C. difficile strains collected from four large tertiary hospitals in Beijing. A total of 31 sequence types (STs) were identified among the 174 strains, of which ST81 was found to be the most prevalent clone, accounting for 26.4% (46/174) of the isolates, followed by ST2 (16.7%, 29/174) and ST54 (9.8%, 17/174). All the isolates were susceptible to metronidazole and vancomycin. The test strains displayed resistance rates of 97.1%, 44.3%, and 44.3% for ciprofloxacin, levofloxacin, and moxifloxacin, respectively. The ST81 isolates displayed a drug resistance rate of 97.8% for the antibiotics levofloxacin and moxifloxacin, which was significantly higher than the rates of the ST2 (0%), ST54 (17.6%), and ST42 (0%) isolates (P<0.05). An amino acid mutation, T82I, was identified in GyrA and the total mutation rate of the C. difficile strains was 40.8% (71/174), while the mutation rate of the ST81 strains was 95.7% (44/46). Three amino acid mutations including D426N, S366A, and D426V were identified in GyrB and the total mutation rate of GyrB was 39.1%. The double-site mutation in GyrB, S366A+D426V was identified in all the ST81 (n=46) strains. In conclusion, the C. difficile ST81 clone showed high levels of fluoroquinolone resistance in Beijing, China, thus highlighting the need for nationwide surveillance of CDI.

8.
Emerg Microbes Infect ; 9(1): 924-927, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32286155

RESUMO

Confirmative diagnosis of SARS-CoV-2 infections has been challenged due to unsatisfactory positive rate of molecular assays. Here we identified a family cluster of SARS-CoV-2 infections, with five of six family members were SARS-CoV-2-specific immunoglobin serology testing positive, while molecular assays only detected two of this five patients even repeated twice. We comprehensively analyzed this familial cluster of cases based on the clinical characteristics, chest CT images, SARS-CoV-2 molecular detection results, and serology testing results. At last, two patients were diagnosed with COVID-19, two were suspected of COVID-19, and two were considered close contacts. Our results emphasized the significance of serology testing to assist timely diagnosis of SARS-CoV-2 infections, especially for COVID-19 close contacts screening.


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus , Família , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus/genética , Betacoronavirus/imunologia , China , Análise por Conglomerados , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/diagnóstico por imagem , Feminino , Humanos , Imunoglobulinas/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico por imagem , Reação em Cadeia da Polimerase/normas , Testes Sorológicos/normas , Fatores de Tempo , Tomografia Computadorizada por Raios X
9.
Artigo em Inglês | MEDLINE | ID: mdl-32247662

RESUMO

BACKGROUND: We describe antibiotic resistance trends of Klebsiella pneumoniae pathogens, responsible for urinary tract infections (UTIs) and intra-abdominal infections (IAIs), isolated from different organs and tissues, hospital departments and Chinese regions between 2014 and 2017. METHODS: Resistances of UTIs and IAIs derived K. pneumoniae isolates from 17 hospitals in 7 Chinese regions to amikacin, imipenem, piperacillin-tazobactam, ertapenem, and cefepime were unequivocally established. RESULTS: Overall resistance rates of K. pneumoniae IAI isolates obtained from gallbladder and abscesses increased to amikacin (14.29-30.95%) and for liver, gallbladder, and abscesses to imipenem (14.29-38.10%), piperacillin-tazobactam (23.81-38.10%), and ertapenem (23.81-38.10%) in 2017, but were constant (20-30%) for K. pneumoniae isolates from UTIs from 2014 to 2017. In medical and surgical ICUs, resistance rates to all tested antibiotics rose to ∼60% for IAIs, which was also reflected in higher resistance rates of hospital acquired (HA) compared to community acquired (CA) infections. In medical ICUs resistance rates increased to 50-60% for amikacin, imipenem, and ertapenem for UTI-derived K. pneumoniae isolates in 2017. Resistance rates to all tested antibiotics were highest in the east Jiangzhe region of China, being ∼60% for K. pneumoniae isolates from IAIs and 40% for K. pneumoniae isolates from UTIs to ertapenem and imipenem, as well as > 40% for piperacillin-tazobactam in 2017. CONCLUSION: In China, ICUs resistance rates to K. pneumoniae IAIs and UTIs isolates was increased in 2017 for all tested antimicrobials including carbapenems, which makes them no longer suitable for empiric treatment. In the east Jiangzhe region this was a general trend that was independent of the type of hospital department.

10.
Clin Infect Dis ; 2020 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-32198501

RESUMO

BACKGROUND: Emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. Current method of detection involves qPCR-based technique, which identifies the viral nucleic acids when present in sufficient quantity. False negative results can be achieved and failure to quarantine the infected patient would be a major setback in containing the viral transmission. We here aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19. METHODS: The host humoral response against SARS-CoV-2 including IgA, IgM and IgG response were examined by using an ELISA based assay on the recombinant viral nucleocapsid protein. Total 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but had typical manifestation). The diagnostic value of IgM was evaluated in this cohort. RESULTS: The median duration of IgM and IgA antibody detection were 5 days (IQR 3-6), while IgG was detected on 14 days (IQR 10-18) after symptom onset, with a positive rate of 85.4%, 92.7% and 77.9% respectively. In confirmed and probable cases, the positive rates of IgM antibodies were 75.6% and 93.1%, respectively. The detection efficiency by IgM ELISA is higher than that of qPCR method after 5.5 days of symptom onset. The positive detection rate is significantly increased (98.6%) when combined IgM ELISA assay with PCR for each patient compare with a single qPCR test (51.9%). CONCLUSIONS: Humoral response to SARS-CoV-2 can aid to the diagnosis of COVID-19, including subclinical cases.

11.
Int J Oncol ; 56(3): 807-820, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32124947

RESUMO

Previous studies have demonstrated that long non­coding RNAs (lncRNAs) are involved in breast cancer development, progression and metastasis. However, the association between lncRNAs and breast cancer stem cells (BCSCs) has been poorly explored. To address this issue, microarray analyses were performed to detect the lncRNA profile of BCSCs. In addition, bioinformatics analyses, including Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes pathway analyses, were performed to explore the functional roles of lncRNAs in BCSCs. Lastly, loss of function assays were used to explore the potential function of lncRNA CUE domain containing 1 (lncCUEDC1). A total of 142 differentially expressed lncRNAs were identified. Among these, 25 were downregulated and 117 were upregulated in BCSCs compared with in non­BCSCs. In addition, the present study revealed that the lncRNAs were largely associated with stemness­related signaling pathways. Furthermore, it was demonstrated that lncCUEDC1 negatively regulated the phenotype and biological functions of BCSCs in vitro. Mechanistically, lncCUEDC1 could bind NANOG to inhibit the stemness. To the best of our knowledge, the present study was the first to established the lncRNA profile of BCSCs. These findings provided evidence for exploring the functions of lncRNAs in BCSCs and indicated that lncCUEDC1 is a prospective target in BCSCs.

12.
J Infect Dis ; 221(Supplement_2): S139-S147, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32176789

RESUMO

BACKGROUND: Candidemia is the most common, serious fungal infection and Candida antifungal resistance is a challenge. We report recent surveillance of candidemia in China. METHODS: The study encompassed 77 Chinese hospitals over 3 years. Identification of Candida species was by mass spectrometry and DNA sequencing. Antifungal susceptibility was determined using the Clinical and Laboratory Standards Institute broth microdilution method. RESULTS: In total, 4010 isolates were collected from candidemia patients. Although C. albicans was the most common species, non-albicans Candida species accounted for over two-thirds of isolates, predominated C. parapsilosis complex (27.1%), C. tropicalis (18.7%), and C. glabrata complex (12.0%). Most C. albicans and C. parapsilosis complex isolates were susceptible to all antifungal agents (resistance rate <5%). However, there was a decrease in voriconazole susceptibility to C. glabrata sensu stricto over the 3 years and fluconazole resistance rate in C. tropicalis tripled. Amongst less common Candida species, over one-third of C. pelliculosa isolates were coresistant to fluconazole and 5-flucytocine, and >56% of C. haemulonii isolates were multidrug resistance. CONCLUSIONS: Non-albicans Candida species are the predominant cause of candidemia in China. Azole resistance is notable amongst C. tropicalis and C. glabrata. Coresistance and multidrug resistance has emerged in less common Candida species.

13.
Emerg Microbes Infect ; 9(1): 320-331, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32037975

RESUMO

Background: Multidrug-resistant bacteria, especially those with high virulence, are an emerging problem in clinical settings.Methods: We conducted a multicentre epidemiological and comparative genomic analysis on the evolution, virulence and antimicrobial resistance of carbapenem-resistant Enterobacteriaceae in patients with bacterial liver abscesses from 2012 to 2016.Results: A total of 477 bacterial isolates were collected. Enterobacteriaceae were the main pathogen (89.3%) with K. pneumoniae (52.4%) predominating followed by Escherichia coli (26.8%). All CRKps (3.2%) were of sequence type (ST) 11 and serotypes K47 or K64, and simultaneously possessed acquired blaKPC-2/blaKPC-5 and blaCTX-M-65 together with the multidrug transporter EmrE. Seven Hv-CRKps (five ST11-K47, two ST11-K64) were confirmed by bacteriological test, neutrophil killing assay and Galleria mellonella infection model. Genomic analysis indicated that the emergence of one ST11-K64 Hv-CRKp strain was related to the acquisition of rmpA/rmpA2 genes and siderophore gene clusters, while ST11-K47 Hv-CRKp lacked these traditional virulence genes. Further complete genome analysis of one ST11-K47 Hv-CRKp strain, R16, showed that it acquired a rare plasmid (pR16-Hv-CRKp1) carrying blaKPC-2, blaSHV-12, blaTEM-1, blaCTX-M-65, rmtB and a predicted virulence gene R16_5486 simultaneously.Conclusion: The emergence of the ST11-K47/K64 Hv-CRKps, which are simultaneously multidrug-resistant and hypervirulent, requires urgent control measures to be implemented.


Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos/isolamento & purificação , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/isolamento & purificação , Abscesso Hepático/microbiologia , Idoso , Técnicas de Tipagem Bacteriana , Enterobacteriáceas Resistentes a Carbapenêmicos/classificação , China , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Klebsiella pneumoniae/classificação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , Plasmídeos/genética , Sorogrupo , Virulência
14.
Thorac Cancer ; 11(3): 805-809, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31970940

RESUMO

Immune checkpoint inhibitors (ICIs) have been widely used in the management of malignant tumors. Programmed death 1 (PD-1)/PD-1 ligand (PD-L1) inhibitors have been introduced to treat non-small cell lung cancer (NSCLC) in recent years. Currently, PD-1/PD-L1 inhibitors are considered to have minor side effects and do not independently increase the risk of infection. However, they may cause immune-related adverse events (irAEs) that require immunosuppressive therapy with corticosteroids and/or immunosuppressants, leading to opportunistic infections. Furthermore, there have been reports describing reactivation of chronic/latent infections without irAEs or having received immunosuppressants. Thus, immune checkpoint inhibitor related infections have received more attention worldwide. In this paper, we review available clinical data, describe the potential mechanism, and propose recommendations for the diagnosis and clinical management of PD-1/PD-L1 inhibitor-related infections.

15.
Int Immunopharmacol ; 80: 106211, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31972424

RESUMO

Melanoma is amongst the most aggressive malignant tumors. The purpose of this study is to detect the tumor microenvironment systematically using multi-omics analyses and to propose strategies for precision medicine. Multiple factors of tumor microenvironment contribute to the drug resistance and immune surveillance failure. Here we analyzed genome mutations and characterized the immune state of tumor microenvironments in mouse melanoma by whole exome sequencing (WES) and RNA sequencing (RNA-Seq) approaches. Somatic mutation analysis revealed 35.1% novel mutations in mouse tumors when compared with B16F10 cell line, provided a basis for multi-site sequencing for accurate neoantigen selection. Mutation cluster, gene expression comparison, and gene ontology (GO) analyses by R packages proved DNA repair damage, inflammation, slower cell division, and metabolic change in tumor microenvironment. Further analyses of T-cell receptor (TCR) sequences, immune signaling pathway activation, tumor infiltrated immune cells and chemokine expression revealed extensive difference of antitumor immune response among individuals. Our study revealed the characteristics of tumor microenvironment with mouse melanoma model, suggested the need of comprehensive genome mutations and personal immune state analyses for cancer precision medicine.

16.
Int J Med Microbiol ; 310(1): 151357, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31570247

RESUMO

Understanding the evolutionary path of M. catarrhalis from macrolide-susceptible to macrolide-resistant organism, is important for hindering macrolide resistance from propagation. Multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) and whole genome SNP typing (WGST), as useful and practical typing tools, have both advantages and disadvantages. We studied the utility of these 3 typing methods, including the level of agreement, consistency and drawbacks, in characterizing M. catarrhalis clones and clonal complexes. We focused on four clonal complexes [CC224, CC363, CC449 (CCN10) and CC446 (CCN08)] and found that PFGE and WGST had a high level of agreement and a proper consistency of the same clone or very closely related clones, while MLST is less discriminatory for different clones. Furthermore, we also established an evolutionary distance cut-off value for "The same clone". Moreover, we detected macrolide-resistant M. catarrhalis in CC224, which had previously been considered as a macrolide-susceptible clonal complex. A higher number of isolates belonged to ST215 compared to ST446, implying that ST215 is more likely to be the primary founder. Our study also demonstrated that all the four clonal complexes belong to the M. catarrhalis lineage 1, which is considered to be related to increased virulence potential and serum resistance. We also observed that copB II was highly related to CC449 and LOS type B was mainly confined in CC224. In conclusion, these findings provide further insight into the evolutionary characteristics of M. catarrhalis.

17.
Cancer Chemother Pharmacol ; 85(1): 3-7, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31377831

RESUMO

BACKGROUND: In clinical practice, chemotherapy-induced interstitial pneumonitis (CIIP) is rare, but it has a high mortality. It has been reported that pegylated liposomal doxorubicin (PLD) may induce interstitial pneumonitis in some cases. However, the relationship between PLD and CIIP in breast cancer is still unknown. This study aims to investigate the incidence of PLD-induced interstitial pneumonitis in breast cancer patients. METHODS: All cases of breast cancer with chemotherapy are collected in our hospital from January 2016 to October 2018, and 354 eligible patients were included in analysis. Patients were divided into two groups according to different chemotherapy regimens received: epirubicin plus cyclophosphamide with or without docetaxel (EC/EC-T group) and PLD plus cyclophosphamide with or without docetaxel (DC/DC-T group). Patients' general information and clinical characteristics, as well as the incidence of interstitial pneumonitis were compared between the two groups. RESULTS: The symptomatic interstitial pneumonitis occurred in 12 patients who received DC/DC-T treatment with an incidence of 12.25% (12/98), while no interstitial pneumonitis occurred in EC/EC-T group (p < 0.001). Of the 12 patients, 4 patients developed interstitial pneumonitis after 3 cycles of chemotherapy,7 patients after 4 cycles and 1 patient after 5 cycles. The mean interval between the beginning of chemotherapy and the onset of CIIP was 3.75 cycles. CONCLUSION: Clinicians should pay attention to CIIP in breast cancer patients who receive more than three cycles of chemotherapy regimens containing pegylated liposomal doxorubicin plus cyclophosphamide with or without docetaxel.

18.
J Microbiol Immunol Infect ; 53(1): 125-132, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29844003

RESUMO

BACKGROUND: To investigate the in vitro antifungal susceptibilities of 25 genetically confirmed Aspergillus species collected from Taiwan and Mainland China. METHODS: A total of 390 non-duplicate and consecutive Aspergillus isolates representing of 25 species recovered from clinical sources at two teaching hospitals in Taiwan and Mainland china were preserved for this study. In vitro antifungal susceptibility testing (AFST) of those Aspergillus isolates against seven antifungal agents was performed using Sensititre YeastOne (SYO) system. The susceptibility profiles of isolates were analyzed according to the general interpretation code drawn from the SYO instruction. The CYP51A gene sequencing analysis was performed for triazole-resistant Aspergillusfumigatus isolates. RESULTS: Among the 390 Aspergillus isolates, 76.7% (n = 299) exhibited complete susceptibility to all the tested antifungals, and 23.3% (91/390) of different Aspergillus species isolates showed resistance to one or two classes of antifungal agents with higher minimum inhibitory concentrations (MICs) of >2 mg/L. Resistance to amphotericin B was found in 91.2% (83/91) of those less susceptible isolates and most of them focused on species being resistant to Amphotericin B innately. The total rate of triazole resistance in this study was low (3.3%, 13/390), and only 3 (2.8%) A. fumigatus isolates were resistant to at least one of the triazoles with mutations of TR34/L98H or TR46/Y121F/T289A in CYP51A gene. The echinocandins were highly potent to the tested Aspergillus isolates. CONCLUSION: The existence of triazole resistance among A. fumigatus isolates in Taiwan and Mainland China indicates the need for continuous monitoring from now on.

19.
Infect Drug Resist ; 12: 3641-3651, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31819547

RESUMO

Introduction: As participants of the national China Hospital Invasive Fungal Surveillance Net program, we sought to describe the epidemiology and antifungal susceptibility patterns of yeast isolates obtained from patients with invasive fungal infection at the First Affiliated Hospital of Zhengzhou University, China. Methods: A total of 434 yeast isolates recovered from blood and other sterile body fluids were identified to species by matrix-assisted laser desorption ionization -time of flight mass spectrometry with or without supplementation by DNA sequencing. Antifungal susceptibilities were determined by Sensititre YeastOneTM YO10 methodology. Results: Candida albicans was the most common causative species (33.9% of isolates) but significantly decreased in frequency from 37.2% to 27.7% from 2012 to 2014. C. tropicalis was the next most common pathogen (25.1%), followed by C. parapsilosis complex (17.3%), C. glabrata (9%), and C. pelliculosa (6.7%), with other species comprising 8% of isolates. Caspofungin, micafungin, and anidulafungin exhibited potent in vitro activities against the majority of Candida isolates. Azoles demonstrated in vitro activities against C. albicans with a susceptibility rate of >95% and against C. parapsilosis complex, >95% isolates were susceptible. Among C. tropicalis and C. glabrata isolates, resistance rates to fluconazole and voriconazole were 11.9%, 9.1% and 7.7%, 28.2%, respectively. Of note, C. pelliculosa had a high incidence rate in newborns and high rates of resistance to fluconazole and voriconazole of 55.2% and 41.4%, respectively. Conclusion: The present study provided valuable local surveillance data on the epidemiology and antifungal susceptibilities of invasive yeast species, which is essential for guiding antifungal treatment protocol development.

20.
Medicine (Baltimore) ; 98(52): e18464, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876729

RESUMO

Enterovirus 71 (EV71) is an important etiological agent of hand, foot, and mouth disease (HFMD), which can also lead to severe neurological complications (eg, encephalitis) in young children. Although a series of reports on EV71 infection have been published, the pathogenic mechanism of EV71 infection is still not fully understood.We evaluated the cerebrospinal fluid (CSF) levels of the inflammatory cytokines interleukin (IL)-8, IL-1ß, IL-6, IL-10, tumor necrosis factor (TNF)-α, and IL-12p70 in 88 children with EV71-related encephalitis and 19 children with febrile convulsion (FC) with the use of commercial cytometric bead array kits.The levels of IL-8, IL-1ß, IL-6, and IL-10 in CSF were significantly higher in encephalitis group when compared with those observed in FC group, while no significant changes were noted in the levels of TNF-α and IL-12p70. In addition, significant and positive correlations among CSF IL-8, IL-1ß, IL-6, and IL-10 were observed in encephalitis group. Furthermore, receiver operator characteristic analysis determined a cut-off value of 10.62 pg/mL for IL-6 to discriminate encephalitis patients from FCs with the sensitivity and specificity of 89.8% and 84.2%, respectively. Moreover, logistic regression analyses revealed that IL-6 was an independent predictor of EV71-related encephalitis (odds ratio = 23.241, P < .001).Our results indicate that 4 inflammatory cytokines (IL-8, IL-1ß, IL-6, and IL-10) play important roles in the pathogenesis of EV71 infection. IL-6 may be used for the evaluation of EV71-related encephalitis and as a potential therapy candidate for EV71 infection.


Assuntos
Citocinas/líquido cefalorraquidiano , Encefalite Viral/líquido cefalorraquidiano , Enterovirus Humano A , Doença de Mão, Pé e Boca/líquido cefalorraquidiano , Pré-Escolar , China/epidemiologia , Encefalite Viral/virologia , Feminino , Doença de Mão, Pé e Boca/virologia , Humanos , Lactente , Interleucina-10/líquido cefalorraquidiano , Interleucina-12/líquido cefalorraquidiano , Interleucina-1beta/líquido cefalorraquidiano , Interleucina-6/líquido cefalorraquidiano , Interleucina-8/líquido cefalorraquidiano , Masculino , Fator de Necrose Tumoral alfa/líquido cefalorraquidiano
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