Risk Factors and Predictive Nomogram for Carbapenem-Resistant Klebsiella pneumoniae in Children in a Grade 3 First-Class General Hospital in Central China.

Background: This study determined risk factors for Carbapenem-resistant Klebsiella pneumoniae (CRKP)in children admitted to a grade 3 first-class general hospital and developed an individualized line graph predictive model. Methods: The clinical data of 185 children infected with Klebsiella pneumoniae from January 2015 to December 2019 were analyzed retrospectively. Patients were grouped according to carbapenem resistance: CRKP group (50 cases) and CSKP (carbapenem-sensitive Klebsiella pneumoniae) group (135 cases). Risk factors for CRKP in children were screened by logistic regression analysis. The predictive model was established using R software and validated using the Bootstrap method. Results: Age (odds ratio [OR]=0.104, 95% confidence interval [CI]: 0.026-0.408), intensive care unit admission (OR =2.829, 95% CI: 1.138-7.030), mechanical ventilation (OR =7.510, 95% CI: 3.140-17.961), surgery history (OR =5.005, 95% CI: 1.507-16.618) and glucocorticoid (OR =0.235, 95% CI: 0.099-0.557) were independent risk factors for CRKP in children (P < 0.05), The total risk score of each factor was 362.5, and the risk rate was 0.1-0.9. In receiver-operating characteristic curve analysis, the area under the curve of CRKP predicted by the total risk score was 0.872 (95% CI=0.844-0.901; P < 0.001). The correction curve indicated that the consistency between the observed value and the predicted value was good. Discussion and Conclusion: This study successfully established a model based on the risk factors, with high accuracy and good predictive value for CRKP in children. Hospitals should take necessary preventive measures against the risk factors for drug-resistant bacteria, such as optimizing the configuration of ICU space, timely isolation of infected children, and adequate disinfection of ICU equipment. Which may reduce CRKP infection rate.

Fabrication of Antimicrobial Multilayered Nanofibrous Scaffolds-Loaded Drug via Electrospinning for Biomedical Application.

Nanofibers prepared by biobased materials are widely used in the field of biomedicine, owing to outstanding biocompatibility, biodegradable characters, and excellent mechanical behavior. Herein, we fabricated multilayered nanofibrous scaffolds in order to improve the performance of drug delivery. The composite layer-by-layer scaffolds were incorporated by hydrophobic poly(l-lactic acid) (PLA): polycaprolactone (PCL) and hydrophilic poly(vinyl alcohol) (PVA) nanofibers via multilayer electrospinning. Morphological and structural characteristics of the developed scaffolds measured by scanning electron microscopy (SEM), and transmission electron microscopy (TEM) confirmed smooth and uniform fibers ranging in nanometer scale. The differences in contact angles and Fourier transform infrared spectrum (FTIR) between single-layered PVA nanofibers and multilayered scaffolds verified the existence of PLA: PCL surface. In vitro biodegradable and drug release analysis depicted multilayered scaffolds had good biodegradability and potential for medical application. Due to the model drug incorporation, scaffolds exhibited good antibacterial activity against Escherichia coli and Staphylococcus aureus by the zone of inhibition test. These results revealed that the multilayered scaffolds were proved to be desirable antibacterial materials for biomedical application.

LncRNA EPIC1 promotes tumor angiogenesis via activating the Ang2/Tie2 axis in non-small cell lung cancer.

AIMS: Non-small cell lung cancer (NSCLC) is considered a highly fatal tumor. Importantly, angiogenesis is critical for tumor progression. Long non-coding RNAs (lncRNAs), which are untranslatable, control cell functions through different pathways. lncRNA EPIC1 has been reported to promote cell viability, cell cycle progression, and invasion. However, the relationship between EPIC1 and tumor angiogenesis remains an enigma. We explored the role of EPIC1 in tumor angiogenesis in NSCLC. MATERIALS AND METHODS: First, EPIC1 expression was analyzed using the GEPIA database and was further verified using qPCR in tumor tissues from patients with NSCLC and NSCLC cell lines. Next, EPIC1 function was detected using loss-of-function and gain-of-function assays. Moreover, EdU staining, flow cytometry, and channel formation assays were performed to assess HUVEC proliferation and channel the formation in the NSCLC-HUVEC transwell co-culture system. KEY FINDINGS: EPIC1 expression was significantly upregulated in NSCLC tissues and cell lines. Furthermore, the overexpression of EPIC1 in NSCLC cells stimulated HUVEC channel formation and proliferation by activating Ang2/Tie2 signaling, and the opposite results were obtained when EPIC1 was silenced in NSCLC cells. The density of new blood vessels was simultaneously increased by EPIC1 overexpression in vivo, using CAM angiogenesis model and a nude mouse tumor model. Finally, all these experimental findings could be established in the samples from patients with NSCLC. We postulate that EPIC1 promotes tumor angiogenesis by activating the Ang2/Tie2 axis in NSCLC. SIGNIFICANCE: Elucidating the molecular and cellular mechanisms of EPIC1 in tumor angiogenesis provides a novel perspective on NSCLC clinical therapy.

The Value of Combination Analysis of Tumor Biomarkers for Early Differentiating Diagnosis of Lung Cancer and Pulmonary Tuberculosis.

OBJECTIVE: Distinguishing early lung cancer from pulmonary tuberculosis is difficult. Biomarkers have been applied to tumor diagnoses widely. However, the ability for tumor biomarkers to uniquely identify either lung cancer or pulmonary tuberculosis remains controversial. METHODS: The retrospective analysis of patients hospitalized with suspected pathological tissue mass in their thoracic cage, found via imaging, was conducted. The levels of tumor biomarkers CEA, NSE, CYFRA21-1, Pro-GRP, and SCC-Ag were measured and compared in patients with defined lung cancer (N=235) and pulmonary tuberculosis (N=224), respectively. RESULTS: In the study, Serum CEA, NSE, CYFRA21-1, Pro-GRP, and SCC-Ag levels were significantly higher in the lung cancer group than in the pulmonary tuberculosis group (P<0.001). The combined detection of CEA, CYFRA21-1, and NSE was used to diagnose lung cancer with a specificity of 89.9%, and a sensitivity of 94.9%. The detection's accuracy was higher (AUC=0.972) than five tumor biomarkers alone or combined. CONCLUSION: The combination of CEA, CYFRA21-1, and NSE possesses better values for identifying lung cancer patients who are at a high risk of being misdiagnosed for pulmonary tuberculosis.

Real-time measurements of airborne biologic particles using fluorescent particle counter to evaluate microbial contamination: results of a comparative study in an operating theater.

BACKGROUND: Airborne bacterial contamination poses a risk for surgical site infection, and routine surveillance of airborne bacteria is important. Traditional methods for detecting airborne bacteria are time consuming and strenuous. Measurement of biologic particle concentrations using a fluorescent particle counter is a novel method for evaluating air quality. The current study was to determine whether the number of biologic particles detected by the fluorescent particle counter can be used to indicate airborne bacterial counts in operating rooms. METHODS: The study was performed in an operating theater at a university hospital in Hefei, China. The number of airborne biologic particles every minute was quantified using a fluorescent particle counter. Microbiologic air sampling was performed every 30 minutes using an Andersen air sampler (Pusong Electronic Instruments, Changzhou, China). Correlations between the 2 different methods were analyzed by Pearson correlation coefficients. RESULTS: A significant correlation was observed between biologic particle and bacterial counts (Pearson correlation coefficient = 0.76), and the counting results from 2 methods both increased substantially between operations, corresponding with human movements in the operating room. CONCLUSION: Fluorescent particle counters show potential as important tools for monitoring bacterial contamination in operating theatres.

Outbreak of carbapenemase-producing Klebsiella pneumoniae neurosurgical site infections associated with a contaminated shaving razor used for preoperative scalp shaving.

Between July 5 and 21, 2011, an outbreak of neurosurgical site infections with carbapenemase-producing Klebsiella pneumonia occurred in a tertiary care hospital. The outbreak affected 7 patients. The subsequent investigation revealed that a barber's contaminated shaving razor may have caused the carbapenemase-producing Klebsiella pneumonia outbreak. Standardized skin preparation performed by registered nurses using sterilized instruments should be emphasized.