Association Between Gut Bacterial Diversity and Mortality in Septic Shock Patients: A Cohort Study.

BACKGROUND Gut bacterial diversity is decreased in a proportion of patients with septic shock. We attempted to validate the hypothesis that low bacterial diversity increases the risk of mortality. MATERIAL AND METHODS All patients with septic shock seen at 2 medical center from 2016 through 2019 were included in this cohort study. Total DNA was isolated from stool, and high-throughput sequencing was performed. Clinical data were extracted from patient medical records and hospital databases. Patients were grouped by gut microbiota bacterial diversity (measured by Shannon diversity index) on presentation. We used logistic regression analysis to evaluate the risk of 28-day mortality in septic patients with low Shannon diversity index. RESULTS Of the 150 patients enrolled in this study, low bacterial diversity (Shannon index <3.0) was found in 80 patients and normal diversity (Shannon index ≥3.0) was found in 70 patients. Low diversity was associated with a higher unadjusted mortality risk, compared to those with normal diversity (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.35-2.83). However, this result became non-significant after adjusting the confounding factors such as age, sex, severity of disease, comorbid status, usage of probiotics, enteral nutrition, and antimicrobial drugs (OR 1.93, 95% CI 0.55-2.69). CONCLUSIONS Our study does not support that low gut bacterial diversity is an independent risk factor for mortality in intensive care unit patients with septic shock.

Prenatal Exposure to LPS Alters The Intrarenal RAS in Offspring, Which Is Ameliorated by Adipose Tissue-Derived Mesenchymal Stem Cells.

BACKGROUND: Prenatal lipopolysaccharide (LPS) exposure causes hypertension in rat offspring through an unknown mechanism. Here, we investigated the role of the intrarenal renin-angiotensin system (RAS) in hypertension induced by prenatal LPS exposure and also explored whether adipose tissue-derived mesenchymal stem cells (ADSCs) can ameliorate the effects of prenatal LPS exposure in rat offspring. METHODS: Sixty-four pregnant rats were randomly divided into 4 groups (n = 16 in each), namely, a control group and an LPS group, which were intraperitoneally injected with vehicle and 0.79 mg/kg LPS, respectively, on the 8th, 10th, and 12th days of gestation; an ADSCs group, which was intravenously injected with 1.8 × 107 ADSCs on the 8th, 10th, and 12th days of gestation; and an LPS + ADSCs group, which received a combination of the treatments administered to the LPS and ADSCs groups. RESULTS: Prenatal LPS exposure increased blood pressure, Ang II expression, Ang II-positive, monocyte and lymphocyte, apoptotic cells in the kidney, and induced renal histological changes in offspring; however, the LPS and control groups did not differ significantly with respect to plasma renin activity levels, Ang II levels, or renal function. ADSCs treatment attenuated the blood pressure and also ameliorated the other effects of LPS-treated adult offspring. CONCLUSIONS: Prenatal exposure to LPS activates the intrarenal RAS but not the circulating RAS and thus induces increases in blood pressure in adult offspring; however, ADSCs treatment attenuates the blood pressure increases resulting from LPS exposure and also ameliorates the other phenotypic changes induced by LPS treatment by inhibiting intrarenal RAS activation.

Evaluation of the human-baited double net trap and BG trap as an alternative to human landing catches for collecting outdoor Aedes albopictus in China

Objective: Monitoring the density of Aedes(Ae.) albopictus was very important in evaluating the efficiency of vector management, especially when Aedes-borne diseases break, like Dengue fever, Chikungunya fever and Zika. Human landing catch (HLC) is regarded as the “gold standard” for Aedes monitoring, but it is unsafe and unethical since it potentially expose field professionals to a series of pathogens. In this study, we compared HLC with human-baited double net (HDN) and BG trap for field Aedes albopictus monitoring.The study aims to find an effective and safe alternative method to HLC in monitoring Ae. albopictus, especially in emergency monitoring. Methods: Latin square design was used, and three sites in Hangzhou city, Zhejiang province, China, were chosen to conduct outdoor HLC, HDN and BG trap catches in June. The tests were performed at three periods: a morning period (8:30-10:00), an afternoon period (15:00-16:30), and an evening period (16:30-18:00). Then a table with 81 elements was made to compare the efficiency of these three methods. Results: A total of 80, 138 and 78 adult Ae. albopitus was captured by HDN, BG trap and HLC, respectively. Among these three catches, BG trap showed the best efficacy in captured Ae. albopitus adults. The mosquitoes caught by HLC and BG trap were nearly the same at all three time series, but the density of mosquitoes caught by HDN at 16:30-18:00 was 2 times the density at 8:30-10:00 (4.44 vs 2.22 per hour). In this study, significant positive correlation between HLC and BG trap of Aedes albopitus female density was found (r=0.921, P<0.001). However, no statistical significant correlation between HLC and HDN, BG trap and HDN of Ae. albopitus female density was found (r=-0.46, P=0.820; r=0.019, P=0.923, respectively). Besides, the human-bait attraction bias of HLC catches might be more apparent than BG trap and HDN catches. Conclusions: According to our study, with high efficiency, less human-bait attraction bias, and significantly positive correlation with HLC in catching Ae. albopitus females, BG trap could be a sensitive and safer alternative to HLC for outdoor Ae. albopitus monitoring. It also showed strong potential in emergency monitoring when Aedesborne diseases break.

An analysis on the reasons for the delay in discovering dengue fever outbreak in Zhejiang Province / 预防医学

Objective To learn the timeliness and reasons for the delay in discovering outbreaks via a dengue fever outbreak in Zhejiang Province,and try to improve our disease monitoring system.Methods Epidemic and clinic data were collected by searching cases and epidemiological investigation,and clinic behavior of cases in dengue fever outbreak were described,then the risk factors involved in the delay in discovering outbreak were analyzed.Results Totally 46 cases were found in this outbreak,among which 36 (78.28％) cases were infected before.The onset date of the first case we found was on July 15 th,57 day before the outbreak confirmation.According to the results,95.65％ of cases see a doctor after their sickness,and the rate of three day hospital visiting was 93.36％ (42/46),among which the rate of three day hospital visiting before pathogen confirmation was 91.67％ (33/36),and there was no statistic significance in diagnostic rate before and after pathogen confirmation(P =1.00).Conclusion Cases in this dengue outbreak presented high and timely outpatient rate.Thus,the delay confirmation of dengue fever outbreak was caused by the low sensitivity of doctors in all levels of hospital.More training on dengue fever diagnosis for doctors should be carried out in the future to control and prevent dengue fever more efficiently.