Pub Date : 2019-04-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.04.004
Lu Gao
Objective To investigate the pathogenic spectrum and epidemiological characteristics of acute diarrhea patients in Tianjin. Methods A total of 1 536 stool samples of diarrhea patients were collected from hospitals between 2015 and 2017. Viral nucleic acids were detected by real-time polymerase chain reaction. Selective medium was used to culture bacteria. Drug susceptibility tests were performed by Kirby-Bauer disk diffusion method recommended by the Association for Standardization of Clinical Laboratories. χ2 test was used for statistical analysis. Results In the stool samples of 1 536 cases of diarrhea, one enteric bacterium was detected in 109 samples with the positive rate of 7.10%, one enterovirus was detected in 171 samples with the positive rate of 11.13%, mixed infection was detected in 20 samples with positive rate of 1.30%, including 8 samples with enteric bacterium and enterovirus and 12 samples with double enterovirus. The total detection rate of diarrhea cases was 19.53%. Norovirus, vibrio parahaemolyticus, rotavirus, Salmonella, stellate virus and sapovirus ranked the top six in the detection rate. The total detection rate curve of bacteria showed a single peak, mainly in August, while the total detection rate curve of the virus showed a double peak, which was from May to June and from November to December. The positive rate of bacteria in patients aged over 30 years old was 9.82% (75/764), while that in those aged less than 30 years old was 5.44% (42/772). The difference was statistically significant (χ2=10.451, P<0.01). The positive rate of viral pathogen in patients aged no less than 25 years old was 10.02% (91/908), while that in those aged less than 25 years old was 17.83% (112/628). The difference was statistically significant (χ2=19.755, P<0.01). Salmonella, Shigella and vibrio parahaemolyticus were resistant to ampicillin in varying degrees. Conclusions The positive rate curves of bacteria and virus are obviously different, showing a trend of "bacterial single peak and viral double peak" . Bacteria mainly infect people aged over 30 years old, while the virus mainly infects people under 25 years old. The main pathogens of diarrhea are norovirus, vibrio parahaemolyticus and rotavirus. Key words: Diarrhea; Population surveillance; Pathogen spectrum
{"title":"Pathogenic spectrum and epidemiological characteristics of diarrhea patients in Tianjin during 2015-2017","authors":"Lu Gao","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.04.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.04.004","url":null,"abstract":"Objective \u0000To investigate the pathogenic spectrum and epidemiological characteristics of acute diarrhea patients in Tianjin. \u0000 \u0000 \u0000Methods \u0000A total of 1 536 stool samples of diarrhea patients were collected from hospitals between 2015 and 2017. Viral nucleic acids were detected by real-time polymerase chain reaction. Selective medium was used to culture bacteria. Drug susceptibility tests were performed by Kirby-Bauer disk diffusion method recommended by the Association for Standardization of Clinical Laboratories. χ2 test was used for statistical analysis. \u0000 \u0000 \u0000Results \u0000In the stool samples of 1 536 cases of diarrhea, one enteric bacterium was detected in 109 samples with the positive rate of 7.10%, one enterovirus was detected in 171 samples with the positive rate of 11.13%, mixed infection was detected in 20 samples with positive rate of 1.30%, including 8 samples with enteric bacterium and enterovirus and 12 samples with double enterovirus. The total detection rate of diarrhea cases was 19.53%. Norovirus, vibrio parahaemolyticus, rotavirus, Salmonella, stellate virus and sapovirus ranked the top six in the detection rate. The total detection rate curve of bacteria showed a single peak, mainly in August, while the total detection rate curve of the virus showed a double peak, which was from May to June and from November to December. The positive rate of bacteria in patients aged over 30 years old was 9.82% (75/764), while that in those aged less than 30 years old was 5.44% (42/772). The difference was statistically significant (χ2=10.451, P<0.01). The positive rate of viral pathogen in patients aged no less than 25 years old was 10.02% (91/908), while that in those aged less than 25 years old was 17.83% (112/628). The difference was statistically significant (χ2=19.755, P<0.01). Salmonella, Shigella and vibrio parahaemolyticus were resistant to ampicillin in varying degrees. \u0000 \u0000 \u0000Conclusions \u0000The positive rate curves of bacteria and virus are obviously different, showing a trend of \"bacterial single peak and viral double peak\" . Bacteria mainly infect people aged over 30 years old, while the virus mainly infects people under 25 years old. The main pathogens of diarrhea are norovirus, vibrio parahaemolyticus and rotavirus. \u0000 \u0000 \u0000Key words: \u0000Diarrhea; Population surveillance; Pathogen spectrum","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"209-213"},"PeriodicalIF":0.0,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44002163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.04.005
Yibin Gu, Yang Li, Liping Zhu, L. Du, Qi Zhao, Biao Xu
Objective To analyze the factors associated with syphilis treatment compliance and adverse pregnant outcomes among pregnant women with syphilis in Shanghai. Methods The prospective cohort was established based on maternal syphilis monitoring system of Shanghai, which included all the pregnant women diagnosed with syphilis during Jan 2013 to Dec 2015. A total of 1 717 pregnant women with syphilis were recruited at the baseline, and 1 147 of them were followed up during treatment and their pregnancy, and the delivery outcomes were recorded. The information of testing/treatment of pregnant women with syphilis and health outcomes of infants were collected. Chi-square test was used for univariate analysis and logistic regression model was used to identify the factors associated with syphilis treatment and adverse pregnant outcomes. Results A total of 685 participants received syphilis treatment during pregnancy, with the treatment rate of 59.7%. Among them, 397(34.6%) patients underwent two courses of complete treatment. The poor educated, unemployed/job-waiting or multipara population had poor compliance to treatment. Only 34.9% (142/407) of cases diagnosed at last trimester received syphilis treatment and 10.1%(41/407) completed the treatment. The proportion of non-treponemal conversion were higher in subjects who received syphilis treatment during pregnancy than those who did not (39.1%[268/285] vs 3.7%[17/462]). Complete syphilis treatment during pregnancy was protective factor to decrease neonatal death adjusted relative risk ([aRR]=0.05, 95%CI: 0.01-0.37, P=0.003) and prematurity/low birth weight (aRR=0.44, 95%CI: 0.27-0.70, P=0.001). Strong positive non-treponemal result before delivery increased the risks of neonatal death (aRR=12.89, 95%CI: 1.70-100.43, P=0.014) and prematurity/low birth weight (aRR=12.78, 95%CI: 152-5.06, P=0.001). Conclusions Factors such as educational level, employment status, and maternal history will affect the compliance of syphilis treatment during pregnancy. Early diagnosis and complete treatment course of syphilis could improve the pregnant outcomes and the health status of infants. Key words: Syphilis; Mother-to-child transmission; Treatment; Adverse pregnant outcome
{"title":"Treatment status of maternal syphilis infection and factors associated with their adverse pregnant outcomes in Shanghai during 2013-2015","authors":"Yibin Gu, Yang Li, Liping Zhu, L. Du, Qi Zhao, Biao Xu","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.04.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.04.005","url":null,"abstract":"Objective \u0000To analyze the factors associated with syphilis treatment compliance and adverse pregnant outcomes among pregnant women with syphilis in Shanghai. \u0000 \u0000 \u0000Methods \u0000The prospective cohort was established based on maternal syphilis monitoring system of Shanghai, which included all the pregnant women diagnosed with syphilis during Jan 2013 to Dec 2015. A total of 1 717 pregnant women with syphilis were recruited at the baseline, and 1 147 of them were followed up during treatment and their pregnancy, and the delivery outcomes were recorded. The information of testing/treatment of pregnant women with syphilis and health outcomes of infants were collected. Chi-square test was used for univariate analysis and logistic regression model was used to identify the factors associated with syphilis treatment and adverse pregnant outcomes. \u0000 \u0000 \u0000Results \u0000A total of 685 participants received syphilis treatment during pregnancy, with the treatment rate of 59.7%. Among them, 397(34.6%) patients underwent two courses of complete treatment. The poor educated, unemployed/job-waiting or multipara population had poor compliance to treatment. Only 34.9% (142/407) of cases diagnosed at last trimester received syphilis treatment and 10.1%(41/407) completed the treatment. The proportion of non-treponemal conversion were higher in subjects who received syphilis treatment during pregnancy than those who did not (39.1%[268/285] vs 3.7%[17/462]). Complete syphilis treatment during pregnancy was protective factor to decrease neonatal death adjusted relative risk ([aRR]=0.05, 95%CI: 0.01-0.37, P=0.003) and prematurity/low birth weight (aRR=0.44, 95%CI: 0.27-0.70, P=0.001). Strong positive non-treponemal result before delivery increased the risks of neonatal death (aRR=12.89, 95%CI: 1.70-100.43, P=0.014) and prematurity/low birth weight (aRR=12.78, 95%CI: 152-5.06, P=0.001). \u0000 \u0000 \u0000Conclusions \u0000Factors such as educational level, employment status, and maternal history will affect the compliance of syphilis treatment during pregnancy. Early diagnosis and complete treatment course of syphilis could improve the pregnant outcomes and the health status of infants. \u0000 \u0000 \u0000Key words: \u0000Syphilis; Mother-to-child transmission; Treatment; Adverse pregnant outcome","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"214-219"},"PeriodicalIF":0.0,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49119982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.04.001
Xia Mei, Weiwei Chen, Wen-gang Li, Wen Xu, Zhe Xu, B. Tu, E. Qin, Lei Shi, Peng Zhao, Min Zhao
Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults, and to provide evidences for clinical management. Methods The data of clinical manifestations, laboratory examinations, chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed. The chi-square test was used for the categorical variables, and the rank sum test was used for the continuous variables of non-normal distribution. Results Compared with patients in HAdV55, those in HAdV7 group displayed more diarrhea (12.1%[26/214] vs 2.6%[6/235], χ2=15.583), more laryngeal lymphatic follicles (33.2%[71/214] vs 17.9%[42/235], χ2=23.566), more tonsil enlargement (56.5%[121/214] vs 20.0%[47/235], χ2=63.870) with secretions (33.2%[71/214] vs 11.5%[27/235], χ2=30.878), more leukocytosis (24.8%[53/214] vs 14.0%[33/235], χ2=8.318), more monocytosis (78.0%[167/214] vs 52.8%[124/235], χ2=31.364), more thrombocytosis (7.1%[15/212] vs 3.8%[9/235], χ2=5.835), more elevated level of C-reactive protein (80.8%[97/120] vs 64.3%[137/213], χ2=10.020), more abnormalities of liver function (alamne aminotransferase [ALT]: 13.5%[28/207] vs 5.6%[13/232], χ2=8.111) and myocardial enzymes (creatine kinase [CK]: 37.6%[77/205] vs 26.4% [61/231], χ2=6.246), creatine kinase isoenzymes ([CK-MB]: 35.6% [73/205] vs 11.1% [24/216], χ2=35.600), and all the differences were statistically significant (all P<0.05, 0.01). Compared with patients in HAdV7 group, those in HAdV55 group displayed longer duration of diseases (7[5] days vs 6[5] days, Z=-2.632), more sore throat (72.8% [171/235] vs 62.1% [133/214], χ2=0.016), more headache (62.1% [146/235] vs 16.4% [35/214], χ2=97.527), more pharyngeal congestion (93.6% [220/235] vs 74.8%[160/214], χ2=30.602), more leukopenia (14.0% [33/235] vs 24.8% [53/214], χ2=8.318), and more elevated level of lactate dehydrogenase (12.6% [29/230] vs 6.3% [13/205], χ2=4.881), more pneumonia (71.5% [168/235] vs 31.8% [68/214], χ2=70.846) (all P<0.05, 0.01). Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different. The type 55 infection is more likely to develop to pneumonia, while the type 7 infection has wider tissue tropism. Key words: Adenovirus infections, human; Pneumonia, viral; Clinical characteristics; Case analysis
{"title":"Comparative study of clinical characteristics between adult patients with adenovirus type 7 and type 55 infections in China during 2012-2018","authors":"Xia Mei, Weiwei Chen, Wen-gang Li, Wen Xu, Zhe Xu, B. Tu, E. Qin, Lei Shi, Peng Zhao, Min Zhao","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.04.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.04.001","url":null,"abstract":"Objective \u0000To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults, and to provide evidences for clinical management. \u0000 \u0000 \u0000Methods \u0000The data of clinical manifestations, laboratory examinations, chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed. The chi-square test was used for the categorical variables, and the rank sum test was used for the continuous variables of non-normal distribution. \u0000 \u0000 \u0000Results \u0000Compared with patients in HAdV55, those in HAdV7 group displayed more diarrhea (12.1%[26/214] vs 2.6%[6/235], χ2=15.583), more laryngeal lymphatic follicles (33.2%[71/214] vs 17.9%[42/235], χ2=23.566), more tonsil enlargement (56.5%[121/214] vs 20.0%[47/235], χ2=63.870) with secretions (33.2%[71/214] vs 11.5%[27/235], χ2=30.878), more leukocytosis (24.8%[53/214] vs 14.0%[33/235], χ2=8.318), more monocytosis (78.0%[167/214] vs 52.8%[124/235], χ2=31.364), more thrombocytosis (7.1%[15/212] vs 3.8%[9/235], χ2=5.835), more elevated level of C-reactive protein (80.8%[97/120] vs 64.3%[137/213], χ2=10.020), more abnormalities of liver function (alamne aminotransferase [ALT]: 13.5%[28/207] vs 5.6%[13/232], χ2=8.111) and myocardial enzymes (creatine kinase [CK]: 37.6%[77/205] vs 26.4% [61/231], χ2=6.246), creatine kinase isoenzymes ([CK-MB]: 35.6% [73/205] vs 11.1% [24/216], χ2=35.600), and all the differences were statistically significant (all P<0.05, 0.01). Compared with patients in HAdV7 group, those in HAdV55 group displayed longer duration of diseases (7[5] days vs 6[5] days, Z=-2.632), more sore throat (72.8% [171/235] vs 62.1% [133/214], χ2=0.016), more headache (62.1% [146/235] vs 16.4% [35/214], χ2=97.527), more pharyngeal congestion (93.6% [220/235] vs 74.8%[160/214], χ2=30.602), more leukopenia (14.0% [33/235] vs 24.8% [53/214], χ2=8.318), and more elevated level of lactate dehydrogenase (12.6% [29/230] vs 6.3% [13/205], χ2=4.881), more pneumonia (71.5% [168/235] vs 31.8% [68/214], χ2=70.846) (all P<0.05, 0.01). \u0000 \u0000 \u0000Conclusions \u0000The clinical characteristics of HAdV7 and HAdV55 infections in adults are different. The type 55 infection is more likely to develop to pneumonia, while the type 7 infection has wider tissue tropism. \u0000 \u0000 \u0000Key words: \u0000Adenovirus infections, human; Pneumonia, viral; Clinical characteristics; Case analysis","PeriodicalId":10127,"journal":{"name":"中华传染病杂志","volume":"37 1","pages":"193-198"},"PeriodicalIF":0.0,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46959329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.03.002
Ling-Hong Zhou, Xuan Wang, Rui-ying Wang, Hua-zhen Zhao, Ying-Kui Jiang, Jia-Hui Cheng, Jingyun Ye, Li-ping Huang
Objective To investigate the clinical efficacy and safety of high-dose caspofungin (70 mg/d) as initial or salvage treatment for invasive pulmonary aspergillosis. Methods Twenty-one patients with proven or probable invasive pulmonary aspergillosis from June 2014 to October 2017 in Huashan Hospital, Fudan University were retrospectively reviewed. According to the anti-fungal treatment before high-dose caspofungin application, patients were divided into initial treatment group and salvage treatment group. Patients′ clinical data and laboratory data were collected. The characteristics, clinical efficacy, adverse reactions, one-year survival rate and the overall effective rate were evaluated. The prognosis of the two groups was compared by Kaplan-Meier analysis. Results Twenty of the 21 patients opportunistic acquired invasive pulmonary aspergillosis during the treatment of underlying diseases. Five patients were initially treated with high-dose caspofungin for 68 (62) days. At week 12, one patient achieved complete response, 3 patients achieved partial response, and the overall effective rate was 80%(4/5). Sixteen patients received caspofungin as salvage therapy for 66.50 (58) days, of which one patient got complete response at week 12, 10 had partial response, and the overall effective rate was 68.75%(11/16). One-year follow-up showed that no patient died in the initial treatment group, and the one-year survival rate was 100%(5/5). In salvage treatment group, 3 patients died of pulmonary bacterial infections and the one-year survival rate was 81.25%(13/16). During treatment, one patient had elevated total bilirubin, which was possibly associated with high-dose caspofungin. Conclusions High-dose caspofungin regimen has good efficacy and safety, both for initial treatment and salvage therapy in patients with invasive pulmonary aspergillosis. Key words: Invasive pulmonary aspergillosis; Caspofungin; High-dose; Efficacy; Safety
{"title":"Efficacy and safety of high-dose caspofungin in the treatment of invasive pulmonary aspergillosis","authors":"Ling-Hong Zhou, Xuan Wang, Rui-ying Wang, Hua-zhen Zhao, Ying-Kui Jiang, Jia-Hui Cheng, Jingyun Ye, Li-ping Huang","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.03.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.03.002","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy and safety of high-dose caspofungin (70 mg/d) as initial or salvage treatment for invasive pulmonary aspergillosis. \u0000 \u0000 \u0000Methods \u0000Twenty-one patients with proven or probable invasive pulmonary aspergillosis from June 2014 to October 2017 in Huashan Hospital, Fudan University were retrospectively reviewed. According to the anti-fungal treatment before high-dose caspofungin application, patients were divided into initial treatment group and salvage treatment group. Patients′ clinical data and laboratory data were collected. The characteristics, clinical efficacy, adverse reactions, one-year survival rate and the overall effective rate were evaluated. The prognosis of the two groups was compared by Kaplan-Meier analysis. \u0000 \u0000 \u0000Results \u0000Twenty of the 21 patients opportunistic acquired invasive pulmonary aspergillosis during the treatment of underlying diseases. Five patients were initially treated with high-dose caspofungin for 68 (62) days. At week 12, one patient achieved complete response, 3 patients achieved partial response, and the overall effective rate was 80%(4/5). Sixteen patients received caspofungin as salvage therapy for 66.50 (58) days, of which one patient got complete response at week 12, 10 had partial response, and the overall effective rate was 68.75%(11/16). One-year follow-up showed that no patient died in the initial treatment group, and the one-year survival rate was 100%(5/5). In salvage treatment group, 3 patients died of pulmonary bacterial infections and the one-year survival rate was 81.25%(13/16). During treatment, one patient had elevated total bilirubin, which was possibly associated with high-dose caspofungin. \u0000 \u0000 \u0000Conclusions \u0000High-dose caspofungin regimen has good efficacy and safety, both for initial treatment and salvage therapy in patients with invasive pulmonary aspergillosis. \u0000 \u0000 \u0000Key words: \u0000Invasive pulmonary aspergillosis; Caspofungin; High-dose; Efficacy; Safety","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"139-143"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42767788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.03.004
Haoran Chen, Zhou Liu, Jiabin Li
Objective To find the target of auranofin with the antibacterial activity against gram-negative bacteria and to investigate the effect of the combination of auranofin and vorinostat on the antibacterial activity against gram-negative bacteria. Methods The strains of E. coli lacking thioredoxin reductase (TrxR) was used to find the target gene. The potential synergies of the combination of auranofin and vorinostat for E. coli strain, A. baumannii strain, P .aeruginosa strain, K. pneumonia strain and multidrug-resistant (MDR) A. baumannii strain were evaluated using susceptibility tests, micro-dilution checkerboard tests and time-kill studies. The genes related to Trx (trxA, trxB, trxC) and the gene expressed glutathione (gor) of E. coli BW25113 strains (WT) were separately knocked out to observe the effect of auranofin on minimum inhibitory concentration (MIC) and the time-kill kinetics of ΔtrxC and Δgor. Furthermore, the complemented strains (C-trxA, C-trxB, C-trxC, C-gor) were used to verify and define the genetic targets. Results According to the results of susceptibility tests, MICs of auranofin were 64 mg/L for E. coli strain BW25113 and K. pneumonia strain ATCC 43816, 128 mg/L for P. aeruginosa strain PA14 and 32 mg/L for both A. baumannii strain ATCC 17978 and A. baumannii strain AB5075. However, MICs of vorinostat are 512 mg/L for all isolates. The fractional inhibitory concentration indexes (FICIs) of the combination of auranofin and vorinostat for E. coli strain BW25113, A. baumannii strain ATCC 17978, MDR A. baumannii strain AB5075, K. pneumonia starin ATCC 43816 and P. aeruginosa strain PA14 were 0.313, 0.375, 0.375, 0.375, and 0.375, respectively, with all values <0.5, which showed synergy. In susceptibility tests of knockout strains, MICs of auranofin for ΔtrxC increased from 64 mg/L to 256 mg/L, decreased to 16 mg/L for Δgor, and no changes for ΔtrxA and ΔtrxB. Auranofin showed the same antibacterial activities against the complemented strains (C-trxC, C-gor) and E. col BW25113, which decreased by about 1.8 lg colong formins units (CFU)/mL of bacterial counts. However, the antibacterial activity of auranofin was significantly reduced for ΔtrxC, and decreased by<1 lg CFU/mL of bacterial counts. For Δgor, bacterial counts decreased 4.6 lg CFU/mL, and the antibacterial activity markedly increased. Conclusions The potential target gene of auranofin against gram-negative bacteria could be trxC, which provides new ideas and methods for the clinical treatment of multidrug-resistant gram-negative bacteria. Key words: Auranofin; Gram-negative bacteria; Thioredoxin reductase; Vorinostat; Synergy
目的探讨金糠蛋白对革兰氏阴性菌的抑菌活性，探讨金糠蛋白与伏立诺他合用对革兰氏阴性菌抑菌活性的影响。方法利用缺乏硫氧还蛋白还原酶(TrxR)的大肠杆菌菌株寻找靶基因。采用药敏试验、微量稀释棋盘棋盘试验和时间杀伤试验，评价了金嘌呤与伏立诺他联合用药对大肠杆菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌和多药耐药鲍曼不动杆菌的潜在协同作用。分别敲除大肠杆菌BW25113菌株(WT) Trx相关基因(trxA、trxB、trxC)和表达谷胱甘肽(gor)的基因，观察金糠蛋白对ΔtrxC和Δgor最低抑菌浓度(MIC)和时间杀伤动力学的影响。利用互补菌株(C-trxA、C-trxB、C-trxC、C-gor)验证和确定遗传靶点。结果药敏试验结果显示，金黄色葡萄蛋白对大肠杆菌BW25113和肺炎克雷伯菌ATCC 43816的mic值为64 mg/L，铜绿假单胞菌PA14的mic值为128 mg/L，鲍曼不动杆菌ATCC 17978和鲍曼不动杆菌AB5075的mic值为32 mg/L。伏立诺他的mic均为512 mg/L。金嘌呤与伏立诺他联用对大肠杆菌BW25113、鲍曼假单胞菌ATCC 17978、耐多药鲍曼假单胞菌AB5075、肺炎克雷伯菌ATCC 43816和铜绿假单胞菌PA14的分数抑制浓度指数(FICIs)分别为0.313、0.375、0.375、0.375，且均<0.5，表现出协同作用。在敲除菌株的药敏试验中，ΔtrxC对金毒苷的mic从64 mg/L增加到256 mg/L， Δgor对金毒苷的mic降低到16 mg/L， ΔtrxA和ΔtrxB对金毒苷的mic没有变化。金丝桃苷对互补菌株C-trxC、C-gor和大肠杆菌BW25113的抑菌活性相同，均降低约1.8个菌落单位(CFU)/mL。然而，对于ΔtrxC，金糠蛋白的抗菌活性明显降低，细菌计数下降<1 lg CFU/mL。对于Δgor，细菌计数降低4.6 lg CFU/mL，抗菌活性显著提高。结论金糠蛋白抗革兰氏阴性菌的潜在靶基因可能是trxC，为临床治疗多重耐药革兰氏阴性菌提供了新的思路和方法。关键词:萘醌;革兰氏阴性细菌;硫氧还蛋白还原酶;Vorinostat;协同作用
{"title":"Effect of auranofin combined with antineoplastic vorinostat on bactericidal activities against gram-negative bacteria and study on the target of auranofin","authors":"Haoran Chen, Zhou Liu, Jiabin Li","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.03.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.03.004","url":null,"abstract":"Objective \u0000To find the target of auranofin with the antibacterial activity against gram-negative bacteria and to investigate the effect of the combination of auranofin and vorinostat on the antibacterial activity against gram-negative bacteria. \u0000 \u0000 \u0000Methods \u0000The strains of E. coli lacking thioredoxin reductase (TrxR) was used to find the target gene. The potential synergies of the combination of auranofin and vorinostat for E. coli strain, A. baumannii strain, P .aeruginosa strain, K. pneumonia strain and multidrug-resistant (MDR) A. baumannii strain were evaluated using susceptibility tests, micro-dilution checkerboard tests and time-kill studies. The genes related to Trx (trxA, trxB, trxC) and the gene expressed glutathione (gor) of E. coli BW25113 strains (WT) were separately knocked out to observe the effect of auranofin on minimum inhibitory concentration (MIC) and the time-kill kinetics of ΔtrxC and Δgor. Furthermore, the complemented strains (C-trxA, C-trxB, C-trxC, C-gor) were used to verify and define the genetic targets. \u0000 \u0000 \u0000Results \u0000According to the results of susceptibility tests, MICs of auranofin were 64 mg/L for E. coli strain BW25113 and K. pneumonia strain ATCC 43816, 128 mg/L for P. aeruginosa strain PA14 and 32 mg/L for both A. baumannii strain ATCC 17978 and A. baumannii strain AB5075. However, MICs of vorinostat are 512 mg/L for all isolates. The fractional inhibitory concentration indexes (FICIs) of the combination of auranofin and vorinostat for E. coli strain BW25113, A. baumannii strain ATCC 17978, MDR A. baumannii strain AB5075, K. pneumonia starin ATCC 43816 and P. aeruginosa strain PA14 were 0.313, 0.375, 0.375, 0.375, and 0.375, respectively, with all values <0.5, which showed synergy. In susceptibility tests of knockout strains, MICs of auranofin for ΔtrxC increased from 64 mg/L to 256 mg/L, decreased to 16 mg/L for Δgor, and no changes for ΔtrxA and ΔtrxB. Auranofin showed the same antibacterial activities against the complemented strains (C-trxC, C-gor) and E. col BW25113, which decreased by about 1.8 lg colong formins units (CFU)/mL of bacterial counts. However, the antibacterial activity of auranofin was significantly reduced for ΔtrxC, and decreased by<1 lg CFU/mL of bacterial counts. For Δgor, bacterial counts decreased 4.6 lg CFU/mL, and the antibacterial activity markedly increased. \u0000 \u0000 \u0000Conclusions \u0000The potential target gene of auranofin against gram-negative bacteria could be trxC, which provides new ideas and methods for the clinical treatment of multidrug-resistant gram-negative bacteria. \u0000 \u0000 \u0000Key words: \u0000Auranofin; Gram-negative bacteria; Thioredoxin reductase; Vorinostat; Synergy","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"149-154"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43190410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.03.007
Yang Wang, Yi Li, Chuanmei Peng, Jia Wang, Xiaoye Fu, Wanting Chen
Objective To investigate the genetic evolution of VP1 gene of pathogenic coxsackievirus A16 (CV-A16) strain isolated from clinical hand, foot, and mouth disease (HFMD) patients. Methods A total of 160 HFMD cases with CV-A16-positive results were collected from hospitals in Kunming during January 2015 to June 2017. Fecal samples were collected. Real-time polymerase chain reaction (PCR) was used to detect the CV-A16 virus nucleic acid. The VP1 genes of CV-A16-positive samples were amplified by reverse transcription-PCR. The amplified positive products were sequenced and aligned. The homologies were identified and their subgenotypes were determined. The phylogenetic tree was constructed and homology modeling was conducted. Results All the 160 CV-A16 isolates were B2 subtypes. The genetic distance between detected strains of CV-A16 and the strains in Fujian, Beijing, Nanjing was 0.76. The genetic distance to the strains in Malaysia was 0.78, and to the strains in Australia was 1.86. Homologous modeling revealed that the amino acid sequence of the VP1 gene of the strain had a G227R mutation. Conclusions There is no major genetic variation in the CV-A16 strains during 3 years. CV-A16 isolates are close to those of epidemic strains in Beijing, Fujian and Malaysia, but are far fram the strains from Australia. Key words: Hand, foot and mouth disease; Coxsackievirus A16; VP1 gene; Phylogenetic tree; Homology modeling
{"title":"Evolution of VP1 gene of coxsackievirus A16 in hand, foot, and mouth disease","authors":"Yang Wang, Yi Li, Chuanmei Peng, Jia Wang, Xiaoye Fu, Wanting Chen","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.03.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.03.007","url":null,"abstract":"Objective \u0000To investigate the genetic evolution of VP1 gene of pathogenic coxsackievirus A16 (CV-A16) strain isolated from clinical hand, foot, and mouth disease (HFMD) patients. \u0000 \u0000 \u0000Methods \u0000A total of 160 HFMD cases with CV-A16-positive results were collected from hospitals in Kunming during January 2015 to June 2017. Fecal samples were collected. Real-time polymerase chain reaction (PCR) was used to detect the CV-A16 virus nucleic acid. The VP1 genes of CV-A16-positive samples were amplified by reverse transcription-PCR. The amplified positive products were sequenced and aligned. The homologies were identified and their subgenotypes were determined. The phylogenetic tree was constructed and homology modeling was conducted. \u0000 \u0000 \u0000Results \u0000All the 160 CV-A16 isolates were B2 subtypes. The genetic distance between detected strains of CV-A16 and the strains in Fujian, Beijing, Nanjing was 0.76. The genetic distance to the strains in Malaysia was 0.78, and to the strains in Australia was 1.86. Homologous modeling revealed that the amino acid sequence of the VP1 gene of the strain had a G227R mutation. \u0000 \u0000 \u0000Conclusions \u0000There is no major genetic variation in the CV-A16 strains during 3 years. CV-A16 isolates are close to those of epidemic strains in Beijing, Fujian and Malaysia, but are far fram the strains from Australia. \u0000 \u0000 \u0000Key words: \u0000Hand, foot and mouth disease; Coxsackievirus A16; VP1 gene; Phylogenetic tree; Homology modeling","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"163-166"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48137370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.03.006
Mei-fen Wang, Zeng-qing Du, Tiesong Zhang, Yunjiao Luo, L. Du, Quan Gan, T. Fu, Junchao Peng, Weiying Ma
Objective To study the prevalence trends and etiology of hand, foot, and mouth disease (HFMD) in hospitalized children. Methods The clinical data of 11 510 cases of children hospitalized with HFMD from 2008 to 2017 in Department of Infection Diseases of Kunming Children′s Hospital were collected, and to retrospectively analyze the characteristics, time distribution and pathogen distribution of the cases. Results Of the 11 510 children with HFMD, 6 100 were male and 5 410 were female. There were 9 814 cases under 3 years old, 1 696 over 3 years old. HFMD occurred throughout the year. The peak months of the disease were April to July, with the time distribution of single peak. There were 4 690 severe cases and 3 452 critical cases, accounting for 70.34%. The main pathogens detected were enteroviruses A71 (EV-A71), coxsackievirus A16 (CV-A16) and other enteroviruses (EV), with 3 803 cases (36.02%), 1 122 cases (10.63%) and 3 401 cases (32.21%) respectively. EV-A71 and CV-A16 infections dominated from 2008 to 2013, while EV-A71 and other EV infection dominated from 2014 to 2017. Conclusions EV-A71, CV-A16 and other EV are the main pathogens of HFMD in Kunming. Critical HFMD cases are mainly caused by EV-A71 infection. Key words: Hand, foot and mouth disease; Enterovirus; Epidemic characteristics
{"title":"Epidemiological characteristics and etiology analysis of 11 510 hospitalized children with hand, foot, and mouth disease","authors":"Mei-fen Wang, Zeng-qing Du, Tiesong Zhang, Yunjiao Luo, L. Du, Quan Gan, T. Fu, Junchao Peng, Weiying Ma","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.03.006","url":null,"abstract":"Objective \u0000To study the prevalence trends and etiology of hand, foot, and mouth disease (HFMD) in hospitalized children. \u0000 \u0000 \u0000Methods \u0000The clinical data of 11 510 cases of children hospitalized with HFMD from 2008 to 2017 in Department of Infection Diseases of Kunming Children′s Hospital were collected, and to retrospectively analyze the characteristics, time distribution and pathogen distribution of the cases. \u0000 \u0000 \u0000Results \u0000Of the 11 510 children with HFMD, 6 100 were male and 5 410 were female. There were 9 814 cases under 3 years old, 1 696 over 3 years old. HFMD occurred throughout the year. The peak months of the disease were April to July, with the time distribution of single peak. There were 4 690 severe cases and 3 452 critical cases, accounting for 70.34%. The main pathogens detected were enteroviruses A71 (EV-A71), coxsackievirus A16 (CV-A16) and other enteroviruses (EV), with 3 803 cases (36.02%), 1 122 cases (10.63%) and 3 401 cases (32.21%) respectively. EV-A71 and CV-A16 infections dominated from 2008 to 2013, while EV-A71 and other EV infection dominated from 2014 to 2017. \u0000 \u0000 \u0000Conclusions \u0000EV-A71, CV-A16 and other EV are the main pathogens of HFMD in Kunming. Critical HFMD cases are mainly caused by EV-A71 infection. \u0000 \u0000 \u0000Key words: \u0000Hand, foot and mouth disease; Enterovirus; Epidemic characteristics","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"160-162"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45384087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.03.003
Yuzhen Xu, Qing-luan Yang, Yuanyuan Liu, Qianqian Liu, Qiaoling Ruan, Yan Gao, L. Shao, Wenhong Zhang, Hong Liu
Objective To retrospectively analyze the clinical and laboratory characteristics of patients with positive blood culture results for Mycobacterium tuberculosis (M.tb). Methods The clinical laboratory database of patients suspected with disseminated tuberculosis from January 2009 to January 2017 in Huashan Hospital affiliated with Fudan University were collected and analyzed. The clinical manifestations, laboratory characteristics and outcomes between disseminated tuberculosis patients with positive blood culture (positive blood culture group) for M. tb and negative results (negative blood culture group) were compared. T test, Mann-Whitney U test and Fisher exact test were used for statistical analysis. Results A total of 5 589 patients suspected with M. tb infection had peripheral blood culture for mycobacterium. Positive blood culture for M. tb was found in 26 disseminated tuberculosis patients, while 6 patients finally identified as nontuberculous mycobacterium (NTM) with species identification, and 22 disseminated tuberculosis patients with negative blood culture results were enrolled during the same period as control. The mean age ([49.1±10.1] years old vs[38.3±17.1] years old, t=2.460, P=0.018), the proportion of diagnosed with fever of unknown origin at admission (FUO) (65.0%[13/20] vs 13.6%[3/22], P=0.001), the proportion of diagnosed with focal infection (30.0%[6/20] vs 86.4%[19/22], P=0.001), the proportion of patients with other diseases (75.0%[15/20] vs 22.7%[5/22], P=0.002), the proportion of patients with hematological diseases (35.0%[7/20] vs 4.5%[1/22], P=0.018) and the proportion of patients with tumor (20%[4/20] vs 0[0/22], P=0.043) in the positive blood culture group were significantly different from those in the negative blood culture group. Laboratory examinations of the percentage of neutrophils, the percentage of lymphocytes, the percentage of monocytes, the value of neutrophil/lymphocyte, the level of hemoglobin, the level of erythrocyte sedimentation rate, the level of C-reactive protein, the level of procalcitonin and the positive rate of T-SPOT.TB in positive blood culture groups were significantly different from those in negative blood culture group (all P<0.05). Conclusions Peripheral blood M. tb culture is more likely to be positive for those elder disseminated tuberculosis patients with hematological diseases or tumors, and those with increase of neutrophil counts and inflammation markers but reduction of lymphocyte counts and hemoglobin. Key words: Mycobacterium tuberculosis; Blood culture; Disseminated tuberculosis
{"title":"Clinical characteristics of patients with positive blood culture for Mycobacterium tuberculosis in a general hospital","authors":"Yuzhen Xu, Qing-luan Yang, Yuanyuan Liu, Qianqian Liu, Qiaoling Ruan, Yan Gao, L. Shao, Wenhong Zhang, Hong Liu","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.03.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.03.003","url":null,"abstract":"Objective \u0000To retrospectively analyze the clinical and laboratory characteristics of patients with positive blood culture results for Mycobacterium tuberculosis (M.tb). \u0000 \u0000 \u0000Methods \u0000The clinical laboratory database of patients suspected with disseminated tuberculosis from January 2009 to January 2017 in Huashan Hospital affiliated with Fudan University were collected and analyzed. The clinical manifestations, laboratory characteristics and outcomes between disseminated tuberculosis patients with positive blood culture (positive blood culture group) for M. tb and negative results (negative blood culture group) were compared. T test, Mann-Whitney U test and Fisher exact test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000A total of 5 589 patients suspected with M. tb infection had peripheral blood culture for mycobacterium. Positive blood culture for M. tb was found in 26 disseminated tuberculosis patients, while 6 patients finally identified as nontuberculous mycobacterium (NTM) with species identification, and 22 disseminated tuberculosis patients with negative blood culture results were enrolled during the same period as control. The mean age ([49.1±10.1] years old vs[38.3±17.1] years old, t=2.460, P=0.018), the proportion of diagnosed with fever of unknown origin at admission (FUO) (65.0%[13/20] vs 13.6%[3/22], P=0.001), the proportion of diagnosed with focal infection (30.0%[6/20] vs 86.4%[19/22], P=0.001), the proportion of patients with other diseases (75.0%[15/20] vs 22.7%[5/22], P=0.002), the proportion of patients with hematological diseases (35.0%[7/20] vs 4.5%[1/22], P=0.018) and the proportion of patients with tumor (20%[4/20] vs 0[0/22], P=0.043) in the positive blood culture group were significantly different from those in the negative blood culture group. Laboratory examinations of the percentage of neutrophils, the percentage of lymphocytes, the percentage of monocytes, the value of neutrophil/lymphocyte, the level of hemoglobin, the level of erythrocyte sedimentation rate, the level of C-reactive protein, the level of procalcitonin and the positive rate of T-SPOT.TB in positive blood culture groups were significantly different from those in negative blood culture group (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Peripheral blood M. tb culture is more likely to be positive for those elder disseminated tuberculosis patients with hematological diseases or tumors, and those with increase of neutrophil counts and inflammation markers but reduction of lymphocyte counts and hemoglobin. \u0000 \u0000 \u0000Key words: \u0000Mycobacterium tuberculosis; Blood culture; Disseminated tuberculosis","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"144-148"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42677133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.03.005
M. Cai
Objective To investigate the clinical features and prognostic factors in patients with acquired immunodeficiency syndrome (AIDS) and liver abscess. Methods The clinical data of AIDS patients with liver abscess admitted in Beijing You-an Hospital during January 2013 to December 2017 were retrospective analyzed to reveal the clinical manifestations, etiologies, imaging features, therapeutic effects and prognostic factors. T test, χ2 test or Fisher exact test were used for statistical analyses. Results A total of 76 patients were recruited. The most common clinical manifestations were fever (72 cases), chills (48 cases), anorexia (42 cases) and abdominal pain (35 cases). Liver abscesses were mainly located in right lobe (57 cases), then in left lobe (11 cases), in both right and left lobes (6 cases) and in caudate lobe (2 cases). Lobulation or division was seen in 19 cases and gas formation was seen in 5 cases. Single abscess was identified in 56 cases. Positive culture results were obtained in 15.5% (9/58) from liver pus and 6.0% (4/67) from blood samples. Thirteen strains of pathogens were detected by liver pus culture, including 9 strains of Staphylococcus, 3 strains of Candida and 1 strain of Mycobacterium. Six strains of pathogens were detected by blood culture, including 5 strains of Staphylococcus and 1 strain of Corynebacterium. The main complications included acute kidney injury (10 cases) and septic shock (6 cases). Sixty-one cases were treated with antibiotics plus imaging-guided percutaneous aspiration, drainage or surgery, of whom 57 cases were effective. Fifteen cases were treated with antibiotics alone, of whom 12 cases were effective. Septic shock (OR=70.16, 95%CI: 4.77-1 032.06, P<0.01), respiratory failure (OR=68.41, 95%CI: 2.40-1 946.53, P=0.01) and gas formation (OR=23.36, 95%CI: 1.30-420.16, P=0.03) were independent risk factors for poor prognosis. Conclusions The clinical features of AIDS patients with liver abscess are uncharacteristic. Bacteria are the main pathogens. Septic shock, respiratory failure and gas formation are independent risk factors for poor prognosis. Imaging-guided percutaneous aspiration, drainage combined with antibiotic therapy is safe and effective. Key words: Acquired immunodeficiency syndrome; Liver abscess; Prognosis; Clinical feature; Treatment
{"title":"Clinical features and prognostic factors in patients with liver abscess and acquired immunodeficiency syndrome","authors":"M. Cai","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.03.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.03.005","url":null,"abstract":"Objective \u0000To investigate the clinical features and prognostic factors in patients with acquired immunodeficiency syndrome (AIDS) and liver abscess. \u0000 \u0000 \u0000Methods \u0000The clinical data of AIDS patients with liver abscess admitted in Beijing You-an Hospital during January 2013 to December 2017 were retrospective analyzed to reveal the clinical manifestations, etiologies, imaging features, therapeutic effects and prognostic factors. T test, χ2 test or Fisher exact test were used for statistical analyses. \u0000 \u0000 \u0000Results \u0000A total of 76 patients were recruited. The most common clinical manifestations were fever (72 cases), chills (48 cases), anorexia (42 cases) and abdominal pain (35 cases). Liver abscesses were mainly located in right lobe (57 cases), then in left lobe (11 cases), in both right and left lobes (6 cases) and in caudate lobe (2 cases). Lobulation or division was seen in 19 cases and gas formation was seen in 5 cases. Single abscess was identified in 56 cases. Positive culture results were obtained in 15.5% (9/58) from liver pus and 6.0% (4/67) from blood samples. Thirteen strains of pathogens were detected by liver pus culture, including 9 strains of Staphylococcus, 3 strains of Candida and 1 strain of Mycobacterium. Six strains of pathogens were detected by blood culture, including 5 strains of Staphylococcus and 1 strain of Corynebacterium. The main complications included acute kidney injury (10 cases) and septic shock (6 cases). Sixty-one cases were treated with antibiotics plus imaging-guided percutaneous aspiration, drainage or surgery, of whom 57 cases were effective. Fifteen cases were treated with antibiotics alone, of whom 12 cases were effective. Septic shock (OR=70.16, 95%CI: 4.77-1 032.06, P<0.01), respiratory failure (OR=68.41, 95%CI: 2.40-1 946.53, P=0.01) and gas formation (OR=23.36, 95%CI: 1.30-420.16, P=0.03) were independent risk factors for poor prognosis. \u0000 \u0000 \u0000Conclusions \u0000The clinical features of AIDS patients with liver abscess are uncharacteristic. Bacteria are the main pathogens. Septic shock, respiratory failure and gas formation are independent risk factors for poor prognosis. Imaging-guided percutaneous aspiration, drainage combined with antibiotic therapy is safe and effective. \u0000 \u0000 \u0000Key words: \u0000Acquired immunodeficiency syndrome; Liver abscess; Prognosis; Clinical feature; Treatment","PeriodicalId":10127,"journal":{"name":"中华传染病杂志","volume":"37 1","pages":"155-159"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48243991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.02.007
Xiao-ya Jin, Yong-ping Chen, Feng-Bin Lu, Yingxiao Chen, Lu Chen, Lei Zhang, Yu Huang, J. Gan
Objective To evaluate therapeutic effects of bone marrow mesenchymal stem cells (MSC) derived exosomes on alcohol-induced liver injury. Methods Eighteen male C57BL/6 mice aged 6 to 8 week were randomly divided into control group, model group and exosomes group, with 6 mice in each group. The mice in the model group and the exosomes group were fed with Lieber-DeCarli ad libitum diet (Dyets Inc.) for 4 weeks, followed by gavage a bolus of ethanol at day 26, 27 and 28. The mice in the control group matched the alcohol-derived calories with dextran-maltose. Meanwhile, the mice in exosomes group were injected with MSC-exosomes via the tail vein at day 14 and 26. After the experiment, serum levels of alanine aminotransferase (ALT) and aspartate aminotransaminase (AST) were detected, and the pathological changes of liver tissues were observed. The expressions of nuclear factor erythroid 2-related factor 2 (Nrf-2), heme oxygenase-1 (HO-1), CD63, CD81, TSG101 and Cytochrome C were analyzed by Western blot, and mRNA levels of Nrf-2, HO-1, interleukin (IL)-10 and IL-17 were analyzed by real-time polymerase chain reaction(RT-PCR). The commercial kits were used to detect serum IL-10, IL-17 levels and liver tissue malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD) oxidative stress indicators. The numbers of regulatory T cell (Treg) and help T (Th)17 cells in the liver were analyzed by flow cytometry. One-way analysis of variance was used for comparison between groups. Results MSC-exosomes expressed positive markers CD63, CD81 and TSG101, but did not express the negative markers Cytochrome C. The serum ALT and AST levels in model group were (87.3±25.1) U/L and (223.2±43.5) U/L, respectively, while those in exosomes group were (47.7±12.0) U/L and (128.2±33.6) U/L, respectively. The differences between the two groups were both statistically significant (F=12.818 and 12.226, respectively, both P<0.05). Compared with control group, the SOD activity and GSH level in the model group significantly decreased with statistically significant differences (F=4.245 and 24.074, respectively, both P<0.05). Lieber-DeCarli ethanol feeding significantly increased intrahepatic MDA level in the model mice, which was reversed by MSC-exosomes supplementation, and the difference was statistically significant (F=36.675, P<0.05). Compared with control group, the intrahepatic protein expressions of Nrf-2 and HO-1 in model group were significantly decreased, while the expressions in exosomes group were obviously increased. The differences were statistically significant (F=33.623 and 14.960, respectively, both P<0.05). The expression trends of Nrf-2 and HO-1 mRNA were the same as those of protein expressions (F=20.784 and 276.336, respectively, both P<0.05). The proportions of liver Treg/Th17 in the control group, model group and exosomes group were 4.3±0.9, 0.4±0.2, and 3.4±0.5, respectively. The differences among groups were statistically significant (F=64.
{"title":"Protective effect of bone marrow mesenchymal stem cells derived exosomes on alcohol-induced hepatic injury","authors":"Xiao-ya Jin, Yong-ping Chen, Feng-Bin Lu, Yingxiao Chen, Lu Chen, Lei Zhang, Yu Huang, J. Gan","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.02.007","url":null,"abstract":"Objective \u0000To evaluate therapeutic effects of bone marrow mesenchymal stem cells (MSC) derived exosomes on alcohol-induced liver injury. \u0000 \u0000 \u0000Methods \u0000Eighteen male C57BL/6 mice aged 6 to 8 week were randomly divided into control group, model group and exosomes group, with 6 mice in each group. The mice in the model group and the exosomes group were fed with Lieber-DeCarli ad libitum diet (Dyets Inc.) for 4 weeks, followed by gavage a bolus of ethanol at day 26, 27 and 28. The mice in the control group matched the alcohol-derived calories with dextran-maltose. Meanwhile, the mice in exosomes group were injected with MSC-exosomes via the tail vein at day 14 and 26. After the experiment, serum levels of alanine aminotransferase (ALT) and aspartate aminotransaminase (AST) were detected, and the pathological changes of liver tissues were observed. The expressions of nuclear factor erythroid 2-related factor 2 (Nrf-2), heme oxygenase-1 (HO-1), CD63, CD81, TSG101 and Cytochrome C were analyzed by Western blot, and mRNA levels of Nrf-2, HO-1, interleukin (IL)-10 and IL-17 were analyzed by real-time polymerase chain reaction(RT-PCR). The commercial kits were used to detect serum IL-10, IL-17 levels and liver tissue malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD) oxidative stress indicators. The numbers of regulatory T cell (Treg) and help T (Th)17 cells in the liver were analyzed by flow cytometry. One-way analysis of variance was used for comparison between groups. \u0000 \u0000 \u0000Results \u0000MSC-exosomes expressed positive markers CD63, CD81 and TSG101, but did not express the negative markers Cytochrome C. The serum ALT and AST levels in model group were (87.3±25.1) U/L and (223.2±43.5) U/L, respectively, while those in exosomes group were (47.7±12.0) U/L and (128.2±33.6) U/L, respectively. The differences between the two groups were both statistically significant (F=12.818 and 12.226, respectively, both P<0.05). Compared with control group, the SOD activity and GSH level in the model group significantly decreased with statistically significant differences (F=4.245 and 24.074, respectively, both P<0.05). Lieber-DeCarli ethanol feeding significantly increased intrahepatic MDA level in the model mice, which was reversed by MSC-exosomes supplementation, and the difference was statistically significant (F=36.675, P<0.05). Compared with control group, the intrahepatic protein expressions of Nrf-2 and HO-1 in model group were significantly decreased, while the expressions in exosomes group were obviously increased. The differences were statistically significant (F=33.623 and 14.960, respectively, both P<0.05). The expression trends of Nrf-2 and HO-1 mRNA were the same as those of protein expressions (F=20.784 and 276.336, respectively, both P<0.05). The proportions of liver Treg/Th17 in the control group, model group and exosomes group were 4.3±0.9, 0.4±0.2, and 3.4±0.5, respectively. The differences among groups were statistically significant (F=64.","PeriodicalId":10127,"journal":{"name":"中华传染病杂志","volume":"37 1","pages":"97-103"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42829101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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