Pub Date : 2018-12-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.12.005
Jie Shi, D. Zheng, Yankun Zhu, Jun-Hua Zhao, Xiao-guang Ma, Shaohua Wang, Hui Li
Objective To investigate the genotype of M. tuberculosis in He′nan Province. Methods A total of 668 M. tuberculosis clinical strains collected in difference regions of He′nan Province during 2015 were genotyped by two standard methods, including classical 24-locus mycobacterium interspersed repetitive unit variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping. Results The 668 isolates were divided into 11 clusters and 35 patterns by spoligotyping. Among the 558 Beijing strains, 546 were typical Beijing strains and the other 12 were atypical Beijing strains. Among the 110 non-Beijing strains, eight were new strains and the remaining 102 non-Beijing strains were divided into 10 families. There were 76 isolates belonging to T family, including 59 of T1 families, 7 of T2 families, and 10 of T3 families. The 668 strains were divided into 550 gene patterns by standard 24-locus VNTR, including 508 un-clustered patterns and 160 clustered into 42 clusters. The largest cluster contained 21 strains, the other clusters contained 2-20 strains. Conclusion Beijing strain is still the most prevalent M. tuberculosis in He′nan Province. Key words: Mycobacterium tuberculosis; 24-locus mycobacterium interspersed repetitive unit-variable number tandem repeat; Spoligotyping
{"title":"Genotypic analysis of Mycobacterium tuberculosis strains collected from He′nan Province by 24-locus variable-number tandem-repeat typing and spoligotyping","authors":"Jie Shi, D. Zheng, Yankun Zhu, Jun-Hua Zhao, Xiao-guang Ma, Shaohua Wang, Hui Li","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.12.005","url":null,"abstract":"Objective \u0000To investigate the genotype of M. tuberculosis in He′nan Province. \u0000 \u0000 \u0000Methods \u0000A total of 668 M. tuberculosis clinical strains collected in difference regions of He′nan Province during 2015 were genotyped by two standard methods, including classical 24-locus mycobacterium interspersed repetitive unit variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping. \u0000 \u0000 \u0000Results \u0000The 668 isolates were divided into 11 clusters and 35 patterns by spoligotyping. Among the 558 Beijing strains, 546 were typical Beijing strains and the other 12 were atypical Beijing strains. Among the 110 non-Beijing strains, eight were new strains and the remaining 102 non-Beijing strains were divided into 10 families. There were 76 isolates belonging to T family, including 59 of T1 families, 7 of T2 families, and 10 of T3 families. The 668 strains were divided into 550 gene patterns by standard 24-locus VNTR, including 508 un-clustered patterns and 160 clustered into 42 clusters. The largest cluster contained 21 strains, the other clusters contained 2-20 strains. \u0000 \u0000 \u0000Conclusion \u0000Beijing strain is still the most prevalent M. tuberculosis in He′nan Province. \u0000 \u0000 \u0000Key words: \u0000Mycobacterium tuberculosis; 24-locus mycobacterium interspersed repetitive unit-variable number tandem repeat; Spoligotyping","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42926146","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 : 2018-11-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.11.006
Jiangfeng Lyu, Jing Zhou, C. Pan
Objective To establish a rapid method for the clinical detection and identification of fungi in clinical urine samples. Methods DNA was extracted from clinically collected urine sample, and the fungal ribosomal internal transcribed spacer was amplified by polymerase chain reaction (PCR) and followed by pyrosequencing. The fungal species were identified by sequence alignment. Results The identification results were compared between PCR-pyrosequencing and conventional culture method. Among the 1320 urine samples, 180 were detected positive by conventional method with the positive rate of 13.6%, while 192 were positive by the pyrosequencing based method with the positive rate of 14.5%. The overall coincidence rate of the two methods was 99.09%, with the positive coincidence rate of 100% and the negative coincidence rate of 98.95%. The Kappa value was 0.963, suggesting a good consistency. The results of 13 standard strains were consistent with the actual results. Conclusions A rapid culture-free method for the detection of fungi in urine sample has been successfully established. This method is based on PCR-pyrosequencing technology with highly accuracy, sensitivity and reproducibility. It is highly automated, cost effective and with high throughput (96 samples per run). The fungal pathogen in urine is identified by single step test within 3 hours without conventional culture. Thus, it is applicable in the clinical laboratory. Key words: Fungi; DNA, ribosomal; Internal transcribed spacer; Pyrosequencing
{"title":"Rapid detection and identification of fungi in urine samples by pyrosequencing","authors":"Jiangfeng Lyu, Jing Zhou, C. Pan","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.11.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.11.006","url":null,"abstract":"Objective \u0000To establish a rapid method for the clinical detection and identification of fungi in clinical urine samples. \u0000 \u0000 \u0000Methods \u0000DNA was extracted from clinically collected urine sample, and the fungal ribosomal internal transcribed spacer was amplified by polymerase chain reaction (PCR) and followed by pyrosequencing. The fungal species were identified by sequence alignment. \u0000 \u0000 \u0000Results \u0000The identification results were compared between PCR-pyrosequencing and conventional culture method. Among the 1320 urine samples, 180 were detected positive by conventional method with the positive rate of 13.6%, while 192 were positive by the pyrosequencing based method with the positive rate of 14.5%. The overall coincidence rate of the two methods was 99.09%, with the positive coincidence rate of 100% and the negative coincidence rate of 98.95%. The Kappa value was 0.963, suggesting a good consistency. The results of 13 standard strains were consistent with the actual results. \u0000 \u0000 \u0000Conclusions \u0000A rapid culture-free method for the detection of fungi in urine sample has been successfully established. This method is based on PCR-pyrosequencing technology with highly accuracy, sensitivity and reproducibility. It is highly automated, cost effective and with high throughput (96 samples per run). The fungal pathogen in urine is identified by single step test within 3 hours without conventional culture. Thus, it is applicable in the clinical laboratory. \u0000 \u0000 \u0000Key words: \u0000Fungi; DNA, ribosomal; Internal transcribed spacer; Pyrosequencing","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42858045","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 : 2018-11-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.11.003
Shu-zhen Xu, Si-yu Yang, Chen Chen, S. Weng, Xiaofei Jiang, Hong Liu, S. Chen, Wenhong Zhang
Objective To explore the clinical characteristics, drug resistance and prognosis of Klebsiella pneumoniae bloodstream infection (KP-BSI), and to analyze the risk factors of death and drug resistance. Methods The clinical data of hospitalized patients with KP-BSI from April 2015 to April 2017 in Huashan Hospital were retrospectively analyzed. Continuous variables were compared using t test. Categorical variables were compared using χ2 test or Fisher exact test. The independent risk factors for death were determined by logistic regression model. Results The majority of the 74 patients with KP-BSI were male (67.6%) and elderly patients (78.4%). Nosocomial infection occurred in 58 cases (78.4%) and a total of 24 (32.4%) cases died. The patients were widely distributed in various departments of the hospital. The first was the Department of Infectious Diseases (29.7%), followed by the intensive care unit (23.0%). The patients were often complicated with various underlying diseases and the most common was pulmonary infection (56.8%). There were 45 (60.8%) multiple drug resistance (MDR) strains and 29 (39.2%) Carbapenems resistant Klebsiella pneumoniae (CRKP) strains. There were significant differences of nosocomial infections (χ2=4.655, P=0.031), deep venous catheters (χ2=5.432, P=0.02), and invasive mechanical ventilation (χ2=7.630, P=0.006) between MDR and non-MDR patients. Deep venous catheters (χ2=5.923, P=0.015), invasive mechanical ventilation (χ2=16.845, P=0.000), other catheters (χ2=4.009, P=0.045) and surgery (χ2=3.910, P=0.048) were all significantly different between CRKP and non-CRKP patients. APACHE Ⅱ scores were performed in all patients. The average APACHE Ⅱ score was 8.74±5.32 of the 50 cases (67.6%) in the survival group and that was 16.46 ± 6.62 of the 24 cases (32.4%) in the death group. The APACHE Ⅱ score in the survival group was significantly lower than that in the death group. The difference was statistically significant (t=5.091, P=0.000). APACHE Ⅱ≥15 was the independent factor of death (B =-2.708, P=0.000). Conclusions The situation of drug-resistant KP-BSI is severe in the clinic. According to the clinical data, nosocomial infections, invasive mechanical ventilation and deep venous catheters may be the risk factors for MDR bloodstream infection. Deep venous catheters, invasive mechanical ventilation, other catheters and surgery may be the risk factors for bloodstream infection with CRKP. APACHEⅡ≥15 is the independent risk factor for death. The evaluation of APACHE Ⅱ score may predict the prognosis of patients with bloodstream infection. Key words: Klebsiella pneumoniae; Risk factors; Bloodstream infection; Clinical features
{"title":"Clinical retrospective analysis of Klebsiella pneumoniae bloodstream infection","authors":"Shu-zhen Xu, Si-yu Yang, Chen Chen, S. Weng, Xiaofei Jiang, Hong Liu, S. Chen, Wenhong Zhang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.11.003","url":null,"abstract":"Objective \u0000To explore the clinical characteristics, drug resistance and prognosis of Klebsiella pneumoniae bloodstream infection (KP-BSI), and to analyze the risk factors of death and drug resistance. \u0000 \u0000 \u0000Methods \u0000The clinical data of hospitalized patients with KP-BSI from April 2015 to April 2017 in Huashan Hospital were retrospectively analyzed. Continuous variables were compared using t test. Categorical variables were compared using χ2 test or Fisher exact test. The independent risk factors for death were determined by logistic regression model. \u0000 \u0000 \u0000Results \u0000The majority of the 74 patients with KP-BSI were male (67.6%) and elderly patients (78.4%). Nosocomial infection occurred in 58 cases (78.4%) and a total of 24 (32.4%) cases died. The patients were widely distributed in various departments of the hospital. The first was the Department of Infectious Diseases (29.7%), followed by the intensive care unit (23.0%). The patients were often complicated with various underlying diseases and the most common was pulmonary infection (56.8%). There were 45 (60.8%) multiple drug resistance (MDR) strains and 29 (39.2%) Carbapenems resistant Klebsiella pneumoniae (CRKP) strains. There were significant differences of nosocomial infections (χ2=4.655, P=0.031), deep venous catheters (χ2=5.432, P=0.02), and invasive mechanical ventilation (χ2=7.630, P=0.006) between MDR and non-MDR patients. Deep venous catheters (χ2=5.923, P=0.015), invasive mechanical ventilation (χ2=16.845, P=0.000), other catheters (χ2=4.009, P=0.045) and surgery (χ2=3.910, P=0.048) were all significantly different between CRKP and non-CRKP patients. APACHE Ⅱ scores were performed in all patients. The average APACHE Ⅱ score was 8.74±5.32 of the 50 cases (67.6%) in the survival group and that was 16.46 ± 6.62 of the 24 cases (32.4%) in the death group. The APACHE Ⅱ score in the survival group was significantly lower than that in the death group. The difference was statistically significant (t=5.091, P=0.000). APACHE Ⅱ≥15 was the independent factor of death (B =-2.708, P=0.000). \u0000 \u0000 \u0000Conclusions \u0000The situation of drug-resistant KP-BSI is severe in the clinic. According to the clinical data, nosocomial infections, invasive mechanical ventilation and deep venous catheters may be the risk factors for MDR bloodstream infection. Deep venous catheters, invasive mechanical ventilation, other catheters and surgery may be the risk factors for bloodstream infection with CRKP. APACHEⅡ≥15 is the independent risk factor for death. The evaluation of APACHE Ⅱ score may predict the prognosis of patients with bloodstream infection. \u0000 \u0000 \u0000Key words: \u0000Klebsiella pneumoniae; Risk factors; Bloodstream infection; Clinical features","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45278432","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 : 2018-11-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.11.001
Hai-bing Gao, Xiangmei Wang, H. Ma, Shenglong Lin, Dongqin Zhang, Wenjun Wu, Jiankai Fang, Minghua Lin
Objective To investigate the baseline independent prognostic factors for 24 months survival of hepatitis B virus (HBV)-associated acute-on-chronic liver failure (ACLF) patients treated with telbivudine. Methods The prospective cohort study was conducted in HBV-associated ACLF patients who were hospitalized in Mengchao Hepatobiliary Hospital of Fujian Medical University and volunteered to be treated with telbivudine for more than 24 months. The patients were observed for survival at month 1, 3, 6, 12, and 24 after treatment. The baseline biochemical index, coagulant function, model for end-stage liver disease (MELD) score, HBV DNA level as well as comorbidities were analyzed in this study. The count data were compared with kappa test or Fisher′s exact test. For the normal distributed measurement data, the homogeneity test of variances (Levene test) was firstly used for comparison between groups. Further, the group t test was applied for variance homogeneity, while the approximate t test was applied for variance non-homogeneity and the Mann-Whitney U test was applied for the non-distributed measurement data. Results A total of 41 patients were enrolled, including 3 drop-outs and 38 accomplishments. Among these 38 patients, there were 3 females (7.9%) and 35 males (92.1%), with ages (38.5±11.1) years. There were 32 patients alive and 6 dead during 1 month′s follow-up, while baseline MELD score was the independent prognostic factor (RR=1.864, 95%CI: 1.151-3.019) for survival. There were 31 patients alive and 7 dead during 3 months′ follow-up, while baseline MELD score and upper gastrointestinal hemorrhage (UGH) were the independent prognostic factors (RR=2.053, 95%CI: 1.163-3.625; RR=394.939, 95%CI: 1.880-82 948.817). There were both 26 patients alive and 12 dead during 6 and 12 months′ follow-up, while baseline MELD score was the independent prognostic factor (RR=1.761, 95% CI: 1.230-2.523). At the end of 24 months′ follow-up, there were 15 patients alive and 23 dead. Viral rebounds were observed in 6 patients and 3 of them were dead. Baseline HBV DNA level, MELD score and electrolyte imbalance were the independent prognostic factors (RR=9.722, 95% CI: 1.607-58.821; RR=1.518, 95% CI: 1.066-2.162; RR=87.505, 95% CI: 2.263-3 384.232) for 24 months′survival. Conclusions Although telbivudine is not recommended as the first-line treatment, ACLF patients with low MELD score and low HBV DNA level at baseline, individualized treatment may improve patient's survival rate. UGH and electrolyte imbalance may affect the efficacy of telbivudine and reduce the survival rate of ACLF patient. Key words: Hepatitis B virus; Liver failure; Telbivudine; Survival analysis
{"title":"Analysis of prognostic factors for 24-month survival of hepatitis B virus-associated acute-on-chronic liver failure patients treated with telbivudine","authors":"Hai-bing Gao, Xiangmei Wang, H. Ma, Shenglong Lin, Dongqin Zhang, Wenjun Wu, Jiankai Fang, Minghua Lin","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.11.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.11.001","url":null,"abstract":"Objective \u0000To investigate the baseline independent prognostic factors for 24 months survival of hepatitis B virus (HBV)-associated acute-on-chronic liver failure (ACLF) patients treated with telbivudine. \u0000 \u0000 \u0000Methods \u0000The prospective cohort study was conducted in HBV-associated ACLF patients who were hospitalized in Mengchao Hepatobiliary Hospital of Fujian Medical University and volunteered to be treated with telbivudine for more than 24 months. The patients were observed for survival at month 1, 3, 6, 12, and 24 after treatment. The baseline biochemical index, coagulant function, model for end-stage liver disease (MELD) score, HBV DNA level as well as comorbidities were analyzed in this study. The count data were compared with kappa test or Fisher′s exact test. For the normal distributed measurement data, the homogeneity test of variances (Levene test) was firstly used for comparison between groups. Further, the group t test was applied for variance homogeneity, while the approximate t test was applied for variance non-homogeneity and the Mann-Whitney U test was applied for the non-distributed measurement data. \u0000 \u0000 \u0000Results \u0000A total of 41 patients were enrolled, including 3 drop-outs and 38 accomplishments. Among these 38 patients, there were 3 females (7.9%) and 35 males (92.1%), with ages (38.5±11.1) years. There were 32 patients alive and 6 dead during 1 month′s follow-up, while baseline MELD score was the independent prognostic factor (RR=1.864, 95%CI: 1.151-3.019) for survival. There were 31 patients alive and 7 dead during 3 months′ follow-up, while baseline MELD score and upper gastrointestinal hemorrhage (UGH) were the independent prognostic factors (RR=2.053, 95%CI: 1.163-3.625; RR=394.939, 95%CI: 1.880-82 948.817). There were both 26 patients alive and 12 dead during 6 and 12 months′ follow-up, while baseline MELD score was the independent prognostic factor (RR=1.761, 95% CI: 1.230-2.523). At the end of 24 months′ follow-up, there were 15 patients alive and 23 dead. Viral rebounds were observed in 6 patients and 3 of them were dead. Baseline HBV DNA level, MELD score and electrolyte imbalance were the independent prognostic factors (RR=9.722, 95% CI: 1.607-58.821; RR=1.518, 95% CI: 1.066-2.162; RR=87.505, 95% CI: 2.263-3 384.232) for 24 months′survival. \u0000 \u0000 \u0000Conclusions \u0000Although telbivudine is not recommended as the first-line treatment, ACLF patients with low MELD score and low HBV DNA level at baseline, individualized treatment may improve patient's survival rate. UGH and electrolyte imbalance may affect the efficacy of telbivudine and reduce the survival rate of ACLF patient. \u0000 \u0000 \u0000Key words: \u0000Hepatitis B virus; Liver failure; Telbivudine; Survival analysis","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46489325","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 : 2018-11-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.11.005
Yang Zhao, Jin Fu, F. Xiao, Li Li, Baoyuan Zhang, Yanwei Li, Xuelian Han, X. Cui, Qing-ping Duan
Objective To investigate the prevalence of pertussis in infants and children with persistent cough in Beijing during 2011-2016. Methods The eligible infants and children from over ten hospitals who were suspected to have pertussis from 2011 to 2016 were enrolled for detection. Nasopharyngeal secretions and blood samples were collected. Multiplex-PCR was performed for Bordetella pertussis and real-time PCR was performed for nucleic acid of Bordetella pertussis. Results A total of 1 318 eligible cases were enrolled, including 820 males and 498 females. Pertussis was detected positive in 534 cases, including 81.3% (434/534) of B. pertussis positive cases and 31.8% (170/534) of IgG positive cases. There were 13.1% (70/534) had double positive for bacteria and antibodies. From 2011 to 2016, the enrolled patients were increased from 103 cases per year to 460 cases per year, and the test positive patients were increased from 29 cases to 194 cases. Among the pertussis patients, 466 (87.3%) cases were younger than one year old. From the first quarter to the fourth quarter of the year, There were 65 cases, 151 cases, 205 cases, and 113 cases, respectively. In further analysis of the 268 cases from Children′s Hospital affiliated to Capital Institute of Pediatrics, 90.7% of the patients who had whooping cough were scattered children; 185 cases (69.0%) of the patients had not begun programmed immunization, 71 cases (26.5%) did not complete programmed immunization and 12 cases (4.5%) completed the programmed immunization. Of all the inpatients, 21.6% were critical ill, 0.8% (2 cases) dead, and the remaining patients were recovered and discharged. Conclusions The prevalence of pertussis is increasing, especially in summer. Infants are the most susceptible population. Bordetella pertussis is one of the most important pathogen that can induce persistent and chronic cough. Key words: Whooping cough; Epidemiology; Polymerase chain reaction
{"title":"The detection rate of pertussis in children and infants with persistent cough in Beijing during 2011-2016","authors":"Yang Zhao, Jin Fu, F. Xiao, Li Li, Baoyuan Zhang, Yanwei Li, Xuelian Han, X. Cui, Qing-ping Duan","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.11.005","url":null,"abstract":"Objective \u0000To investigate the prevalence of pertussis in infants and children with persistent cough in Beijing during 2011-2016. \u0000 \u0000 \u0000Methods \u0000The eligible infants and children from over ten hospitals who were suspected to have pertussis from 2011 to 2016 were enrolled for detection. Nasopharyngeal secretions and blood samples were collected. Multiplex-PCR was performed for Bordetella pertussis and real-time PCR was performed for nucleic acid of Bordetella pertussis. \u0000 \u0000 \u0000Results \u0000A total of 1 318 eligible cases were enrolled, including 820 males and 498 females. Pertussis was detected positive in 534 cases, including 81.3% (434/534) of B. pertussis positive cases and 31.8% (170/534) of IgG positive cases. There were 13.1% (70/534) had double positive for bacteria and antibodies. From 2011 to 2016, the enrolled patients were increased from 103 cases per year to 460 cases per year, and the test positive patients were increased from 29 cases to 194 cases. Among the pertussis patients, 466 (87.3%) cases were younger than one year old. From the first quarter to the fourth quarter of the year, There were 65 cases, 151 cases, 205 cases, and 113 cases, respectively. In further analysis of the 268 cases from Children′s Hospital affiliated to Capital Institute of Pediatrics, 90.7% of the patients who had whooping cough were scattered children; 185 cases (69.0%) of the patients had not begun programmed immunization, 71 cases (26.5%) did not complete programmed immunization and 12 cases (4.5%) completed the programmed immunization. Of all the inpatients, 21.6% were critical ill, 0.8% (2 cases) dead, and the remaining patients were recovered and discharged. \u0000 \u0000 \u0000Conclusions \u0000The prevalence of pertussis is increasing, especially in summer. Infants are the most susceptible population. Bordetella pertussis is one of the most important pathogen that can induce persistent and chronic cough. \u0000 \u0000 \u0000Key words: \u0000Whooping cough; Epidemiology; Polymerase chain reaction","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45996726","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 : 2018-11-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.11.004
Tingting Wu, J. Zeng, Xiao-peng Jing, Xiaochun Min
Objective To analyze clinical characteristics of bloodstream infections caused by coagulase-negative Staphylococci (CNS) and antibiotic resistance of the bacteria, so that to provide basis for the clinical diagnosis and treatment. Methods A retrospective analysis of CNS in blood cultures collected from 108 hospitalized patients in Puai Hospital of Tongji Medical College from January 2016 to December 2017 was performed. The antimicrobial susceptibilities were tested by Kirby-Bauer method and E test method. For measurement variables, normally distributed variables were compared using t test, and non-normal distributed data were compared using Mann-Whitney U test. Categorical variables were compared using χ2 test. Results Of the 108 patients, 66 were male and 42 were female; the age range was 26 to 98 years and the average was 49 years. According to the criteria for bacteremia, 36 of 108 (33.3%) patients with CNS-positive blood cultures were diagnosed with bacteremia and 72 (66.7%) cases were contaminated. CNS bacteremia mainly occurred in the intensive care unit and nephropathy ward. Among them, 23 (62.2%) patients were catheter-related blood stream infections, and 11 (29.7%) patients were dialysis catheter-related bloodstream infections. Fifteen of 36 (41.7%) strains were isolated within 48 hours of admission. The level of serum procalcitonin (PCT) for bacteremia patients was 2.56 (1.44, 7.60) μg/L, and that was 0.13 (0.05, 0.23) μg/L in contaminated patients. The difference was statistically significant (Z=8.097, P 0.05). After antibiotic treatment, 26 of 36 bacteremia patients were survived. The PCT levels before antibiotic treatment were 2.05 (1.42, 4.32) μg/L, and 0.24 (0.07, 0.61) μg/L after antibiotic treatment. Serum PCT was decreased significantly after antibiotic treatment (Z=4.457, P 0.05). No significant difference was found in white blood cell count between survivors and deaths at 28 days (t=0.771, P>0.05). There was no statistical difference of the anti-bacterial drug susceptibility between pathogens and contaminants (P>0.05). All strains were sensitive to vancomycin, teicoplanin and linezolid. Conclusions The incidence of CNS contamination in blood culture is relatively high. It is important to distinguish true bacteraemia from contamination by a review of the clinical and laboratory indicators. PCT is of clinical value to indicate CNS infection and to monitor therapeutic effect. Key words: Bacteremia; Coagulase negative Staphylococci; Procalcitonin
目的分析凝固酶阴性葡萄球菌(CNS)血流感染的临床特点及耐药情况，为临床诊断和治疗提供依据。方法回顾性分析2016年1月至2017年12月同济医学院普爱医院108例住院患者血培养标本的中枢神经系统。采用Kirby-Bauer法和E试验法进行药敏试验。对于计量变量，正态分布变量比较采用t检验，非正态分布数据比较采用Mann-Whitney U检验。分类变量比较采用χ2检验。结果108例患者中，男性66例，女性42例;年龄范围为26岁至98岁，平均年龄为49岁。根据菌血症诊断标准，108例cns阳性血培养患者中36例(33.3%)诊断为菌血症，72例(66.7%)被污染。中枢神经系统菌血症主要发生在重症监护病房和肾病病房。其中导管相关血流感染23例(62.2%)，透析导管相关血流感染11例(29.7%)。36株中有15株(41.7%)在入院48小时内分离。菌血症患者血清降钙素原(PCT)水平为2.56 (1.44,7.60)μg/L，污染患者血清PCT水平为0.13 (0.05,0.23)μg/L。差异有统计学意义(Z=8.097, p0.05)。36例菌血症患者经抗生素治疗后，26例存活。抗生素治疗前PCT水平为2.05 (1.42,4.32)μg/L，抗生素治疗后为0.24 (0.07,0.61)μg/L。抗生素治疗后血清PCT显著降低(Z=4.457, P 0.05)。存活组与死亡组28天白细胞计数无显著差异(t=0.771, P < 0.05)。病原菌与污染物的抗菌药物敏感性比较，差异无统计学意义(P < 0.05)。所有菌株对万古霉素、替可普宁和利奈唑胺敏感。结论血培养中中枢神经系统污染发生率较高。重要的是通过审查临床和实验室指标来区分真正的菌血症和污染。PCT对提示中枢神经系统感染和监测治疗效果有临床价值。关键词:菌血症;凝固酶阴性葡萄球菌;原降钙素
{"title":"Clinical significance of coagulase-negative Staphylococci isolated from blood cultures","authors":"Tingting Wu, J. Zeng, Xiao-peng Jing, Xiaochun Min","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.11.004","url":null,"abstract":"Objective \u0000To analyze clinical characteristics of bloodstream infections caused by coagulase-negative Staphylococci (CNS) and antibiotic resistance of the bacteria, so that to provide basis for the clinical diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis of CNS in blood cultures collected from 108 hospitalized patients in Puai Hospital of Tongji Medical College from January 2016 to December 2017 was performed. The antimicrobial susceptibilities were tested by Kirby-Bauer method and E test method. For measurement variables, normally distributed variables were compared using t test, and non-normal distributed data were compared using Mann-Whitney U test. Categorical variables were compared using χ2 test. \u0000 \u0000 \u0000Results \u0000Of the 108 patients, 66 were male and 42 were female; the age range was 26 to 98 years and the average was 49 years. According to the criteria for bacteremia, 36 of 108 (33.3%) patients with CNS-positive blood cultures were diagnosed with bacteremia and 72 (66.7%) cases were contaminated. CNS bacteremia mainly occurred in the intensive care unit and nephropathy ward. Among them, 23 (62.2%) patients were catheter-related blood stream infections, and 11 (29.7%) patients were dialysis catheter-related bloodstream infections. Fifteen of 36 (41.7%) strains were isolated within 48 hours of admission. The level of serum procalcitonin (PCT) for bacteremia patients was 2.56 (1.44, 7.60) μg/L, and that was 0.13 (0.05, 0.23) μg/L in contaminated patients. The difference was statistically significant (Z=8.097, P 0.05). After antibiotic treatment, 26 of 36 bacteremia patients were survived. The PCT levels before antibiotic treatment were 2.05 (1.42, 4.32) μg/L, and 0.24 (0.07, 0.61) μg/L after antibiotic treatment. Serum PCT was decreased significantly after antibiotic treatment (Z=4.457, P 0.05). No significant difference was found in white blood cell count between survivors and deaths at 28 days (t=0.771, P>0.05). There was no statistical difference of the anti-bacterial drug susceptibility between pathogens and contaminants (P>0.05). All strains were sensitive to vancomycin, teicoplanin and linezolid. \u0000 \u0000 \u0000Conclusions \u0000The incidence of CNS contamination in blood culture is relatively high. It is important to distinguish true bacteraemia from contamination by a review of the clinical and laboratory indicators. PCT is of clinical value to indicate CNS infection and to monitor therapeutic effect. \u0000 \u0000 \u0000Key words: \u0000Bacteremia; Coagulase negative Staphylococci; Procalcitonin","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69753663","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 : 2018-10-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.10.003
Ming-Hui Yang
{"title":"Treatment strategy of patients with refractory and special hepatitis C virus infection","authors":"Ming-Hui Yang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.10.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.10.003","url":null,"abstract":"","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41835636","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}
Objective To evaluate the diagnostic value of T cells spot test of tuberculosis infection (T-SPOT.TB) on blood and cerebrospinal fluid for tuberculous meningitis (TBM). Methods One hundred and fifteen adult patients with suspected tuberculous meningitis were retrospectively enrolled from March 2013 to March 2017 in Huashan Hospital affiliated to Fudan University. Among them, 30 were diagnosed with TBM (7 definite, 19 highly probable and 4 possible), 37 with other infectious meningitis and 29 with non-infectious meningitis. The diagnostic sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of T-SPOT.TB on peripheral mononuclear cells (PBMC) and cerebrospinal fluid mononuclear cells (CSF-MC) were analyzed using Fisher exact test, and the diagnostic performance was evaluated by using receiver operating characteristic (ROC) curve and area under the curve (AUC). Results When including the 30 TBM cases and 66 non-TBM cases into analysis, the sensitivities and specificities, PPV and NPV of PBMC and CSF-MC for diagnosing TBM were as follows: 93.1% and 66.7%, 77% and 87.7%, 65.9% and 71.4%, 95.9% and 85.1%, respectively. When including the 30 TBM and 37 other infectious meningitis into analysis, the sensitivities and specificities, PPV and NPV of the PBMC and CSF-MC for diagnosing TBM were as follows: 93.1% and 66.7%, 68.6% and 86.5%, 71.1% and 80.0%, 92.3% and 76.2%, respectively. By ROC curve analysis, the AUC of blood and CSF were 0.882 (95%CI: 0.795-0.969) and 0.814 (95% CI: 0.704-0.925), respectively. Using a cut-off value of 32 spot forming cells (SFC) per million CSF-MC for T-SPOT.TB on CSF-MC showed a sensitivity of 66.7%, a specificity of 91.9%, PPV of 87.0% and NPV of 77.3%. The positive likelihood ratio and negative likelihood ratio were 8.22 and 0.363 respectively. Conclusions T-SPOT.TB on CSF-MC has a role in diagnosing TBM. And 32 SFC per million CSF-MC might be the optimal cut-off value to differentiate TBM and non-TBM. Key words: T cells spot test of tuberculosis infection; Cerebrospinal fluid; Tuberculosis, meningeal; Diagnosis
{"title":"Diagnostic value of T cells spot test of tuberculosis infection on blood and cerebrospinal fluid for tuberculous meningitis","authors":"Qing-luan Yang, Bingyan Zhang, Qianqian Liu, Wei Zhang, Yuanyuan Liu, X. Weng, L. Shao, Wenhong Zhang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.10.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.10.009","url":null,"abstract":"Objective \u0000To evaluate the diagnostic value of T cells spot test of tuberculosis infection (T-SPOT.TB) on blood and cerebrospinal fluid for tuberculous meningitis (TBM). \u0000 \u0000 \u0000Methods \u0000One hundred and fifteen adult patients with suspected tuberculous meningitis were retrospectively enrolled from March 2013 to March 2017 in Huashan Hospital affiliated to Fudan University. Among them, 30 were diagnosed with TBM (7 definite, 19 highly probable and 4 possible), 37 with other infectious meningitis and 29 with non-infectious meningitis. The diagnostic sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of T-SPOT.TB on peripheral mononuclear cells (PBMC) and cerebrospinal fluid mononuclear cells (CSF-MC) were analyzed using Fisher exact test, and the diagnostic performance was evaluated by using receiver operating characteristic (ROC) curve and area under the curve (AUC). \u0000 \u0000 \u0000Results \u0000When including the 30 TBM cases and 66 non-TBM cases into analysis, the sensitivities and specificities, PPV and NPV of PBMC and CSF-MC for diagnosing TBM were as follows: 93.1% and 66.7%, 77% and 87.7%, 65.9% and 71.4%, 95.9% and 85.1%, respectively. When including the 30 TBM and 37 other infectious meningitis into analysis, the sensitivities and specificities, PPV and NPV of the PBMC and CSF-MC for diagnosing TBM were as follows: 93.1% and 66.7%, 68.6% and 86.5%, 71.1% and 80.0%, 92.3% and 76.2%, respectively. By ROC curve analysis, the AUC of blood and CSF were 0.882 (95%CI: 0.795-0.969) and 0.814 (95% CI: 0.704-0.925), respectively. Using a cut-off value of 32 spot forming cells (SFC) per million CSF-MC for T-SPOT.TB on CSF-MC showed a sensitivity of 66.7%, a specificity of 91.9%, PPV of 87.0% and NPV of 77.3%. The positive likelihood ratio and negative likelihood ratio were 8.22 and 0.363 respectively. \u0000 \u0000 \u0000Conclusions \u0000T-SPOT.TB on CSF-MC has a role in diagnosing TBM. And 32 SFC per million CSF-MC might be the optimal cut-off value to differentiate TBM and non-TBM. \u0000 \u0000 \u0000Key words: \u0000T cells spot test of tuberculosis infection; Cerebrospinal fluid; Tuberculosis, meningeal; Diagnosis","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48383445","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 : 2018-10-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.10.006
D. Ji, Yandong Yang, Q. Shao, Zhongbin Li, Jiajie Liao
Objective To evaluate the effectiveness and safety of direct-acting antiviral agents (DAA) treatment in Chinese chronic hepatitis C (CHC) patients with genotype (GT) 1b HCV infection in a real world setting. Methods The consecutive GT1b CHC Chinese patients treated with sofosbuvir (SOF) plus daclatasvir (DCV) (n=62) or SOF plus ledipasvir (LDV) (n=171) were enrolled from July 2014 to December 2016 at 302 Military Hospital of China. The treatment duration for all the patients was 12 weeks. All the clinical parameters were measured at baseline and then 4-weekly till 12 weeks after the end-of-treatment (EOT). Baseline clinical characteristics, treatment efficacy, safety and tolerance were compared. Serum HCV RNA concentration was detected by means of COBAS TaqMan assay with a lower detection limit of 15 IU/mL, and liver stiffness was measured using FibroScan®. Sustained virologic response (SVR) was defined as HCV RNA under the lower limit of quantification 12 weeks after EOT (SVR12). Students′ t-test, pearson χ2 test, Spearman rank correlation analysis and Fisher exact test were used for comparison between groups when appropriate. Results Among 233 patients, 173 cases had baseline HCV RNA level ≥6.0 lg IU/mL and 97 cases hade liver stiffness measurement (LSM)≥17.5 kPa. The baseline liver inflamation, liver fibrosis, and HCV RNA load of patients in the two groups were not significantly different (all P>0.05). The HCV RNA of all the 233 patients was undetectable at the end of 12-week treatment, while 2 patients relapsed after 12 weeks of EOT with the overall SVR12 of 99.1%. HCV RNA decline was significantly faster in patients with lower LSM than those with higher LSM (ρ=0.233, P=0.001), and SVR12 was higher in those with lower LSM. In terms of other clinical characteristics of SOF+ DCV and SOF+ LVD groups, alanine transaminase declined from (68.0±60.1) and (70.1±56.1) U/L to (21.1±10.9) U/L and (15.3±9.5) U/L, respectively, total bilirubin declined from (21.3±17.3) and (18.2±14.0) μmol/L to (13.2±6.7) and (10.2±4.6) μmol/L, respectively, AFP declined from 19.6 (10.6, 62.3) and 15.0 (12.0, 25.0) μg/L to 6.5(4.5, 18.7) and 7.8(5.3, 15.4) μg/L, respectively, LSM declined from 17.6 (8.9, 25.4) and 15.7 (7.8, 23.9) kPa to 13.9(6.5, 21.4) and 9.1(5.6, 19.9) kPa, respectively, serum album elevated form (37.5±5.8) and (38.7±5.5) g/L to (41.3±4.7) and (42.8±5.1) g/L, respectively, platelet elevated from (120.9±78.2) ×109/L and (136.6±65.8)×109/L to (139.5±71.8)×109/L and (149.7±71.4)×109/L, respectively. Reports of adverse events were low in both groups. Conclusions Both SOF+ DCV and SOF/LDV therapy are highly effective with >98% of SVR12 and reduce LSM value significantly with good safety for CHC GT1b Chinese patients. Key words: Hepatitis C, chronic; Treatment; Direct-acting antiviral agents
{"title":"Direct acting antiviral agent for Chinese patients with chronic hepatitis C genotype 1b infection——a real world experience","authors":"D. Ji, Yandong Yang, Q. Shao, Zhongbin Li, Jiajie Liao","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.10.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.10.006","url":null,"abstract":"Objective \u0000To evaluate the effectiveness and safety of direct-acting antiviral agents (DAA) treatment in Chinese chronic hepatitis C (CHC) patients with genotype (GT) 1b HCV infection in a real world setting. \u0000 \u0000 \u0000Methods \u0000The consecutive GT1b CHC Chinese patients treated with sofosbuvir (SOF) plus daclatasvir (DCV) (n=62) or SOF plus ledipasvir (LDV) (n=171) were enrolled from July 2014 to December 2016 at 302 Military Hospital of China. The treatment duration for all the patients was 12 weeks. All the clinical parameters were measured at baseline and then 4-weekly till 12 weeks after the end-of-treatment (EOT). Baseline clinical characteristics, treatment efficacy, safety and tolerance were compared. Serum HCV RNA concentration was detected by means of COBAS TaqMan assay with a lower detection limit of 15 IU/mL, and liver stiffness was measured using FibroScan®. Sustained virologic response (SVR) was defined as HCV RNA under the lower limit of quantification 12 weeks after EOT (SVR12). Students′ t-test, pearson χ2 test, Spearman rank correlation analysis and Fisher exact test were used for comparison between groups when appropriate. \u0000 \u0000 \u0000Results \u0000Among 233 patients, 173 cases had baseline HCV RNA level ≥6.0 lg IU/mL and 97 cases hade liver stiffness measurement (LSM)≥17.5 kPa. The baseline liver inflamation, liver fibrosis, and HCV RNA load of patients in the two groups were not significantly different (all P>0.05). The HCV RNA of all the 233 patients was undetectable at the end of 12-week treatment, while 2 patients relapsed after 12 weeks of EOT with the overall SVR12 of 99.1%. HCV RNA decline was significantly faster in patients with lower LSM than those with higher LSM (ρ=0.233, P=0.001), and SVR12 was higher in those with lower LSM. In terms of other clinical characteristics of SOF+ DCV and SOF+ LVD groups, alanine transaminase declined from (68.0±60.1) and (70.1±56.1) U/L to (21.1±10.9) U/L and (15.3±9.5) U/L, respectively, total bilirubin declined from (21.3±17.3) and (18.2±14.0) μmol/L to (13.2±6.7) and (10.2±4.6) μmol/L, respectively, AFP declined from 19.6 (10.6, 62.3) and 15.0 (12.0, 25.0) μg/L to 6.5(4.5, 18.7) and 7.8(5.3, 15.4) μg/L, respectively, LSM declined from 17.6 (8.9, 25.4) and 15.7 (7.8, 23.9) kPa to 13.9(6.5, 21.4) and 9.1(5.6, 19.9) kPa, respectively, serum album elevated form (37.5±5.8) and (38.7±5.5) g/L to (41.3±4.7) and (42.8±5.1) g/L, respectively, platelet elevated from (120.9±78.2) ×109/L and (136.6±65.8)×109/L to (139.5±71.8)×109/L and (149.7±71.4)×109/L, respectively. Reports of adverse events were low in both groups. \u0000 \u0000 \u0000Conclusions \u0000Both SOF+ DCV and SOF/LDV therapy are highly effective with >98% of SVR12 and reduce LSM value significantly with good safety for CHC GT1b Chinese patients. \u0000 \u0000 \u0000Key words: \u0000Hepatitis C, chronic; Treatment; Direct-acting antiviral agents","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69753588","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}
Objective To explore the possible associations between EBV capsid antigen-immunoglobulin M antibody (EBV-VCA-IgM), serum EBV DNA load and clinical severity, laboratory results in adolescent and adult patients with infectious mononucleosis (IM). Methods Clinical data of 250 adolescent and adult IM patients were retrospectively analyzed. Patients were divided into two groups by EBV-VCA-IgM titer (>160 U/mL or≤160 U/ mL) and serum EBV DNA level (>3.38 lg copies/mL or <3.38 lg copies/mL), respectively. Clinical data were compared between the two groups, respectively. The t test was used for intergroup comparison and the Mann-Whitney U test was used for non-normally distributed data. Results Compared with those with lower VCA-IgM antibody titer (≤160 U/ mL), sore throat (83.0% [122/147] vs 67.2%[43/64], χ2=6.534, P=0.011), pharynx secretion (59.9% [88/147] vs 40.6% [26/64], χ2=6.645, P=0.010), and swollen tonsils (78.9% [116/147] vs 59.4% [38/64], χ2=8.631, P=0.003) were more common in those with higher VCA-IgM antibody titer (>160 U/mL). ALT level was higher as well in those with higher VCA-IgM antibody titer (290.5[168.0, 460.5] U/L vs 221.0[113.0, 440.5] U/L, Z=-2.251, P=0.024). The peak body temperature ([39.2±0.7] °C vs [38.7±0.7] °C, t=-3.150, P=0.002), maximum WBC counts (16.2 [12.2, 20.4]×109/L vs 13.4[11.1, 17.3] ×109/L, Z=-2.098, P=0.036), maximum percentage of lymphocyte ([72.0±7.8]% vs [68.2±7.0]%, t=-2.238, P=0.028), and lymphocyte EBV DNA load ([5.5±0.9] lg copies/mL vs [4.8±1.0] lg copies/mL, t=-2.602, P=0.012) in those with higher serum EBV DNA load >3.38 lg copies/mL were higher than those with serum EBV DNA load <3.38 lg copies/mL. Regression analysis showed that serum EBV DNA load was associated with the peak body temperature (regression coefficient 0.368, P=0.003) and lymphocyte EBV DNA load (regression coefficient 0.389, P=0.002). Conclusions In adolescents and adults, EBV-VCA-IgM antibody titer and serum EBV DNA load are associated with severity of patients with infectious mononucleosis. Key words: Infectious mononucleosis; Virology; Adult; Adolescent; Severity
{"title":"EBV capsid antigen-immunoglobulin M antibody titer and serum EBV DNA load are associated with severity of patients with infectious mononucleosis: a retrospective analysis of clinical features of 250 cases","authors":"Niuniu Li, Jinghang Xu, Yiyi Shi, N. Huo, Guiqiang Wang, Xiaoyuan Xu","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.10.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.10.008","url":null,"abstract":"Objective \u0000To explore the possible associations between EBV capsid antigen-immunoglobulin M antibody (EBV-VCA-IgM), serum EBV DNA load and clinical severity, laboratory results in adolescent and adult patients with infectious mononucleosis (IM). \u0000 \u0000 \u0000Methods \u0000Clinical data of 250 adolescent and adult IM patients were retrospectively analyzed. Patients were divided into two groups by EBV-VCA-IgM titer (>160 U/mL or≤160 U/ mL) and serum EBV DNA level (>3.38 lg copies/mL or <3.38 lg copies/mL), respectively. Clinical data were compared between the two groups, respectively. The t test was used for intergroup comparison and the Mann-Whitney U test was used for non-normally distributed data. \u0000 \u0000 \u0000Results \u0000Compared with those with lower VCA-IgM antibody titer (≤160 U/ mL), sore throat (83.0% [122/147] vs 67.2%[43/64], χ2=6.534, P=0.011), pharynx secretion (59.9% [88/147] vs 40.6% [26/64], χ2=6.645, P=0.010), and swollen tonsils (78.9% [116/147] vs 59.4% [38/64], χ2=8.631, P=0.003) were more common in those with higher VCA-IgM antibody titer (>160 U/mL). ALT level was higher as well in those with higher VCA-IgM antibody titer (290.5[168.0, 460.5] U/L vs 221.0[113.0, 440.5] U/L, Z=-2.251, P=0.024). The peak body temperature ([39.2±0.7] °C vs [38.7±0.7] °C, t=-3.150, P=0.002), maximum WBC counts (16.2 [12.2, 20.4]×109/L vs 13.4[11.1, 17.3] ×109/L, Z=-2.098, P=0.036), maximum percentage of lymphocyte ([72.0±7.8]% vs [68.2±7.0]%, t=-2.238, P=0.028), and lymphocyte EBV DNA load ([5.5±0.9] lg copies/mL vs [4.8±1.0] lg copies/mL, t=-2.602, P=0.012) in those with higher serum EBV DNA load >3.38 lg copies/mL were higher than those with serum EBV DNA load <3.38 lg copies/mL. Regression analysis showed that serum EBV DNA load was associated with the peak body temperature (regression coefficient 0.368, P=0.003) and lymphocyte EBV DNA load (regression coefficient 0.389, P=0.002). \u0000 \u0000 \u0000Conclusions \u0000In adolescents and adults, EBV-VCA-IgM antibody titer and serum EBV DNA load are associated with severity of patients with infectious mononucleosis. \u0000 \u0000 \u0000Key words: \u0000Infectious mononucleosis; Virology; Adult; Adolescent; Severity","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41840504","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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