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Objective To investigate the distribution and resistance profile of bacterial isolates in Shanghai Children's Hospital. Methods Antimicrobial susceptibility of all isolates was determined by Kirby-Bauer disk diffusion method according to 2016 CLSI standard. The data were analyzed by WHONET 5.6 software. Results A total of 23 259 non-duplicate strains were isolated from 2011 to 2016, including 10 885(46.8％)gram-postive cocci and 12 374(53.2％)gram-negative bacilli. The average prevalence of methicillin-resistant S. aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)was 35.8％ and 82.2％, respectively. The prevalence of MRSA rose from 27.4％ in 2011 to 42.9％ in 2016. The resistance rate of MRSA and MRCNS strains were significantly higher than methicillin sensitive strains. The resistance rate of Enterococcus faecium strains was significant higher than Enterococcus faecalis. The prevalence of non-susceptible Streptococcus pneumoniae was 31.2％(908). No gram-positive strain was resistant to vancomycin or linezolid. The prevalence of carbapenem resistance increased in gram-negative strains. The resistance rate of Klebsiella pneumoniae to imipenem and meropenem rose from 3.1％ and 4.8 ％ in 2011 to 28.7％ and 37.4％ in 2016, respectively.The rate of Pseudomonas aeruginosa resistance to imipenem and meropenem rose from 13.8％ and 16.5％ in 2011 to 18.8％ and 19.4％ in 2016, respectively, while Acinetobacter baumannii showed resistance rate of 38.3％ and 39.9 ％ in 2011 to 68.4％ and 69.7％ in 2016. Conclusions Increasing prevalence of MRSA, carbapenem-resistant K. pneumoniae, extensively drug-resistant A.baumannii has become a concern in clinical practice. Therefore, antimicrobial resistance surveillance should be highly strengthened in children's hospital.
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Objective To establish normal reference intervals of plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) in children′s hospital.Methods A total of 183 fresh EDTA anticoagulant samples and 125 fresh urine in healthy children were collected from May 2014 to October 2014.According to the CLSI C28-A2 ,the unilateral upper limit 95% was established the normal reference value in different age group.Results There was significant difference in four groups (P<0.05).The normal reference intervals of plasma NGAL in healthy children:0 to <7 months;<291.28 μg/L;7 months to <5 years old;<150.87 μg/L;5 years old to <9 years old:<127.93 μg/L;9 years old to ≤16 years old:<161.74 μg/L;the normal reference intervals of healthy children urine NGAL:0 to <7 months:<257.31 μg/L;7 months to <5 years old:<201.55 μg/L;5years old to <9 years old:<197.69 μg/L;9 years old to ≤16 years old:<151.46 μg/L.Plasma and urine NGAL results in neonatal group were higher than the other three groups.Conclusion The normal reference intervals of plasma and urine NGAL in children′s hospital is established.this could provide clinical evidence for the diagnosis and treatment of acute renal injury in pediatric patients.
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Objective To investigate the correlation among mean platelet volume (MPV) ,serum vitamin D (VD) and immuno-globulin E(IgE) level .Methods A total of 775 children patients in our hospital were selected and grouped according to MPV ,VD and IgE levels .The corresponding detection methods were adopted to detect MPV ,VD and IgE levels .Methods The correlation a-mong these 3 indicators was analyzed .Results The MPV level had statistical difference among the groups with different VD levels (P<0 .05) ,and the MPV level had statistical difference among the groups with different IgE levels (P<0 .05) .The MPV level was negatively correlated with the VD level(r2 =0 .026 ,P<0 .01) ,the MPV level was positively correlated with the IgE level E (r2 =0 .008 ,P<0 .01)and the IgE level and VD level had negative correlation (r2 =0 .08 ,P<0 .01) .Conclusion The VD level is nega-tively correlated with the MPV and IgE levels ,the positive correlation exists between IgE level and MPV level .VD supplement can inhibit platelet activation and inflammation reaction ,and has significant clinical value in the prevention and treating hypersensitive reactive diseases .
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Objective To investigate the effects of pediatric subclinical hypothyroidism on bone age and height and their treatment outcome.Methods Ninety-seven children with subclinical hypothyroidism were served as this study group and 80 children with normal thyroid function as control group.Bone age and height were detected.Patients in study group were treated with thyroid hormone replacement therapy.The efficacy and lipid changes were evaluated before and after treatment.Results The height and bone age in patients of study group were (1.31 ± 0.06) m and (8.29 ± 0.35) years,significantly lower than the control group ((1.41± 0.09) m,(10.02 ± 1.45) years; t =13.532,P ＜ 0.001 and t =14.590,P ＜ 0.001).Thyroid-stimulating hormone showed a significant negative correlation with bone age (r =-0.783,P ＜ 0.001).In a total of 97 children with subclinical hypothyroidism,71 cases were cured,24 cases with improvement and 2 cases with ineffective,and the total effective rate was 97.9％.Before treatment total cholesterol ((3.45 ±0.42) mmol/L),low density lipoprotein cholesterol((2.50 ± 0.35) mtmol/L) in the study group were significantly higher than those of control group((3.33 ± 0.26) mmol/L,(2.24 ±0.22) mmol/L;t =4.378,5.103 ;P =0.036,0.002).After treatment,the level of low density lipoprotein cholesterol in children with subclinical hypothyroidism was significantly lower than before treatment((2.34 ±0.36) mmol/L vs (2.50 ±0.35) mmol/L,t =4.389,P =0.033),but there was no significant difference in terms of other parameters.Contusion Children with subclinical hypothyroidism can lead to lower bone age and shorter height and it may also lead to changes in lipid levels.More attention should be paid on this disease and early intervention should be provided.
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Objective: To study the dietary habits and serum leptin levels of obese children and its possible association to lipids and glucose metabolism, serum lipids and C peptide (CP) in children with different body weight. Methods: 52 obese children were inquired about their favorite foods and food intake. 145 healthy children (85 boys, 60 girls), aged 6-13, with a wide range of body mass index (BMI) 14 to 30 kg/m 2, were measured for fasting serum leptin, CP, glucose, lipids (TG, TC, LDL C,HDL C), height and weight. The children were classified into three groups by BMI, i.e. normal weight group (A group), overweight and slight obese group (B group). moderate and severe obese group (C group). Results: 65% of obese children liked meat best. 38.46% of them ate most in supper. The serum leptin, CP, TG in obese children were higher than that in normal children. Leptin concentration of girls were higher than that in boys in A and B groups (P