ABSTRACT
Objective:To analyze the distribution of clinically isolated fungal strains and their resistance to common antifungal drugs in Shandong province.Methods:Through the Shandong Children’s Bacterial & Fungal Drug Resistance Surveillance and Research Collaborative Network, a total of 1 030 fungi were collected in 46 hospitals of Shandong province from January 1 to December 31, 2018. The source and type of strains were analyzed, and antifungal drug sensitivity tests were performed by using the micro-dilution method. Whonet 5.6 and SPSS 22.0 were applied to analyze the data.Results:The overall main strains were Candida albicans (38.74%, 399/1 030), Candida tropicalis (16.99%, 175/1 030) and Candida parapsilosis (16.41%, 169/1 030); the main fungi strains in child patients were C. albicans (52.50%, 63/120), C. parapsilosis (12.50%, 15/120) and C. tropicalis (9.17%, 11/120); the main fungi strains in adult patients were C. albicans (36.37%, 331/910), C. tropicalis (17.03%, 155/910) and C. parapsilosis (15.27%, 139/910). The isolation rate of main Candida strains from January to March and August to December was much higher than that of other months. The drug resistance rates of C. albicans to fluconazole and voriconazole were 7.14% and 7.43%, respectively, and the drug resistance rates to itraconazole were 50.44%. The resistance rates of C. tropicalis to fluconazole, voriconazole and itraconazole were 29.05%, 23.29% and 48.65%, respectively. The sensitivity rates of C. parapsilosi to fluconazole, voriconazole and itraconazole were 93.06%, 93.75% and 94.44%, respectively. Candida glabrata showed a dose-dependent sensitivity rate of 2.33% to fluconazole. Analysis of 244 blood fungi strains showed that non-candida albicans bacteremia accounted for 70.08%. In the pathogen spectrum covering 92.22%, fluconazole was sensitive to 64.65% of the pathogens, voriconazole was 68.88%, and amphotericin B was 88.75%. After quantification, the effective rates of fluconazole, voriconazole and amphotericin B in the clinical treatment of fungal bacteremia were 70.10%, 74.69% and 96.23%, respectively. Among them, the sensitivity rate of voriconazole to C. tropicalis was lower than that of fluconazole. Conclusions:Candida is the main clinical fungus isolates in hospitals of Shandong province. The resistance rate of C. tropicalis to azole antifungal drugs is on the rise, and the sensitivity of other Candida species to clinically used antifungal drugs is basically stable.
ABSTRACT
Objective To investigate the effects of visfatin gene overexpressian on insulin sensitivity and plasma fibroblast growth factor 21 (FGF-21) level in rats. Methods The recombinant visfatin plasmid was constructed and transfected into normal rats. The euglyeemic-hyperinsulinemie clamp experiments were performed to evaluate the change of insulin sensitivity before and after administration of the plasmid, and plasma FGF-21 level was determined by radioimmunoassay. Results Plasma visfatin levels and glucose infusion rates (GIR) were significantly increased [(1.49±0.06 vs 0.99±0.04) and (35.3±1.4 vs 27.6±1.7) mg·kg-1·min-1,respectively, all P<0.01]. Fasting insulin level was significantly decreased [(14.5±3.7 vs 24.4±6.2) mU/L,P<0.05], total cholesterol and high-density lipoprotein cholesterol were significantly decreased [(1.31±0.10 vs1.76±0.22) mmol/L and (0.59±0.04 vs 0.95±0.15) mmol/L, respectively, all P<0.05], and plasma FGF-21 level was also decreased [(2.25±0.19 vs 2.59±0.23)μg/L, P<0.05] after plasmid being injected 3 days compared with that before injection, but there were no significant differences in fasting glucose and adiponectin levels before and after administration. Conclusion The transfection of visfatin plasmid increases plasma visfatin level, decreases FGF-21 levels and improves insulin sensitivity in normal rats.