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Objective To analyze the pathogen distribution and drug resistance of candida isolated from children with blood infections in our hospital,and to provide reference for clinical effective prevention and treatment.Methods The blood specimens of pediatric patients were collected between January 2009 and December 2015,and were cultured using BacT/ALERT 3D and BD9140 instruments.The candida were separated with Sobaurandps agar culture medium,and identified with chromogenic medium,API 20CAUX test strips or VITEK-2 compact YST card.The minimal inhibitory concentration of 5 drugs were determined by ATB FUNGUS 3 system.Results In 176 cases,92 strains (52.3％) were from neonatal ward,and 46 strains (26.1％) were from PICU.In newborn group,85 strains were isolated from premature,which contained the low and very low birth weight infants (37 strains),pneumonia(20 strains),neonatal respiratory distress syndrome(9 strains).In PICU,the strains were commonly isolated from children with severe infection.Among 176 strains of candida,71 strains (40.3％) were C.albicans,62 strains (35.2％) were C.parapsilosis,16 strains(9.1％) were C.glabrata,9 strains(5.1％) were C.tropicalis,and 18 strains(10.2％) belonged to other candida.Conclusion Candida blood infections can happen at all age of chlidren.The most common strains detected from blood were C.albicans,followed by C.parapsilosis.Most of these strains are susceptible to antifungal drugs,such as fluconazole,except C.glabrata.The sensitive rates to commonly used antifungal drug are more than 93％.The selection of antifungal drugs should be based on the species of strains.
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Objective To study the clinical characteristic and antifungal drug sensitivity of neonatal Candida parapsilosis infections in blood and to provide reference for clinical prevention and therapy.Methods The drug resistance of Candida parapsilosis which were isolated from 8 neonatal blood specimen on the laboratory were analyzed and clinical characteristic of infections in neonates were investigated retrospectively.The blood cultured with BD9120.The fungi were isolated with Sabourand Dextrose Agar and CHROMagar colored medium and identified with API20C.The susceptibility test was then performed with FUNGUS3 micro dilution plate.Results Candida parapsilosis susceptibility results to antifungal drugs showed that 5-flucytosine≤ 4 μg/ml,amphotericin B ≤ 0.5 μg/ml,fluconazole ≤ 1 ～ 2.0 μg/ml,itraconazole ≤ 0.125 ～0.125 μg/ml,voriconazole ≤0.06 ～0.06 μg/ml.Seven cases were preterm infants(low birth weight infants or extremely low birth weight infants),one case was term infant after operation of congenital pyloric atresia.Before blood culture,all the 8 cases of Candida parapsilosis sepsis had received broad-spectrum antibiotics and intravenous nutrition.All the 8 cases had received peripherally inserted central catheter,and 3 cases had received mechanical ventilation.Four cases with fluconazole,3 cases with fluconazole and amphotericin B,1 case with fluconazole at the onset but changed VFend,all 8 cases were cured.Conclusion Candida parapsilosis has become the one of the main pathogens of neonatal infection fungal in blood of premature or low birth weight infants,which is sensitive to 5 kinds of antifungal drugs in vitro susceptibility test.Early detection and antifungal therapy can improve the prognosis.
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<p><b>OBJECTIVE</b>To report a rare case of hemolytic disease of the newborn (HDN) with kernicterus caused by anti-Di(a) diagnosed using high-throughput genotyping multiplex ligation-dependent probe amplification (MLPA).</p><p><b>METHODS</b>Conventional serological methods were used to detect the antibodies related with HDN. The genotypes of more than 40 red blood cell antigens for the newborn and her parents were obtained using the high-throughput MLPA assay. The antibody titers were tested using a standard serological method.</p><p><b>RESULTS</b>The unknown antibody against the low-frequency antigens was predicted based on the primary serological tests. The genotyping results for more than 40 red blood cell antigens of the newborn and her parents showed incompatible antigens of MNS and Diego blood group system, indicating the existence of anti-N or anti-Di(a). Further serological tests confirmed anti-Di(a) existence in the plasma of the newborn and her mother. The titer of anti-Di(a) in the mother's plasma was 1:32.</p><p><b>CONCLUSION</b>Severe HDN including kernicterus can result from anti-Di(a). High-throughput genotyping MLPA assay can help type some rare antigens in complicated cases. The reagent red cell panels including Di(a)-positive cells are necessary in routine antibody screening test in Chinese population.</p>
Subject(s)
Female , Humans , Infant, Newborn , Blood Group Incompatibility , Genetics , Erythroblastosis, Fetal , Diagnosis , Allergy and Immunology , Exchange Transfusion, Whole Blood , Genotype , Nucleic Acid Amplification Techniques , Methods , Rh-Hr Blood-Group System , Genetics , Allergy and Immunology , Rho(D) Immune Globulin , Genetics , Allergy and ImmunologyABSTRACT
Objective To investigate the dynamic changes of infectious distribution,current resistant situation of Streptococcus pneumoniae(SP) and resistant to penicillin and other 10 kinds of antibiotics for the guidance of clinical therapy of SP.Methods Bacteria were identified by French BioMerieux API identification system,VITEK 2-COMPACT identification system and Optochin test,bile solubility test.In vitro,drug susceptibility test to penicillin,cefotaxime,and other 10 kinds of antibiotics were conducted with K-B disk diffusion method combined with the concentration gradient method.Drug susceptibility results were analyzed from 2001 to 2011.Results In recent 11 years,SP antimicrobial resistance rate had increased year after year,especially rates of penicillin-resistant and penicillin not-sensitive had increased significantly,rising from 8.3％( in 2001 ) to 72.7％ ( in 2011 ) ( meningitis 86.4％,non-meningitis 59.0％ ).Resistance rate of cefotaxime,belonging to third-generation cephalosporin had already accounted for 54.0％ ( meningitis 64.0％,non-meningitis 44.0％ ) ;and the resistance rate of macrolide antimicrobial was 100％ ; vancomycin-resistant strains and linezolid-resistant strains had not been detected.Conclusion Penicillin non-susceptible SP has accounted for a high percentage,antimicrobial resistance of Streptococcus pneumoniae penicillin,cephalosporins,macrolides are in serious condition.Vancomycin and linezolid should be preferred or the right antibiotics be chosen according to vitro susceptibility results of isolates in clinical treatment of severe infections caused by SP.
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OBJECTIVE To study the changes in drug resistance and distribution of Pseudomonas aeruginosa to guide drug treatment in clinic.METHODS P.aeruginosa was identified by API and VITEK2 system,and its antimicrobial ressistance was determined by Kirby-Bauer method.The antimicrobial ressistance rates were analyzed by WHONET 5.4 software.RESULTS The resistance of P.aeruginosa to 12 antibiotics was increased in the past nine years.The resistant rate to meropemem,imipenem,ciprofloxacin and ceftazidime was below 30%.Among 2127 strains of P.aeruginosa,94 strains were identified multi-drug resistant and found more frequently in ICU,and Respiratory Department.CONCLUSIONS P.aeruginosa is resistant to many kinds of antimicrobial agents,and resistant rate is increasing year by year.In order to control and slow down the occurrence of the resistant strains,it should be more careful to choose antimicrobial agents according to the antimicrobial susceptibility test.
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OBJECTIVE To observe the antibacterial effect of the foot-ulcer-cure ointment a compound traditional chinese materia medica(TCMM) preparation manufatured on ulceration of(diabetic) rat,in order to give the basis for clinical treatment.METHODS The total(amount) of bacteria and amount of G~-bacteria and the quota of wound healing after the ointment given to the ulceration surface of(diabetic) rats were observed.RESULTS At the third and seventh day,the total amount of(bacteria) and amount of G~-bacteria of the experiment group were remarkably less than the first day and the control group;the speed rate of the wound healing was faster than the control one.CONCLUSIONS The foot-ulcer-care ointment of TCMM has excellent antibacterial functions to diabetic ulceration.It is worth for popularization.