ABSTRACT
Objectives To explore the associations between higher antibiotic use rates (AURs) and adverse outcomes in very-low-birthweight (VLBW) infants without culture-proven sepsis or necrotizing enterocolitis (NEC) in a multicenter of China. Methods A prospective cohort study was performed on VLBW infants admitted to 24 neonatal intensive care units from January 1, 2018, to December 31, 2018. AUR was calculated as calendar days of antibiotic therapy divided by total hospital days. The composite primary outcome was defned as mortality or severe morbidity, including any of the following: severe neurologic injury, bronchopulmonary dysplasia (BPD), and stage 3 or higher retinopathy of prematurity. Results A total of 1,034 VLBW infants who received antibiotics without culture-proven sepsis or NEC were included in this study. The overall AUR of eligible VLBW infants was 55%, and the AUR of each eligible VLBW infant ranged from 3 to 100%, with a median of 56% (IQR 33%, 86%). After generalized propensity score and logistic regression analysis of 4 groups of VLBW infants with diferent AUR range, infants in the higher quartile AUR, (Q3, 0.57~0.86) and (Q4, 0.87~1.00), had higher odds of composite primary outcome (adjusted OR: 1.81; 95% CI: 1.23–2.67; adjusted OR 2.37; 95% CI: 1.59–3.54, respectively) and BPD (adjusted OR: 3.09; 95% CI: 1.52–6.57; adjusted OR 3.17; 95% CI: 1.56–6.57, respectively) than those in the lowest AUR (Q1). Conclusions Antibiotic overexposure in VLBW infants without culture-proven sepsis or NEC was associated with increased risk of composite primary outcome and BPD. Rational empirical antibiotic use in VLBW infants is urgently needed in China.
ABSTRACT
With the world's focus on bio-fuel, cellulolytic microorganisms are being exclusively explored. In this paper, a strain of rod, NBG, was obtained from the rumen of Inner Mongolia sheep by an enrichment method with Whatman No.1 filter paper as the selective substrate. The strain was found to effectively degrade filter paper in solution. It was identified as Fibrobacter succinogenes based on DNA G + C mol %, together with morphological, physiological and biochemical tests. The endo-glucanase, -glucosidase and filter paper enzyme activity of NBG reached 62.5 ± 3.0 Uâ¢mL-1, 169.0 ± 9.4 Uâ¢mL-1 and 30.8 ± 5.4 Uâ¢mL-1, respectively, within 72 h of fermentation.
Com o foco mundial em biocombustíveis, microrganismos celuloliticos estão sendo exclusivamente explorados. Neste trabalho, uma cepa de bastão, NBG foi obtida do rumen de ovelhas do interior DA Mongolia com o método de enriquecimento e o papel de filtro No.1 como substrato seletivo. A cepa foi encontrada para degradar efetivamente o papel de filtro na solução. Foi identificado como Fibrobacter succinogenes baseado em DNA + c mol% juntamente com testes morofológicos, fisiológico e bioquímicos. A endo-glucanase e o papel de filtro chegaram com relação a atividade de enzima NBG 62.5 ± 3.0 U.ml-1, 169±9.4U.ml-1 e 30.8±5.4U.ml-1, respectivamente, com 72 horas de fermentação.