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Objective:This work aims to investigate the virulence features, spore formation and the resistance mechanisms of major sequence types (STs) of clinical Clostridium difficile isolates from nosocomial infectious diarrhea. Methods:Clostridium difficile isolates were prospectively collected from 816 loose stool samples of in patients with antibiotic associated diarrhea at the Beijing Friendship Hospital of Capital Medical University from September 2017 to September 2019. The main ST types ST81 (26 strains), ST8 (15 strains) and ST42 (14 strains) of C. difficile were used as experimental strains. The polymerase chain reaction (PCR) and enzyme-linked immunoassay (ELISA) were performed to detect toxin genes and toxin production of different C. difficile ST types, respectively. The count of the colony forming units (CFU) of the strains as conducted by using the brain-heart infusion (BHI) agar plates. The antimicrobial resistance patterns of the strains to eleven kinds of antibiotics were determined by agar dilution method. The antimicrobial resistance genes: gyrA, gyrB and ermB were amplified and sequenced from the stains. Mutations in the resistance genes were analyzed by sequencing. Measure data was compared by Kruskal Wallis Test, differences in the resistance rates in three group were compared using Fisher exact test. Results:ST81 strains were identified as the tcdA-tcdB+/ cdtA-cdtB-toxin type, ST8 and ST42 strains belonged to tcdA+tcdB+/ cdtA-cdtB-toxin type. The toxin production of ST42 strains (41.9) were higher than ST8 (2.4) and ST81 groups (0.83) (all P<0.001). The number of spore quantities of ST81, ST8 and ST42 strains were 494×10 5CFU/ml, 160×10 5CFU/ml and 166×10 5CFU/ml, respectively. The spore quantities of ST81 strains were much higher than that of ST81 and ST42 strains (all P<0.001). From the in vitro susceptibility test, 100% (26/26) ST81 strains were featured as multi-drug resistant (MDR), and they were resistant to moxifloxacin, ceftriaxone, erythromycin and clindamycin. The resistance rates of ST8 strain to moxifloxacin, erythromycin and clindamycin were 9/15, 11/15 and 11/15, respectively. ST81 strains had higher resistance rates to moxifloxacin, clindamycin and erythromycin, compared to ST8 strains ( P=0.001, P=0.005 and P=0.005). All ST42 strains were susceptible to ceftriaxone and 3/14 ST42 strains were resistant to moxifloxacin. ST81 strains had higher resistance rates to ceftriaxone and moxifloxacin than the ST42 strains (both P<0.001). The positive rate of ermB in ST81 strains (100%, 26/26) were higher the ST8 strains (11/15) ( P<0.005). Amino acid mutation analysis showed that ST81and ST8 stains had one amino acid substitution in both GyrA and GyrB, but the amino acid substitutions were different in GyrB between two ST types. ST81 strains had two point-mutations: Thr82 replaced by Ile in GyrA, and Asp426 replaced by Val in GyrB. ST8 strains had point-mutation: Thr82 replaced by Ile in GyrA; Asp426 replaced by Asn in GyrB. For ST42 strains, Thr82 was replaced by Ile in GyrA. Conclusions:ST81 and ST42 strains were MDR. ST81 had higher spore ability, whereas ST42 strains had more virulence. ST81 strains and most of ST8 strains had high level of fluoroquinolones resistance. It is important to supervise persistently these three ST genotypes to prevent further dissemination.
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Clostridioides difficile is a kind of opportunistic pathogen ubiquitous in human intestinal tracts. It can induce intestinal inflammation by releasing its unique toxins when the body has dysbacteriosis due to various triggers, causing patients to experience a variety of clinical symptoms ranging from simple diarrhea to fatal septic shock. In recent years, the BI/NAP1/027 strain of Clostridioidesdifficile has been detected in stool samples of patients from medical institutions all around China. This kind of strain can produce higher levels of toxins and spores that are more difficult to eradicate. More importantly, the strain will pose tremendous threats and challenges to global public health security once it spreads. In this paper, the epidemiological characteristics, virulence, pathogenic mechanisms, molecular diagnostic techniques and the treatment methods of hypervirulent Clostridioides difficile strain BI/NAP1/027 were summarized based on the existing research results and case reports at home and abroad. The possible future research hotspots and endeavors in the field have also been suggested. This article aimed to make a comprehensive understanding of hypervirulent Clostridioides difficile strain BI/NAP1/027, and to provide a theoretical basis for more in-depth analysis of its pathogenic mechanism and more scientific formulation of its prevention and treatment plans in the future.
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Objective:To investigate the correlation of serum hepatitis B virus large protein (HBV-LP), HBV-DNA, and Pre S1 antigen (Pre S1-Ag) with HBV replication.Methods:Serum samples were collected from 650 patients with chronic hepatitis B (CHB) who were treated in Beijing Friendship Hospital from March 2017 to March 2019. Serum HBV-LP and Pre S1-Ag were detected by enzyme-linked immunosorbent assay (ELISA). HBV markers (HBV-M) were measured using chemiluminescent microparticle immunoassay (CMIA). Quantitative real-time PCR (qRT-PCR) was used to detect HBV-DNA. The positive detection rates of HBV-DNA, HBV-LP and Pre S1-Ag were calculated and compared, and the correlation of HBV-LP (S/CO value) and hepatitis B surface antigen (HBsAg, log 10 IU/ml) with HBV-DNA(log 10 IU/ml)was analyzed. Results:In the 650 CHB patients, the positive rates of HBV-DNA, HBV-LP and Pre S1-Ag were 65.4% (425/650), 79.2% (515/650) and 43.1% (280/650), respectively ( P<0.01). The positive rates of HBV-DNA and HBV-LP in 243 HBeAg-positive patients were 93.0% (226/243) and 94.6% (230/243), and no significant difference was found between them ( P=0.45). However, there was significant difference between the positive rates of HBV-DNA and HBV-LP in 407 patients negative for HBeAg [48.9% (199/407) vs 70.0% (285/407), P<0.01]. The positive rates of HBV-DNA and HBV-LP in HBsAg-, HBeAg- and HBcAb-positive groups were 92.8% (206/222) and 94.1% (209/222), which showed no significant difference ( P=0.56). In HBsAg-, HBeAb- and HBcAb-positive groups, the positive rates of HBV-DNA and HBV-LP were 45.4% (124/273) and 69.9% (191/273) ( P<0.01). The detection rate of HBeAg was lower than that of HBV-LP significantly in both HBV-DNA-positive and HBV-DNA-negative groups ( P<0.01). With the increasing of HBV-DNA load, the S/CO value and the positive rate of HBV-LP increased significantly ( P<0.05). Conclusions:HBV-LP had a good correlation with HBV-DNA load as compared with Pre S1-Ag, HBeAg and HBsAg. HBV-LP in combination with HBV-M might be used as predictive markers that could efficiently reflect the status of HBV replication.
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Objective@#To explore the application value of matrix assisted laser desorption time of flight mass spectrometry (MALDI-TOF-MS) inproteomics of HBV-related liver cancer.@*Methods@#Thirty patients with HBV-related liver cancer, and 25 healthy volunteers were selected from January2018 to June 2018 in our hospital. The serum proteins of these participantswere captured by weak cation exchange (WCX) beads. MALDI-TOF-MS and related software were used to analyze the proteins, detect the marker of serum proteins in HBV-related liver cancer, establish the liver cancer diagnosis model and perform blind test.@*Results@#Totally 81 protein peaks were screened out, and 27 protein peaks had significant difference (P<0.05), of which 17 were up-regulated, 10 were down-regulated. Three differential protein peaks (M/Z 9179.55, 7789.00, 4097.00) were screened by BPS5.0 software to establish the model. Further blind test showed that the sensitivityand specificity of the protein peaks were 90.91% and 77.78%, respectively.@*Conclusions@#MALDI-TOF-MS provided an important basis for the diagnosis and treatment of HBV-related liver cancer.
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Objective To find the rational selection of specimens for the detection of Epstein-Barr virus ( EBV ) DNA.Methods A total of 117 patients were diagnosed with EBV infection at Beijing Friendship Hospital from January to June 2017, including 44 patients with infectious mononucleosis (IM), 36 patients with EBV-associated hemophagocyticlymphohistiocytosis ( HLH ) and 37 patients with post-transplant lymphoproliferative disorders (PTLD).Patients were aged from 6 months to 28 years.EBV DNA loads (median and quartile) in peripheral blood mononuclear cells (PBMC) and plasmawere detected by real-time quantitative PCR.The viral loads of different specimen types were compared by nonparametric rank sum test ( Mann-Whitney test, M-W test) .Spearman correlation analysis was performed for correlation analysis.Results TheEBV DNA loads in PBMC of IM and PTLD were 53600 (7875,626500) copies/ml and 114000 (3396,590500) copies/ml, which were significantly higher than those in plasma [4500 (675, 8600)copies/ml and 0(0, 0)copies/ml, respectively].The M-W values were 372.5 and 30.5 respectively (both P<0.001), which indicated statistically significant differences .However, the EBV DNA loads in PBMC and plasma of HLH were 5100 (1425, 170000) copies/ml and 13500 (1303, 152500) copies/ml.The M-W value was 646.5 (P=0.991), which indicated no statistically significant difference . Spearman correlation analysis showed good correlations of EBV DNA loads between PBMC and plasmain IM and HLH, and the r values were 0.548 and 0.400, respectively (both P<0.05), while the correlation of EBV DNA loads between PBMC and plasma in PTLD was poor , and the r value was 0.308 ( P>0.05 ) . Conclusions For the diagnosis and monitoring of EBV infection , the types of specimens recommended by different diseases are different .Plasma or serum specimens are recommended for quantitative detection of EBV DNA in IM and HLH, while PBMC and plasma specimens are recommended in PTLD .Clinically, the type of specimen should be chosen reasonably according to the type of disease .
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Objective Comparison the corrective effect of plasma exchange method and formula method for chylemia on hematology analysis.Methods A total of 10 samples without hemolysis,jaundice and lipemia were set as control group,each sample was divided into 4 parts,then 5,10,20 and 40 μl lipid emulsion was added.Each chylous samples was treated by plasma exchange method for two times,and routine blood test was reanalyzed with hematology analyzer.The comparisons before and after the exchange was made,while the test results on each exchange were analyzed.For another part,the HGB of chylous plasma was tested,the value was substituted into HGBcorrected value =HGBbefore correction-(HGBchylous plasma-HGBchylous plasma ×HCTbefore correction).Results The chylemia could lead significant increase of HGB,MCH and MCHC (P＜0.05).After plasma exchanging for two times,the three parameters returned to normal and the count of WBC,RBC and PLT decline slightly with no significance.There were no differences between plasma exchange method and formula calibration method.Conclusion Plasma exchange method and formula calibration method could significantly reduce the impact of chylemia on routine blood analysis,which facilitate the clinical work with correct analysis of routine blood test.
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Objective To determine pathogens and epidemiological characteristics of adults with acute respiratory infection (ARI) in Beijing area.Methods During 2015,a total of 2 700 cases of ARI were sampled and detected for 9 respiratory pathogens including Legionella pneumophila type1 (LP1),mycoplasma pneumoniae (MP),qrickettsia (COX),chlamydia pneumoniae (CP),adenovirus (ADV),respiratory syncytial virus (RSV),influenza virus type A and B (INFA,IFVB) and parainfluenza viruses type1,2 and 3 (PIVs) using indirect fluorescence immunoassay.Results A total of 620 cases of ARI were tested positive with positive rate of 22.97％ (620/2 700).MP had the highest prevalence followed by LP1,INFB,COX,CP,PIVs,INFA,ADV and RSV in turn.There were 109 cases found mixed infection with the proportion of 17.58％ (109/620).Mixed infection of LP1 along with MP was the most common pattern.The highest detection rate of pathogens was observed in November,whereas the lowest in April in terms of months (x2 =31.288,P＜ 0.01).Different pathogens had distinct prevalent features.The prevalence of male was significant higher than that of female (x2 =6.402,P =0.011).As for stratificated by age,the middle-aged people had the highest infection rate (x2 =9.094,P=0.059).There was no significant difference between the out-and in-patient in terms of infection rate (x2 =0.114,P=0.736).Conclusion MP,LP1 and INFB accounted for ARI of adults in Beijing area during 2015.
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Objective@#To understand the epidemic characteristics of group A rotavirus diarrhea in pediatric outpatients in Beijing.@*Methods@#Data of children with diarrhea and their stool specimens were collected from Beijing Friendship Hospital from May 2015 to May 2017; group A rotavirus detection kit (colloidal gold) was used for screening of group A rotavirus positive specimens. Reverse transcription-polymerase chain reaction (RT-PCR) was used to analyze the genotype distribution.@*Results@#Of the 1813 cases of children with diarrhea, 319 were positive for rotavirus A, accounting for 17.6%; Positive rate of 1-2 years old children was the highest (27.2%). Six months to 12 months age group and 2 ~-3 years of age group had the highest detection rate (17.5% and 16.7%, respectively). Minimum age of positive detection was 12 days, the highest age of positive detection was 12 years. In February, group A rotavirus had the highest positive proportion, 24.5%, and the lowest was seen in June, 1.2%. The most common genotype of Group A rotavirus was G9 P [8] (55.5%), G1P [8] (22.6%) and G3P [8] (9.7%).@*Conclusions@#Rotavirus is the common pathogens of diarrhea in children under the age of five years in Beijing, the main epidemic strains were of G9P [8] genotype, rotavirus diarrhea has obvious time-specific characteristics.
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Objective To understand the prevalence and genotype distribution of human papillomavirus among male patients attending to venereal outpatient department and provide basic data for prevention and treatment of HPV.Methods Retrospective analysis method was used to analyze 1 074 patients from venereal outpatient department of Beijing Friendship Hospital during January to August in 2015.Swab specimen were analyzed by flow-through hybridization and gene chip to detect the type of HPV.Chi-square test was used to compare the distribution of CA and suspected patients.Results Among the 434 CA samples, the positive rate was 72.6%(315/434).The 58.1%(252/434) samples were high risk HPV positive and 14.5%(63/434) samples were low risk HPV positive.In high risk HPV infection, multiple infection accounted for 40.4%(175/434) and single infection was 17.7%(77/434), while in low risk HPV infection, single infection accounted for 12.9%(56/434).HPV-11, HPV-6, HPV-16, HPV-52, HPV-58 and HPV-51 were common.The positive rate among suspected CA patients was 36.6%(234/640) , and dominated in high risk HPV infection 25.3%( 162/640 ) .The positive rates of high risk HPV in CA patients [ 40.4%( 175/434 ) and 17.7%( 77/434 ) ] were obviously higher than that of suspected ones [12.9%(56/434) and 1.6%(7/434)], χ2 =95.956 and 9.122, both P<0.05.Conclusions Male patients from venereal outpatient department have a high prevalence of HPV, and common genotype are HPV-11, HPV-6, HPV-16, HPV-52, HPV-58 and HPV-51.The intensity of HPV screening should be strengthened in order to provide the vital basis for the prevention and treatment HPV related diseases.
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Objective To analysis TORCH pathogens infection of women in childbearing age in Beijing area,and to explore the relationship of TORCH infection with the level of TNF-α.Methods Using ELISA detect serum IgM and IgG antibody of TOX,RV,CMV,HSV-I and HSV-II from 970 cases of women during Jan.2015 to Dec.2015.TNF-αlevels of TORCH infection and control group were also determined by ELISA,the results were analyzed.Results Of 970 women,the IgM pos-itive rates of TOX,RV,CMV,HSV-I and HSV-II were 1.65%,2.16%,4.54%,17.42% and 6.08%,respectively.The IgG positive rates of them were 3.81%,93.40%,92.47%,64.02% and 14.64% respectively.The positive rates of CMV and HSV-I IgM for women <30 years old were higher than that of ≥30 years old (χ2=4.558,4.051;P<0.05).HSV-I IgM had statistically higher infection rate in summer than other seasons (χ2=5.356,P<0.05).TNF-αlevels of TORCH IgM positive group were elevated compared with control group (t=10.219,P<0.01).Conclusion Women planning pregnancy were easier infected by TORCH in Beijing area during 2015 with specific epidemiological features.TNF-αalso plays detri-mental role during reproduction of childbearing age women.
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Objective In order to prevent the infection of Acinetobacter baumannii and use antibiotics rationally,the clinical infection and drug resistant data of multi-drug resistance Acinetobacter baumannii (MRAB)detected in intensive care unit (ICU)of Beijing Friendship Hospital from 2011 to 2013were analyzed.Methods This study is a retrospective study.One hundred and eighty five strains of MRAB were collected from the patients in ICU from January 2011 to December 2013.Identificationand antibiotic susceptibility of strains were determined with Vitek-2 Compact automatic bacteria identification system.The annual infection rate of MRAB was counted.PCR was used to detect the resistance genes.The clinical features of the patients with MRAB were analyzed.The average age,acute physiology and chronic health evaluation (APACHE) Ⅱ score,duration in ICU and mortality ratio of the MRAB patients were compared with the patients without MRAB.Rank-sum test was used to analyze the average age,APACHE Ⅱ score and duration in ICU.Chi-squared test was used to analyze the mortality ratio and annual infection rate.Results The average age [(67 ± 17)vs (59-± 19) years old,Z =-5.365,P =0],APACHE Ⅱ score [(25.68±7.93) vs (17.62±8.39),Z=-14.821,P=0],duration in ICU [(27 ±29) vs (5 ±8) d,Z =-4.342,P =0] and mortality ratio [10.82％ (53/185) vs 28.65％ (147/1 359),x2 =45.92,P =0] of the patients infected by MRAB were significantly higher than those without the infection.The MRAB was found mostly in sputum and bronchial precipitates (83.78％,155/185).Though detection rate reduced yearly and there was a significant reduction in 2013 compared with 2011 [11.07％ (69/469) vs 8.37％ (52/621),x2 =8.755,P =0.003],the drug resistant rate was in high level and did not show any change in the 3 years.OXA-23 and OXA-51 were detected in all MRAB.Conclusions The main drug resistant mechanism of MRAB in ICU is related to OXA-23.More active methods of coutrol and prevention of MRAB should be used in elderly aud severely pneumonic patients.Intensive disinfection and isolation measures can decrease MRAB detection rate.Combined antibiotics should be used in patients with MRAB infection.
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Objective To investigate the clinical value of combined detection of anti-cyclic citrullinated peptide antibody(anti-CCP antibody),rheumatoid factor(RF),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in the diagnosis of rheu-matoid arthritis(RA).Methods The detection results of the four serum indicators of 290 cases of patients with RA(RA group), 286 cases of patients with non-RA autoimmune diseases(non-RA group)and 1 50 cases of healthy individuals(control group),from March 2013 to August 2014 in this hospital,were retrospectively analysed.Results The serum levels of the four indicators have significant differences among the three groups,between the RA group and non-RA group,and between the RA group and control group(P =0.000).Between non-RA group and control group,there was significant difference of serum levels of anti-CCP antibodies (P =0.013),while the other three serum indicators had no significant differences (P >0.05).The sensitivity of combined detection of anti-CCP antibody and RF,combined detection of anti-CCP antibody,RF and CRP,combined detection of anti-CCP antibody,RF and ESR,and combined detection of anti-CCP antibody,RF,CRP and ESR for RA diagnosis have statistically significant differences (P 0.05 ).The area under a receiver operating characteristic (ROC) curve of anti-CCP antibody,RF,CRP and ESR were 0.873,0.893,0.678 and 0.747,respectively. Conclusion Combined detection of anti-CCP antibody and RF has good specificity and sensitivity,which could improve the clinical diagnosis of RA.Combined detection of CRP and ESR could improve the detection rate of RA.
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Objective To understand the prevalence and sub‐genotypes distribution situation of high risk human papillomavirus (HPV) infection in the gynecological outpatient department in Beijing area in order to provide the reference basis for the prevention and treatment of HPV infection and cervical cancer .Methods The detection results of 13 kinds of high risk HPV genotypes among 1 294 women in the gynecological outpatient department of this hospital from January 2013 to May 2014 were performed the retro‐spective analysis for comparing the epidemiological characteristics of different HPV genotypes .The SPSS17 .0 software was adopted to perform the statistical analysis .Results Among 1 294 detected women ,HPV‐58 ,HPV‐16 and HPV‐52 were most common ,the detection rates were 10 .5% ,9 .2% and 8 .2% respectively .Among various age groups ,the 30 - 0 .05) .Conclusion The women going to the local outpatient department have the higher prevalence of high risk HPV infection .The intensity of HPV screening should be strengthened in order to provide the fundamental basis for the prevention and treatment of HPV related diseases .
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Objective To compare the load of EB virus in peripheral white blood cell,plasma and serum in the patients with he-matologic diseases,and to discuss the feasibility of detecting EB virus load by using plasma or serum instead of peripheral white blood cell.Methods Venous blood of 125 patients with hematologic diseases were collected,and peripheral white blood cell,plasma and serum were isolated.The real-time quantitative PCR was used to detect the virus load in three kinds samples with the EB virus load in peripheral blood cell as the gold standard.Results Compared to peripheral white blood,the EB virus load in plasma and ser-um showed no statistical difference(P >0.05).Conclusion Using plasma or serum instead of peripheral white blood cell for con-ducting the quantitative detection of the load of EB virus will be a reliable method.
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Objective To explore the serum lipid metabolism and immunoregulation of patients with primary nephritic syndrome (PNS) .Methods 50 PNS patients were served as the test group and 50 healthy people the control group .Automatic biochemical analyzer was utilized to detect their serum low density lipid-cholesterol (LDL-C ) ,high density lipid-cholesterol (HDL-C ) , triglyceride(TG) ,total cholesterol(TC) ,apolipoprotein(Apo)A1 ,ApoB ,and lipoprotein (a) .Immunization rate nephelometry was employed to measure their serum IgG ,IgA ,IgM ,complement C3 ,complement C4 ,CD3+ ,CD4+ ,CD8+ and CD4/CD8 .Results Compared with the control group ,serum levels of TC ,TG ,LDL-C ,ApoB ,ApoA1 ,IgM and CD4/CD8 of patients in the test group were significantly higher ,while those of HDL-C ,IgG ,complement C3 ,complement C4 ,CD3+ ,CD4+ ,CD8+ were obviously lower , with both statistically significant differences (P0 .05) .Conclusion Serum lipid level of PNS patients is higher than healthy people ,and considerable loss of Ig and complements and T cell subsets disproportion results in humoral and cellular immune dysfunction .
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Objective To discuss the effect of the combination detection of cardiac troponin I (cTnI) and homocysteine(Hcy) for increasing the diagnosis and treatment offects of non-ST elevation myocardial infarction (NSTEMI) .Methods The levels of cTnI and Hcy were detected in 47 patients with NSTEMI(NSTEMI group) before and after therapy and 63 healthy individuals(control group) .The detection results were performed the statistical analysis for verifying their value to judge the diagnostic and treatment effect of NSTEMI .Results The levels of cTnI and Hcy were (2 .37 ± 0 .65)ng/mL and(19 .23 ± 2 .94)μmol/L in the NSTEMI group ,which were significantly higher than(0 .33 ± 0 .14)ng/mL and(10 .62 ± 3 .27)μmol/L in the control group ,the differences showing statistical significance (P< 0 .05);the sensitivities of single cTnI and Hcy were 95 .74% and 85 .11% respectively ,and their specificities were 85 .71% and 90 .48% respectively ;the sensitivity and sepecificity of cTnI and Hcy combination detection were risen to 97 .87% and 98 .41% respectively ;after therapy ,the cTnI and Hcy levels in the NSTEMI group were significantly lowered and close to the normal levels .Conclusion The combination detection of cTnI and Hcy can not only be used for the diagno-sis of NSTEMI ,but also has the important significance to the judgment of the therapeutical effect of NSTEMI .
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Objective To investigate the resistance and infection case for the Multidrug-Resistant Acinetobacter baumanii (MDRAb) strains.Methods Retrospective study.Thirty-eight MDRAb strains were collected in Beijing Friendship Hospital from February to August 2008.VITEK2-compact system was used to detect the MDRAb.PCR was carried out to detect their resistance related genes and look up the medical records those who were infected by MDRAb.Results The resistance rate of the MDRAb is the highest in ICU.PCR confirmed that OXA-23 and OXA-51 were 100％ related with the MDRAb.Combination drug therapy such as sulbactam combined with β-lactam antibiotics was more effective than β-lactam antibiotics only to treat the infection with MDRAb.Cases analysis showed that a number of patients infected by MDRAb were the aged with basic diseases,low immunity,received a variety of antibiotic therapy even traumatic operation,and they had a poor prognosis finally.Conclusions The resistance rate of the MDRAb is the highest in ICU,OXA-23 is closely related to multidrug-resistance.Combination drug therapy is necessary and sulbactam can play a great role in curing the inpatients infected with MDRAb.
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Although echinocandins,a new generation of antifungal drugs,shows good fungicidal activity against distinct species of Candida,with the extending usage,the activity of echinocandins is gradually to decline,which is caused by different resistance mechanisms.Also,a number of factors may influence its results of susceptibility in vitro (e.g.,human serum,culture temperature in vitro,the pH of the culture medium,and others).Paradoxical effect of echinocandins has its own characteristics and need a further study.In China,there are a few reports about the instances of drug resistance because of the limited clinic application.The study on the echinocandins in prevalence rate of drug resistance and antifungal activity under different status has important clinical significance.
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Objective To evaluate the activity of antibiotics against pan-drug-resistant (PDR) Acinetobacter baumannii by combination antimicrobial susceptibility test in viro with epsilometric methods (Etest method) and microdilution checkerboard (CB method),and to detect a good correlation between timekill curve with the above mentioned two assays.Methods Thirty-one clinical isolates of PDR Acinetobacter baumannii were selected for mono and combination antimicrobial susceptibility test in vitro by E-test and CB method,then a comparison was conducted between the test results and the time-kill curve.Mono drugs involved tigecycline,colistin,imipenem and amikacin,and combinations involved two of drugs above,and three drugs involved imipenem/tigecycline,plus amikacin combination.Results Synergistic effect was detected in imipenem plus colistin and tigecycline plus imipenem combination.A high comparability was revealed between the E-test method with antimicrobial drugs added into the culture medium and the time-kill curves.Synergy in the combination of imipenem/tigecycline,plus amikacin was detected by the CB method and time-kill curves.Conclusion The results showed that the effect of specific combination of antibiotics against PDR Acinetobacter baumannii could be predicted by testing their synergistic effect with combination antimicrobial susceptibility test.
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Objective To discuss the best bacterial combination for the diagnosis of Bacterial vaginosis (BV).Methods This is a retrospective study,230 BV-positive patients and 360 healthy women were enrolled based on the Amsel criteria and Nugent score.5 BV-associated bacteria,including Gardnerella vaginalis,Atopobium vaginae and Leptotrichia/Sneathia species,et al.were amplified by specific-PCR assay,the detection rate were compared between two groups.ROC curve and Kappa test were used to select the best combination.Results The detection rate of Gardnerella vaginalis,Atopobium vaginae,Leptotrichia/Sneathia species,Megasphaera species and Mobiluncus mulieris in BV group (91.3％,83.5％,39.1％,42.6％ and 36.5％ respectively) were markedly higher than that in healthy women (37.2％,14.4％,11.7％,8.9％ and 5.6％ respectively),x2 value were 168.848,275.776,60.949,92.886 and 92.68,all P ＜ 0.05.The area under ROC curve of A.vag,G.Vag + A.vag,G.Vag + A.vag + Lepto,G.Vag + A.vag +Mega and G.Vag + A.vag + M.mul were 0.845,0.862,0.865,0.869 and 0.867,and the sensitivity and specifity were higher than 80％,the value of Kappa were larger than 0.75 (P ＜ 0.05).Thus,these five methods were coincident.Conclusion Detection of Atopobium vaginae may be a better way for the diagnosis of BV.