ABSTRACT
Objective To investigate the molecular epidemiology and antimicrobial resistance status of uropathogenic Escherichia coli (UPEC) in senior population in Putuo District ,Shanghai .Methods A total of 72 UPEC strains were isolated from elderly inpatients with urinary tract infections in Putuo Hospital ,Shanghai University of Traditional Chinese Medicine from January 2013 to March 2015 .The strains were characterized by multi‐locus sequence typing (MLST ) .The β‐lactamase gene and the plasmid mediated quinolone resistance (PMQR) gene were detected ,and the mutations of quinolone resistance‐determining regions (QRDR) in gyrA and parC genes were demonstrated .In vitro drug susceptibility test was performed .Continuous variables were compared using t test and categorical variables were compared using chi‐squared test or Fisher exact test .Results The UPEC strains showed different resistance rates to ciprofloxacin ,cefotaxime and trimethoprim‐sulfamethoxazole ,which were 76 .4% ,73 .6% and 65 .3% , respectively .UPEC still remained highly sensitive to imipenem ,meropenem ,amikacin and piperacillin‐tazobactam .Among 72 isolates ,55 (76 .4% ) of 49 (68 .1% ) extended‐spectrum β‐lactamase (ESBL )‐positive strains harbored blaCTX‐M genes .Among the 55 ciprofloxacin resistant strains ,51 (92 .7% ) had three or four mutations in QRDR of gyrA and parC genes .The “hot‐spot” mutations of QRDR were located at amino acid position 83 and 87 in gyrA gene and at positions 80 and 84 in parC gene .Forward analysis by MLST showed that the most frequent sequence types (ST ) were ST131 (18/72 ,25 .0% ) , ST1193(7/72 ,9 .7% ) ,ST405 (7/72 ,9 .7% ) ,ST38 (5/72 ,6 .9% ) and ST648 (3/72 ,4 .2% ) .ST131 isolates were predominant in ST which caused community‐onset urinary tract infections .Multiple drug‐resistance were detected in ST 131 ,ST405 ,ST38 and ST648 which were mainly producing blaCTX‐M ESBL .Conclusions Community‐acquired multiple drug‐resistant UPEC strains such as ST131 clone are prevalent in elderly patients .Thus ,monitoring of molecular epidemiology would be beneficial to prevent the prevalence of multiple drug‐resistant UPEC .
ABSTRACT
ObjectiveTo analyze the craniocerebrum ultrasonographic images of the infants born by women with hypertension in pregnancy and investigate the effect of hypertension in pregnancy on neonate brain injury and brain development.MethodsTo assess the brain injury and brain development, 106 infants born by women with hypertension in pregnancy (study group) and 200 infants born by women without high risk factors during perinatal period (control group) in the neonatal intensive care unit of First Affiliated Hospital of Harbin Medical University between 2013 and 2014 underwent brain ultrasonography. The abnormal ultrasound images and the constitution of abnormal ultrasound images distribution in two groups were compared. The relationship between the abnormal ultrasound images and the degree of hypertension in pregnancy were analyzed.ResultsThe brain ultrasonographic result of the infants : (1) In the group with hypertension in pregnancy, the abnormal ultrasound images were found in 78 cases (73.6%). For the preterm infants, the solitary abnormality was found in 41 cases (25 cases of cerebral white matter injury, 14 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities were found in 15 cases; for the full-term infants, the solitary abnormality was found in 17 cases (12 cases of peri-intraventricular hemorrhage, 3 cases of hypoxic-ischemic encephalopathy and 2 case of brain hypoevolutism) and multiple abnormalities were found in 5 cases. (2) In the group without high risk factors, abnormalities were found in 73 cases (36.5 %). For the preterm infants, abnormal ultrasound images were found in 45 cases, including solitary abnormality found in 30 cases (24 cases of cerebral white matter injury, 4 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities found in 15 cases; for the full-term infants, the abnormal ultrasound images were found in 30 cases, including solitary abnormality found in 24 cases (10 cases of peri-intraventricular hemorrhage and 14 cases of hypoxic-ischemic encephalopathy) and multiple abnormalities found in 6 cases. (3) There were obvious statistical significances between the comparativeness of two groups (χ2=38.119,P<0.001), but there were no statistical significances in the constitution of the abnormal ultrasound images distribution between the two groups (χ2=0.552,P=0.759). (4) There were statistical significances between the comparativeness of the abnormal ultrasound images and the degree of hypertensive disorder complicating pregnancy (P<0.001). ConclusionCraniocerebrum ultrasonography is the first choice to detect and monitor brain abnormal and can provide basis for clinical diagnosis, treatment and intervention at early stage for the infants born by women with hypertension in pregnancy.
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ObjectiveTo observe ultrasound images of normal full-term intracranial venous system,in order to provide reference images and guidelines for clinical practice.Methods Courser shape and spectrum characters by anterior fontanel acoustic window of 65 normal newborn infants had been observed.Results①The demonstration of subendymal vein,cerebral vein,Galen vein longitudinal sinus,straight sinus,lateral sinus confluence was 100％,that of basal vein and falcial sinus was 21％ (14/65) and 29％ (19/65),respectively.②The flow rate of a cranial vein decreased.③ In the overall 65 cases,9 ependymal veins,intracranial veins,Galen veins,62 sinus rectus,63 lateral sinuses,65 longitudinal sinuses and confluence sinuums had impulsive blood spectrum.A basal vein had impulsivity in 14 cases.4 of 19 falcial sinuses had impulsivity.Conclusions Color Doppler ultrasound can identify intracranial veins effectively,but some limitations must be taken into account.Blood flow rate of Galen vein sinus confluence is immeasurable.