ABSTRACT
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Age Factors , COVID-19/diagnosis , COVID-19 Testing , China , Hospitalization , Retrospective Studies , SARS-CoV-2/isolation & purification , Symptom AssessmentABSTRACT
Objective To investigate the risk factors involved in the refractory pneumonia caused by multidrug resistant acinetobacter baumannii (MDRAb) in pediatric Intensive care unit (PICU).Methods From January 2009 to August 2011,115 patients with MDRAb pneumonia were treated in Department of Emergency,Wuhan Children's Hospital,Wuhan.Another 45 patients with negative MDRAb (NMDRAb)pneumonia served as control.The patients in the two goups were analyzed using univariate and multivariate Logistic regression to find out the risk factors for MDRAb infection.Results Among the 176 clinical strains of acinetobacter baumannii isolated,128 (72.73％) strains were MDRAb.After drug susceptibility tests,acinetobacter baumannii showed the rates of resistance to β-lactams antibiotics not including cefoperazone-sulbactam were more than 70％,and the rates of resistance to carbapenems antibiotics were higher than 90％.All rates of resistance to antibiotics of betalactams and carbapenems in MDRAb were higher than those in NMDRAb significantly.There were very low rates of drug-resistance found in Amikacin,Levofloxacin,Ciprofloxacin and Minocycline ( ＜20％ ).Multivariate logistic regression revealed that ICU stay,length of time for mechanical ventilation,anemia,hypoproteinemia and the use of carbapenems were independent risk factors involved in MDRAb pneumonia.Conclusions MDRAb was an important conditional pathogen with high rate of drug-resistance to many antibiotics leading to pneumonia in PICU.It increased the mortality of patients significantly.To control the infection of MDRAb was the key to increasing efficacy of treatment of pneumonia in PCIU.
ABSTRACT
Objective To study the pathogenic bacteria strains with drug-resistance prevailing in patients with ventilator-associated pneumonia(VAP)in Pediatric Intensive Care Unit(PICU)in order to provide a reasonable guidance to the clinical use of suitable antibiotics.Method A retrospective clinical study in 46 patients with VAP was carried out in PICU of Wuhan Children's Hospital between January 2008 and June 2010.The prevalent strains of the pathogenic bacteria with drug-resistance isolated from lower respiratory tract by aspiration were analyzed.Results In total,119 pathogenic microbial strains were isolated including Gram-negative bacilli(G-,65.55%),fungi(21.01%)and Gram-positive cocci(G+,13.45%).Among pathogens,the most common pathogenic strains were Acinetobacter baummannii, Escherichia coli,Klebsiella pneumoniae,candida albicans and coagulase-negative staphylococci.Antibiotic susceptibility tests indicated that the situation of the multiple drug-resistances to antibiotics found in G- and G+ Was serious. Most of G- were sensitive to ciprofloxacin, amikacin, imipenem, meropenem,cefoperazone-sulbaetam and piperacillin-tazobactam.The G+ cocci were 100% susceptibility to vancomycin, teicoplanin and linezolid.Fungi were almost sensitive to all the anti-funaus agents. Conclusions The oredominant oathogens of VAP were G- bacilli,and their multiple drug-resistances to antibiotics were the serious problems.The monitoring of the drugresistance should be emphasized, and the option of antibiotics should depend on the antibiotic sensitivity test.
ABSTRACT
Alternations of lymphocyte in biophysical properties (e.g., morphology and viscoelasticity) are related to the human health, disease diagnosis and treatment. Here, we used atomic force microscopy (AFM) to characterize the morphology and mechanical properties of normal lymphocyte and Jurkat. The AFM images revealed that their cell shapes appeared similar. The mechanical properties of the two groups were tracked with AFM-based force spectroscopy. The normal lymphocyte cells had a high adhesion force distribution in (796.7 +/- 248.5) pN, whereas the Jurkat cells had a low force distribution in (158.5 +/- 37.5) pN. The adhesion force revealed that the Young's modulus of normal lymphocyte cells (0.471 kPa +/- 0.081 kPa) was nearly four times higher than that of Jurkat cells (0.0964 kPa +/- 0.0229 kPa) at the same loading rate. The stiffness of normal lymphocyte cells was (2.278 +/- 0.488) mN/m and that of Jurkat cells was (4.322 +/- 0.382) mN/m. The differences in mechanical properties of normal and cancerous cells were obvious that healthy and diseased states could be clearly distinguished. These results may be applied to the clinic disease diagnosis for distinguishing the normal cells from the cancer ones even when they show similar shapes.
Subject(s)
Humans , Biomechanical Phenomena , Jurkat Cells , Physiology , Lymphocytes , Physiology , Microscopy, Atomic Force , MethodsABSTRACT
Objective To investigate the role of hepatocyte growth factor(HGF),keratinocyte growth factor(KGF) and interleukin-1β(IL-1β) in tracheal aspirates (TA) in the genesis and development of acute respiratory distress syndrome (ARDS).Methods The levels of HGF,KGF and IL-1β in TA of 25 children with ARDS (ARDS group) and 23 children with non-ARDS (control group) were assayed by ELISA.Lung injury score was applied to all patients.Results The levels of HGF,KGF and IL-1β in TA were significantly higher in ARDS group than in control group(P<0.0 1).As compared with survivors,the levels of HGF,KGF and IL-1β in TA were markedly higher in dead patients(P<0.01).LIS had a positive correlation with the levels of HGF,KGF and IL-1β(P<0.01).Conclusion HGF,KGF and IL-1β participate in the development of ARDS.The degree of lung injury and prognosis of ARDS may be early estimated by the levels of HGF,KGF and IL-1β in TA.
ABSTRACT
Atomic force microscope(AFM) has one important feature that it is used to scan the samples with non-modified and modified probes to obtain sample appearance,and force-distance curve at certain point,based on which the adhesion,bond force and mechanical properties of the sample can be obtained.Until recently,the application of the AFM to measure the mechanical properties of biological sample is very extensive,which is significant in biomedicine and clinical medicine.This paper introduced the force curve theory of AFM,and reviewed the application of AFM to measure the mechanical properties of biological sample including elasticity,adhesion,stiffness,the interaction between antibody and antigen of the cell.In addition,we prospected the application and development of AFM to analyze cell mechanical properties.