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Objective:To analyze the characteristics of plasmids in KPC-2-producing Serratia marcescens ( S. marcescens) isolates. Methods:Four carbapenem-resistant S. marcescens strains were isolated from four patients admitted to the hepatobiliary ward of Affiliated Cancer Hospital of Zhengzhou University in 2016. BD Phenix-100 was used to identify the strains and detect the minimum inhibitory concentrations (MICs). Homology analysis was performed using pulsed-field gel electrophoresis (PFGE). The modified Hodge test was used to detect the phenotypes of carbapenemase. PCR and gene sequencing were used to detect the types of carbapenem resistance genes. The transferability of plasmids was detected by conjugation test. The characteristics of plasmids were analyzed by genomic alignment method after whole genome sequencing. DNAMAN V9 software was used to compare the amino acid sequences of the replication initiation proteins. A phylogenetic tree was constructed with neighbor-joining method using MEGA7.0. Results:All of the four S. marcescens strains were resistant to carbapenem antibiotics. They were highly homologous according to PFGE. Hodge test results were all positive and the carbapenemase genotype was blaKPC-2. Conjugation test results were positive. The plasmid was a circular DNA of 42 742 bp in length. It had the similar skeleton of incX6 plasmid and the similar amino acid sequence of replication initiation protein. Moreover, it and incX6 plasmid were at the same node in the phylogenetic tree. The blaKPC-2 was located in the core of drug resistance, which was composed of insertion elements including Tn3 family transposons, recombinant enzyme genes, △ISKpn6 and ISKpn27. Conclusions:The plasmid was incX6-like. The blaKPC-2 gene was located in the transposon of △Tn6296. More attention should be paid to the bacteria carrying KPC-2 in incX plasmids.
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Objective To study plasmid-mediated transfer,plasmid replicon typing,and genetic environment of blaNDM-1 gene in Enterobacteraerogenes(E.aerogenes).Methods E.aerogenes HN-NDM0711 was used as the subject of this research,the transferable properties of plasmid were analyzed by conjugation testing,conjugant was performed stability testing,plasmid type was determined by PCR-based replicon typing (PBRT),downstream and upstream of blaNDM-1 were sequenced using chromosome walking method,genetic context was analyzed by BLASTN and BALSTP,as well as annotated using Vector NTI 11.5.1 software,sequence pipeline graph was made,the sequence was submitted to Genbank through software Banklt.Results The conjugation testing of E.aerogenes pHN-NDM0711 was positive,after positive conjugant was conducted 4-day passage,minimal inhibitory concentrations (MICs) of imipenem and meropenem to all the cloned strains didn't change,blaNDM-1 were all positive.The replicon type was IncA/C;blaNDM-1 gene was localized between ISAba14 and IS91,at upstream of the blaNDM-1,class 1 integron and Tn3 transposon were identified,class 1 integron contained a new mosaic structure of a drug-resistant resistance gene cassette.Conclusion E.aerogenes pHN-NDM071 1,bearing blaNDM-1 gene in IncA/C plasmid,derived from gene recombination under different antimicrobial selection pressure.Antimicrobial use in clinical,industrial and agricultural area should be strictly controlled,so as to reduce the emergence of such bacteria.
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@#ObjectiveTo analyze burden and tolerance of caregivers of elders with dementia in Shanghai.MethodsOn the basis of surveyed before, total 1271 caregivers of elders with dementia were investigated with the questionnaire that concerned the demographic characteristics, influence on body, psychology, life and tolerance.ResultsNearly 60% of the caregivers felt stress, nearly 40% of the caregivers thought that mental pressure had a negative impact on their health as a result of caring patients. Most of the caregivers responded with tolerance to non-adaptive behavior.ConclusionDementia caregivers are old, the burden is heavy. It is necessary to establish a social support system for elderly with dementia as soon as possible.
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@# ObjectiveTo evaluate probability and severity of behavioral and psychological symptoms in dementia (BPSD) in elderly with dementia in Shanghai.MethodsOn the basis surveyed before, total 1271 elderly with dementia were investigated with the international neuropsychiatric inventory (NPI) to evaluate BPSD.ResultsThe proportion of elderly with dementia that had BPSD was 50.95% , it was 32.17% for clinical significant disturbance (CSD). The symptoms had greatest impact on the caregivers were paranoia (2.32±1.48), followed by abnormal motor behavior (2.30±1.31) and hallucinations (2.16±1.25). The severity rating included mild 620 cases, moderate 238 cases, and severe 406 cases.ConclusionThe incidence rate of BPSD in elderly with dementia was high. The standard of severity grading should be selected with purposes.
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@#ObjectiveTo investigate the epidemiology of senile dementia in Shanghai.Methods15158 residents aged 65 or over were selected by stratified random cluster sampling from 3 districts in Shanghai. Two stages was carried to ascertain dementia: in the first stage, Mini Mental State Examination (MMSE) and Activity of Daily Living Scale (ADL) were used as screening tools; in the second stage, DSM-Ⅳ criteria for dementia was applied to diagnosis.ResultsScreening positive rate of MMSE and ADL are both 9.9%. 1271 cases of elderly with dementia were identified. The crude and age-standardized prevalence in residents aged 65 or over was 8.1% and 6.1%. The female, older age, lower education and worse marriage seemed to be more susceptible to senile dementia(P<0.01).ConclusionSenile dementia has become one of major diseases harmful to elderly's health.