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Objective To investigate the distribution and transmission characteristics of vancomycin -resistant Enterococcus faecium (VREF) carrying both vanA and vanM in the intensive care unit.Methods VREF strains were isolated from patients in the intensive care unit of Jinshan Hospital , Fudan University in Shanghai from 2013 to 2017.Antimicrobial susceptibilities of the VREF strains to nine antibiotics , including vancomycin, teicoplanin, linezolid and chloromycetin , were tested by broth microdilution method.Multiple polymerase chain reaction (PCR) was used for van genotyping and pulsed field gel electrophoresis (PFGE) was used for homology analysis.Results Thirty-five strains were mainly isolated from urine (16 strains), blood (11 strains), feces ( five strains ), bile ( two strains ) and pleural effusion ( one strain ).All the strains (100.00%) were resistant to vancomycin , ampicillin and levofloxacin , but only 40.00% were resistant to teicoplanin.All the strains were sensitive to linezolid.The results of van genotyping showed that 33 (94.3%) strains belonged to vanA and vanM dual genotype VREF, and the other two were vanA type VREF.PFGE results showed that 35 strains could be divided into 14 PFGE patterns, and seven out of 10 strains isolated in 2014 were identical and the other three belonged to three different PFGE patterns.Conclusions A dual genotype VREF carrying both vanA and vanM has been emerging and spreading in the intensive care unit of Jinshan Hospital , Fudan University in Shanghai.
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Objecive To investigate the prevalence of NDM-type carbapenemases in the carbapenem-resistant Escherichia coli strains collected from Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The epidemiological characteristics of NDM-type carbapenemase-producing isolates were analyzed.Methods Eighteen strains were collected from November 2013 to January 2015 in the clinical microbiology laboratory of Ruijin Hospital. All of them were resistant to imipenem or meropenem (inhibition zone diameter≤19 mm). The blaNDM gene was detected by PCR. The amplified products were subjected to sequencing analysis. Conjugation experiment was carried out to verify the transferability of plasmids. Multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) were performed to analyze the molecular epidemiology.Results The blaNDM gene was identified in 6 strains, 4 of which had blaNDM-1-type and 2 had blaNDM-5-type carbapenemase gene. Three strains were positive in the conjugation experiment. MLST analysis showed that 6 NDM carbapenemase-producing isolates belonged to ifve sequence types, corresponding to five PFGE-DNA patterns (A-E). Two of these isolates shared the identical sequence type (ST5018) and nearly the same PFGE-DNA patterns (A1, A2).Conclusions NDM-type carbapenemase-producing E. coli is identified in this study. Most blaNDM-positive cases were sporadic. Plasmid might play an important role in the spread of blaNDM inE. coli. The blaNDM-5 type carbapenemase gene was first identified in Shanghai, to which more attention should be paid.
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Objective To study the relationship between EBV infection of classic Hodgkin's lyphoma and expression of p16 protein.Methods EBER-1 and p16 protein expression in 80 cases of CHL were studied with EBER-1 oligonucleotide probe and immunohistochemistry respectively.Results 80 cases of CHL were enrolled in this study,including male 52 cases,28 cases of female,male to female ratio of 1.86 ∶ 1.The positive rate of EBER-1 in female was 39.29％ and in male was 63.46％,which have statistically significant difference (x2 =4.298,P =0.038).The positive rate of EBER-1 in children and the older was significantly higher than that in adult (x2 =20.13,P =0.000).EBER-1 positive expression located in the R-S nuclei which positive expression rate was 55.00％,including mixed cell type (MC) 71.79％,lymphocyte depletion type (LD) 42.85％.lymphocyte predominance (LP) 47.06％ and nodular sclerosis type (NS) 29.41％.MG type was significantly higher than NS ( x2 =8.787,P =0.003 ) ; p16 was noted in thc nucleus and cytoplasm.The total positive expression rate was 45％,and subtype positive rates were 47.05％ (LP),48.71％ ( MC),35.29％ (NS) and 42.85％ (LD).There was a negative correlation between p16 protein and EBER-1 ( r =-0.242,P ＜ 0.05 ).Conclusions CHL may be related to EBV latent infection and it can be considered as potential markers to identify HRS cells in diagnosis.