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Objective@#To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection.@*Methods@#A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed.@*Results@#A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%.@*Conclusions@#Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.
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Objective@#To analyze the hints role of surveillance cultures of Carbapenem-resistant Enterobacteriaceae (CRE) by perianal swabs in patients with hematological diseases, and seek risk factors of CRE bloodstream infection.@*Methods@#The resistance of CRE from 2 914 patients with hematological diseases who cultured perianal swabs, CRE bloodstream infection and risk factors were analyzed during January 2016 to December 2017.@*Results@#In this study, perianal swabs from 2 914 patients with hematological diseases were cultured, 74 patients were CRE positive, and bloodstream infection with CRE was found in 13 of these patients. A total of 87 CRE strains were isolated (The same patient only keep the first one for the same location), including 31 Klebsiella pheuminiae, 43 Escherichia coli, 8 Enterobacter cloacae and 6 other Enterobacteriaceae. The resistance rates to piperacillin / tazobactam, imipenem, meropenam, amikacin, levofloxacin, tigecycline were 91.9%, 74.4%, 98.8%, 17.6%, 74.4% and 8.0%, respectively. Resistance to carbapenem, aminoglycoside, quinolones and tegacycline were highly consistent between two sites from 13 patients, whose both perianal swabs and blood were positive in CRE cultures. Febrile neutropenic time, digestive tract symptoms and perianal infection were independent risk factors for bloodstream infection in patients with perianal swabs positive results, the odds ratios (OR) were 1.10 (P=0.029), 1.13 (P=0.005) and 1.23 (P=0.016), respectively.@*Conclusion@#Perianal swabs surveillance cultures of CRE can be hints for CRE bloodstream infection in patients with hematological diseases, and also can provide suggestions for antibiotics. Long time of febrile neutropenic, digestive tract symptoms and perianal infection can be the early warning for CRE bloodstream infections.
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<p><b>OBJECTIVE</b>To explore the relationship between Helicobacter pylori (H. pylori) infection and lower esophageal diseases in light of the changes of the bacterial flora in the lower esophagus.</p><p><b>METHODS</b>Thirty BALB/C mice were randomized into negative control group and H. pylori infection group, and in the latter group, the mice were subjected to intragastric administration of solution containing H. pylori. After 4 weeks of administration, all the mice were sacrificed, and the V6 areas in 16S rDNA were amplified from the bacterial DNA extracted from the lower esophagus using polymerase chain reaction-denaturing gradient gel electrophoresis. The bacterial floras were analyzed on DGGE atlas with Quantity-One 1-D analysis software, and the differential bands between the two groups were amplified using a 16S rDNA v6 area primer followed by DNA sequencing and BLAST analysis.</p><p><b>RESULTS</b>DGGE finger-prints showed a significantly greater number of DNA bands in the infection group than in the negative control group (P<0.01). The diversity index and richness index were also significantly higher in the infection group (0.01<P<0.05). Bacterium cluster class analysis well separated the dendrogram in the infection group. Principal component analysis showed that different groups of bacteria gathered in different locations, and BLAST analysis revealed the presence of special bacteria in the infection group.</p><p><b>CONCLUSION</b>In normal mice, Lactobacillus and the Bacteroides are the predominant bacterial flora colonizing in the lower esophagus, and Staphylococcus, Acinetobacter and Bacteridium become the predominant bacteria after H. pylori infection.</p>