Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia / 医学前沿

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2 = 0.033; P = 0.018), followed by acute kidney injury (AKI; R2 = 0.032; P = 0.011) and plasma MIP-1β level (R2 = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

The use of short dental implants in rigid fixed bridge for multiple missing teeth:a 2-year follow-up visit / 中国组织工程研究

BACKGROUND: Short dental implants have been widely used in the posterior area when one tooth loses. How effective is it when we use the short implants in the rigid fixed bridge for the multiple teeth lost area?OBJECTIVE: To observe the clinical effect of short dental implants used in the rigid fixed bridge.METHODS: Forty-three patients with multiple missing teeth were enrolled and underwent the rigid fixed bridge supported by short dental implants, including 26 males and 17 females, with an age range of 44-67 years. After 2 years of dental implantation, the success rate of dental implants, amount of alveolar bone loss and dental implant-related complication were followed up.RESULTS AND CONCLUSION: A total of 92 short dental implants, 6-8 mm in length, were implanted,including 44 in the maxilla and 48 in the mandible. There were two cases of peri-implantitis and the success rate of implants was 97.8%. There was no significant difference in the amount of alveolar bone loss between the 8 mm, 7 mm and 6 mm length implants as well as between the C/I ≤ 1, 1 2 groups at 1-2 years after implantation. There were four cases of central screw loose and one case of porcelain fracture after restoration. To conclude, the clinical use of short dental implants in the rigid fixed bridge has achieved good outcomes during the short period, but long-term observation is needed.

Epidemiological investigation on an epidemic of methicillin-resistant Staphylococcus aureus infection / 中国感染控制杂志

Objective To investigate transmission routes of healthcare-associated infection(HAI)caused by methi-cillin-resistant Staphylococcus aureus (MRSA),and make effective measures for preventing and controlling the oc-currence and epidemic of HAI caused by multidrug-resistance bacteria.Methods From February 24 to March 29, 2012,12 MRSA-infected patients were performed epidemiological study,these patients underwent bronchoscopy be-cause of tracheal stenosis,strains were identified by amplifying the sequences of 16S rRNA ,femA and mecA with real-time quantitative polymerase chain reaction (PCR),homology analysis of strains were performed by Spa geno-typing.Results All 12 MRSA-infected patients were susceptible to multidrug-resistance bacterial infection,5 cases of MRSA infection occurred during this hospitalization.Detection of specimens from health care workers and envi-ronment were all negative;Spa gene of all 12 MRSA isolates was type t 030 ,which was the main epidemic strain in Asia;Spa gene of Staphylococcus aureus isolated from nurses’noses was type t1425 .Conclusion The assumption of MRSA spread among health care workers aren’t supported by the epidemiological investigation results,genotypes of 12 MRSA isolates are identical,but the result of gene typing can’t be as the evidence of homology of infection ;patients at high risk for MRSA infection should be screened as early as possible,early contact isolation should be performed,so as to prevent and control the occurrence of HAI.