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Objective A preliminary study on the etiology , the gene typing , the PCR-ribotyping and the clinical features of Clostridium difficile from clinical isolates at Xiangya Hospital could improve the isolation rate and provide the basis for effectively prevention of C.difficile.Methods A prospective observational study was performed.A total of 452 stool samples were collected during June to December 2012 at Xiangya Hospital.All stools were anaerobic cultured by selective medium and identified by API 20A for C.difficile.The positive isolates were detected the toxin genes ( tcdA, tcdB, cdtA, cdtB ) and ribotyping (16S-23S internal spacer region ) by PCR.The clinical data of all patients were collected and analyzed through Logistic regression to discover the risk factors for the development of C.difficile infection ( CDI ) . Results The rate of CDI occurrence was 13.94%(63/452), among them, 42.86%(36/63) were A-B+strains and only 14.29%(9/63) were obtained from community acquired-CDI.No binary toxin was detected in any of the isolates.Eleven different PCR ribotypes were identified , the dominant ribotype CD017 accounted for 22.22%(14/63).Logistic regression analysis showed that the risk factors for CDI included age>55(P=0.016;OR=4.45;95%CI:1.33-14.91), diarrhea frequency(P=0.007, OR=0.03;95%CI:0.002 -0.38 ) and the duration of diarrhea ( P =0.015; OR =7.86; 95%CI: 1.50 -41.16 ) . Conclusions C.difficile is the main pathogens of diarrhea patients and is mainly from hospital infections with higher detection rate of A -B+ in Xiangya Hospital.Ribotyping exist comparative advantages type CD017.No evidence suggests outbreak of C.difficile infection.
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OBJECTIVE@#To explore the correlation between peripheral blood cytomegalovirus (CMV) DNA level and cyclosporine A (CsA) plasma concentration among allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients who received immunosuppressant treatment, and to evaluate the potential clinical value.@*METHODS@#A total of 32 allo-HSCT patients were enrolled and their data were analyzed retrospectively. Ganciclovir was used to prevent CMV infection before the transplantation. Routine fluorescence PCR was admitted to test the blood CMV DNA level. The patients were divided into 2 groups: a CMV DNA positive group and a CMV DNA negative group. Enzyme multiplied immunoassay technique was adopted regularly to monitor the blood CsA concentration. The correlation between CMV DNA level and CsA concentration was analyzed.@*RESULTS@#The CMV infection rate in patients who received allo-HSCT was 53.13%. The blood CsA concentration in the CMV DNA positive group was significantly higher than that in the CMV DNA negative group (P<0.05). Through the ROC curve, the area under the curve on Day 1, 7, and 14 had statistical significance compared with 0.5, and the corresponding blood CsA concentration was 203.15, 215.55, and 302.65 ng/mL, respectively.@*CONCLUSION@#Immunosuppressive drug concentration can affect the dynamic changes of CMV DNA. High blood CsA concentration may be one of the reasons for CMV infection. Monitoring the blood CsA concentration may provide guidance for clinical treatment.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Cyclosporine , Blood , Therapeutic Uses , Cytomegalovirus , Cytomegalovirus Infections , DNA, Viral , Blood , Ganciclovir , Therapeutic Uses , Hematopoietic Stem Cell Transplantation , Immunosuppressive Agents , Blood , Therapeutic Uses , Leukemia , Therapeutics , Retrospective StudiesABSTRACT
Objective To observe the effect of anti-Helicobacter pylori (H.pylori) treatment on patients with idiopathic thrombocytopenic purpura (ITP) and its effect on blood platelet. Methods From April 2006 to April 2008, a total of 31 patients diagnosed as having ITP and H.pylori infection were collected. These patients were given standard antibiotic therapy for H.pylori eradication (omeprazole 20 mg, clarithromycin 0.5 g, and amoxicillin 1.0 g, twice per day for 1 week). The effect of anti-H.pylori treatment was analyzed, and the blood platelets were counted before the treatment and on day 7, 14, and 28 after the treatment. Results Of the 31 ITP patients with H.pylori infection, 21 were cured and 10 were not effective, with the effective rate 67.74 %. Blood platelet increased in the cured group but did not change in the no-effect group. Conclusion Anti-H.pylori treatment could increase the blood platelet, and H.pylori infection may be related to the reduction of blood platelet in ITP patients.
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spectrum beta-lactamase genes:blaOXA-128 and blaOXA-129.