Secular trends in Klebsiella pneumoniae isolated in a tertiary-care hospital: increasing prevalence and accelerated decline in antimicrobial susceptibility

Abstract: INTRODUCTION Klebsiella pneumoniae has become an increasingly important etiologic agent of nosocomial infections in recent years. This is mainly due to the expression of virulence factors and development of resistance to several antimicrobial drugs. METHODS This retrospective study examines data obtained from the microbiology laboratory of a Brazilian tertiary-care hospital. To assess temporal trends in prevalence and antimicrobial susceptibility, K. pneumoniae isolates were analyzed from 2000 to 2013. The relative frequencies of K. pneumoniae isolation were calculated among all Gram-negative bacilli isolated in each period analyzed. Susceptibility tests were performed using automated systems. RESULTS: From 2000-2006, K. pneumonia isolates comprised 10.7% of isolated Gram-negative bacilli (455/4260). From 2007-2013, this percentage was 18.1% (965/5331). Strictly considering isolates from bloodstream infections, the relative annual prevalence of K. pneumoniae increased from 14-17% to 27-32% during the same periods. A progressive decrease in K. pneumoniae susceptibility to all antimicrobial agents assessed was detected. Partial resistance was also observed to antimicrobial drugs that have been used more recently, such as colistin and tigecycline. CONCLUSIONS Our study indicates that K. pneumoniae has become a major pathogen among hospitalized patients and confirms its recent trend of increasing antimicrobial resistance.

The Influence of Secular Trends in Body Height and Weight on the Prevalence of Overweight and Obesity among Chinese Children and Adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the influence of secular trends in body height and weight on the prevalence of overweight and obesity among Chinese children and adolescents.</p><p><b>METHODS</b>The data were obtained from five cross-sectional Chinese National Surveys on Students' Constitution and Health. Overweight/obesity was defined as BMI-for-age Z-score of per the Wold Health Organization (WHO) reference values. Body height and weight for each sex and age were standardized to those reported in 1985 (standardized height: SHY; standardized weight: SWY) and for each sex and year at age 7 (standardized height: SHA; standardized weight: SWA) using the Z-score method.</p><p><b>RESULTS</b>The prevalence of overweight/obesity in Chinese children was 20.2% among boys and 10.7% among girls in 2010 and increased continuously from 1985 to 2010. Among boys and girls of normal weight, SHY and SHA were significantly greater than SWY and SWA, respectively (P < 0.001). Among boys and girls with overweight/obesity, SHY was significantly lower than SWY (P < 0.001), and showed an obvious decreasing trend after age 12. SHA was lower than SWA among overweight boys aged 7-8 years and girls aged 7-9 years. SHY/SHW and SHA/SWA among normal-weight groups were greater than among overweight and obese groups (P < 0.001).</p><p><b>CONCLUSION</b>The continuous increase in the prevalence of overweight/obesity among Chinese children may be related to a rapid increase in body weight before age 9 and lack of secular increase in body height after age 12.</p>

Secular Trends of Gestational Length Distribution in Korean Singleton and Twin Birth: 1997~99, 2011~13

PURPOSE: To compare the secular trends of gestational length distribution in singleton and twin birth by analyzing the birth certificated data of Statistics Korea. METHODS: The birth certificated data of Statistics Korea was used for this analysis (1997~99: 1,850,236 births, 2011~13: 1,325,301 births). The data of triplet birth cases, extra-marital birth, non-hospital birth cases, teenage birth, and gestational length information missing cases were excluded. Odds ratio and 95% confidence intervals were calculated from multinomial logistic regression analyses to describe the secular trend (1997~99 and 2011~13) of early preterm birth rate (≤33 weeks), late preterm birth rate (34~36 weeks), term birth rate (37~41 weeks), and post-term birth rate (≥42 weeks) adjusted for maternal age (20, 25, 30, 35, 40), birth order (1st=1, 2nd=2, ≧3rd=3), infantile gender (male=1, female=0), maternal occupation (none=1, yes=0), and education (≤middle=1, high=2, college/university=3). RESULTS: From phase I (1997~99) to phase II (2011~13), the gestational length distribution in singleton and twin births shifted the left and toward shorter gestational distribution, and mean gestational length decreased from 39.4 weeks to 38.7 weeks in singleton birth, and decreased from 36.9 weeks to 35.7 weeks in twin birth, During the period, the term birth rate of singleton birth was unchanged at 95 percent, but the term birth rate of twin birth was decreased from 65.7 percent to 46.1 percent. The odds ratio of early preterm birth, late preterm birth, term birth rate, and post-term birth rate in singleton birth for phase II were, respectively, 1.138 (95% confidence interval: 1.106~1.171), 1.556 (1.532~1.581), 1.094 (1.081~1.107), and 0.113 (0.109~0.118), compared with rate of each gestational length for phase I. The odds ratio of each gestational length in twin birth of phase II, comparing phase I, were 1.495 (1.405~1.590) for early preterm birth, 2.110 (2.029~2.194) for late preterm birth, 0.444 (0.428~0.461) for full term birth, and 0.055 (0.026-0.117) for post-term birth. CONCLUSION: The risk of early preterm birth, late preterm birth between phase I & II increased higher in twin birth than that of singleton birth. The rise in early and late preterm birth, and decrease in mean gestational length in singleton and twin birth during the period. There was a need to more research in this area to understand the contributing factors to gestational length.

Secular Trends in Body Dimensions among Young Tennis Players from 1992 to 2008 / Tendencias Seculares en las Dimensiones Corporales entre Tenistas Jóvenes desde 1992 hasta 2008

Several studies have examined both physical characteristics and fitness of children and youth. The aim of the study was first, to find the tendency of changes in selected morphological characteristics of young male and female tennis players of various ages in the periods 1992-2000-2008; and second, to find the changes in selected variables of young tennis players and to compare them with the results of boys and girls of same age from normal school population. Sample of variables included body height, body weight and body mass index (BMI). Multivariate analysis of variance revealed statistically significant differences in all main factors (group, age, gender and period) and additionally in interactions group*period, group*gender and age*gender. Univariate analysis of variance revealed statistically significant differences in body height and BMI between the groups of tennis players and the same age school population for both sexes and between three age groups (12-13 years, 14-15 years, 16-17 years) for body height, body weight and BMI. Differences between the sexes indicate statistically significant differences only in variables body height and weight. Changes in the observed morphological characteristics point to the increase in body height, body weight and BMI values in both school population and young tennis players.

Diversos estudios han examinado las características y estado físico de niños y jóvenes. El objetivo de este estudio fue encontrar la tendencia de los cambios para determinadas características morfológicas de jóvenes tenistas (hombres y mujeres) de distintas edades, en los períodos 1992-2000-2008. Además, encontrar cambios en las variables seleccionadas de jugadores de tenis jóvenes y compararlos con los resultados de niños y niñas de la misma edad en la población escolar normal. Las variables de la muestra incluyeron altura y peso corporal e índice de masa corporal (IMC). El análisis multivariado de varianza reveló diferencias estadísticamente significativas en todos los factores principales (grupo, edad, sexo y periodo) y, además, en las interacciones de grupo-período, grupo-edad y grupo-sexo. El análisis univariado de varianza reveló diferencias estadísticamente significativas en la altura corporal e IMC entre los grupos de jugadores de tenis y la misma población en edad escolar para ambos sexos y entre los tres grupos de edad (12-13 años, 14-15 años, 16-17 años) para altura y peso corporal e IMC. Las comparación entre sexos indican diferencias estadísticamente significativas sólo en las variables altura y peso corporal. Los cambios en las características morfológicas observadas señalan un aumento de la altura y peso corporal e IMC tanto en la población escolar como en los jóvenes jugadores de tenis.