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Bloodstream infection (BSI) is a systemic infectious disease. The incidence and mortality of BSI caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) remain high, which brought severe challenges into clinical anti-infection treatment and enormous economic burdens for the patients. This article reviews the current research progress on risk factors of BSI caused by CRKP, hoping to provide reference for the early diagnosis and treatment of this disease.
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Objective To analyze the clinical characteristics and microbiological pathogens associated with infective endocarditis (IE) in Chinese patients in a university hospital over a 10-year period.Methods We retrospectively evaluated 144 adult IE patients admitted to Peking University First Hospital from 2006 to 2015.Statistical analysis was performed to analyze data on demographics,clinical and laboratory findings,as well as microbiological pathogens.Results The mean age of the 144 patients was 46.6 years.The male to female ratio was 2.3.The most common underlying heart diseases were congenital heart disease (22.9％),followed by degenerative valvular disease (18.8％) and rheumatic heart disease (10.4％).The most common clinical manifestation was fever (91.7％),followed by cardiac murmur (90.3％) and anemia (76.4％).Mitral (40.3％) and aortic valves (39.6％) were most frequently affected.The right-sided IE cases were all found in patients with congenital heart disease.Positive blood culture was documented in 87 IE patients.Streptococcus viridans was the most common pathogen (55.2％,48 episodes),followed by Staphylococcus (24.1％,21 episodes).The prevalence of methicillin-resistant Staphylococcus was 38.1％.Forty-eight (94.1％) of the 51 strains of Streptococcus spp.were susceptible to penicillin.Conclusions Congenital heart disease and degenerative valvular disease have overtaken rheumatic heart disease as the major underlying heart diseases associated with IE.Streptococcus viridans is still the most common pathogen ofIE in China.
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Objective To provide evidences for rational use of antibiotics in treatment of hospital-acquired urinary tract infection.Methods The bacteria isolated from mid-stream urine samples were collected for susceptibility test(MIC)using international standard plate dilution method.According to breakpoints defined in CILS guidelines(2009),each strain of bacteria was determine for susceptibility to antimicrobial agents,and calculated for rates of resistance(R%),intermediate(I%)and susceptibility(R%)to compounds tested.Results 552 strains of bacteria were collected,including 432 strains(78.3%)of Gram-negative bacilli and 120(21.7%)of Gram-positive bacilli;Escherichia coli was one of the most common bacteria in the urinary tract infection(55.3 %),followed by Enterococcus(17.4%).The results of antibiotic susceptibility test in vitro showed that Enterobacteriaceae was 100% susceptible to imipenem;Gram-positive cocci were sensitive most to glycopeptide antibiotics.Conclusion Clinicians should pay attention to the species of pathogenic bacteria causing urinary tract infection and their susceptibility to clinically common used antibiotics for reasonable use of drugs.
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Objective To investigate the clinical and pathological characteristics of IgAN with moth-eaten lesions of GBM.Methods Seven hundred and fifty-six primary IgAN patients(from 1997.1 to 2003.12)were divided into two groups according to the ultrastructural changes of GBM:the IgAN with moth-eaten GBM lesions group(24 cases)and the IgAN without moth-eaten GBM lesions group(101 cases randomly selected).The moth-eaten GBM lesions revealed a local dilatation of irregular outline.Small fragments of the splitting or branching lamina densa were occasionally seen in the swollen GBM.Results The incidence of moth-eaten GBM lesions in IgAN were 3.1%.There were more severe hematuria and proteinuria[(3.5?2.5)g/d vs(2.1?2.4)g/d]and higher percentage of glomerular sclerosis(62.5% vs 49.5%)in moth-eaten GBM lesions group than in the non-moth-eaten GBM lesions group(P﹤0.05).During mean 27 months'follow-up in the 17 patients,none of them showed worse outcome.Conclusion This result suggests that moth-eaten GBM lesions relate to more severe clinical manifestations and pathological changes but further studies are required to clarify the influence of moth-eaten GBM lesions on the prognosis of IgAN.