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Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.
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Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical bacterial isolates from bloodstream infections in China in 2021.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2021 to December 2021. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 11 013 bacterial strains were collected from 51 hospitals, of which 2 782 (25.3%) were Gram-positive bacteria and 8 231 (74.7%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.6%), Klebsiella pneumoniae (18.9%), Staphylococcus aureus (9.8%), coagulase-negative Staphylococci (6.3%), Pseudomonas aeruginosa (3.6%), Enterococcus faecium (3.6%), Acinetobacter baumannii (2.8%), Enterococcus faecalis (2.7%), Enterobacter cloacae (2.5%) and Klebsiella spp (2.1%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 25.3% and 76.8%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci was detected; more than 95.0% of Staphylococcus aureus were sensitive to ceftobiprole. No vancomycin-resistant Enterococci strains were detected. The rates of extended spectrum B-lactamase (ESBL)-producing isolated in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 49.6%, 25.5% and 39.0%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.2% and 15.8%, respectively; 7.9% of carbapenem-resistant Klebsiella pneumoniae was resistant to ceftazidime/avibactam combination. Ceftobiprole demonstrated excellent activity against non-ESBL-producing Escherichia coli and Klebsiella pneumoniae. Aztreonam/avibactam was highly active against carbapenem-resistant Escherichia coli and Klebsiella pneumoniae. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii (5.5% and 4.5%). The prevalence of carbapenem-resistance in Pseudomonas aeruginosa was 18.9%. Conclusions:The BRICS surveillance results in 2021 shows that the main pathogens of blood stream infection in China are gram-negative bacteria, in which Escherichia coli is the most common. The MRSA incidence shows a further decreasing trend in China and the overall prevalence of vancomycin-resistant Enterococci is low. The prevalence of Carbapenem-resistant Klebsiella pneumoniae is still on a high level, but the trend is downwards.
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Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.
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Objective To investigate the distribution of age and relationship of ESR with HCT.Methods The HCT,age and ESR datas of the patients which all ages were above 40 years were Collected,then count the mean and standard deviation x±s with different groups of HCT,t test was made to identify the significance of difference.Results HCT:The levels of hct in males was 0.47±0.26 in higher groups of HCT,0.39±0.27 in normal groups and 30.01 ±3.59 in lower groups.The levels of HCT in fe-males was 0.42±0.17 in higher groups,0.30±0.36 in normal groups,0.27±0.45 in lower groups;Age:The average age in males was 57.41±10.62 years in higher HCT groups of patients,67.23 ±12.75 in lower hct groups,there were significantly difference between them.The avarage age in females was 60.70 ± 11.60 in higher HCT groups of patients,61.60 ± 12.40 in lower HCT groups,there were no significantly difference between them.ESR:The levels of ESR in males was (3.95 ±3.26)mm/h in higher HCT groups,(61.61±40.04)mm/h in lower HCT groups;The ESR in females was (28.26±28.62)mm/h in higher HCT groups, (60.20±43.71)mm/h in lower HCT groups,there were significantly difference between different groups included both males and femals.Conclusion When the HCT were decreased,the age and ESR were increased in males,the ESR were also increased but had no relationship with ages in females.Conjuction the age and ESR,it could improve the prevention and monitoring in heart-brain blood disease through the HCT.
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MicroRNA (miRNA),sharing the character of regulating the transcriptional level and expression level of mRNAs,is one kind of small non-coded RNAs.At present,innate immune has become one of the hot topics for researchers,and miRNAs as a sort of bioactive substance greatly take part in the whole regulation progress.In detailed,miRNAs can influence the immune state of immune cells during innate immune period and further regulate inflammatory conditions in whole body.By systematically summarizing miRNA function during innate immunity,this present review may provide a reference for peer researchers.
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Objective To evaluate the reliability and accuracy of the fully automated erythrocyte sedimentation rate (ESR) analy‐ser Monitor‐100 for determining ESR .Methods 146 outpatients and inpatinets were selected and detected ESR by the fully automa‐ted ESR analyser 1 h ,30 min and the Westergren method .Then these three kinds of method were compared and the repeatability test was performed .Results (1)The ESR values determined by the analyser 1 h ,analyser 30 min and Westergren method were 37 . 8 ± 34 .1 ,38 .1 ± 33 .7 ,36 .4 ± 32 .9 respectively ,there were no statistical significance between any two methods (P>0 .05) .(2)The detection rates of the positive results by the analyser 1 h ,analyser 30 min and Westergren method were 43 .2% ,44 .5% and 45 .2%respectively ,no statistical difference between them was found (P>0 .05) .(3)The Kapper values between the analyser 30 min with the analyser1h ,between the analyser 30 min with the Westergren method and between the analyzer 1h with the Westergren method were 0 .944 ,0 .875 and 0 .903 .4 respectively .(4)The CV values in the repeatability test were very lower and within the acceptable limits .Conclusion Compared with the Westergren method ,the fully automated ESR analyser Monitor‐100 has lower false positive rate and lower false negative rate ,moreover its consistency and repeatability are excellent ,it is convenient ,fast ,safe and should be largely promoted in clinic .
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Objective To investigate the altered lipid in systemic sclerosis(SSc),and the relationship between the altered lipid and inflammation.Methods A total of 58 SSc patients were recruited into SSc group,and 58 healthy persons were recruited into control group from 2012 to 2014.Triglyceride(TG),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-c)and high density lipoprotein-cholesterol(HDL-c),lipoprotein a[LP(a)],C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR) were assessed using standard techniques in all cases,antinuclear antibody(ANA)and anti-Scl-70 antibody were assessed only in SSc patients.The levels of lipids between SSc patients and healthy controls,patients with antibody and patients without antibody were compared by using t test,corrections between lipid and inflammation were analyzed by Spearman′s correlation test.Results The clinical manifestations of SSc were mostly Raynaud′s phenomenon(91.4%),large area of black hard shin(87.9%),gastrointestinal manifestations(75.9%).The rates of an increased level of TG and decreased level of HDL-c were 29.3%,89.7% respectively.The level of TG in SSc was significant higher than in healthy controls(P =0.021),and the level of HDL-c in SSc was significant lower than in healthy controls(P =0.033).The levels of lipids in patients with ANA and anti-Scl-70 antibody had no significant difference with the patients without ANA and anti-Scl-70 antibody (P >0.05 ).Spearman′s correlation test demonstrated that HDL-c level correlated negatively with serum CRP (r=-0.285,P =0.039)and ESR (r =-0.271,P =0.043)in SSc.Conclusion Dyslipi-demia is a common feature in SSc patients that are characterized by an increase in TG and a decrease in HDL-c,inflammation might partly account for the changes.
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Objective To construct a novel bioartificial liver (BAL) system and evaluate its functions in vitro. Methods Chinese experimental minipig hepatocytes were isolated by in situ recirculating collagenase perfusion method and 1.0?10~(10) hepatocytes were cultured in serum-free medium with restriction of(attachment), and using spinner method to form hepatocyte(spheroids).cted by inoculating the hepatocyte(spheroids) into cell circuit of a hollow fiber bioreactor from BIOLIV A3A. Observing the number and viability of the(hepatocytes), the changes of alanine aminotransferase (ALT), total bilirubin (TBI), albumin (ALB) in(circulating) hepatocyte suspension and(RPMI1640) medium; in addition, lidocaine metabolism test was(determined),(during) 6h circulation of the system. (Results) There were no significant differences in number and viability of the hepatocytes before and after 6h(circulation). The BAL system has relatively strong albumin synthesis and lidocaine(metabolism) functions. (Conclusions) The BAL system that we developed had ability to support liver functions and could be used in the treatment of liver failure, or to provide temporary liver support for candidates of liver(transplantation).