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Objective To explore the clinical features of children with Burkholderia gladioli (B. gladioli) bloodstream infection and the drug susceptibility of B. gladioli. Methods The clinical data of 63 children with B. gladioli bloodstream infection admitted to Wuhan Children’s Hospital, Tongji Medical College of Huazhong University of Science and Technology from Jan. 2015 to Jan. 2016 were retrospectively analyzed, and 81 children with non-bacterial infectious diseases in the same period were enrolled as controls. The C-reactive protein (CRP) level, procalcitonin (PCT) level and white blood cell (WBC) counts of children were compared between the two groups. B. gladioli was isolated from the blood samples of children and cultured for preliminary identifying by Phoenixtm100 automatic microorganism identification instrument and confirming by MALDI-TOP MS mass spectrometer. The in vitro antimicrobial susceptibility testing of B. gladioli were performed by Kirby-Bauer method. Results The children infected with B. gladioli were mainly infants, with 52 cases (82.54%) being three years old or below. All cases had serious underlying diseases, including bronchitis, pneumonia and leukemia. Compared with the control group, the PCT level, CRP level, and WBC counts in the children of the B. gladioli group were significantly increased (all P<0.05). According to the drug susceptibility criteria of Pseudomonas aeruginosa, the isolated B. gladioli was highly sensitive to amikacin, gentamycin, tetracycline, minocycline, cotrimoxazole, ciprofloxacin, levofloxacin, imipenem, meropenem, cefepime, piperacillin, piperacillin/tazobactam and cefoperazone/sulbactam, but had low resistance to chloramphenicol and high resistance to ceftazidime and aztreonam. Conclusion Children infected with B. gladioli are mainly infants aged≤3 years old, with low immunity and poor resistance. Blood culture and CRP level, PCT level and WBC counts can be used as diagnostic indicators of disease outcomes. Piperacillin/tazobactam and cefoperazone/sulbactam should be the first selected drugs for the treatment of children with B. gladioli bloodstream infection.
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<p><b>Background</b>One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) is to diminish variation in the interpretation and reporting of prostate imaging, especially among readers with varied experience levels. This study aimed to retrospectively analyze diagnostic consistency and accuracy for prostate disease among six radiologists with different experience levels from a single center and to evaluate the diagnostic performance of PI-RADS v2 scores in the detection of clinically significant prostate cancer (PCa).</p><p><b>Methods</b>From December 2014 to March 2016, 84 PCa patients and 99 benign prostatic shyperplasia patients who underwent 3.0T multiparametric magnetic resonance imaging before biopsy were included in our study. All patients received evaluation according to the PI-RADS v2 scale (1-5 scores) from six blinded readers (with 6 months and 2, 3, 4, 5, or 17 years of experience, respectively, the last reader was a reviewer/contributor for the PI-RADS v2). The correlation among the readers' scores and the Gleason score (GS) was determined with the Kendall test. Intra-/inter-observer agreement was evaluated using κ statistics, while receiver operating characteristic curve and area under the curve analyses were performed to evaluate the diagnostic performance of the scores.</p><p><b>Results</b>Based on the PI-RADS v2, the median κ score and standard error among all possible pairs of readers were 0.506 and 0.043, respectively; the average correlation between the six readers' scores and the GS was positive, exhibiting weak-to-moderate strength (r = 0.391, P = 0.006). The AUC values of the six radiologists were 0.883, 0.924, 0.927, 0.932, 0.929, and 0.947, respectively.</p><p><b>Conclusion</b>The inter-reader agreement for the PI-RADS v2 among the six readers with different experience is weak to moderate. Different experience levels affect the interpretation of MRI images.</p>
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Objective To investigate the value of T-SPOT in the diagnosis of tuberculosis (TB) in children.Methods 43 children who were admitted to a hospital and confirmed with TB between March 2015 and May 2016 were as TB group,50 children who were excluded TB as well as healthy children in the outpatient and inpatient departments of this hospital during the same period were as control group,two groups were underwent detection of TSPOT,PPD,MTB-Ab,and acid fast stain,results were compared,subgroup analysis was conducted on the positive of T-SPOT in children with different infection sites and in different age groups.Results Sensitivity and negative predictive value of T-SPOT were significantly higher than the other three methods(P＜0.05),specificity was also higher than that of PPD(P＜0.05);positive rates of T-SPOT in pulmonary tuberculosis and extrapulmonary tuberculosis were 88.9 ％ and 81.3 ％ respectively,difference was not statistically significant(P＞0.05);positive rates of T-SPOT in children ≤5 years and ＞5 years were 70.6％ and 96.2％ respectively,difference was statistically sig-nificant(P＜0.05).The sensitivity and specificity of combined detection of T-SPOT and PPD for diagnosis of TB were 95.3 ％ and 98.0％ respectively,which were both higher than the single method(P＜0.05).Conclusion The sensitivity and specificity of T-SPOT for detecting TB in children are both superior to traditional methods,T SPOT is also suitable for the detection of extrapulmonary tuberculosis,and can be used as the main method for laboratory diagnosis of tuberculosis in children,but it is uncertainty in children under 5 years of age,and should be rationally combined with PPD to improve the diagnosis of TB among children.
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The present study was performed to investigate the seroprevalence and risk factors for Dirofilaria immitis infection in cats from Liaoning province, northeastern China. From October 2014 to September 2016, sera of 651 cats, including 364 domestic cats and 287 feral cats (332 females and 319 males) were assessed. They were tested for the presence of D. immitis antigen using SNAP Heartworm RT test kit. In this population, the average prevalence was 4.5%. Age and rearing conditions (feral or domestic) were found to be associated with the prevalence of D. immitis. The prevalence was significantly higher in feral cats compared with domestic cats (8.4% vs 1.4%, P 0.05), but older cats (≥3 years old) showed a statistically higher prevalence compared with younger cats ( 0.05), all these results suggest that outdoor exposure time may be one of the most important factors for D. immitis prevalence in cats. Results reveal that D. immitis are prevalence in domestic and feral cats in northeastern China, which indicates that appropriate preventive measures should be taken to decrease the incidence of feline heartworm disease in Liaoning province, northeastern China.