ABSTRACT
Objective: To analyze the distribution and drug resistance of pathogenic bacteria in blood culture specimens of patients with bloodstream infections before and after COVID-19 (2018-2019 and 2020-2021), and to provide scientific basis and reference for rational treatment and effective control of bloodstream infections in the post-epidemic period. Methods: Blood culture specimens were collected from patients in Zhongnan Hospital of Wuhan University in the two years before and after the COVID-19 outbreak (2018-2021). The Automated Blood Culture Systems were used to perform blood culture on blood specimens sent for clinical inspection, and the Vitek MS automatic bacterial identification mass spectrometer was used for strain identification and the Vitek 2 automatic bacterial drug susceptibility analyzer was used for drug susceptibility testing and drug resistance analysis. Results: Blood culture specimens were performed on 28 736 patients with suspected bloodstream infection submitted for inspection from January 2018 to December 2019, and a total of 2 181 strains of pathogenic bacteria were detected after removing duplicate strains, with a positive rate of 7.69%, including 1 046 strains of Gram-negative bacteria, accounting for 47.96%. From January 2020 to December 2021, blood culture specimens from 26 083 patients with suspected bloodstream infection were submitted for inspection, and a total of 2 111 strains of pathogenic bacteria were detected after excluding duplicate strains, with a positive rate of 8.09%, including 1 000 strains of Gram-negative bacteria accounted for 47.37%. The drug resistance of Klebsiella pneumoniae was relatively serious, and the sensitivity rate to ertapenem, polymyxin B and tigecycline was more than 90%. The main non-fermentative bacteria Acinetobacter baumannii was more than 50% sensitive to piperacillin/tazobactam, amikacin and polymyxin B. The sensitivity rates of Pseudomonas aeruginosa to piperacillin/tazobactam, ceftazidime, cefepime, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, piperacillin and meropenem were more than 50%. Conclusions: In the two years before and after COVID-19, there are many types of pathogenic bacteria in bloodstream infection, but the distribution do not differ significantly. The pathogens of bloodstream infection are mainly distributed in ICU, hepatobiliary research institute, and nephrology department. Among them, Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii are the main ones, and different pathogens showed great differences in drug resistance.
ABSTRACT
Children are usually affected by pneumonia, which is a common ailment caused by Pathogenic Streptococcus pneumoniae. This study's objective was to isolate and identify S. pneumoniae, which was recovered from blood samples of suspected paediatric pneumonia patients using conventional techniques, such as antibiotic sensitivity profiles and molecular approaches. In this study, forty (40) samples from three major hospitals in the Dinajpur region of Bangladesh were collected and assessed using various bacteriological, biochemical, antibiotic susceptibility test, and molecular techniques. 37.5% of the 40 samples tested positive for pneumonia, and 15 isolates were discovered. In terms of age, pneumonia was more common in children aged 3-5 years (50%) than in those aged 6 to 8 (33.33%), 9 to 11 (25%) and 12 to 15 (20%). According to the results of the current study, the study area had no statistically significant impact (P > 0.05), while age and socioeconomic status had a significant impact on the prevalence of pneumonia in patients with pneumonia (P 0.05). The age group for which pneumonia was most prevalent (at 50%) was that for children between the ages of 3-5. Poor socioeconomic status was associated with the highest prevalence of pneumonia (54.54%). By sequencing the 16S rRNA gene, S. pneumoniae was identified as S. pneumoniae NBRC102642. In the antibiotic investigation, S. pneumoniae was found to be extremely resistant to ciprofloxacin, amikacin, vancomycin, and cefexime, but responsive to erythromycin and azithromycin, as well as neomycin, kanamycin, streptomycin, and bacitracin. S. pneumoniae causes serious complications in paediatric patients, and this scenario requires prevention through vaccination and the development of new, efficient antibiotic therapies for pneumonia. If specific laboratory features of paediatric patients with pneumonia are understood, sepsis will be easier to detect early, treat, and reduce mortality.
ABSTRACT
The outbreak of COVID-19 has led to the increase in face mask waste globally. In this study, face mask-derived carbocatalysts doped with nitrogen (N-Mask) were fabricated through one-step pyrolysis of 1:5 w/w mixture of face mask and urea at different temperatures to activate peroxymonosulfate (PMS) for gatifloxacin (GAT) degradation. The N-Mask prepared at 800 degrees C (N-Mask800) exhibited the highest GAT degradation rate with k(app) = 0.093 min(-1) which could be attributed to its high N doping level (17.1 wt%) and highest specific surface area (237.13 m(2) g(-1)). The relationship between k(app), catalyst loading and PMS dosage at various pHs on GAT degradation were successfully established. It was also found that the GAT degradation rate was inhibited in the sequential operating mode compared to the simultaneous operating mode. It was construed that adsorption and catalysis share the same active sites. Deterioration in catalytic performance was observed over successive cycles due to the surface chemistry change during catalysis, and difficulty in catalyst recovery after treatment. Radical scavenger study revealed that both radical and nonradical pathways were involved during GAT degradation, with nonradical pathway playing a dominant role. XPS analysis revealed that pyrrolic N and graphitic N can facilitate PMS activation via radical and nonradical pathways. Based on the LC-MS/MS analysis, the GAT degradation intermediates were identified, and the possible degradation pathways were tentatively proposed. Overall, this study demonstrated that carbocatalyst derived from face mask could be transformed into costeffective and environmentally friendly PMS activator for environmental wastewater treatment applications.
ABSTRACT
OBJECTIVE: To investigate and analyze the genotyping, virulence genes and drug-resistant genes of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from skin and soft tissue infections in this area. METHODS: The skin secretions of 204 patients with skin and soft tissue infections in the Fifth Central Hospital of Tianjin between Jan. 2019 and Dec. 2020 were collected, and MRSA strains identified as non-repetitive strains were isolated. The Staphylococcal cassette chromosome mec (SCCmec) and Staphylococcal protein A gene (spa) genotyping and Panton-valentine leukocidin (PVL) gene carrying status were analyzed among the MRSA strains, and their relationship with drug resistance was analyzed. RESULTS: Totally 82 strains of S. aureus were isolated from the skin secretions of 204 patients with skin and soft tissue infections, including 44 strains of MRSA (53.66%). The most common SCCmec genotype was genotype III (accounting for 84.09%) and the most common spa genotype was genotype t030 (accounting for 84.09%). PVL genes encoding virulence factors were amplified in 5 strains (11.36%). The drug resistance rates of 44 MRSA strains to vancomycin and compound sulfamethoxazole were 0.00%, and all the strains were drug-resistant to penicillin. Different SCCmec and spa genotypes were highly resistant to erythromycin, cefazolin, clindamycin and levofloxacin, but the differences in drug resistance rates of different SCCmec genotypes to clindamycin and levofloxacin were significant (P < 0.05). The resistance rates of strains with PVL positive genes to chloramphenicol, gentamicin and tetracycline were significantly higher than those with PVL negative genes (P < 0.05). CONCLUSION: Strains carrying SCCmec III and spa t030 genotypes may be the dominant strains of MRSA in skin and soft tissue infections in this area. Spa genotypes and PVL gene have certain impact on drug resistance of MRSA, and the isolated MRSA strains are all sensitive to vancomycin and compound sulfamethoxazole, which can provide a reference for anti-MRSA treatment in this area.
ABSTRACT
OBJECTIVE: To investigate the diagnosis and clinical characteristics of 10 cases of clustered Chlamydia pneumoniae pneumonia during the prevention and control of the COVID-19 pandemic. METHODS: The clinical data of 10 patients with clustered Chlamydia pneumoniae infection in a college diagnosed and treated by the Third Medical Center of the PLA General Hospital from Mar. 10, 2021 to Mar. 17, 2021 were retrospectively analyzed, the clinical characteristics of Chlamydia pneumoniae infection were summarized, and the diagnosis and treatment plan was selected quickly and accurately. RESULTS: All 10 cases with Chlamydia pneumoniae pneumonia infection had no history of contact with live or dead birds, 80% of them had cough symptom, 50% of them had fever symptom. Laboratory test results showed that 80% of patients had white blood cell count in normal range, 60% of patients had increased c-reactive protein level to varying degrees, 70% of patients had creatine kinase above normal, creatinine and procalcitonin were all normal, and some coagulation function indexes were abnormal. Lung CT scan showed increased density of unilateral lung floccus, nodules or spots, with air bronchial signs and even consolidation. The results of respiratory tract five-link card showed that all 10 patients were positive for Chlamydia pneumoniae immunoglobulin M(IgM) antibody. The nucleic acid sequence of Chlamydia pneumoniae was detected by metagenomics next-generation sequencing(mNGS)in 2 patients after hospitalization. 10 patients were treated with moxifloxacin hydrochloride and sodium chloride injection and moxifloxacin hydrochloride tables in sequences, all of which were cured. After 1 month, the outpatient reexamination of lung CT showed that the inflammation was basically absorbed. CONCLUSION: Chlamydia pneumoniae infection can cause outbreak through respiratory transmission, which tend to occur in the spring. The combination of respiratory pathogen antibody detection and mNGS technology can improve the efficiency of clinical diagnosis and treatment.
ABSTRACT
Background: COVID-19 is an infectious disease caused by a new type of virus named SARS-CoV-2. There is still no specific treatment for COVID-19;the antibiotic is used for therapy and to prevent severe disease, so the increasing use of antibiotics in COVID-19 patients will lead to a detrimental impact and the risk of antibiotic resistance. Purpose: This study aims to analyze antibiotic use frequency and determine the number of DDD per 100 bed-days in July - December 2020 at Bhayangkara Hospital Surabaya.
ABSTRACT
Objectives: To examine the clinical characteristics, drug resistance, and factors influencing development of a pulmonary fungal infection in patients with severe respiratory diseases in order to provide a reference for clinical treatment.
ABSTRACT
Objectives: To investigate pathogenic bacteria, their drug resistance, and changes in levels of cytokines in patients with a puerperal infection after a Cesarean section.
ABSTRACT
INTRODUCTION: Acinetobacter baumannii is an important causative agent of ventilation-associated pneumonia capable of long-term survival in the hospital setting. Increasing resistance to antibiotics effective against this pathogen is of concern. In this study, the antibiotic resistance profiles of A. baumannii strains grown in endotracheal aspirate (ETA) cultures in intensive care units and the effect of the COVID-19 pandemic on the resistance profiles in our province where the highest number of cases were observed in our country for a long time were investigated. METHODS: Our study included 74 A. baumannii isolates isolated from ETA samples that was sent to our laboratory from the intensive care units of Bafra State Hospital between January 2019 and December 2020. Bacteria were identified using conventional methods and a semi automatic bacterial identification system Vitek-2 (bioMerieux, France). The antibiotic susceptibility tests of the isolated strains were studied in accordance with the European Committee for Antimicrobial Susceptibility Testing (EUCAST) standards. Antibiotic susceptibility of A. baumannii strains was tested with Vitek-2 system. RESULTS: The mean age and standard deviations of 18 patients before the COVID-19 pandemic and 56 patients after the pandemic were found to be 83.0 +or- 8.3 and 70.5 +or- 14.9 (p < 0.001), respectively. A statistically significant difference was found between the distributions of gender by years (p=0.025). While 55.6% of the patients were female in 2019, 73.2% of the patients in 2020 were male. There was no difference between the two periods in terms of death rates (p=0.628) and respiratory support needs (p=0.191). It was determined that the pandemic increased the number of isolated A. baumannii by 311%. For the two periods, resistance was greatest for piperacillin/tazobactam, ceftazidime, ciprofloxacin and against imipenem. Examinig the two periods, amikacin resistance was seen to a lesser extent in 2020. A statistically significant difference was found between tigecycline resistance rates according to years (p < 0.001). While the tigecycline susceptibility of strains was 88.9% in 2019, it was found to be 26.8% in 2020.11.1% of the strains in 2019 and 64.3% in 2020 were found to be moderately susceptible. In this study, colistin resistance was observed in one (1.4%) of all isolates, while tigecycline resistance was detected in five isolates (6.8%). One isolate (1.4%) was susceptible to all antibiotics except ceftazidime. When the multi-antibiotic resistance of 73 A. baumannii isolates was examined, multidrug resistant (MDR) was 22.9% (n: 17), extensive drug resistance (XDR) was 74.3% (n: 55), pandrug resistance (PDR) was 1.4% (n: 1). Although there was a statistical difference in amikacin, meropenem and tigecycline resistances before and after the pandemic, no difference was found between the resistance patterns (p=0.281). DISCUSSION AND CONCLUSION: It has been observed that the most effective antibiotics against A. baumannii are colistin and tigecycline. It was determined that the COVID-19 pandemic did not change the resistance pattern rates. It is thought that success in fighting this infection will increase when each hospital determines its own resistance patterns, updates empirical treatment protocols based on their results, and clinicians use appropriate antibiotics early.