Teicoplanin combined with conventional vancomycin therapy for the treatment of pulmonary methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis infections.

BACKGROUND: Vancomycin and teicoplanin are both antibiotics that have significant antimicrobial effects on Gram-positive cocci. AIM: To explore the value of teicoplanin combined with conventional (vancomycin only) anti-infective therapy for the treatment of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis pulmonary infections. METHODS: A total of 86 patients with methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis pulmonary infections, treated in our hospital between January 2018 and February 2020, were assigned to the study and control groups using a random number table method, with 43 patients in each group. The control group received conventional treatment (vancomycin), and the study group received both teicoplanin and conventional treatment. The following indicators were assessed in both groups: the time required for symptom relief, treatment effectiveness, serum levels of inflammatory factors (procalcitonin, interleukin-1ß, tumor necrosis factor-α, C-reactive protein), clinical pulmonary infection scores before and after treatment, and the incidence of adverse reactions. RESULTS: Patients in the study group were observed to have faster cough and expectoration resolution, white blood cell count normalization, body temperature normalization, and rales disappearance than patients in the control group (all P < 0.05); the total rate of effectiveness was 93.02% in the study group, higher than the 76.74% in the control group (P < 0.05). The pre-treatment serum levels of procalcitonin, interleukin-1ß, tumor necrosis factor-α, and C-reactive protein as well as the clinical pulmonary infection scores were similar among the patients in both groups. However, the post-treatment serum levels of procalcitonin, interleukin-1ß, tumor necrosis factor-α, and C-reactive protein as well as the clinical pulmonary infection scores were significantly lower in the study group than in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the groups. CONCLUSION: Compared with conventional (vancomycin only) therapy, teicoplanin and vancomycin combination therapy for patients with pulmonary methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis infections can improve patient clinical symptoms, modulate serum inflammatory factor levels, and improve treatment efficacy, without increasing the risk of adverse reactions.

Application of gene sequencing directly to identify the pathogens in specimens.

BACKGROUND: Accurate identification of bacterial isolates is an essential task in clinical microbiology. This study compared culturing to analyzing 16S rRNA gene sequences as methods to identify bacteria in clinical samples. We developed a key technique to directly identify bacteria in clinical samples via nucleic acid sequences, thus improving the ability to confirm pathogens. METHODS: We obtained 225 samples from Beijing Tongren Hospital and examined them by conventional culture and 16S rDNA sequencing to identify pathogens. This study made use of a modified sample pre-treatment technique which came from our laboratory to extract DNA. 16S rDNA was amplified by PCR. The amplified product was sequenced on a CEQ8000 capillary sequencer. Sequences were uploaded to the GenBank BLAST database for comparison. RESULTS: Among the positively cultivated bacterial strains, seven strains were identified differently by Vitek32 and by 16S rDNA sequencing. Twelve samples that were negative by standard culturing were determined to have pathogens by sequence analysis. CONCLUSION: The use of 16S rRNA gene sequencing can improve clinical microbiology by providing better identification of unidentified bacteria or providing reference identification of unusual strains.

[Comparison study between clinical diagnosis and experimental diagnosis of fungal sinusitis].

OBJECTIVE: To compare the differences between clinical diagnosis and laboratory diagnosis of fungal sinusitis. METHODS: One hundred cases of fungal sinusitis were reviewed in this study. The clinical characters including symptoms, physical signs, images and intraoperative signs were the main aspects of clinical diagnosis. The results of clinical diagnosis, pathology, direct observation of the nasal and sinus samples with microscope and the fungal culture were compared. RESULTS: The numbers of fungal ball, allergic fungal sinusitis, acute fulminant invasive fungal sinusitis, and chronic invasive fungal sinusitis were 82, 10, 6, and 2 respectively. The positive rates of clinical diagnosis, pathology, direct observation with microscope and the fungal culture were 95%, 61%, 78%, and 74% respectively. There was significant difference among the positive rates of above methods (P < 0. 01). CONCLUSION: Clinical diagnosis can be used as the preliminary method for fungal sinusitis diagnosis. The demonstrative diagnosis needs to combine all above methods. The culture was the main method for confirm the types of pathogenic fungus.