Resistance traits and molecular characterization of multidrug-resistant Acinetobacter baumannii isolates from an intensive care unit of a tertiary hospital in Guangdong, southern China / Rasgos de resistencia y caracterización molecular de aislamientos multirresistentes de Acinetobacter baumannii de una unidad de cuidados intensivos de un hospital terciario en Guangdong, sur de China

Purpose: This study aims to characterize antimicrobial resistance (AMR) of all the non-duplicated Acinetobacter baumannii strains isolated from an intensive care unit in a tertiary hospital during the period of January 1 to December 31, 2015. Methods: A. baumannii (n = 95 strains) isolated from patients was subjected to antimicrobial susceptibility test (AST) by Vitek 2 Compact system to determine minimum inhibitory concentrations, followed by genotyping by enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR). Resistance genes of interest were PCR amplified and sequenced. Results:All isolates were qualified as MDR, with a resistance rate of > 80% to 8 antimicrobials tested. In terms of beta-lactamase detection, the blaOXA23, blaTEM-1, and armA genes were detected frequently at 92.63%, 9 1.58%, and 88.42%, respectively. The metallo-β-lactamase genes blaIMP and blaVIM were undetected. Aph (3’)-I was detected in 82 isolates (86.32%), making it the most prevalent aminoglycoside-modifying enzyme (AMEs) encoding gene. In addition, ant (3″)-I was detected at 30.53%, while 26.32% of the strains harbored an aac (6')-Ib gene. ERIC-PCR typing suggested moderate genetic diversity among the isolates, which might be organized into 10 distinct clusters, with cluster A (n = 86 isolates or 90.53%) being the dominant cluster. Conclusions: All of the A. baumannii strains detected in the ICU were MDR clones exhibiting extremely high resistance to carbapenems and aminoglycosides as monitored throughout the study period. They principally belonged to a single cluster of isolates carrying blaOXA23 and armA co-producing different AMEs genes.(AU)

Resistance traits and molecular characterization of multidrug-resistant Acinetobacter baumannii isolates from an intensive care unit of a tertiary hospital in Guangdong, southern China.

PURPOSE: This study aims to characterize antimicrobial resistance (AMR) of all the non-duplicated Acinetobacter baumannii strains isolated from an intensive care unit in a tertiary hospital during the period of January 1 to December 31, 2015. METHODS: A. baumannii (n = 95 strains) isolated from patients was subjected to antimicrobial susceptibility test (AST) by Vitek 2 Compact system to determine minimum inhibitory concentrations, followed by genotyping by enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR). Resistance genes of interest were PCR amplified and sequenced. RESULTS: All isolates were qualified as MDR, with a resistance rate of > 80% to 8 antimicrobials tested. In terms of beta-lactamase detection, the blaOXA23, blaTEM-1, and armA genes were detected frequently at 92.63%, 9 1.58%, and 88.42%, respectively. The metallo-ß-lactamase genes blaIMP and blaVIM were undetected. Aph (3')-I was detected in 82 isolates (86.32%), making it the most prevalent aminoglycoside-modifying enzyme (AMEs) encoding gene. In addition, ant (3″)-I was detected at 30.53%, while 26.32% of the strains harbored an aac (6')-Ib gene. ERIC-PCR typing suggested moderate genetic diversity among the isolates, which might be organized into 10 distinct clusters, with cluster A (n = 86 isolates or 90.53%) being the dominant cluster. CONCLUSIONS: All of the A. baumannii strains detected in the ICU were MDR clones exhibiting extremely high resistance to carbapenems and aminoglycosides as monitored throughout the study period. They principally belonged to a single cluster of isolates carrying blaOXA23 and armA co-producing different AMEs genes.

Risk factors related to HIV new infections among men who have sex with men in a cohort study / 中华流行病学杂志

Objectives: To analyze and understand the risk factors related to HIV new infections among men who have sex with men (MSM). Methods: A longitudinal observational study among MSM was conducted to collect information on HIV related behaviors and sero-conversion. Univariate and multivariate generalized estimating equations (GEE) were used to discuss the risk factors for HIV new infection. Results: A total number of 4 305 MSM were followed during 2013-2015. Among those self-reported MSM who are seeking partners on the Interner tended to have higher proportion on receptive anal intercourse and consistent condom use during anal intercourse than the subgroups seeking their partners in gay bars or bathrooms. HIV incidence among followed MSM during the study period appeared as 4.3/100 person years, with adjusted RR (aRR) of HIV infection for receptive anal intercourse as group 2.20 (95% CI: 1.49-3.24) times than that of insertion anal intercourse group. Those who used rush-poppers (aRR=1.55, 95% CI: 1.10-2.17), unprotected anal intercourse (aRR=2.24, 95%CI: 1.62-3.08), and those with syphilis infection (aRR=2.95, 95%CI: 2.00-4.35) were also risk factors for HIV new infections. After controlling other factors, the relationship between the ways of seeking partners and HIV new infection was not statistical significant. Conclusion: Risk factors for HIV new infection among MSM appeared complex and interactive, suggesting that further studies are needed to generate tailored strategies for the prevention of HIV epidemic among MSM population.

Estimating HIV Incidence Rates among MSM in an Urban Area of Chongqing Using Three Approaches / 生物医学与环境科学（英文）

To evaluate the HIV pandemic in Chongqing, the pooled PCR, IgG-capture BED enzyme immunoassay (BED-CEIA), and cohort observations were used to estimate the HIV incidences among men who have sex with men (MSM). 617 MSM subjects completed the survey at a voluntary counseling and testing (VCT) site. The observed HIV incidence was 12.5 per 100 P-Ys (95% CI = 9.1-15.7). The annual acute HIV infection (AHI) incidence estimated by pooled PCR was 14.0% (95% CI = 10.9-17.1). The HIV-1 annual incidence estimated based on the BED-CEIA was 12.0% (95% CI = 7.5-16.5). The HIV incidences estimated by these three approaches were consistent and complementary. The HIV incidence rates were alarmingly high with an uptrend among the urban MSM of Chongqing.

Loss to follow-up and associated factors in a cohort study among men who have sex with men / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the associated factors on loss to follow-up among men who have sex with men (MSM) in a prospective cohort study.</p><p><b>METHODS</b>We recruited eligible HIV-negative MSM at baseline in eight cities from June to October 2009. Interviewer-administrated questionnaire and blood testings for HIV, syphilis and human simplex virus type 2, were accomplished upon enrollment, 6-month and 12-month follow-up visits in the program. Loss to follow-up was recorded at each visit in this cohort. Univariate and multivariate statistical analysis were conducted to examine the associated factors on loss to follow-up.</p><p><b>RESULTS</b>A total of 3196 eligible MSM were enrolled at the baseline study. During one year of follow-up, 894 (28.0%) of them dropped out thoroughly while 2302 (72.1%) showed up at least on one visit. Factors as MSM who were at age 25 or younger, resided locally less than 1 year, being unemployed, self-recognized as heterosexuality or bisexuality, never taking HIV testing in the past year, having had sex with women in the past 6 months etc., were more likely to withdraw from the follow-up visits. Conclusion Age, length of residency, sex orientation and history of HIV testing were associated with the loss of follow-up among MSM cohort in our study. These factors should be considered in this kind of study design in the future.</p>

Analysis of expenditure cost of intervention among men who have sex with men in certain city / 中华预防医学杂志

<p><b>OBJECTIVES</b>To learn the use of fund investment and actual expenditure cost among men who have sex with man (MSM) intervention in the city, in order to provide related evidences for carrying out the intervention effectively MSM.</p><p><b>METHODS</b>Financial records were used to collect the information about the fund source and allocation of the resource invested for the MSM intervention between 2006 and 2009. Key staff was interviewed to get related information. The activity-based costing method was adopted to analyze the actual expenditure of MSM intervention in different sites, and the allocation of the total cost to each activity, the intervention times in different sites and the unit cost in actual HIV testing person-times promoted by MSM intervention was then calculated.</p><p><b>RESULTS</b>Interventions through internet and in bar and bathhouse were conducted in the certain city. Total funds for MSM intervention between 2006 and 2009 were 4.441 million, 56.7% (¥2.530 million) of which were from international cooperation programs, whose direct cost covered 50.5% (¥2.243 million) of the total cost. The actual expenditure in interventions through Internet was ¥750 656 (16.9%), including direct expenditure ¥317 088 and indirect expenditure ¥433 568. The actual expenditure in interventions in bar was ¥2 061 846 (46.4%), including direct expenditure ¥1 114 423 and indirect expenditure ¥947 423. The actual expenditure in interventions in bathhouse was ¥1 628 751 (36.7%), including direct expenditure ¥811 474 and indirect expenditure ¥817 277. The person-times of receiving MSM intervention and the unit cost for promoting HIV test through the above 3 access all decreased. The average cost for one person-time intervention through internet and in bar and bathhouse decreased from ¥68.7 (1011 person-times), ¥67.3 (3282 person-times), ¥67.9 (3140 person-times) in 2006 to ¥40.9 (25 523 person-times), ¥30.2 (28 121 person-times), ¥17.5 (28 381 person-times) in 2009 respectively, and the cost for promoting one person-time HIV test decreased from ¥1789.2 (58 person-times), ¥1175.6 (188 person-times), ¥574.2 (312 person-times)per person time to ¥676.9 (394 person-times), ¥556.5 (1637 person-times), ¥316.5 (2237 person-times) respectively.</p><p><b>CONCLUSION</b>The unit cost of MSM intervention through internet and in bar and bathhouse decreased, as well as the cost for HIV test promotion per person-time in the city. Meanwhile, the intervention covered more and more people annually.</p>

Application on size estimation through the network scale-up method on men who have sex with men in Chongqing municipality / 中华流行病学杂志

Objective To estimate the size of men who have sex with men (MSM) in Chongqing municipality.Methods A community based investigation was conducted in Chongqing to estimate the number of personal social network (c value) in the general population through the network scale-up method (NSUM).All the participants were selected by multistage sampling randomly.Factors as c value,the number of acquaintance of MSM and its respective coefficient were used to estimate and adjust the size of MSM in Chongqing.Results The average size of personal social network for Chongqing residents was 330,with differences among place(P＜0.001),sex (P＜0.0001),age (P＜0.0001),education level (P＜0.0001).The size of social network changed into 310 after the adjustment on demography,back estimation and elimination of the outliers.The estimated population size for MSM was 16 767 after the adjustment according to the respective levels,with 95％CI from 14 602 to 18 932,which accounted for 0.21％ of the total number of males,aged from 15 to 49 in Chongqing municipality.Conclusion NSUM was a new method for estimation of population size,which seemed worthy in promoting the practice of NSUM for its efficiency.

Surveillance on the dynamics of leptospirosis epidemics in the Chongqing Section of the Three Gorges dam area / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the changes of leptospirosis epidemic characteristics before and after the Phase 2 'reservoir store water project' in Chongqing section of the Three Gorges dam area and to provide prevention, control and intervention measures to prevent the spread of leptospirosis from infectious focus to the Three Gorges dam area and downstream region of Changjiang River.</p><p><b>METHODS</b>Changshou district and Fengdu county were selected as surveillance sites. We monitored the source of infection through examining the serum antibody of patients, healthy groups together with farm cattle measured by micro agglutination test (MAT).</p><p><b>RESULT</b>Sporadic cases were reported before and after the storage of water in the reservoir. There was no significant difference found between mouse density before and after the Phase 2 reservoir project (chi2 = 1.00, P > 0.05). The main species of rat were Sewer rat before and Insectivorea after the storage of water. The germ-carrying rate of rats was 1.72% (10/583) and positive carrying rate of rats was 16.51% (18/109) when using PCR. Results showed a significant difference when comparing it to culture method (chi2 = 51.80, P < 0.01). Positive rate of leoptopirosis appeared in the serum of patients was 73.33% (33/45) with the major serum group as the Australia group. The rate of infection among the healthy group was 26.84% (233/868). There was significant difference seen between the serum antibody positive rate of epidemic prophase (23.85%) and epidemic anaphase (29.86%) of the healthy group (chi2 = 3.99, P < 0.05). The GMRT of ox serum antibody of leoptopirosis was 29.97 with Bailen group as the predominant microbial population.</p><p><b>CONCLUSION</b>There was no epidemics of leptopirosis occurred in the Three Gorges dam area. There was no significant difference between mouse density before and after the storage of water in the reservoir. However, the major species of rats had a change. The natural infection level of people living in the dam area was low, but there existed potential of leoptopirosis outbreak.</p>

Relationship between alpha- and beta-isoform of corticosteroid receptors and corticosteroid resistant allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To clarify the relationship between the expression of alpha- and beta-isoform of corticosteroid receptors (CS) in peripheral blood mononuclear cell (PBMC) and response to corticosteroid in patients with allergic rhinitis (AR).</p><p><b>METHODS</b>Semi-quantitative RT-PCR was used to detect the expression of CS-alpha, beta in PBMC in patients with AR and to observe the different responses to corticosteroid in controls. Immunocytochemical assay was used to detect the expression of protein of CS-alpha and CS-beta.</p><p><b>RESULTS</b>1) The expression of CS-alpha mRNA was detected in the sensitive group and the resistant group of patients with AR and the controls with CS-alpha/GAPDH mRNA (x +/- s) 1.15 +/- 0.75, 1.63 +/- 0.78, 1.27 +/- 0.51 respectively. 2) The expression of CS-beta mRNA in PBMC in the resistant group of patients with AR was significantly higher than that in the sensitive group and the controls (P < 0.05), with CS-beta/GAPDH mRNA 1.42 +/- 0.73, 0.82 +/- 0.59, 0.80 +/- 0.68 respectively. 3) The number of CS-beta-positive PBMC in the resistant group was significantly higher than that in the sensitive group and the controls (P < 0.01), with the number of CS-beta-positive PBMC 28.8% +/- 9. 9%, 5.9% +/- 3.2%, 5.5% +/- 6.8% respectively.</p><p><b>CONCLUSIONS</b>It is shown that the excessive expression of CS-beta may serve as a novel predictor of corticosteroid resistance in patients with AR.</p>