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Objective:To study the safety of different peripherally inserted central catheter (PICC) dressing replacement frequencies in preterm infants.Method:From June 2017 to February 2020, preterm infants were enrolled in this prospective randomized controlled study. Preterm infants with PICC were randomly assigned into 7 d, 11 d and 14 d dressing replacement groups using online randomization software. Polyurethane transparent dressing and the same dressing replacement method were used in all three groups. The incidences of catheter-related bloodstream infection (CRBSI) and positive skin bacterial culture at dressing site were compared among the three groups.Result:A total of 296 cases were enrolled, including 96 cases in the 7 d group, 108 cases in the 11 d group and 92 cases in the 14 d group. The incidences of CRBSI in three groups were 2.5/1 000 catheter day in 7 d group, 1.1/1 000 catheter day in 11 d group and 0.8/1 000 catheter day in 14 d group. The incidences of catheter pathogen colonization were 1.0% in 7 d group, 0.9% in 11 d group and 0% in 14 d group. The positive rates of skin bacterial culture at dressing site were 1.0% in 7 d group, 2.8% in 11d group and 2.2% in 14 d group. The incidences of PICC exit site infection in three groups were 1.0% in 7 d group, 0.9% in 11d group and 1.1% in 14 d group and no significant differences existed among the groups ( P>0.05). Gram-positive cocci were the main bacteria [91.7% (11/12)] of CRBSI and skin bacterial culture at dressing site and gram negative bacilli accounted for 8.3% (1/12). No fungal infection were found. Conclusion:It is safe to replace the PICC dressing in premature infants as needed within 14 days if the dressing is intact without curling, bleeding and exudation.
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Background: Group B streptococcus (GBS) colonized in late pregnancies has been associated with neonatal early-onset GBS disease (GBS-EOD) in China. Objective: This study investigated if GBS serotype and genotype in late pregnancy is associated with GBS-EOD, providing a reference for GBS-EOD prevention and treatment. Methods: A total of 298 pregnant women with GBS colonization during their late pregnancy and 32 invasive GBS-EOD cases were included in this study for GBS serotyping and genotyping using commercial kits and DNA sequencing. Results: We identified 266 GBS strains from mothers whose newborns were not infected with GBS-EOD. Serotype III [54.9% (146/266)] was the most common serotype, followed by Ib [17.3% (46/266)] and V [10.1% (27/266)]. ST19 was the most prevalent genotype [19.9% (53/266)], followed by ST862 [9.4% (25/266)] and ST12 [7.9% (21/266)]. We found that 32 mothers and their neonates with GBS-EOD had the same GBS strains. In 32 cases of GBS-EOD, the top three serotypes were III, Ia, and Ib, while the top three genotypes were ST17, ST23, and ST19. ST17 was the dominant genotype of serotype III, which was the most common prevalent in GBS-EOD [72.2% (13/18)], and ST23 was the dominant genotype of serotype Ia, the second most prevalent in GBS-EOD [87.5% (6/8)]. There were statistically significant differences in serotypes (p = 0.046) and genotypes (p = 0.000) distribution between the 266 pregnant women without GBS-EOD neonates and 32 cases of GBS-EOD. Conclusion: This study revealed a statistically significant associations of GBS serotype Ia, and ST17 and ST23 between GBS colonization in women during late pregnancy and in neonatal GBS-EOD. The GBS ST23 of serotype Ia and ST17 of serotype III possessed a strong pathogenicity.
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Objective:To investigate the serotype features of group B Streptococcus (GBS) vaginal colonization in late pregnancies and their relationship with early-onset neonatal GBS disease (GBS-EOD). Methods:Thirty-two strains were isolated from neonates delivered by GBS-positive mothers and hospitalized for GBS-EOD in Xiamen Maternal and Child Care Hospital from June 2016 to June 2018. Another 266 strains were isolated from vaginal samples from randomly selected late pregnant women who received antenatal screening and delivered in the same hospital during the same period with an allocation ratio of 12∶1. A total of 298 strains from mothers and 32 strains from neonates were involved. Every isolate was serotyped with latex agglutination assay. GBS infection caused by eleven serotypes and the correlation between GBS serotypes in late pregnant women and neonatal GBS-EOD were analyzed. Qualitative variables were compared using Chi-square or Fisher's exact test. A correlation analysis was presented by the column contact number C. Multiple analysis of multiple sample rates was performed with Post hoc testing. Differences between groups were analyzed according to the adjusted standardized residual. Results:A total of nine serotypes were identified among the 298 strains isolated from the mothers. The most prevalent serotype wasⅢ [55.0% (164/298)], followed byⅠb [16.4% (49/298)], Ⅰa [11.1% (33/298)], Ⅴ [9.4% (28/298)], Ⅱ [5.0% (15/298)], non-typable [NT, 1.0% (3/298)], and Ⅵ, Ⅷ and Ⅸ [0.7% (2/298) in each]. Neither Ⅳ nor Ⅶ serotype was identified. The 32 strains isolated from neonates with GBS-EOD belonged to five serotypes, which were Ⅲ [18/32 (56.3%)], Ⅰa [8/32 (25.0%)], Ⅰb [3/32 (9.4%)], Ⅱ [2/32 (6.2%)] and Ⅴ [1/32 (3.1%)]. The positive rates of GBS Ⅲ serotype in neonates with pneumonia, sepsis, and meningitis were 6/13, 7/14, and 5/5. However, no statistically significant difference was observed in the distribution of the five serotypes in GBS-EOD neonates ( P=0.654). Thirty neonates (93.7%) were cured, while two (6.3%) died. There were statistically significant differences among neonatal GBS-EOD caused by vertical transmission with Ⅰa, Ⅰb, Ⅱ, Ⅲ and Ⅴ, Ⅵ, Ⅷ, Ⅸ and NT serotypes ( P=0.046, contingency coefficient: 0.183). Further analysis showed that the adjusted absolute value of the standardized residual of serotype Ⅰa was 2.7 (>2), and the difference was statistically significant. However, the adjusted absolute value of the standardized residual of serotype Ⅲ was only 0.1, which was not statistically significant. Conclusions:Serotype Ⅲ is the most prevalent GBS serotype in late pregnant women and GBS-EOD neonates, and also the predominant serotype in infants with early-onset meningitis. Serotype Ⅰa could be highly vertically transmitted, while the virulence of serotypes Ⅲ and Ⅰa strains of GBS are the strongest.
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Objective To investigate the infection status of Ureaplasma urealyticum (Uu) and its situation of drug resistance . Methods The separation ,identification and drug resistance test plate was used for Uu detection in 3 249 cases of cervical samples . Results The total infection rate of Uu was 47 .18% (1 533/3 249) .The patients with Uu infection mainly distributed in >20-40 years ,with the constituent ratio accounted to 90 .8% .The sensitive rates of Uu to josamycin and doxycycline were both higher than 95 .00% ,however ,the resistant rate of Uu to azithromycin and ofloxacin were both higher than 50 .00% .Conclusion The drug re‐sistant strains of Uu were common .The clinic should choose the sensitive antibiotics for the treatment according to the results of drug sensitivity test .
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Objective To discuss the therapeutic effect of treating diabetic neurogenic bladder with integrative medicine. Methods 60 patients with diabetic neurogenic bladder were randomly recruited into a treatment group and a control group. The treatment group (30 cases) treated with methylcobalamin, pancreatic kallikrein enteric-coated tablets and Guantong decoction, while the control group (30 cases) was treated with western medicine exclusively. The residual urine volume and symptoms were observed before and after the treatment. Results The treatment group showed significantly better results in improving the symptoms and reducing the residual urine volume than the control group(P＜0.05).Conclusion It is curative to treat diabetic neurogenic bladder with integrative medicine.
