ABSTRACT
BACKGROUND: Aplastic anemia (AA), paroxysmal nocturnal hemoglobinuria (PNH), and myelodysplastic syndrome (MDS) are the common spectrums of acquired bone marrow failure syndromes (BMFs). Accurate and timely diagnosis is a significant clinical challenge because of the overlapping features. The pathogenesis is not fully understood, but several studies have suggested that defective monocyte functions play an important role. We aimed to find whether the different expressions of CD52, CD14 and HLA-DR on CD4+ monocytes would be helpful in the preliminary diagnosis of acquired BMFs. METHODS: This study included 45 patients (21 AA patients, 13 MDS patients, 11 PNH patients). The control group was composed of 33 healthy adults. Flow cytometry was performed to determine the fluorochrome conjugated antibodies, including CD52, CD14 and HLA-DR. RESULTS: In this study, we found the expression of CD52 on CD4+ monocytes in AA patients was significant lower than MDS [15.90% (2.39 - 25.70) vs. 60.63% (26.0 - 94.98), p < 0.001] and healthy controls [15.90% (2.39 - 25.70) vs. 67.19% (25.5 - 88.4)%, p < 0.001], and a little higher than PNH patients [15.90% (2.39 - 25.70) vs. 4.55% (3.1 - 6.0), p < 0.05]. While comparing the levels of HLA-DR on CD4+ monocytes, AA patients were lower than PNH [40.05% (17.2 - 73.3) vs. 83.14% (80.7 - 94.3), p < 0.001] and MDS patients [40.05% (17.2 - 73.3) vs. 82.37% (69.1 - 91.2), p < 0.001]. CONCLUSIONS: According to our knowledge, this is a new clinical diagnostic method that uses surface markers for CD4+ monocytes such as CD52, CD14, and HLA-DR to make differential diagnoses within AA, PNH, and MDS patients in clinical practice. In addition, CD52 in patients shows that CD52 represents the most valuable molecular marker for differential diagnosis of three types of acquired BMFs.
Subject(s)
Anemia, Aplastic/immunology , CD52 Antigen/analysis , HLA-DR Antigens/analysis , Hemoglobinuria, Paroxysmal/immunology , Lipopolysaccharide Receptors/analysis , Monocytes/immunology , Myelodysplastic Syndromes/immunology , Adult , Aged , Case-Control Studies , Female , Flow Cytometry , Humans , Male , Middle AgedABSTRACT
Objective To analyze the clinical characteristics of acinetobacter baumannii infection and drug resistance tendency of our hospital in 2014 ,so as to promote the clinical rational use of antibiotics .Methods The study was a retrospective review ,the re‐sults of clinical distribution and drug resistance of acinetobacter baumannii isolated from our hospital in 2014 were analyzed .The an‐timicrobial susceptibility testing(AST) of acinetobacter baumannii was determined by K‐B disk diffusion method and minimal inhib‐itory concentration(MIC) test ,respectively .The AST was performed as recommended by CLSI 2010 .Results A total of 299 strains of acinetobacter baumannii were isolated from clinical specimens throughout the year .Of the 299 Acinetobacter baumannii isolates , 268 strains(89 .63% ) were isolated from sputum ,165 strains(55 .18% ) of Acinetobacter baumannii were from intensive care unit (ICU) and 52 strains(17 .39% ) were from neurosurgery .The resistance rate of Acinetobacter baumannii to cefoperazone/sulbactam was 5 .02% while its resistance to Imipenem and Meropenem significantly increased to 52 .17% and 56 .86% ,respectively .And the resistance rates ofβ‐lactams ,fluoroquinolones and aminoglycosides were higher than 60% .Conclusion The isolation rate of Acine‐tobacter baumannii is increasing in recent year in our hospital ,as well the resistance rate to the common Antibiotics .Monitoring the resistance of Acinetobacter baumannii should be strengthened for preventing resistant bacteria from spreading .
