Clinical value of procalcitonin-to-albumin ratio for identifying sepsis in neonates with pneumonia.

BACKGROUND: It is possible that neonates with pneumonia also have unrecognized sepsis. Identifying sepsis in neonates with pneumonia may cause some trouble for clinicians. This study aimed to evaluate the clinical value of the procalcitonin-to-albumin ratio (PAR) in identifying sepsis in neonates with pneumonia. METHODS: We retrospectively included 912 neonates with pneumonia from January 2016 to July 2021. Clinical and laboratory data were collected from electronic medical records. Among neonates with pneumonia, 561 neonates were diagnosed with sepsis, according to the International Pediatric Sepsis Consensus. Neonates were divided into a sepsis group and a pneumonia group. A multivariate logistic regression analysis was used to evaluate whether PAR was a potential independent indicator for identifying sepsis in neonates with pneumonia. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of PAR in sepsis. RESULTS: Neonates with sepsis have a higher PAR (p < 0.001). Correlation analysis showed that PAR was positively correlated with the level of C-reactive protein (r = 0.446, p < 0.001). Multiple logistic regression analysis showed that PAR was an independent predictor of the presence of sepsis in neonates with pneumonia. ROC curve analysis revealed that PAR had good power in identifying sepsis in neonates with pneumonia (area under curve (AUC) = 0.72, 95% confidence interval (CI), 0.68-0.75, p < 0.001). CONCLUSION: PAR can be used as a new biomarker to identify sepsis in neonates with pneumonia.

Compared with neonates with pneumonia, neonates with both pneumonia and sepsis had a higher PAR.PAR was a useful biomarker in distinguishing septic neonates from neonates with pneumonia.

Correction: Detection of Neisseria gonorrhoeae and Chlamydia trachomatis infections in pregnant women by multiplex recombinase polymerase amplification.

[This corrects the article DOI: 10.1371/journal.pone.0251119.].

Association of Procalcitonin to Albumin Ratio with the Presence and Severity of Sepsis in Neonates.

Purpose: Previous studies have demonstrated that procalcitonin and albumin have a close correlation with sepsis. However, the role of procalcitonin (PCT) to albumin (ALB) ratio (PAR) in sepsis was still unclear, especially in neonates. Thus, this study aimed to investigate the association between PAR and neonatal sepsis. Patients and Methods: A total of 1,196 neonates with suspected sepsis were included in this study. Neonates were divided into control group and sepsis group, according to whether they were diagnosed with sepsis. Neonates with sepsis were further divided into mild sepsis and severe sepsis group according to the severity of sepsis. PAR was calculated as serum PCT (ng/mL)/ALB (mg/mL). All statistical analyses were performed using the statistical package SPSS 24.0, as appropriate. Results: Compared with the control group, neonates with sepsis had a higher PAR. PAR also showed a significant gradual increase in the control, mild sepsis, and severe sepsis groups (P<0.001). Correlation analysis showed that there was a strong positive correlation between PAR and hsCRP, neonatal sequential organ failure assessment score (nSOFA), and prolonged length of hospital stay (P<0.001). On multiple logistic regression, higher PAR was independently associated with the presence and severity of neonatal sepsis. According to the receiver operating characteristic curve analysis, a PAR ≥0.065 had 64% sensitivity and 72% specificity in predicting the presence of neonatal sepsis (area under curve (AUC)=0.72, 95% CI=0.69-0.75, P<0.001) and a PAR≥0.070 had 69% sensitivity and 63% specificity in predicting the presence of severe sepsis (AUC=0.71, 95% CI=0.68-0.74, P<0.001). Conclusion: PAR is significantly higher in neonates with sepsis and correlated with the severity of the disease. Increased PAR is an independent predictor useful for identifying the presence and severity of neonatal sepsis.

Detection of Neisseria gonorrhoeae and Chlamydia trachomatis infections in pregnant women by multiplex recombinase polymerase amplification.

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the main pathogenic microorganisms causing sexually transmitted infections. In this study, a multiplex thermostable recombinase polymerase amplification-lateral flow detection (RPA-LFD) assay was established, and the reaction conditions such as the ratio of primer concentration, magnesium ion concentration, amplification time and template DNA concentration in the multiplex RPA reaction were optimized. The optimized multiplex RPA-LFD method was used to detect both CT and NG positive control plasmids, and it was found that the LFD could be used to obtain visible results when the plasmid copy number was only 200. The sensitivity of the multiplex RPA-LFD method used for clinical samples was 85.62 (95% CI at 53.66-97.29) for NG detection and 90.90 (95% CI at 57.12-99.52) for CT detection.

Isolation of antimicrobial resistant bacteria in upper respiratory tract infections of patients.

Haemophilus influenzae, Streptococcus pyogenes, Moraxella catarrhalis, Staphylococcus aureus, and Streptococcus pneumoniae are usual cause of upper respiratory tract infection cases. The present study aims the isolation of bacterial strains which are resistant to the commonly prescribed antibiotics. In total, 900 throat swabs were obtained from the patients suffering from upper respiratory tract infections residing in three different localities. The maximum number of isolates (64 %) were obtained from locality-1 (L-1), whereas lowest isolates were found in second locality (L-2). H. influenzae was found to be the most dominant bacterial pathogen in upper respiratory tract infections in patients with 42 % of the total isolates. H. influenzae and Chlamydia pneumoniae were resistant to ß-lactam antibiotics but susceptible to fluroquinolones and aminoglycosides, whereas S. aureus and S. pneumoniae were found to be highly resistant to ß-lactam, aminoglycosides and fluroquinolones. S. aureus was also moderately resistant to fluroquinolones and aminoglycosides with percent resistance of 26, 33 and 18 %, respectively. 56 % S. pneumoniae isolates were resistant against erythromycin, 27 % against chloramphenicol and 23 % against cefuroxime. The studies revealed that S. aureus and S. pneumoniae strains were high producer of biofilms which could be one of the reasons for their high pathogenicity.

Association of cytotoxic T lymphocyte antigen-4 +49A/G polymorphism and cancer risk: An updated meta-analysis.

BACKGROUND: Associations between cytotoxic T lymphocyte antigen-4 (CTLA-4) +49A/G polymorphism and cancer risk are inconclusive. We performed this meta-analysis to derive a more precise estimation of the relationship. METHODS: A comprehensive literature search was performed using electronic databases. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. RESULTS: A total of 16,358 cases and 19,737 controls from 46 studies were included. Overall, significant association between CTLA-4 +49A/G polymorphism and cancer risk was observed in all genetic models (G vs. A: OR=0.88, 95%CI=0.83-0.93, PH=0.000; GA vs. AA: OR=0.87, 95%CI=0.79-0.97, PH=0.000; GG vs. AA: OR=0.75, 95%CI= 0.65-0.86, PH=0.000; GG vs. GA+AA: OR=0.84, 95%CI=0.79-0.91, PH=0.001; GG+GA vs. AA: OR=0.83, 95%CI=0.74-0.92, PH=0.000). Stratified analysis by cancer type revealed that the CTLA-4+49A/G polymorphism is associated with the decreased risk of cervical cancer, breast cancer, lung cancer, HCC. Further subgroup analysis by ethnicity indicated that there was a statistically decreased cancer risk in Asian population. CONCLUSION: This meta-analysis suggests that CTLA-4+49A/G polymorphism is associated with cancer risk, especially in Asian population.