Genotypic diversity and antifungal susceptibility of Scedosporium species from clinical settings in China.

BACKGROUND: Scedosporium species have drawn significant interest as inhabitants of polluted soil and water and as cause of high mortality in near-drowning patients. So far, most cases have been reported from Europe and Australia, while knowledge on their prevalence and genotypic diversity from Asia is scant. OBJECTIVES: To increase the knowledge of the genetic diversity and in vitro antifungal susceptibility of Scedosporium species involved in human infections from China. METHODS: Here, we applied the ISHAM-MLST consensus scheme for molecular typing of Scedosporium species and revealed both high species diversity and high genotypic diversity among 45 Chinese clinical Scedosporium isolates. RESULTS: Among the five species, Scedosporium boydii (n = 22) was the most common, followed by S. apiospermum (n = 18), S. aurantiacum (n = 4) and S. dehoogii (n = 1). S. aurantiacum was reported for the first time from clinical samples in China. The predominant sequence types (STs) were ST17 in S. apiospermum, ST4 in S. boydii and ST92 in S. aurantiacum, including four novel STs (ST40, ST41, ST42 and ST43) in S. apiospermum. Based on the CLSI-M38 A2 criterion, voriconazole was the only antifungal compound with low MIC values (MIC90 ≤ 1 µg/ml) for all Scedosporium isolates in our study. CONCLUSIONS: The genetic diversity of clinical isolates of Scedosporium species from China is extremely high, with S. boydii being predominant and S. aurantiacum being firstly reported here. VOR was the only antifungal compound with low MIC values for all Scedosporium isolates in our study, which should be recommended as the firstline antifungal treatment against scedosporiosis in China.

Analysis of Antineutrophil Cytoplasm Antibody from 118 730 Patients in Tertiary Hospitals in Jiangxi Province, China.

BACKGROUND The discovery of antineutrophil cytoplasm antibody (ANCA) makes the early diagnosis of primary vasculitis possible, and also has important guiding significance for the diagnosis and treatment of secondary vasculitis. This study aimed to investigate the clinical significance of ANCA. MATERIAL AND METHODS ANCA was detected by indirect immunofluorescence assay (IIF), and anti-myeloperoxidase (MPO) antibody, and anti-proteinase 3 (PR3) antibody were detected by ELISA. The results were analyzed retrospectively. RESULTS Among 118 730 patients, a total of 5853 (4.93%) were positive for ANCA. In the positive cases, 3.98% were male and 6.33% were female, with significant differences (χ²=123.38, P<0.01). For ANCA, the department with the highest positive rate (15.06%) was the Department of Rheumatology, followed by 7.78% in the Department of Dermatology, 6.79% in the Department of Nephrology, and 5.72% in the Department of Traditional Chinese Medicine (TCM). Anti-PR3 and cANCA were highly specific in primary vasculitis (P<0.01). Anti-MPO and pANCA had high specificity for other autoimmune diseases (P<0.01). CONCLUSIONS ANCA has important guiding significance for vasculitis-related diseases. Therefore, it is important in the diagnosis and treatment of this disease and has value in clinical practice.

Comparison of biomarkers between PLA2RAb+ and PLA2RAb- in patients with idiopathic membranous nephropathy.

OBJECTIVE: The presence of antibodies against the M-type phospholipase A2 receptor (PLA2RAb) is considered to be a promising serological diagnostic biomarker of idiopathic membranous nephropathy (IMN). We compare the change in serum Cystain C (CysC), urea, creatinine (CREA), uric acid (UA), total protein (TP), albumin (ALB), IgG4 and 24-h urinary protein (proteinuria, PRO) between PLA2RAb+ and PLA2RAb- of IMN patients. MATERIALS AND METHODS: The serum and urine samples were collected from 120 patients with IMN. The presence of circulating PLA2RAb was determined by indirect immunofluorescence, and their titer was quantified by ELISA. CysC, urea, CREA, UA, TP, ALB and 24-h PRO were examined by automatic biochemical analyzer. RESULTS: Serum IgG4 level was determined by specific protein analyzer. PLA2RAb-positive percentage by ELISA was higher than that by IIF, but no significant difference was found by McNemar's Chi-square test. Serum IgG4 level and 24-h PRO level were significantly higher in PLA2RAb+ than in PLA2RAb- (P < 0.05). In PLA2RAb+ group, PLA2RAb is positively related to serum IgG4 and 24-h PRO and negatively related to serum TP and ALB (P < 0.01). CONCLUSION: This is the first study to show that combined detection of IgG4 concentration and PLA2RAb was usable for IMN patients.