Objective To evaluate the clinical efficacy of tigecycline combinated with isepamicin for treatment of pneumonia caused by multidrug-resistant Acinetobacter baumannii.Methods A retrospective analysis was performed in adult patients with multidrug-resistant Acinetobacter baumannii pneumonia in two general hospitals from January 2012 to January 2014.Total eighty-four patients with MDR-Acinetobacter baumannii pneumonia were randomly divided into two groups(n=42).One group was treated with tigecycline combinated with isepamicin(termed combination therapy group),and another group was administrated with cefoperazone sulbactam (termed control group ).The clinical cure rates,microbiological eradication rates and adverse events were collected and compared. Results There was no difference in APACHEⅡ score between two groups.The clinical cure rates in combination therapy group was significantly higher than that in control group(88% vs 61%,P<0.05),and with a higher rate of microbiological eradication(59.5% vs 35.7%,P <0.05 ).However,the occurence rate of adverse events was similar in the two groups (7.1% vs 1 1.9%). Conclusion With a higher rate of clinical efficacy and a lower rate of adverse events,the combination therapy with tigecycline and isepamicin would be a promising alternative for treatment with MDR-Acinetobacter baumannii pneumonia.

Objective To investigate the clinical manifestations and the antibiotics resistance patterns in children with positive blood culture of Escherichia coli. Methods The clinical data of children with positive blood culture of Escherichia coli were retrospectively analyzed from Jan.2007 to Dec.2014. Results In a total of 154774 children who had blood culture in the study period, 8446 children were positive, among whom 408 (4.83%) children were isolated Escherichia coli. The children with the positive blood culture of Escherichia coli mainly were under one year old (51.72%), of which 36.77%was neonates. There were 275 children had underlying diseases, and the most common disease was Leukemia. 199 (48.77%) Escherichia coli strains were producing extended spectrumβ-lactamase (ESBLs) and 85.23%were resistant to ampicillin. All strains were susceptible to meropenem. Conclusions Septicemia caused by Escherichia coli is usually occurred in children with leukemia or in neonates. Since blood infections of Escherichia coil had high rate of ESBLs, the use of carbapenem antibiotics should be cautious.

Objective To analyze the single nucleotide polymorphisms(SNPs) in promoter region,5' untranslated region,exon 1 and haplotypes of mannose binding-lectin(MBL) gene in Han nationality and Hui etheic children in China.Methods Sixty nine Hui ethnic children from Ningxia Huizu Auto.Reg.and 105 Han children from Zhejiang Prov.were enrolled in the present study.Whole blood samples(1.5 ml) were collected into potassium-EDTA tubes.SNPs in promoter region,5' untranslated region and exon 1 of MBL gene were determined by sequence analysis using BigDye Mix 3730 genetic analyzer,and genetic analysis was performed using SHEsis software.Results The variant allele frequencies at-221 sites in Han and Hui objects were 0.091 and 0.123,respectively,with no difference between the two groups(?2=0.684,P=0.408).No mutation was found at sites +223 and +239 in exon 1 of MBL gene in the study.The variant frequency at +230 site in Hui children(0.268) was significantly higher than that in Han objects(0.167,?2=5.223,P=0.022).The most common haplotype was YA,and the frequencies of YA haplotype in Han and Hui ethnic were 0.770 and 0.669,respectively,with significant difference between the two groups(?2=4.312,P=0.038).Conclusion The variant allele frequency at +230 sites in exon 1 in Hui ethnic children is higher than that in Han subjects.The most common haplotype is YA,and the frequency of YA haplotype is higher in Han children than that in Hui subjects.

256?g/ml.Oxacillin-resistance rate in adults was significantly higher than that in children(?2=54.15,P

Objective To explore the common pathogens distribution and the drug resistance pattern in vitro from cerebrospinal lfuid culture in children. Methods The results of cerebrospinal lfuid culture in hospitalized children from January 2007 to December 2014 were retrospectively analyzed. Bacteria identiifcation and antimicrobial susceptibility were assayed by Vitek system from Bio Mrieux Company. Some bacterial strains were tested by disk diffusion method. Results Cerebrospinal lfuid from 23099 patients were tested at least one time during research period. 671 strains of bacteria were isolated with positive rate of 2 . 9%, among which there were 579 strains of gram positive bacteria ( 86 . 3%) and 92 strains of gram negative bacteria ( 13 . 7%). The top ifve bacteria were coagulase negative Staphylococcus ( 399 strains, 58 . 9%), Micrococcus ( 37 strains, 5 . 5%), Streptococcus pneumoniae (34 strains, 5.1%), Escherichia coli (32 strains, 4.8%), and Enterococcus faecium (26 strains, 3.9%). The positive rates of cerebrospinal lfuid culture in 8 consecutive years showed a downward trend (χ2?=?10 . 410 , P=?0 . 001 ). The positive rates of coagulase negative Staphylococci showed annual decline trend (χ2?=?31 . 200 , P

Objective:To analyze the gene polymorphisms at code 54 of exon 1 in mannose-binding lectin(MBL) gene and the palsma MBL concentrations in Mongols and Huis in China.Methods:MBL plasma concentrations were measured by ELISA method with human MBL ELISA kit,Single nucleotide polymorphisms of MBL gene were determined with sequence analysis method.Geneticanalysis was deployed with SHEsis software,and the statistics package for social science,SPSS11.0 was used in the study.Results:The median values of MBL plasma in 79 Mongols and 69 Huis were 1 686 ng/ml and 1 909 ng/ml respectively and no significant difference was found between them(Z=0.63,P=0.4).In 79 Mongols,the variant allele frequencies of the codon 54 of MBL gene was 0.203,62.0% of the 79 cases were A/A exon type,while 35.4% were A/B type and 2.50% were B/B type instead.In all 69 Huis,the variant allele frequencies was 0.268,58.0% of 40 cases were A/A exon type,while 30.4% were A/B type and 11.6% were B/B type instead.The frequency of point mutation at +230 site was 0.203.No significant difference of variant allele frequencies was found between the Mongols and Huis nationalities(?2=1.772,P=0.183).Neither C nor D exon type were found in the study.The A/A wild type was associated with the highest plasma concentration with median values,the A/B type was associated with lower MBL levels and the B/B type with the lowest levels(?2=86.526,P

Objective To investigate the association between genetic polymorphisms and protein levels of mannose-binding lectin (MBL) and the sensitivities of common infections in a pediatric Han population lived in Zhejiang Province.Methods MBL genetic polymorphisms of patients and controls were detected by PCR-based sequencing.MBL protein levels were measured using MBL ELISA Kit.Results No mutations at positions +223 and +239 of the exon 1 were detected in either patients or controls.No mutation at position +4 of the promoter was detected in controls.The frequencies of the three genotypes HH,HL,and LL at position-550 of the promoter were different between patients and controls(P＜0.05).The frequencies of genotypes YA and XB relevant to MBL protein levels were also different between patients and controls(P＜0.05).Comparing the frequencies of genotypes YA and XB in separate infectious disease with controls,significant differences were found in the group of RRI and CMV infection.The distributions of serum MBL level frequencies in patients and controls were both characterized by skewed distributions.MBL levels of patients with CMV infection were lower than those of controls(P＜0.05).Inversely,MBL levels of patients with acute respiratory infection and localized abscess were higher than those of controls (P＜O.05).Conclusion Genetic polymorphism of MBL gene is seemed to be relative to the sensitivity of common infections in children.

Objective To analyze the clinical features and the plasma secretory leukocyte proteinase inhibitor (SLPI) levels in children with Mycoplasma pneumoniae pneumonia (MPP). Methods Clinical data and plasma SLPI levels of 136 children with MPP were retrospectively analyzed. Results From July 2011 to June 2013,136 children (male 80, female 56) with MPP were included in the study. The onset ages of all children ranged from 11 months to 14 years (mean age, 6.2±3.0 years), and 82.4%of the cases were at the age of 4 to 14 years. One hundred and twenty six cases (92.7%) with long-last high fever, 83.8%with cough, 74.3%with rale were found in the study. Small or large patchy shadows in chest X-ray radiography were found in all the cases. At the acute phase, 72.1%with low white blood cell count, 59.6%with normal neutrophil cell and 63.2%with higher high sensitive C-reactive protein (hs-CRP) were observed. The SLPI level at the acute phase in 85 cases was (9.3±8.8) ng/ml, which was signiifcant lower than that at the convalescent phase (11.8±8.0 ng/ml, Z=3.08, P=0.002). Conclusions The clinical features of MPP are usually presented with high fever, cough, higher hs-CRP, normal or lower white blood cell and neutrophil cell count, small or large patchy shadows in chest X-ray radiography. The plasma SLPI level at the acute phase was signiifcantly lower than that in convalescent phase in children with MPP.

Objective To measure the concentrations of antibodies against outer membrane protein P6 and its T-and B-combined antigenic epitopes of nontypeable Haemophilus influenzae ( NTHi) in children and adults of different ages and to evaluate the differences among different subjects for further investigation on NTHi multiple antigenic peptide vaccine .Methods A prokaryotic expression system was established to ex-press the recombinant outer membrane protein P 6 of NTHi.The expressed protein was purified by using Ni-NTA affinity chromatography .T-and B-cell epitopes in protein P6 were predicted with Epitope prediction software 1.0 and ANTIGENIC program and were used to synthesize T-and B-combined antigenic epitopes .A total of 605 subjects aged from 1 day to 103 years old were recruited from October 2013 to March 2014 .Ser-um concentrations of antibodies against protein P 6 and its T-and B-combined antigenic epitopes were meas-ured by using ELISA .Mann-Whitney U test was used to analyze the differences between groups .Pearson product-moment correlation coefficient was used for correlation analysis .Results Four T-and B-combined antigenic epitopes including P 6-2, P6-61, P6-95 and P6-122 were predicted and synthesized .The levels of antibodies against NTHi P6 and P6-2, P6-61, P6-95 and P6-122 were significant lower in the <1 months group than those in the 1-6 months group (all P<0.001) and 7 months-3 years group (all P<0.001).Three groups including 7 months-3 years group , 4-6 years group and 7-14 years group showed significant differ-ences regarding to the antibodies levels , among the 7 months-3 years group showed the highest levels , fol-lowed by the 4-6 years group and the 7-14 years group.However, no significant difference was found be-tween other adjacent groups .Concentrations of antibodies against P 6-2, P6-61, P6-95 and P6-122 were pos-itively correlated with the level of antibody against P 6 (P<0.0001).Conclusion The distribution of anti-bodies against T-and B-combined antigenic epitopes in P6 was highly in accord with those against P6, which indicated good immunogenicity of those epitopes .The highest antibodies levels were found in subjects aged 7 months to 3 years old , which might correlate with the high risk of NTHi infection at that stage .

Objective Clinical effect analysis of low dose dopamine(LDD)and dobutamine (DOB)subsidiary in the treatment of 86 cases of Children serious pneumonia.Methods From July 2011 to July 2013,86 CSP patients who were diagnosed with CSP in People's Hospital of Wenzhou were selected.Patientas were randomly divided into observation group(n=43)and control group(n=43)according to the random number method.Both groups were treated with routine treatment,then observation group on the basis with LDD and DOB subsidiary,then compared efficacy of two groups at 1 week after treatment,as well as the time of symptoms and signs which had improvements,and changes of levels of Interleukin-6(IL-6),Interleukin-8(IL-8), C-reactive protein(CRP)and Tumor necrosis factor-α(TNF-α)before and after treatment. Results The efficacy in observation group was significantly better than that of control group(P<0.05 ).And time of symptoms and signs which had improvement in the observation group was significantly less than control group(P<0.05).After treatment,IL-6,IL-8,CRP and TNF-αlevels were lower than before,but the observation group had a greater degree of reducing(P<0.05).Conclusion Routine treatment combined with LDD and DOB for CSP patients,can significantly improve the therapeutic effect,and relieve the clinical symptoms.