1.Study on the relationship between colonization pressure and MRSA cross transmission among hospitalized patients
Junrui WANG ; Qian XIANG ; Xinrong SHANG ; Yingjun Lü ; Jian PANG ; Lu JIANG ; Yong WANG ; Xinxin LU
Chinese Journal of Laboratory Medicine 2010;33(10):936-941
Objective Based on active monitoring MRSA carriage for hospitalized patients, the relationship between colonization pressure and MRSA cross transmission in wards without rigorous contactisolation measures was analyzed, and the role of colonization pressure in predicting MRSA cross transmission was further evaluated. Methods From March to December 2009, active MRSA colonization screening was performed for 240 hospitalized patients in emergency ward and 94 cases in RICU in our hospital. rep-PCR method was employed to do homology analysis on MRSA strains obtained in this study. MRSA weekly colonization pressure, threshold colonization pressure ,cross transmission rate were calculated respectively. RR of MRSA cross transmission under higher level of colonization pressure and lower level of colonization pressure was analyzed. Results MRSA carriage rates on admission for patients in emergency wards and RICU were 6. 25% (15/2A0) and 13. 83 % (13/94) ,and MRSA cross transmission occurred in 13 weeks and 14 weeks in above two units, respectively. Threshold colonization pressures for above two units were 6. 49%and 17. 66%, respectively. For emergency ward, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure (x2 = 7. 10,P<0. 01), the RR of MRSA transmission was 9. 61 (95% CI:1. 25-74.00). For RICU, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure(x2 = 12. 60, P<0. 01 ), the RR of MRSA transmission was 15.87 (95% CI:2. 06-122. 10). Conclusions Higher level of colonization pressure is an important risk factor for MRSA transmission, and average colonization pressure can be used as a prediction index for MRSA transmission and strengthening prevention and control measures.
2.Virulence characteristics and multilocus sequence type of Vibrio parahaemolyticus isolated from clinic
Yanyan FAN ; Min ZHU ; Xinrong SHANG ; Mei WANG ; Yanfei HUANG ; Haitong GU ; Xinxin LU
Chinese Journal of Laboratory Medicine 2013;(6):548-552
Objective To study on virulence characteristics and multilocus sequence type of Vibrio parahaemolyticus isolated from clinic in Beijing Tongren hospital.Methods Total 152 strains of Vibrio parahaemolyticus isolates were collected from diarrheal patients of outpatients in Beijing Tongren Hospital,Capital Medical University from 2009 to 2011.PCR was used to detect hemolysin gene thermo stable direct themolysin gene (tdh),TDH-related hemolysin gene (trh),type Ⅲ secretion system 2 (T3SS2α,T3SS2β)and systematic functional gene (toxRS/new,orf8) for pandemic 03∶ K6 clone and its derivatives.The genetic features of these strains were determined by multilocus sequence typing (MLST).Results 96% (146/152) VP harbored tdh gene,2% (3/152) VP harbored trh gene and 100% (152/152) VP harbored T3SS2 gene.In this study there were 107 pandemic strains (both tdh and toxRS/new positive and trh negative),38 pathogenic strains (tdh positive and/or trh positive) and 6 nonpathogenic strains (both tdh and trh negative).All nonpathogenic strains harbored systematic functional gene (toxRS/new,orf8).Only one pathogenic strains harbored orf8 gene.One clone harbored all virulence gene.In this study there were 16 sequence types,and ST3 is the pandemic sequence type,including 113 strains,and four new sequence types were found.Conclusions In this study more than 90% Vibrio haemolyticus harbored tdh gene and ST3 was the pandemic sequence type in Beijing.One can get bacterial pathogenic charateristic and population genetics information by virulence gene testing and MLST.
3.Four novel sequence types in catheter-related MRSE isolates
Xinrong SHANG ; Junrui WANG ; Mei WANG ; Lijun WANG ; Yanfei HUANG ; Haitong GU ; Xianxi KONG ; Xinxin LU
Chinese Journal of Laboratory Medicine 2011;34(3):245-248
Objective To study the genotypic and biological characteristics of catheter-related MRSE isolates and to further provide information for the diagnosis and prevention of catheter-related bloodstream infection. Methods Thirty strains of catheter-related MRSE isolates were collected from venosus blood and whole blood of 30 inpatients including 20 males and 10 females from Beijing Tongren Hospital, Capital Medical University from January 2006 to December 2009. The genetic features of these strains were determined by MLST. PCR was used to detect the icoA gene (encoding the polysaccharide intercellular adhesion associated with pathogenicity), and the antimicrobial susceptibility test was detected by disc diffusion test. Results A total of 15 STs were obtained from 30 strains ST259, ST20, ST2 and ST235 were common clones obtained from 17 strains. Four novel STs were found and uploaded to the MLST database (http://www. mlst. net), including ST259 (6 strains), ST260 (1 strain), ST261 (1 strain) and ST262 (1 strain). The ST259 was the dominant clone of catheter-related MRSE isolates in this hospital, and 3 strains carrying icaA gene were detected in this study. Conclusion Some ST259 isolates express high pathogenesis among the four novel STs, which may make them as the pandemic strains in nosocomial infection, and this would increase the difficulty of the prevention and control of nosocomial infection.
4.The effect of hemodialysis and conventional treatment on the heart function of elderly patients with chronic renal-cardiac syndrome
Jingsheng YANG ; Xinrong DENG ; Shang GAO ; Hong ZHOU
Chinese Journal of Postgraduates of Medicine 2022;45(2):140-143
Objective:To explore the effect of hemodialysis and conventional treatment on the heart function of elderly patients with chronic renal heart syndrome(CRCS).Methods:Sixty elderly patients with CRCS who were admitted to Qinhuangdao Port Hospital from July 2017 to July 2018 were selected and divided into the observation group (received hemodialysis and conventional treatment) and the control group (received conventional treatment) according to the random number table method, each group with 30 patients. The levels of left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and left atrium anterior and posterior diameter (LAD) before and after treatment of two weeks were compared between two groups, the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), cystatin C (CysC), creatinine (Cr) and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein (hs-CPR), interleukin 6 (IL-6) before and after treatment for two week were compared between two groups, and the safety of the two treatment methods was evaluated.Results:After treatment, the levels of LVESD, LVEDD, LAD in the observation group were lower than those in the control group: (26.13 ± 1.28) mm vs. (29.09 ± 1.26) mm, (47.58 ± 1.22) mm vs. (51.34 ± 1.49) mm, (30.02 ± 0.83) mm vs. (33.15 ± 1.02) mm, the level of LVEF in the observation group was higher than that in the control group: (39.63 ± 5.21)% vs. (35.77 ± 4.93)%, the differences were statistically significant ( P<0.05). After treatment, the levels of NT-proBNP, BUN, CysC and Cr in the observation group were lower than those in the control group: (1 089.31 ± 243.29) ng/L vs. (2 990.56 ± 531.22) ng/L, (16.08 ± 3.35) mmol/L vs.(21.93 ± 4.21) mmol/L, (0.35 ± 0.11) mg/L vs. (0.57 ± 0.18 mg/L, (251.62 ± 29.28) μmol/L vs. (290.66 ± 38.12) μmol/L, the differences were statistically significant ( P<0.05). After treatment, the levels of TNF-α, hs-CPR and IL-6 in the observation group were lower than those in the control group: (149.26 ± 19.53) μg/L vs. (182.33 ± 20.25) μg/L, (4.02 ± 1.33) mg/L vs. (5.38 ± 1.57) mg/L, (18.91 ± 3.11) μg/L vs. (22.45 ± 3.82) μg/L, the differences were statistically significant ( P<0.05). The incidence of adverse reactions during the treatment in the two groups had no significant difference ( P>0.05). Conclusions:The use of hemodialysis on the basis of conventional treatment can improve the heart and kidney function of elderly patients with CRCS, and this method is beneficial to alleviate left heart dilation and inflammation. It is a safe and effective treatment method.