1.Analysis of bacterial drug resistance of bloodstream infections in Fujian in 2021
WU Quan-ming ; CHEN Fa-lin ; WU Chang-sheng
China Tropical Medicine 2022;22(12):1194-
Abstract: Objective To understand the distribution and drug resistance of pathogenic bacteria of bloodstream infection
in Fujian Province, and to provide reference for clinical rational drug use. Methods Bacteria identification and antimicrobial
susceptibility test were carried out on the isolated strains of blood culture samples in 31 medical institutions in Fujian Province
according to the unified plan. The data were statistically analyzed by WHONET 5.6 software according to the Clinical and
Laboratory Standards Institute (CLSI) drug sensitivity executive standard in 2021. Results After removing the duplicate
strains, 10 356 strains of bacteria were collected, including 3 668 strains of Gram-positive bacteria (35.4%) and 6 688 strains
of Gram-negative bacteria (64.6%). The top 5 bacteria are Escherichia coli, Klebsiella pneumoniae, coagulase negative
Staphylococcus, Staphylococcus aureus and Pseudomonas aeruginosa. In this study, the detection rate of methicillin-resistant
Staphylococcus aureus (MRSA) was 24.5%, and the detection rate of methicillin-resistant coagulase-negative Staphylococcus aureus (MRCNS) was 76.8%. Vancomycin, teicoplanin and linezolid resistant staphylococci were not found. The detection rate
of penicillin resistant Streptococcus pneumoniae was 3.2%. Vancomycin resistant Enterococcus faecalis and Enterococcus
faecium were 0.8% and 1.1% respectively. The resistance rate of Escherichia coli to carbapenems was 0.8%, and the resistance
rate to levofloxacin was 41.9%; the resistance rate of Klebsiella pneumoniae to carbapenems was 15.0%. The resistance rate of
Acinetobacter baumannii to carbapenems was 45.1%; the detection rate of Pseudomonas aeruginosa was only 14.2%, and it
maintained a high sensitivity to most drugs. Conclusions Most bloodstream infections in Fujian Province are caused by
Escherichia coli, Klebsiella pneumoniae and Staphylococcus. The drug resistance of some strains is not optimistic, so we should
continue to strengthen the clinical application management of antibiotics and use them correctly and reasonably.
Keywords: Bloodstream infection; bacteria; antibiotics; drug resistance monitoring
2.Host-schistosome interactions mediated by cross-species microRNA
ZHANG Jing⁃yu ; QIN Ming ; FANG Jing-jing ; LI Jia-yi ; ZHANG Xin-xin ; ZHOU Fang-bin ; HE Xing
China Tropical Medicine 2022;22(12):1201-
Abstract: Schistosomiasis is a serious major parasitic disease that threatens human life and health. A better understanding
of the mechanism of host-schistosome interactions is the key to designing new prevention and control strategies. MicroRNAs
(miRNAs) are endogenous small non-coding RNA molecules, which lead to the degradation of the target messenger RNA
(mRNA) or inhibition of its translation in a sequence-specific manner. Both schistosome and its host produce miRNAs, which
can be secreted by extracellular vesicles (EVs). There is accumulating evidence that miRNAs from schistosome can be taken
up by host cells, and finely manipulate the phenotype of host cells for their survival or pathogenesis in a cross-species manner,
even inhibiting the growth and metastases of hepatoma cells. It is still unknown whether host free miRNAs can be taken up by
schistosome, but this phenomenon is highly probable. miRNA-mediated cross-species regulation has emerged as a novel
mechanism for host-schistosome interactions, and this review summarizes the advances in this regard.
3.Review of relationship between Toxoplasma gondii infection and neuropsychiatric diseases
YANG Yi-we ; DU Shu-tong ; YAN Han ; ZHANG Li ; LI Hai-long ; LV Yan
China Tropical Medicine 2022;22(12):1206-
Abstract: Toxoplasma gondii, an opportunistic pathogenic protozoan, is widely distributed worldwide and can cause
zoonoses, which is a serious threat to human health. Nowadays, the relationship between T. gondii infection and
neuropsychiatric diseases has attracted researchers' attention increasingly. T. gondii infection is related to the pathogenesis of
many neuropsychiatric diseases by affecting the nervous system, such as schizophrenia, depression, Alzheimer's disease, and so
on. This review will focus on the relationship between T. gondii infection and neuropsychiatric diseases and summarizes the
possible mechanisms of disorders resulting from T. gondii infection. It is expected that the study on the related pathogenic
mechanism of T. gondii will lead to new therapeutic directions and feasible solution for the clinical treatment of
neuropsychiatric diseases caused by T. gondii infection.
4.An excerpt of Society for Maternal-Fetal Medicine Consult Series #56: Hepatitis C in pregnancy—updated guidelines: Replaces Consult Number 43, November 2017
ZHONG Si-qi ; XU He ; JIANG Liang-kun ; FAN Jing-hua
China Tropical Medicine 2022;22(12):1211-
Abstract: In the United States, it is estimated that 1% to 4% of pregnant women are infected with hepatitis C virus
(HCV), which carries approximately a 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to
the infant in utero or during the peripartum period, and infection during pregnancy is associated with an increased risk of
adverse fetal outcomes, including fetal growth restriction and low birthweight. The purpose of an excerpt of Society for
Maternal-Fetal Medicine Consult Series #56: Hepatitis C in pregnancy—updated guidelines: Replaces Consult Number 43,
November 2017 is to discuss the current evidence, provide updated recommendations regarding screening, review treatment,
and address management of hepatitis C virus during pregnancy.
5.A case report of infection of Mycobacterium senegalense after abdominal liposuction
YU Ya-zhuan ; ZHU Chuan-long ; DU Yong-guo ; LI Wen-ting ; ZHANG Li-yuan ; WU Kun-liang ; WANG Qiang
China Tropical Medicine 2022;22(12):1215-
Abstract: Mycobacterium senegalense is one of the major pathogens causing bovine farcy, and reports of its infection in
human are rare. Here is a report on a woman who had been taking hormones and immunosuppressants for a long time for SLE
and underwent abdominal soft tissue infection with Mycobacterium senegalense after abdominal liposuction, to provide reference
for clinical diagnosis and treatment. The patient, female, 32 years old, has a history of SLE for more than 2 years, and currently
takes "methylprednisolone, hydroxychloroquine, and mycophenolate mofetil" regularly. Nine months before the patient was
admitted to the hospital, she once performed abdominal, waist and buttock liposuction in a medical beauty institution. One
month after the operation, several masses gradually appeared on the abdominal wall, accompanied by tenderness, one of the
masses had obvious fluctuation on palpation and purulent fluid could be drawn out. The location of the abdominal wall mass
was consistent with the insertion site of the liposuction needle. After the onset of the disease, the patient went to the medical
beauty institution for puncture of the abdominal wall mass, and 5 mL of purulent fluid was pierced and sent for bacterial
culture, and cultured "Mycobacterium Senegalense", after 3 days of treatment with "cephalosporin" antibiotics (specifically
unknown), the symptoms did not improve, so she went to the second affiliated hospital of hainan medical college. After
completing the relevant examinations during the hospitalization in our hospital, in order to clarify the etiology, another
abdominal puncture to extract pus was performed, the mycobacterial culture + identification results: Mycobacterium
senegalense. Consistent with the out-of-hospital results, the diagnosis of Mycobacterium senegalense infection was confirmed.
After 3 months of treatment with "cefoxitin, azithromycin, amikacin, and levofloxacin", the patient's abdominal wall soft tissue
infection was cured. Trauma or invasive procedures can lead to skin, muscle, or bone infection with nontuberculous
mycobacteria (NTM), which can manifest as chronic painless nodules that progress to purulent folliculitis and abscesses. NTM
infection should be suspected when the patient's wound has been exposed to water, there is a history of surgery, and empirical
anti-infection is ineffective. This is the first case of Mycobacterium senegalense infection caused by medical beauty, which tell
people that they should be cautious when choosing medical aesthetic projects and medical aesthetic institutions.
6.Bacterial distribution and drug resistance in blood samples in Ningxia Hui Autonomous Region, 2018-2020
ZOU Cui-mei ; REN Zheng ; YANG Xiao-yan ; CAO Jia-jing ; ZHANG Fang-fang ; ZHAO Mei ; LI Gang
China Tropical Medicine 2022;22(11):1003-
Abstract: Objective To understand the distribution and drug resistance of bacteria in clinical blood culture specimens in Ningxia in recent years, and to provide a basis for the prevention and treatment of bloodstream infection diseases. Methods The blood culture isolation bacteria and drug resistance of Ningxia bacterial resistance monitoring network hospitals from 2018 to 2020 were statistically analyzed by WHONET5.6 software. Results In the past three years, a total of 6 757 strains of bacteria were isolated from blood samples, including 3 697 strains (54.7%) of gram-negative bacteria and 3 060 (45.3%) of gram-positive bacteria. Among the gram-negative bacteria, Escherichia coli (2 074 strains,30.7%), Klebsiella pneumoniae (696 strains), Pseudomonas aeruginosa (139 strains), and Acinetobacter baumannii (121 strains). Among the gram-positive bacteria, coagulase-negative Staphylococcus (1 691 strains,25.0%), Staphylococcus aureus (442 strains), Streptococcus spp. (431 strains), Enterococcus spp. (379 strains). Resistance to Escherichia coli and Klebsiella pneumoniae was 56.6% and 22.6% against third-generation cephalosporins, and resistance to carbapenems was 1.0% and 3.7%, respectively. Pseudomonas aeruginosa and Acinetobacter baumannii were resistant to carbapenems at 9.0%(12/139) and 80.7%(71/121). Methicillin-resistant Staphylococcus aureus (MRSA) was detected at 26.8%, methicillin-resistant coagulase-negative Staphylococcus was detected at 70%, and no Staphylococcus bacteria resistant to vancomycin and linezolid were found. For three years, only 1 strain of vancomycin-resistant Enterococcus faecalis was detected, and no linezolid-resistant Staphylococcus and Enterococcus were detected. Conclusions Ningxia clinical blood specimen isolates of Escherichia coli, coagulase-negative Staphylococcus, and Klebsiella pneumoniae are more common. Among them, the resistance rate of Escherichia coli and Klebsiella pneumoniae to the third generation of cephalosporins is relatively stable, and the resistance rate to carbapenems is low. Acinetobacter baumannii is highly resistant to carbapenems, and methicillin-resistant Staphylococcus aureus detection rates are on the rise and should be closely monitored.
7.Analysis of pathogenic bacteria distribution and drug resistance characteristics of bloodstream infection in patients with neutrophilic deficiency after chemotherapy in acute leukemia
XU Hai-lin ; ZHANG Zhi-jie ; XU Zi-han ; LIU Yong ; QIN Xiao-song
China Tropical Medicine 2022;22(11):1009-
Abstract: Objective To investigate the distribution and drug resistance characteristics of pathogenic bacteria in patients with neutropenic acute leukemia (AL) and bloodstream infections (BSI). Methods The clinical data of 258 neutropenic acute leukemia patients with bloodstream infections, who admitted to Shengjing Hospital of China Medical University from January 2016 to December 2021, were collected and analyzed for pathogenic bacteria and drug resistance. Results A total of 268 strains of pathogenic bacteria were isolated from 258 patients, including 180 strains of gram-negative bacteria (67.16%), 61 strains of gram-positive bacteria (22.76%), and 27 strains of fungi (10.07%). Gram-negative bacteria were mainly Klebsiella pneumoniae (53/268, 19.78%), Escherichia coli (49/268, 18.28%) and Pseudomonas aeruginosa (41/268, 15.30%). Gram-positive bacteria were mainly coagulase negative Staphylococcus (31/268, 11.57%) and Staphylococcus aureus(17/268, 6.34%). The main fungi were Candida tropicalis (25/268, 9.33%). Escherichia coli (33/268, 12.31%) was the most common pathogen isolated from acute myeloid leukemia (AML), followed by Pseudomonas aeruginosa (25/268, 9.33%), coagulase-negative Staphylococcus (18/268, 6.72%) and Candida tropicalis (18/268, 6.72%). Klebsiella pneumoniae (35/268, 13.06%) was the most common pathogen isolated from acute lymphoblastic leukemia (ALL),followed by Pseudomonas aeruginosa (15/268, 5.60%) and Escherichia coli (14/268, 5.22%). The resistance of Gram-negative bacteria to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, ertapenem, amikacin, cefoxitin, amoxicillin/clavulanic acid was low. Gram-positive bacteria were sensitive to linezolid and vancomycin. Candida was sensitive to flucytosine, amphotericin B and itraconazole. Conclusions In patients with granulosa after AL chemotherapy combined with BSI, the pathogenic bacteria isolated from AML are diverse, and the pathogenic bacteria isolated from ALL are mainly gram-negative bacteria. Pathogenic bacteria have different degrees of drug resistance to commonly used antibacterial drugs, so it is important to strengthen the monitoring of the distribution of pathogenic bacteria and the change of drug resistance and rational use of antibacterial drugs to minimize the death of patients.
8.Analysis of the etiological characteristics and drug resistance of adult patients with bloodstream infection in a hospital in Hainan, 2018-2020
CHEN Lin ; YAN Yu ; ZHANG Hui ; CHEN Xiao-juan ; LI Fei-fei ; XU Yu-ni ; CHEN Shao-wen ; LIN Chong
China Tropical Medicine 2022;22(11):1021-
Abstract: Objective To analyze the etiological characteristics and drug resistance of patients with bloodstream infection (BSI) in the bacterial resistance monitoring network in Hainan Province from 2018 to 2020, so as to provide laboratory data for clinical diagnosis and treatment. Methods The clinical data of the subjects were collected, and the etiological characteristics of BSI patients and drug resistance of commonly used drugs in clinical treatment were analyzed retrospectively. SPSS 26.0 software was used for statistical analysis. Results A total of 877 strains were isolated, including Gram-negative bacteria (584 strains, 66.6%), Gram-positive bacteria (239 strains, 27.2%) and fungi (54 strains, 6.2%); male patients (591 cases, 67.4%), female patients (286 cases, 32.6%); inpatients (780 cases, 88.9%), outpatient and emergency patients (97 cases, 11.1%); the main primary diseases of BSI patients were hypertension, cerebral infarction and type 2 diabetes, and the main primary infections were pulmonary infection and urinary system infection. Intensive care unit (25.2%, 221 cases), emergency department (10.9%, 96 cases), oncology department (9.1%, 80 cases), nephrology department (6.8%, 60 cases) and hepatobiliary and pancreatic surgery department (4.3%, 38 cases) had the highest proportion of pathogenic bacteria. Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, coagulase-negative Staphylococcus, Viridans group streptococci and Candida albicans were the most frequently isolated pathogens. The detection rates of carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii were 3.4%, 15.2% and 36.4% respectively. The carbapenem-resistant Escherichia coli was not checked out. The detection rates of methicillin resistant Staphylococcus aureus and methicillin resistant coagulase negative Staphylococcus were 18.5% and 79.1% respectively. Conclusions Gram-negative bacteria are the most common pathogens of BSI, and inpatients are the main source of BSI. Age, underlying diseases and primary infection are the risk factors of BSI. Clinical laboratories should strengthen the etiological monitoring of high-risk patients with BSI, and the resistance analysis of common antibiotics can provide a basis for the rational use of antibiotics in clinical practice.
9.Aeromonas hydrophila bloodstream infection in patients with hematologic diseases: a report of 4 cases
XU Yan-ling ; YANG Xu ; LI Jiang ; HE Wei ; HE Ping-an ; LYU Mei ; BI Hui
China Tropical Medicine 2022;22(11):1028-
Abstract: To report the diagnosis, treatment and outcome of 4 patients with hematological diseases complicated with Aeromonas hydrophila bloodstream infection in the Second Affiliated Hospital of Kunming Medical University, further clarify the importance of blood culture and deepen the clinical understanding of the disease. Four patients with hematological diseases complicated with Aeromonas hydrophila bloodstream infection treated in the Second Affiliated Hospital of Kunming Medical University from 2017 to 2021 were recruited as the study objects. The clinical manifestations, blood culture collection, detection time of Aeromonas hydrophila, laboratory examination, treatment and prognosis of the patients were retrospectively analyzed. In this study, 4 cases were male patients with hematological diseases, who were in myelosuppression after chemotherapy. After fever, blood culture was collected and Aeromonas hydrophila was detected. The positive time of blood culture in 4 cases ranged from 4 to 11 hours. The results of antibiotic sensitivity showed that it was highly sensitive to the second, third and fourth generation cephalosporins, quinolones and carbapenems. Four patients were treated with imipenem cilastatin sodium in the early stage, and one patient recovered after active anti infection and leukocyte raising treatment. One patient did not complete chemotherapy due to a request for discharged, and the follow-up was unknown. Two patients developed rapidly into necrotizing fasciitis and died later. Hematological diseases complicated with Aeromonas hydrophila bloodstream infection are rare, but the mortality rate is high. For patients with repeated fever and considering infection, blood culture should be carried out as soon as possible to confirm the pathogen and drug sensitivity test. During clinical treatment, the treatment should be adjusted in time in combination with the patient's situation. In addition to anti-infection treatment, the patient's immunity should be improved and the development of necrotizing fasciitis should be vigilant.
Keywords: Aeromonas hydrophila; hematologic diseases; leukemia; bloodstream infection; blood culture; necrotizing fasciitis
10.Drug resistance characteristics of pathogenic bacteria in neonatal bloodstream infections from a hospital in Chuzhou, Anhui, 2017-2021
XIE Qiang ; XU Tian-tian ; XIE Rui-yu ; TANG De-gang
China Tropical Medicine 2022;22(11):1034-
Abstract: Objective To investigate the distribution and antimicrobial resistance profile of the bacterial strains isolated from blood cultures in neonatal septicemia children of Neonatology Department, the First People's Hospital of Chuzhou during Jan. 2017-Dec. 2021, in order to guide clinical rational drug use. Methods The distribution and the results of antimicrobial susceptibility tests and characteristics of the pathogenic bacteria isolated from blood culture samples in neonatal septicemia children in the First Hospital of Chuzhou from Jan. 2017 to Dec. 2021 were retrospectively analyzed. The results were analyzed with WHONET 5.6 software, according to the Clinical and Laboratory Standards Institute (CLSI) 2021 breakpoints. Results A total of 189 strains were isolated from the 4 538 sample of blood cultures, the positive rate was 4.2%, including 59(31.2%) Gram-negative bacterial strains, 130 (68.8%) Gram-positive bacterial strains. The most frequently isolates were coagulase-negative staphylococci(64.0%), Serratia liquefaciens (15.9%), Escherichia coli (3.2%), Acinetobacter lwoffii (2.6%) and Delftia acidovorans (2.6%). The prevalence of methicillin-resistant isolates was 81.8%(99/121) in coagulase-negative Staphylococci and 25.0%(1/4) in Staphylococcus aureus. No staphylococcal strains were found resistant to vancomycin, quinupristin-dalfopristin or linezolid. The sensitivity of the antibacterial drug monitored by Serratia liquefaciens was 100.0%.Conclusions Gram-positive bacterial are the main pathogen of neonatal septicemia, and is highly resistant to the common antibacterial drugs. The clinical should choose antibacterial agents reasonably according to drug sensitivity.