BACKGROUND: Enteropathgenic Escherichia coli (EPEC) commonly causes infantile diarrhea in the developing countries. This study aims to find out the phenotypic and genotypic characteristics of EPEC in children with diarrhea in Gwangju city. METHODS: We isolated 35 strains from the stool obtained from diarrheal patients and investigated the presence of various virulence genes, adherence patterns, hemolysis, and antibiotic resistance patterns. RESULTS: All isolates were negative for the EPEC adherence factor (EAF) plasmid, and 14 isolates were bfpA-positive by PCR. The eae, tir, espA, and espB genes were analyzed by multiplex PCR. When the results of the four multiplex PCRs were analysed, we observed that the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was highest. The incidence of enteroaggregative E. coli heat-stable enterotoxin (east) was 17.1%. Analysis of Hep-2 cell adherence showed three adherence patterns:the localized adherence pattern, the diffuse adherence pattern, the localized adherence-like pattern. In hemolysin assay, four isolates produced enterohemolysin. The resistance rate of isolates against tetracycline, streptomycin, ampicillin, and rifampin was 56%, 39%, 34%, and 34%, respectively. All isolates were susceptible to ciprofloxacin and colistin. CONCLUSION: In our study, the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was the highest. Analysis of Hep-2 cell adherence showed various adherence patterns. Seventy-five percent of isolates were resistant to at least one antibiotic and 28% were resistant to four or more antibiotics.
Ampicillin ; Anti-Bacterial Agents ; Child* ; Ciprofloxacin ; Colistin ; Developing Countries ; Diarrhea* ; Diarrhea, Infantile ; Drug Resistance, Microbial ; Enteropathogenic Escherichia coli* ; Enterotoxins ; Escherichia coli ; Gwangju* ; Hemolysis ; Humans ; Incidence ; Infant ; Multiplex Polymerase Chain Reaction ; Plasmids ; Polymerase Chain Reaction ; Rifampin ; Streptomycin ; Tetracycline ; Virulence

BACKGROUND: Enteropathgenic Escherichia coli (EPEC) commonly causes infantile diarrhea in the developing countries. This study aims to find out the phenotypic and genotypic characteristics of EPEC in children with diarrhea in Gwangju city. METHODS: We isolated 35 strains from the stool obtained from diarrheal patients and investigated the presence of various virulence genes, adherence patterns, hemolysis, and antibiotic resistance patterns. RESULTS: All isolates were negative for the EPEC adherence factor (EAF) plasmid, and 14 isolates were bfpA-positive by PCR. The eae, tir, espA, and espB genes were analyzed by multiplex PCR. When the results of the four multiplex PCRs were analysed, we observed that the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was highest. The incidence of enteroaggregative E. coli heat-stable enterotoxin (east) was 17.1%. Analysis of Hep-2 cell adherence showed three adherence patterns:the localized adherence pattern, the diffuse adherence pattern, the localized adherence-like pattern. In hemolysin assay, four isolates produced enterohemolysin. The resistance rate of isolates against tetracycline, streptomycin, ampicillin, and rifampin was 56%, 39%, 34%, and 34%, respectively. All isolates were susceptible to ciprofloxacin and colistin. CONCLUSION: In our study, the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was the highest. Analysis of Hep-2 cell adherence showed various adherence patterns. Seventy-five percent of isolates were resistant to at least one antibiotic and 28% were resistant to four or more antibiotics.
Ampicillin ; Anti-Bacterial Agents ; Child* ; Ciprofloxacin ; Colistin ; Developing Countries ; Diarrhea* ; Diarrhea, Infantile ; Drug Resistance, Microbial ; Enteropathogenic Escherichia coli* ; Enterotoxins ; Escherichia coli ; Gwangju* ; Hemolysis ; Humans ; Incidence ; Infant ; Multiplex Polymerase Chain Reaction ; Plasmids ; Polymerase Chain Reaction ; Rifampin ; Streptomycin ; Tetracycline ; Virulence

Objective To investigate the effects of esketamine on respiration,complications and acute phase inflammatory factors in patients undergoing single-port thoracoscopic surgery under general anesthesia with preserved spontaneous respiration.Methods Ninety patients,aged 16～74 years,BMI 18～28 kg/m2,ASA physical status Ⅰ or Ⅱ,who were scheduled to undergo single-port thoracoscopic surgery under general anesthesia were selected.Patients were randomly divided into two groups by random number table:esketamine group(group E,n=45)and control group(group C,n=45).Esketamine 0.5 mg/kg was given for induction of anesthesia,and 0.25 mg/kg again before cutting skin.In group C,sufentanilwas given at 0.15 μg/kg for induction of anesthesia.Other anesthesia induction and maintenance durgs in both groups were the same.SP02,PaCO2 and PaO2 were recorded at the patient's entrance(T0),before pleuraopening(T1),15 min after pleuraopening(T2),30 min after pleuraopening(T3),and beforelaryngeal mask removal(T4).3 mL of blood was extracted from themedian cubital vein at T0 and 24 h after surgery(T5)todetect the concentrations of TNF-α and IL-6.The length of spontaneous respiration recovery and laryngeal mask removal,the number of respiratory intervention,the incidence of body movement during operation,nausea,vomiting,psychiatric symptom,awareness,the length of hospital stay was recorded.Results Compared with group C,PaO2was significantly decreased and PaCO2was significantly increased in group E at T1,PaO2was significantly increased and PaCO2was significantly decreased at T2(P<0.01).Compared with group C,the length of spontaneous respiration recovery was significantly shortened and the number of respiratory intervention was significantly decreased in group E(P<0.01).Compared with group C,the concen-trations of TNF-α and IL-6 in venous blood in group E at T5 was significantly decreased(P<0.01).There were no significant difference in the length of laryngeal mask removal,and the incidenceofcomplications,hospitalstay between the two groups.Conclusion Esketamine reducesintraoperative respiratory depression,shortens spontaneous respiration recovery,maintains respiratory stability and reduces acute inflammatory response in patients under general anesthesia with preserved spontaneous respiration for single-port thoracoscopic surgery.