1.Analysis of components absorbed into blood and brain of Lithocarpus litseifolius leaves
Huan LIU ; Zirong YI ; Ting HUANG ; Xiuhong LIU ; Yunyao YE ; Yuming MA ; Mengqi HU ; Nan ZHANG ; Wenhao YANG ; Yang LIU ; Guopeng WANG
China Pharmacy 2026;37(7):889-894
OBJECTIVE To analyze the prototype components absorbed into blood and brain of Lithocarpus litseifolius leaves, so as to provide a reference for clarifying the pharmacological material basis of its prevention and treatment of central nervous system dis eases. METHODS The ethanol extract of L. litseifolius leaves, as well as the gastric lavage fluid and perfusion solution were prepared. Using rats as subjects, plasma samples of intestinal wall metabolism, intestinal flora metabolism and hepatic metabolism were prepared via in situ intestinal perfusion and closed intestinal loop method; while comprehensive metabolic plasma samples, brain tissue samples, and cerebrospinal fluid samples were collected after intragastric administration. UPLC-HRMS technology was utilized to analyze and identify chemical components and prototype components absorbed into blood and brain of L. litseifolius leaves. RESULTS A total of 66 chemical constituents were identified in L. litseifolius leaves, primarily consisting of flavonoids, organic acids, and others. A total of 16, 13, 11, and 5 prototype components were identified in intestinal wall metabolism, intestinal flora metabolism, hepatic metabolism, and comprehensive metabolic plasma samples, respectively. Additionally, 4 prototype components were detected in brain tissue and 9 in cerebrospinal fluid. Phloridzin, trilobatin, phloretin-2- O -malonyl hexoside, and phloretin were identified as common components across all sample types. CONCLUSIONS Prototype components absorbed into blood and brain of L. litseifolius leaves, such as phloridzin, trilobatin, phloretin, and other components may serve as the pharmacological material basis for their therapeutic effects on central nervous system diseases.
2.The influencing factors of prognosis in critically ill patients and the predictive value of CALLY index
Pu LI ; Ting YE ; Yangmei MEI ; Yujie WANG ; Wenting WU ; Zhipeng HU
Clinical Medicine of China 2025;41(6):446-451
Objective:To investigate the factors influencing the prognosis of critically ill patients and the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index.Methods:A retrospective analysis was conducted on the clinical data of 122 critically ill patients admitted to Guoyao Dongfeng General Hospital affiliated with Hubei University of Medicine from June 2022 to December 2023. Patients were divided into a death group and a survival group based on their 28-day prognosis. Clinical data were compared between the two groups to analyze the factors influencing prognosis and assess the predictive value of various indicators. Normally distributed measurement data were expressed as Mean±SD, and intergroup comparisons were performed by independent samples t-test; non-normally distributed measurement data were expressed as M( Q1,Q3), and intergroup comparisons were performed by the Mann-Whitney U test. Counting data were expressed as case (%), and intergroup comparisons were performed by the χ2 test. Multivariate logistic regression was used to analyze factors influencing patient prognosis, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator. Results:The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, blood lactate, CRP, and B-type natriuretic peptide levels in the death group were higher than those in the survival group [22 (17, 30) points vs. 17 (14, 22) points, (4.8±1.4) mmol/L vs. (3.3±1.0) mmol/L, 134 (83, 2 381) mg/L vs. 13 (10, 27) mg/L, 259 (111, 592) ng/L vs. 108 (40, 247) ng/L; Z=3.04, P=0.002; t=5.79, P<0.001; Z=8.57, P<0.001; Z=3.28, P=0.001, respectively]. Albumin, neutrophil count, lymphocyte count (LYC), and the CALLY index were lower in the death group than in the survival group [(31±5) g/L vs. (37±6) g/L, (58±9)×10 9/L vs. (63±10)×10 9/L, 0.6 (0.4, 0.8)×10 9/L vs. 1.3 (0.8, 1.7)×10 9/L, 0.03 (0.02, 0.11) vs. 0.26 (0.13, 0.49); t=6.05, P<0.001; t=3.04, P=0.003; Z=5.82, P<0.001; Z=6.52, P<0.001, respectively]. Multivariate logistic regression analysis indicated that the APACHE Ⅱ score and CRP were risk factors for poor prognosis in critically ill patients ( OR=1.349, 95% CI: 1.004-1.821, P=0.048; OR=1.006, 95% CI: 1.003-1.010, P=0.001, respectively), while LYC and the CALLY index were protective factors ( OR=0.297, 95% CI: 0.111-0.795, P=0.016; OR=0.989, 95% CI: 0.955-0.999, P=0.001, respectively). The area under the ROC curve for the CALLY index predicting 28-day mortality in critically ill patients was 0.872 (95% CI: 0.800-0.926), which was higher than that of the APACHE Ⅱ score, LYC, and CRP [0.673 (95% CI: 0.582-0.756), 0.664 (95% CI: 0.573-0.748), 0.576 (95% CI: 0.482-0.665), respectively]. The cut-off values were 0.06, 20 points, 0.8×10 9/L, and 50 mg/L, respectively. When the CALLY index was 0.06, the specificity was 97.65%, the sensitivity was 72.97%, and the Youden index was 0.706. Conclusions:The APACHE Ⅱ score, CRP, LYC, and CALLY index are all factors influencing the prognosis of critically ill patients. The CALLY index has certain predictive value, but its false negative rate is relatively high. Further combination with other indicators is needed to improve its predictive value.
3.A promising novel local anesthetic for effective anesthesia in oral inflammatory conditions through reducing mitochondria-related apoptosis.
Haofan WANG ; Yihang HAO ; Wenrui GAI ; Shilong HU ; Wencheng LIU ; Bo MA ; Rongjia SHI ; Yongzhen TAN ; Ting KANG ; Ao HAI ; Yi ZHAO ; Yaling TANG ; Ling YE ; Jin LIU ; Xinhua LIANG ; Bowen KE
Acta Pharmaceutica Sinica B 2025;15(11):5854-5866
Local anesthetics (LAs), such as articaine (AT), exhibit limited efficacy in inflammatory environments, which constitutes a significant limitation in their clinical application within oral medicine. In our prior research, we developed AT-17, which demonstrated effective properties in chronic inflammatory conditions and appears to function as a novel oral LA that could address this challenge. In the present study, we further elucidated the beneficial effects of AT-17 in acute inflammation, particularly in oral acute inflammation, where mitochondrial-related apoptosis played a crucial role. Our findings indicated that AT-17 effectively inhibited lipopolysaccharide (LPS)-induced nerve cell apoptosis by ameliorating mitochondrial dysfunction in vitro. This process involved the inhibition of mitochondrial reactive oxygen species (mtROS) production and the subsequent activation of the NRF2 pathway. Most notably, improvements in mitochondria-related apoptosis were key contributors to AT-17's inhibition of voltage-gated sodium channels. Additionally, AT-17 was shown to reduce mtROS production in nerve cells through the Na+/NCLX/ETC signaling axis. In conclusion, we have developed a novel local anesthetic that exhibits pronounced anesthetic functionality under inflammatory conditions by enhancing mitochondria-related apoptosis. This advancement holds considerable promise for future drug development and deepening our understanding of the underlying mechanisms of action.
4.Expert consensus on evaluation index system construction for new traditional Chinese medicine(TCM) from TCM clinical practice in medical institutions.
Li LIU ; Lei ZHANG ; Wei-An YUAN ; Zhong-Qi YANG ; Jun-Hua ZHANG ; Bao-He WANG ; Si-Yuan HU ; Zu-Guang YE ; Ling HAN ; Yue-Hua ZHOU ; Zi-Feng YANG ; Rui GAO ; Ming YANG ; Ting WANG ; Jie-Lai XIA ; Shi-Shan YU ; Xiao-Hui FAN ; Hua HUA ; Jia HE ; Yin LU ; Zhong WANG ; Jin-Hui DOU ; Geng LI ; Yu DONG ; Hao YU ; Li-Ping QU ; Jian-Yuan TANG
China Journal of Chinese Materia Medica 2025;50(12):3474-3482
Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards*
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Humans
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Consensus
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Drugs, Chinese Herbal/therapeutic use*
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Surveys and Questionnaires
5.HuiNet report of 2024: the distribution and antimicrobial resistance profile of clinical bacterial isolates in Anhui province
Yanyan LIU ; Yasheng LI ; Liang YU ; Yi YANG ; Ting WU ; Jun YIN ; Lifen HU ; Ying YE ; Jiabin LI
Chinese Journal of Clinical Infectious Diseases 2025;18(1):63-76
Objective:To report the surveillance results of the distribution and antimicrobial resistance profile of clinical isolates in Anhui province.Methods:Surveillance data from 94 members of the Anhui Antimicrobial Resistance Surveillance Network(HuiNet)from October 2023 to September 2024 were collected,the major drug-resistant bacteria and the resistance to commonly used antibiotics were analyzed. WHONET 5.6 and SPSS 25.0 software were used for data analysis.Results:Among 240 339 clinical strains,Gram-negative bacteria accounted for 75.0%(180 153 strains). The detected bacteria mainly include Escherichia coli( n=53 587,22.3%), Klebsiella pneumoniae( n=39 774,16.5%), Pseudomonas aeruginosa( n=25 505,10.6%), Staphylococus aureus( n=19 438,8.1%), Acinetobacter baumannii complex( n=14 239,5.9%),and so on. The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus aureus(MRCNS)were 37.7%(7 112/18 853)and 73.9%(13 221/17 895),respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of carbapenem-resistant Escherichia coli(CREC)and Klebsiella pneumoniae(CRKP)were 1.9%(971/51 991)and 12.3%(4 864/39 414),respectively. The resistance rate of CRKP to tigecycline and polycolistin B was 7.7% and 7.9%,respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)complex and Pseudomonas aeruginosa(CRPA)were 57.9%(8 222/14 198)and 18.2%(4 569/25 052),respectively,with low resistance to polycolistin B(2.0% and 7.2%,respectively). The detection rates of MRSA,MRCNS,CRAB complex,third-generation cephalosporin-resistant Escherichia coli(3GC-R-EC)and quinolone-resistant Escherichia coli(QREC)in northern Anhui were the highest(46.8%,77.1%,65.6%,57.6% and 55.5%,respectively),which were higher than those in central and southern Anhui( χ2=107.858 and 566.202,5.950 and 142.223,39.254 and 289.137,135.402 and 449.114,39.142 and 185.114, P<0.05 or <0.01),and the detection rates in central Anhui were higher than those in southern Anhui( χ2=272.031,102.717,162.409,118.891 and 66.889,all P<0.001). The detection rates of CRKP,CRPA and thirdgeneration cephalosporinresistant Klebsiella pneumoniae(3GC-R-KP)in central Anhui were the highest(16.7%,21.7% and 32.0%,respectively),which were higher than those in northern and southern Anhui( χ2=229.656 and 439.377,156.599 and 65.818,77.386 and 232.568,all P<0.001). The detection rates of CREC,3GC-R-EC and QREC were the highest in the elderly(2.2%,54.0% and 56.4%,respectively),which were higher than those in children and adults( χ2=8.034 and 13.150,17.032 and 103.437,438.353 and 183.099,all P<0.01). The detection rates of CRKP and 3GC-R-KP in neonates were the highest(20.6% and 56.9%,respectively),which were significantly higher than those in children,adults and the elderly( χ2=38.869,8.337 and 7.921;65.517,55.525 and 49.214,all P<0.01),and the detection rate of 3GC-R-KP in the elderly was higher than that in children and adults( χ2=14.122 and 7.501,both P<0.01). The detection rates of CRAB complex,CRPA,CREC,CRKP and 3GC-R-KP in tertiary hospitals were higher than those in secondary hospitals( χ2=25.606,16.501,5.820,33.116 and 117.086, P<0.05 or <0.01). Except for MRSA,vancomycin-resistant Enterococcus faecium and QREC,the detection rates of major drug-resistant bacteria in intensive care unit(ICU)were the highest(all P<0.001). From 2019 to 2024,the detection rates of MRSA,MRCNS,CRKP,CRAB complex and CRPA all showed a slow decreasing trend( χ2=42.319,122.779,340.381,83.512 and 81.668,all P<0.001). Conclusions:The situation of antimicrobial resistance in Anhui province shows a downward trend,but it is still serious,especially in northern and central Anhui. It is necessary to pay attention to the bacterial resistance particularly for the elderly,newborns,children and ICU.
6.Practical research on nursing coordination training for rapid sequential intubation in children based on LSPPDM framework
Yu-xia YANG ; Jing HU ; Wei-ming CHEN ; Ye CHENG ; Wei-jie SHEN ; Yi ZHANG ; Ting-ting XUE ; Bei-bei WANG ; Yu-qing WANG ; Pan LIU ; Ying-ying ZHANG ; Guo-ping LU ; Ying GU
Fudan University Journal of Medical Sciences 2025;52(6):847-853
Objective To investigate the practical effects of pediatric rapid sequence intubation(RSI)nursing coordination training based on the LSPPDM(learn,see,practice,prove,do,maintain)framework in order to provide evidence for optimizing pediatric RSI nursing training programs.Methods Nurses from the intensive care unit(ICU)of Children's Hospital,Fudan University during Feb 2023 and Jan 2024 were divided into the experimental group(n=35)and the control group(n=35)by block randomization.The experimental group received LSPPDM framework-based training,while the control group underwent conventional training with theoretical lectures and procedural demonstrations.Outcomes included training satisfaction,theoretical knowledge and procedural skill assessment scores,team collaboration compliance and RSI procedure time were compared between the two groups.Results The experimental group demonstrated significantly higher training satisfaction(123.80±2.04 vs.117.26±9.82,P<0.05),superior post-training theoretical knowledge and procedural skills(P<0.05),enhanced team collaboration compliance(P<0.05),and shorter RSI completion time(P<0.05)compared with the control group.Conclusion Pediatric RSI nursing coordination training based on the LSPPDM framework can effectively increase training satisfaction,promote theoretical and procedural skills and reduce completion time in nurses.
7.Practical research on nursing coordination training for rapid sequential intubation in children based on LSPPDM framework
Yu-xia YANG ; Jing HU ; Wei-ming CHEN ; Ye CHENG ; Wei-jie SHEN ; Yi ZHANG ; Ting-ting XUE ; Bei-bei WANG ; Yu-qing WANG ; Pan LIU ; Ying-ying ZHANG ; Guo-ping LU ; Ying GU
Fudan University Journal of Medical Sciences 2025;52(6):847-853
Objective To investigate the practical effects of pediatric rapid sequence intubation(RSI)nursing coordination training based on the LSPPDM(learn,see,practice,prove,do,maintain)framework in order to provide evidence for optimizing pediatric RSI nursing training programs.Methods Nurses from the intensive care unit(ICU)of Children's Hospital,Fudan University during Feb 2023 and Jan 2024 were divided into the experimental group(n=35)and the control group(n=35)by block randomization.The experimental group received LSPPDM framework-based training,while the control group underwent conventional training with theoretical lectures and procedural demonstrations.Outcomes included training satisfaction,theoretical knowledge and procedural skill assessment scores,team collaboration compliance and RSI procedure time were compared between the two groups.Results The experimental group demonstrated significantly higher training satisfaction(123.80±2.04 vs.117.26±9.82,P<0.05),superior post-training theoretical knowledge and procedural skills(P<0.05),enhanced team collaboration compliance(P<0.05),and shorter RSI completion time(P<0.05)compared with the control group.Conclusion Pediatric RSI nursing coordination training based on the LSPPDM framework can effectively increase training satisfaction,promote theoretical and procedural skills and reduce completion time in nurses.
8.The influencing factors of prognosis in critically ill patients and the predictive value of CALLY index
Pu LI ; Ting YE ; Yangmei MEI ; Yujie WANG ; Wenting WU ; Zhipeng HU
Clinical Medicine of China 2025;41(6):446-451
Objective:To investigate the factors influencing the prognosis of critically ill patients and the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index.Methods:A retrospective analysis was conducted on the clinical data of 122 critically ill patients admitted to Guoyao Dongfeng General Hospital affiliated with Hubei University of Medicine from June 2022 to December 2023. Patients were divided into a death group and a survival group based on their 28-day prognosis. Clinical data were compared between the two groups to analyze the factors influencing prognosis and assess the predictive value of various indicators. Normally distributed measurement data were expressed as Mean±SD, and intergroup comparisons were performed by independent samples t-test; non-normally distributed measurement data were expressed as M( Q1,Q3), and intergroup comparisons were performed by the Mann-Whitney U test. Counting data were expressed as case (%), and intergroup comparisons were performed by the χ2 test. Multivariate logistic regression was used to analyze factors influencing patient prognosis, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator. Results:The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, blood lactate, CRP, and B-type natriuretic peptide levels in the death group were higher than those in the survival group [22 (17, 30) points vs. 17 (14, 22) points, (4.8±1.4) mmol/L vs. (3.3±1.0) mmol/L, 134 (83, 2 381) mg/L vs. 13 (10, 27) mg/L, 259 (111, 592) ng/L vs. 108 (40, 247) ng/L; Z=3.04, P=0.002; t=5.79, P<0.001; Z=8.57, P<0.001; Z=3.28, P=0.001, respectively]. Albumin, neutrophil count, lymphocyte count (LYC), and the CALLY index were lower in the death group than in the survival group [(31±5) g/L vs. (37±6) g/L, (58±9)×10 9/L vs. (63±10)×10 9/L, 0.6 (0.4, 0.8)×10 9/L vs. 1.3 (0.8, 1.7)×10 9/L, 0.03 (0.02, 0.11) vs. 0.26 (0.13, 0.49); t=6.05, P<0.001; t=3.04, P=0.003; Z=5.82, P<0.001; Z=6.52, P<0.001, respectively]. Multivariate logistic regression analysis indicated that the APACHE Ⅱ score and CRP were risk factors for poor prognosis in critically ill patients ( OR=1.349, 95% CI: 1.004-1.821, P=0.048; OR=1.006, 95% CI: 1.003-1.010, P=0.001, respectively), while LYC and the CALLY index were protective factors ( OR=0.297, 95% CI: 0.111-0.795, P=0.016; OR=0.989, 95% CI: 0.955-0.999, P=0.001, respectively). The area under the ROC curve for the CALLY index predicting 28-day mortality in critically ill patients was 0.872 (95% CI: 0.800-0.926), which was higher than that of the APACHE Ⅱ score, LYC, and CRP [0.673 (95% CI: 0.582-0.756), 0.664 (95% CI: 0.573-0.748), 0.576 (95% CI: 0.482-0.665), respectively]. The cut-off values were 0.06, 20 points, 0.8×10 9/L, and 50 mg/L, respectively. When the CALLY index was 0.06, the specificity was 97.65%, the sensitivity was 72.97%, and the Youden index was 0.706. Conclusions:The APACHE Ⅱ score, CRP, LYC, and CALLY index are all factors influencing the prognosis of critically ill patients. The CALLY index has certain predictive value, but its false negative rate is relatively high. Further combination with other indicators is needed to improve its predictive value.
9.HuiNet report of 2024: the distribution and antimicrobial resistance profile of clinical bacterial isolates in Anhui province
Yanyan LIU ; Yasheng LI ; Liang YU ; Yi YANG ; Ting WU ; Jun YIN ; Lifen HU ; Ying YE ; Jiabin LI
Chinese Journal of Clinical Infectious Diseases 2025;18(1):63-76
Objective:To report the surveillance results of the distribution and antimicrobial resistance profile of clinical isolates in Anhui province.Methods:Surveillance data from 94 members of the Anhui Antimicrobial Resistance Surveillance Network(HuiNet)from October 2023 to September 2024 were collected,the major drug-resistant bacteria and the resistance to commonly used antibiotics were analyzed. WHONET 5.6 and SPSS 25.0 software were used for data analysis.Results:Among 240 339 clinical strains,Gram-negative bacteria accounted for 75.0%(180 153 strains). The detected bacteria mainly include Escherichia coli( n=53 587,22.3%), Klebsiella pneumoniae( n=39 774,16.5%), Pseudomonas aeruginosa( n=25 505,10.6%), Staphylococus aureus( n=19 438,8.1%), Acinetobacter baumannii complex( n=14 239,5.9%),and so on. The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus aureus(MRCNS)were 37.7%(7 112/18 853)and 73.9%(13 221/17 895),respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of carbapenem-resistant Escherichia coli(CREC)and Klebsiella pneumoniae(CRKP)were 1.9%(971/51 991)and 12.3%(4 864/39 414),respectively. The resistance rate of CRKP to tigecycline and polycolistin B was 7.7% and 7.9%,respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)complex and Pseudomonas aeruginosa(CRPA)were 57.9%(8 222/14 198)and 18.2%(4 569/25 052),respectively,with low resistance to polycolistin B(2.0% and 7.2%,respectively). The detection rates of MRSA,MRCNS,CRAB complex,third-generation cephalosporin-resistant Escherichia coli(3GC-R-EC)and quinolone-resistant Escherichia coli(QREC)in northern Anhui were the highest(46.8%,77.1%,65.6%,57.6% and 55.5%,respectively),which were higher than those in central and southern Anhui( χ2=107.858 and 566.202,5.950 and 142.223,39.254 and 289.137,135.402 and 449.114,39.142 and 185.114, P<0.05 or <0.01),and the detection rates in central Anhui were higher than those in southern Anhui( χ2=272.031,102.717,162.409,118.891 and 66.889,all P<0.001). The detection rates of CRKP,CRPA and thirdgeneration cephalosporinresistant Klebsiella pneumoniae(3GC-R-KP)in central Anhui were the highest(16.7%,21.7% and 32.0%,respectively),which were higher than those in northern and southern Anhui( χ2=229.656 and 439.377,156.599 and 65.818,77.386 and 232.568,all P<0.001). The detection rates of CREC,3GC-R-EC and QREC were the highest in the elderly(2.2%,54.0% and 56.4%,respectively),which were higher than those in children and adults( χ2=8.034 and 13.150,17.032 and 103.437,438.353 and 183.099,all P<0.01). The detection rates of CRKP and 3GC-R-KP in neonates were the highest(20.6% and 56.9%,respectively),which were significantly higher than those in children,adults and the elderly( χ2=38.869,8.337 and 7.921;65.517,55.525 and 49.214,all P<0.01),and the detection rate of 3GC-R-KP in the elderly was higher than that in children and adults( χ2=14.122 and 7.501,both P<0.01). The detection rates of CRAB complex,CRPA,CREC,CRKP and 3GC-R-KP in tertiary hospitals were higher than those in secondary hospitals( χ2=25.606,16.501,5.820,33.116 and 117.086, P<0.05 or <0.01). Except for MRSA,vancomycin-resistant Enterococcus faecium and QREC,the detection rates of major drug-resistant bacteria in intensive care unit(ICU)were the highest(all P<0.001). From 2019 to 2024,the detection rates of MRSA,MRCNS,CRKP,CRAB complex and CRPA all showed a slow decreasing trend( χ2=42.319,122.779,340.381,83.512 and 81.668,all P<0.001). Conclusions:The situation of antimicrobial resistance in Anhui province shows a downward trend,but it is still serious,especially in northern and central Anhui. It is necessary to pay attention to the bacterial resistance particularly for the elderly,newborns,children and ICU.
10.HuiNet report of 2023: The distribution and antimicrobial resistance profile of clinical bacterial isolates in Anhui
Yanyan LIU ; Yasheng LI ; Liang YU ; Yi YANG ; Ting WU ; Jun YIN ; Lifen HU ; Ying YE ; Jiabin LI
Chinese Journal of Clinical Infectious Diseases 2024;17(2):113-125
Objective:To analyse the distribution and antimicrobial resistance profile of clinical bacterial isolates in Anhui province.Methods:Surveillance data was collected from 83 members of the Anhui Antimicrobial Resistance Surveillance Network(HuiNet)during October 2022 to September 2023,to analyze the resistance of major bacteria to commonly used antibiotics and the detection of clinically common drug-resistant bacteria. The data was analyzed using WHONET 5.6 and SPSS 25.0 software.Results:A total of 201 647 clinical bacteria isolates were collected,with Gram-negative bacteria accounting for 74.8%(150 847/201 647). The most prevalent Gram-positive bacterial strains were Staphylococus aureus(32.8%,16 648/50 800),followed by Staphylococcus epidermidis(14.0%,7 098/50 800), Enterococcus faecalis(10.7%,5 458/50 800), Enterococcus faecium(9.1%,4 613/50 800)and Staphylococcus hominis(7.4%,3 778/50 800);the most prevalent Gram-negative bacterial strains were Escherichia coli(28.9%,43 577/150 847),followed by Klebsiella pneumoniae(22.5%,34 006/150 847), Pseudomonas aeruginosa(14.7%,22 171/150 847), Acinetobacter baumannii complex(9.4%,14 194/150 847)and Enterobacter cloacae(3.5%,5 235/150 847). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus aureus(MRCNS)were 39.5%(6 442/16 325)and 75.7%(12 343/16 312),respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were 0.5% and 0.6%,respectively. The prevalence of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae(CR-KPN)were 1.9%(805/42 956)and 11.7%(3 950/33 761),respectively. The resistance rate of CR-KPN to tigecycline was 3.9%. The prevalence of carbapenem-resistant Pseudomonas aeruginosa(CR-PAE)and Acinetobacter baumannii(CR-ABA)complex were 18.4%(3 936/21 447)and 62.9%(8 649/13 744),respectively,with low resistance rate to polycolistin B(6.9% and 1.7%,respectively). The detection rates of MRSA,CR-ABA complex,third-generation cephalosporin-resistant Escherichia coli(CTX/CRO-R-ECO)and quinolone-resistant Escherichia coli(QNR-ECO)in northern Anhui were the highest(50.3%,72.9%,59.2% and 55.6%,respectively),which were higher than those in central and southern Anhui( χ2=112.734 and 575.069,132.747 and 233.885,93.986 and 471.209,60.062 and 230.669,all P<0.001),and the detection rate in central Anhui was higher than that in southern Anhui( χ2=278.671,29.219,207.395 and 80.267,all P<0.001). The detection rates of CR-KPN and thirdgeneration cephalosporinresistant Klebsiella pneumoniae(CTX/CRO-R-KPN)in central Anhui were the highest(15.5% and 33.3%,respectively),which were higher than those in northern and southern Anhui( χ2=156.237 and 325.533,76.928 and 180.686,all P<0.001),and the detection rate in northern Anhui was higher than that in southern Anhui( χ2=32.202 and 25.539, P<0.001). The detection rates of CTX/CRO-R-ECO and QNR-ECO were the highest in the elderly(55.2% and 55.8%,respectively),which were higher than those in children,and young and middle aged adults( χ2=23.906 and 120.575,376.404 and 196.612, P<0.001). The detection rate of CTX/CRO-R-KPN in neonates was the highest(57.1%),which was significantly higher than that in children,adults and the elderly( χ2=46.141,38.843 and 32.093, P<0.001),and the detection rate in the elderly was higher than that in children and adults( χ2=13.604 and 13.471, P<0.001). The detection rates of MRSA and MRCNS were the highest in children(42.8% and 77.8%,respectively),which were higher than those in adults( χ2=21.766 and 10.704, P<0.001). Except MRSA and vancomycin-resistant Enterococcus faecium and faecalis,the detection rates of major drug-resistant bacteria in tertiary hospitals were higher than those in secondary hospitals( P<0.05 or <0.01). Conclusion:In 2023,the situation of antimicrobial resistance in Anhui province was serious,especially in northern and central Anhui,and targeted drug resistance control measures should be taken according to the monitoring results. At the same time,it is necessary to pay attention to the bacterial resistance in the elderly,newborns and children,and strengthen the rational use of antibiotics by clinicians to curb the spread of drug-resistant bacteria.

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