Objective:To analyze the molecular epidemiology, drug resistance and virulence of Haemophilus influenzae in children with ocular infection. Methods:Haemophilus influenzae isolates were obtained from ocular specimens of children. Antimicrobial susceptibility testing was conducted using the disk diffusion method and E-test. Whole-genome sequencing was performed to determine serotype, multilocus sequence typing, drug resistance genes, and virulence factors. Results:All 13 Haemophilus influenzae strains isolated from ocular infection specimens in children were identified as non-typeable Haemophilus influenzae. A total of 11 sequence types were identified through multilocus sequence typing, with ST2838 representing a novel sequence type. Haemophilus influenzae were 100.0% (13/13) sensitive to ceftriaxone, meropenem, and levofloxacin. The resistance rates to ampicillin, cefuroxime, ampicillin/sulbactam, amoxicillin/clavulanic acid, chloramphenicol, and trimethoprim-sulfamethoxazole were 84.6% (11/13), 46.2% (6/13), 38.5% (5/13), 15.4% (2/13), 15.4% (2/13), and 46.2% (6/13). The non-susceptible rate to azithromycin was found to be 46.2% (6/13). Whole-genome sequencing revealed the presence of resistance genes blaTEM-1B (84.6%, 11/13), tet( B) (15.4%, 2/13), catA2 (15.4%, 2/13), msr(D) (30.8%, 4/13), mef( A) (46.2%, 6/13). Additionally, 71 virulence genes were detected across the 13 strains, comprising 7 genes associated with adherence, 12 genes related to nutritional and metabolic functions, and 52 genes involved in immune modulation. Conclusions:Haemophilus influenzae in pediatric patients with ocular infections exhibits a high rate of resistance to ampicillin, predominantly mediated by the blaTEM-1B. Clinical laboratories should pay attention to the detection of Haemophilus influenzae in ocular specimens and maintain ongoing surveillance of antimicrobial resistance patterns and virulence factors.

More and more studies suggest that targeting neuronal antibodies,particularly anti-Hu antibody,can cause various degrees of damage to central nervous system and/or enteric nervous system and affect the occurrence,progression,and prognosis of related diseases.Therefore,elucidating the mechanisms of anti-Hu antibody-induced nervous system injury and its relevance to diseases is of significant importance for individualized diagnosis and treatment.This article reviewed the associations between anti-Hu antibody and paraneoplastic gastrointestinal dysmotility,chronic intestinal pseudo-obstruction,and irritable bowel syndrome,as well as the mechanisms of neuronal damage caused by anti-Hu antibody.

Objective:To analyze the molecular epidemiology, drug resistance and virulence of Haemophilus influenzae in children with ocular infection. Methods:Haemophilus influenzae isolates were obtained from ocular specimens of children. Antimicrobial susceptibility testing was conducted using the disk diffusion method and E-test. Whole-genome sequencing was performed to determine serotype, multilocus sequence typing, drug resistance genes, and virulence factors. Results:All 13 Haemophilus influenzae strains isolated from ocular infection specimens in children were identified as non-typeable Haemophilus influenzae. A total of 11 sequence types were identified through multilocus sequence typing, with ST2838 representing a novel sequence type. Haemophilus influenzae were 100.0% (13/13) sensitive to ceftriaxone, meropenem, and levofloxacin. The resistance rates to ampicillin, cefuroxime, ampicillin/sulbactam, amoxicillin/clavulanic acid, chloramphenicol, and trimethoprim-sulfamethoxazole were 84.6% (11/13), 46.2% (6/13), 38.5% (5/13), 15.4% (2/13), 15.4% (2/13), and 46.2% (6/13). The non-susceptible rate to azithromycin was found to be 46.2% (6/13). Whole-genome sequencing revealed the presence of resistance genes blaTEM-1B (84.6%, 11/13), tet( B) (15.4%, 2/13), catA2 (15.4%, 2/13), msr(D) (30.8%, 4/13), mef( A) (46.2%, 6/13). Additionally, 71 virulence genes were detected across the 13 strains, comprising 7 genes associated with adherence, 12 genes related to nutritional and metabolic functions, and 52 genes involved in immune modulation. Conclusions:Haemophilus influenzae in pediatric patients with ocular infections exhibits a high rate of resistance to ampicillin, predominantly mediated by the blaTEM-1B. Clinical laboratories should pay attention to the detection of Haemophilus influenzae in ocular specimens and maintain ongoing surveillance of antimicrobial resistance patterns and virulence factors.

Objective:To analyze the anti-drug resistance, molecular epidemiology and virulence gene distribution of non-A-F group serotype isolates of Salmonella enterica enteric subspecis, so as to provide epidemiological basis for clinical diagnosis and treatment.Methods:Serotyping, antimicrobial susceptibility test and whole genome sequencing were performed on 11 isolates of non-A-F group serotype isolates of Salmonella enterica enteric subspecies that were isolated from The Children′s Hospital, Zhejiang University School of Medicine between 2017 and 2020. The serotype, multilocus sequence typing and virulence gene of the whole genome sequencing results were analyzed. Results:In our hospital, the detection rate of non-A-F group serotype isolates of Salmonella enterica enteric subspecies was low (1.13%). Among the 11 strains, there were 3 strains belong to Jangwani serotype, 2 strains of Hvittingfoss serotype, and Wandsworth, Pomona, Kedougou, Urbana, Poona and Kumasi serotypes have 1 strain each. Except for the two multi-drug resistant strains, the other strains were sensitive to most antibiotics, and the MICs were at low levels. A total of 9 ST types were detected in the 11 strains, the 3 Jangwani serotype strains were ST3918, and the other isolates were of different ST types. The phylogenetic tree shown that the three strains of Jangwani serotype were closely related. A total of 103 virulence genes were detected in the 11 strains, including 78 genes related to secretion system, 21 genes related to adherence, 2 genes related to magnesium uptake, 1 gene related to resistance to antimicrobial peptides and 1 gene related to typhoid toxin. Conclusions:The detection rate of the non-A-F group serotype isolates of Salmonella enterica enteric subspecies was low, and the sensitivity of the isolates to common antibiotics was high. The ST types and genetic relationship showed diversity. Clinical laboratory should pay attention to the detection of the non-A-F group serotype isolates of Salmonella enterica enteric subspecies, and the changes in drug resistance and virulence genes of the isolates should be closely monitored.

Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common functional gastrointestinal disorders (FGIDs) and account for a large proportion of consulting patients. These 2 disorders overlap with each other frequently. The pathogenesis of IBS or FD is complicated and multi-factors related, in which infectious or non-infectious inflammation and local or systemic immune response play significant roles. There are few studies focusing on the mechanism of inflammation in patients with overlap syndrome of irritable bowel syndrome and functional dyspepsia (IBS-FD). This review focuses on current advances about the role of inflammation in the pathogenesis of IBS and FD and the possible mechanism of inflammation in IBS-FD.

Diabetic gastroparesis (DGP) is a common complication in patients with diabetes mellitus of long duration, presenting with recurrent nausea, vomiting, postprandial fullness and early satiety caused by delayed gastric emptying. The treatments of DGP include dietary therapy, nutritional support, glycemic control, use of prokinetic and antiemetic agents. This review focuses on current status of the drug treatment and the progress of new agents of DGF under the preclinical and clinical trials.

Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common functional gastrointestinal disorders (FGIDs) and account for a large proportion of consulting patients. These 2 disorders overlap with each other frequently. The pathogenesis of IBS or FD is complicated and multi-factors related, in which infectious or non-infectious inflammation and local or systemic immune response play significant roles. There are few studies focusing on the mechanism of inflammation in patients with overlap syndrome of irritable bowel syndrome and functional dyspepsia (IBS-FD). This review focuses on current advances about the role of inflammation in the pathogenesis of IBS and FD and the possible mechanism of inflammation in IBS-FD.

Objective:To investigate the role of type Ⅵ secretion system (T6SS) in the pathogenicity and antibiotic resistance of Acinetobacter baumanii. Methods:From January 1 to December 31, 2016, a total of 45 Acinetobacter baumanii isolates were collected from patients with bloodstream infection in the First Affiliated Hospital of Wenzhou Medical University. The susceptibilities to commonly used antimicrobial agents were determined by VITEK 2 Compact automatic microbiology analyzer. Detection of T6SS characteristic gene hemolysin coregulated protein ( hcp) was achieved by polymerase chain reaction. Biofilm formations, serum resistances and competition tests of T6SS-positive/negative Acinetobacter baumanii were performed in vitro. The clinical data of patients with bloodstream infection were collected and analyzed. Chi-square test, t test and Kruskal-Wallis test were conducted for statistical analysis. Results:The positive rate of T6SS in 45 Acinetobacter baumanii isolates was 53.3% (24/45). The resistance rates of T6SS-positive Acinetobacter baumanii to ceftazidime, ciprofloxdcin, gentamicin, imipenem, levofloxacin, piperacillin/tazobactam, tobramycin and cefepime (95.8%, 95.8%, 66.7%, 95.8%, 79.2%, 95.8%, 79.2%, 91.7%)were all higher than that of T6SS-negative Acinetobacter baumanii (28.6%, 28.6%, 28.6%, 28.6%, 9.5%, 23.8%, 23.8%, 28.6%), and the differences were all statistically significant ( χ2=22.12, 22.12, 6.51, 22.12, 21.83, 24.72, 13.79, 18.97, respectively, all P<0.05). The biofilm formation ability, serum resistance and competitive ability of T6SS-positive Acinetobacter baumanii were stronger than those of T6SS-negative Acinetobacter baumanii, and the differences were all statistically significant ( t=4.99, Z=-2.61 and -2.27, respectively, all P<0.05). The positive rate of T6SS isolated from intensive care unit (ICU) ward (80.0%, 16/20) was significantly higher than that from non-ICU ward (32.0%, 8/25; χ2=10.29, P<0.05). But T6SS had no effect on the prognosis of patients ( χ2=1.74, P=0.188). Conclusions:T6SS of Acinetobacter baumanii is associated with high pathogenicity, and the high drug resistance rate makes treatment extremely difficult. Physicians need to pay much attention, especially to the patients from ICU wards.

The pathophysiological process of irritable bowel syndrome (IBS) is complex. Recent studies showed that alteration in gut microbiota, damage of intestinal mucosal barrier and increase of mucosal permeability due to inflammation, diet and stress, as well as abnormalities of enteric nervous system in both function and morphology play important roles in the development of IBS. In this article, the advances in studies on above mentioned pathogenic mechanisms of IBS were briefly summarized.

Background/Aims: A strong correlation between depression and irritable bowel syndrome with diarrhea (IBS-D) has been identified. The aim of this study is to identify the correlations among depression, structural factors, gastrointestinal (GI) and extra-GI symptoms, and efficacy of neuromodulators in patients with IBS-D. Methods: Patients meeting the Rome III Diagnostic Criteria for IBS-D were enrolled. The intestinal symptoms and psychological states were evaluated using IBS-specific symptom questionnaires and Hamilton Depression Rating Scale. Results: In total, 410 patients with IBS-D were enrolled, 28.8% (118/410) had comorbid depression. Patients with depression did not readily experience improvement in abdominal pain/discomfort after defecation, and had a higher prevalence of passing mucus, overlapping functional dyspepsia, and extra-GI symptoms. The structural factor “mental disorders” significantly correlated with main bowel symptom score and degree of pre-defecation abdominal pain/discomfort. No structural factor significantly correlated with bowel movements or stool form. Patients who had passing mucus, overlapping functional dyspepsia and extra-GI painful symptoms have higher score of “anxiety/somatization.” Patients with sexual dysfunction have higher score of “retardation symptoms.” In total, 28.3% of patients with IBS-D were prescribed neuromodulators. Baseline scores of “anxiety/somatization” and “retardation symptoms” positively correlated with improvement of diarrhea after paroxetine, and “sleep disturbances” positively correlated with improvement of abdominal pain/discomfort and diarrhea after mirtazapine. Conclusions Comorbid depression and higher scores of structural factors might aggravate GI and extra-GI symptoms other than bowel movements and stool form. Structural factors of Hamilton Depression Rating Scale correlated with efficacy of paroxetine and mirtazapine in patients with IBS-D.