OBJECTIVE: Blood culture remains the gold standard for diagnosing bloodstream infections. Clinical laboratories must ensure the quality of blood culture processes from receipt to obtaining definitive results. We examined laboratory analytical indicators associated with positive blood culture results. METHODS: Blood cultures collected from Peking Union Medical College Hospital between January 1, 2020, and December 31, 2022, were retrospectively analyzed. The mode of transportation (piping logistics delivery vs. staff), source of blood cultures (outpatient/emergency department vs. inpatient department), rotation of personnel, and time of reception (8:00-19:59 vs. 20:00-07:59) were compared between blood culture-positive and -negative results. RESULTS: Between 2020 and 2022, the total positive rate of blood culture was 8.07%. The positive rate of blood cultures in the outpatient/emergency department was significantly higher than that in the inpatient department (12.46% vs. 5.83%; P < 0.0001). The time-to-detection of blood cultures was significantly affected by the delivery mode and personnel rotation. The blood culture positive rate of the total pre-analytical time within 1 h was significantly higher than that within 1-2 h or > 2 h ( P < 0.0170). CONCLUSION Laboratory analytical indicators such as patient source, transportation mode, and personnel rotation significantly impacted the positive detection rate or time of blood culture.
Blood Culture/statistics & numerical data* ; Humans ; Retrospective Studies ; Emergency Service, Hospital/statistics & numerical data*

OBJECTIVES: Bloodstream infections in emergency patients have a high incidence, severe disease progression, and rapid deterioration. Early administration of appropriate antimicrobial agents is crucial for improving patient outcomes. This study aims to investigate the incidence, pathogen distribution, and antimicrobial resistance patterns of bloodstream infections in emergency patients, providing a reference for rational antibiotic use in clinical practice. METHODS: Medical records of patients diagnosed with bloodstream infections in the emergency department of a hospital in Hunan Province between January 2018 and October 2022 were retrospectively collected. Clinical characteristics of bloodstream infection patients were analyzed, and the distribution trends and antimicrobial susceptibility of clinical isolates were examined. RESULTS: During the study period, 2 215 blood culture samples were submitted from the emergency department, with a positivity rate of 13.27%. After excluding eight cases with missing data or suspected contamination, 286 patients with bloodstream infections were included, with community-acquired infections accounting for the majority (85.66%). The most common primary infection site was the urinary tract (24.48%), followed by respiratory tract infections (20.28%) and biliary and intra-abdominal infections (17.13%). The 30-day mortality rate of bloodstream infections was 16.08%. A total of 286 pathogens were isolated, including 181 (63.29%) Gram-negative bacteria, primarily Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa; 101 (35.31%) Gram-positive bacteria, mainly Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae; and only 4 (1.40%) fungal isolates. Antimicrobial susceptibility testing showed that the key Enterobacteriaceae strains exhibited resistance rates of 2.4% to carbapenems, 16.3% to piperacillin sodium and tazobactam sodium, and 15.3% to ceftazidime, with no detected resistance to tigecycline or polymyxins. The main non-fermentative bacteria showed resistance rates of 29.6% to piperacillin sodium and tazobactam sodium, 13.3% to cefoperazone sodium and sulbactam sodium, and 27.1% to quinolones. Among Gram-negative bacteria, multidrug-resistant strains accounted for 40.9% (74/181), with carbapenem-resistant Escherichia coli and Klebsiella pneumoniae detected in 5.4% (5/92) and 13.6% (6/44) of cases, respectively. No carbapenem-resistant Pseudomonas aeruginosa was identified. Among Gram-positive bacteria, resistance rates to penicillin G, rifampicin, and cefoxitin were 74.7%, 4.2%, and 50%, respectively, with only 3 cases of resistant to glycopeptide antibiotics. CONCLUSIONS Bloodstream infections in emergency patients are predominantly community-acquired, with Gram-negative bacteria being the most common pathogens. The isolated pathogens exhibited relatively low resistance rates to commonly used clinical antibiotics.
Retrospective Studies ; Emergency Service, Hospital/statistics & numerical data* ; Drug Resistance, Bacterial ; Anti-Bacterial Agents/therapeutic use* ; Incidence ; Microbial Sensitivity Tests/statistics & numerical data* ; Bacteremia/microbiology* ; Community-Acquired Infections/microbiology* ; Gram-Negative Bacteria/isolation & purification* ; Blood Culture/statistics & numerical data* ; Humans ; Male ; Female ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; China/epidemiology*

Objective: To explore the drug resistance of Isolated From Blood Culture Escherichia coli (E. coli) in a hospital in Qinghai over the past seven years, to evaluate the ability of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to analyze the homologous origin of E. coli, and to establish a protein fingerprint library to match with it, adjuvant clinical experience medication so as to provide the basis for the prevention and control of hospital-acquired infections. Methods: Retrospective analysis of blood cultures sent to hospitals from January 2016 to December 2022. Drug resistance and resistance changes in E. coli.A total of 1 841 E. coli strains were isolated from Qinghai Provincial People's Hospital from January 2016 to December 2022; all strains were identified by MALDI-TOF MS, and the VITEK2.0 drug sensitivity analyzer was applied for drug sensitivity analysis of the strains, and the mass spectrometry homology analysis and self-constructed protein fingerprint library were carried out by MALDI-Biotyper software; the protein fingerprint library was built by using WHONET5.6 software was used to statistically analyze the drug sensitivity results, SPSS23.0 software was used to analyze the relationship between fingerprint typing and drug sensitivity, and the χ² test was used for intergroup comparisons. Results: A total of 1 841 strains of E. coli were detected in 4 582 positive blood culture specimens from January 2016 to December 2022, with a detection rate of 40.17%; the resistance rate of E. coli from blood sources to piperacillin/tazobactam and ceftriaxone was on the rise, and it was slightly decreased to cefepime, amikacin, levofloxacin, and sulfamethoxazole, and there was not much change to the rest of the drugs; After MALDI-Biotyper clustering analysis, the 1841 E. coli strains from Isolated From Blood Culture were classified into two major clusters and five subtypes, of which type Ⅰa1 accounted for about 40%, type Ⅰa2 accounted for about 2.7%, type Ⅰb accounted for about 3.8, type Ⅱa accounted for about 46%, and type Ⅱb accounted for about 7.5%. The detection rate of type Ⅰa1 E. coli was higher in general surgery (50.45%) and emergency surgery (50.92%), and the detection rate of type Ⅰb E. coli was higher in emergency medicine(10.05%)than in other departments. The drug sensitivity results of different subtypes were compared with each other, the resistance rate of type Ⅰa1 E. coli to cefepime was 21.3% higher than that of the remaining four types, and the difference was statistically significant (χ²=37.74,P=0.000); the resistance rate of type Ⅱ E. coli(>60%) to sulfamethoxazole was higher than that of type Ⅰ (<60%) as a whole, and the difference was statistically significant (χ²=15.248,P=0.004); and a preliminary database of homologous protein fingerprints of E. coli has been established E. coli homologous protein fingerprint library and validated. The drug susceptibility results of 1 288 E. coli strains in the validation set were statistically analyzed and compared with those in the training set. There was no significant difference(P>0.05). Conclusion: In recent years, the resistance rate of E. coli isolated from a hospital in Qinghai province to piperacillin/Tazobactam, cefepime, amicacin and other antibiotics has changed greatly. A fingerprint database of E. coli homologous protein was established, and it was found that the drug sensitivity data of E. coli were different among different fingerprint types. According to drug sensitivity, drug use could assist clinical experience and provide evidence for prevention and control of hospital illness.
Humans ; Blood Culture ; Escherichia coli ; Cefepime ; Retrospective Studies ; Drug Resistance ; Sulfamethoxazole ; Piperacillin ; Tazobactam

Objective: To explore the drug resistance of Isolated From Blood Culture Escherichia coli (E. coli) in a hospital in Qinghai over the past seven years, to evaluate the ability of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to analyze the homologous origin of E. coli, and to establish a protein fingerprint library to match with it, adjuvant clinical experience medication so as to provide the basis for the prevention and control of hospital-acquired infections. Methods: Retrospective analysis of blood cultures sent to hospitals from January 2016 to December 2022. Drug resistance and resistance changes in E. coli.A total of 1 841 E. coli strains were isolated from Qinghai Provincial People's Hospital from January 2016 to December 2022; all strains were identified by MALDI-TOF MS, and the VITEK2.0 drug sensitivity analyzer was applied for drug sensitivity analysis of the strains, and the mass spectrometry homology analysis and self-constructed protein fingerprint library were carried out by MALDI-Biotyper software; the protein fingerprint library was built by using WHONET5.6 software was used to statistically analyze the drug sensitivity results, SPSS23.0 software was used to analyze the relationship between fingerprint typing and drug sensitivity, and the χ² test was used for intergroup comparisons. Results: A total of 1 841 strains of E. coli were detected in 4 582 positive blood culture specimens from January 2016 to December 2022, with a detection rate of 40.17%; the resistance rate of E. coli from blood sources to piperacillin/tazobactam and ceftriaxone was on the rise, and it was slightly decreased to cefepime, amikacin, levofloxacin, and sulfamethoxazole, and there was not much change to the rest of the drugs; After MALDI-Biotyper clustering analysis, the 1841 E. coli strains from Isolated From Blood Culture were classified into two major clusters and five subtypes, of which type Ⅰa1 accounted for about 40%, type Ⅰa2 accounted for about 2.7%, type Ⅰb accounted for about 3.8, type Ⅱa accounted for about 46%, and type Ⅱb accounted for about 7.5%. The detection rate of type Ⅰa1 E. coli was higher in general surgery (50.45%) and emergency surgery (50.92%), and the detection rate of type Ⅰb E. coli was higher in emergency medicine(10.05%)than in other departments. The drug sensitivity results of different subtypes were compared with each other, the resistance rate of type Ⅰa1 E. coli to cefepime was 21.3% higher than that of the remaining four types, and the difference was statistically significant (χ²=37.74,P=0.000); the resistance rate of type Ⅱ E. coli(>60%) to sulfamethoxazole was higher than that of type Ⅰ (<60%) as a whole, and the difference was statistically significant (χ²=15.248,P=0.004); and a preliminary database of homologous protein fingerprints of E. coli has been established E. coli homologous protein fingerprint library and validated. The drug susceptibility results of 1 288 E. coli strains in the validation set were statistically analyzed and compared with those in the training set. There was no significant difference(P>0.05). Conclusion: In recent years, the resistance rate of E. coli isolated from a hospital in Qinghai province to piperacillin/Tazobactam, cefepime, amicacin and other antibiotics has changed greatly. A fingerprint database of E. coli homologous protein was established, and it was found that the drug sensitivity data of E. coli were different among different fingerprint types. According to drug sensitivity, drug use could assist clinical experience and provide evidence for prevention and control of hospital illness.
Humans ; Blood Culture ; Escherichia coli ; Cefepime ; Retrospective Studies ; Drug Resistance ; Sulfamethoxazole ; Piperacillin ; Tazobactam

Blood stream infection (BSI),a blood-borne disease caused by microorganisms such as bacteria,fungi,and viruses,can lead to bacteremia,sepsis,and infectious shock,posing a serious threat to human life and health.Identifying the pathogen is central to the precise treatment of BSI.Traditional blood culture is the gold standard for pathogen identification,while it has limitations in clinical practice due to the long time consumption,production of false negative results,etc.Nanopore sequencing,as a new generation of sequencing technology,can rapidly detect pathogens,drug resistance genes,and virulence genes for the optimization of clinical treatment.This paper reviews the current status of nanopore sequencing technology in the diagnosis of BSI.
Humans ; Nanopore Sequencing ; Sepsis/diagnosis* ; Bacteremia/microbiology* ; Bacteria ; Blood Culture/methods*

OBJECTIVE: To investigate the effect of vitamin D3 to platelet activation by tumor cell culture medium. METHODS: The peripheral blood platelets of BALB/c mice were isolated. The platelets were activated in 4T1 culture fluid for 24 h. The platelets were divided into 7 groups: control group, activation group, 1 nmol/L vitamin D3 group, 10 nmol/L vitamin D3 group, 50 nmol/L vitamin D3 group, 100 nmol/L vitamin D3 group, and positive drug (0.1 μmol/L eptifibatide) group. CCK-8 assay was used to detect the platelet proliferation at 24, 48 and 72 h. Flow cytometry was used to detect the expression of CD61 and CD62p and receptor for advanced glycation end products (RAGE) at 24, 48 and 72 h. ELISA was used to detect the level of platelet-endothelial cell adhesion molecule-1 (PECAM-1) at 24, 48 and 72 h. RESULTS: The CD41 CONCLUSION Vitamin D3 shows antiplatelet effect and can inhibit platelet proliferation and activation.
Animals ; Blood Platelets ; Cell Culture Techniques ; Cholecalciferol/pharmacology* ; Flow Cytometry ; Mice ; Mice, Inbred BALB C ; P-Selectin ; Platelet Activation

INTRODUCTION Early onset sepsis is difficult to diagnose due to nonspecific symptoms and a lack of
reliable tests. It can progress quickly, and lead to neurodevelopmental consequences or be fatal if not
treated. However, approximately 10-fold more newborns are treated with antibiotics empirically and often
unnecessarily. This study aimed to compare the management recommendations of the Neonatal Early
Onset Sepsis Calculator with those of the Centers for Disease Control/American Academy of Pediatrics
guidelines.

METHODS Neonatal Early Onset Sepsis Calculator was applied to the data set to examine how an alternative
model would perform compared to current guidelines published by the CDC and compared to current
practice within the institution. Chi square and kappa value agreement was used to determine the difference
between treatment recommendations of NEOS calculator and AAP guideline.

RESULTS Of the 330 patients who received therapy, only 14.2% were recommended empiric antibiotics by
the EOS calculator, compared to the 39% recommended by the CDC guidelines (p < 0.001, ? = 0.372).
Eleven patients were identified to have culture-positive sepsis.

CONCLUSION The number of infants suspected with EOS and subsequently require antibiotic use at birth
may be dramatically reduced with the use of the neonatal EOS calculator.

OBJECTIVE: To compare the efficacy of directional erythroid differentiation in different serum free culture systems and to screen the optimal culture systems for inducing the differentiation of umbilical cord blood hematopoietic stem and progenior cells (HSPC) to erythroid cells. METHODS: The CD34 cells from umbilical blood munonuclear cells were sorted by using the magnetic beads, and were inoculated into 3 different of culture systems (system 1, 2 and 3 respectively), to induce erythrold differentiation by 3 stage culture. The living cells were counted in different differentiation stages and were observed by Wright-Giemsa staining; the expression of CD71 and CD235a on cell surface was detected by flow cytometry, the erythroid differentiation pteency was detected via colony-forming test. RESULTS: The ability of system 2 to promote the HSPC proliferation was the strongest, the efficacy of system 3 to promote the erythroid differentiation of HSPC was the most optimal; the proliferation ability of cells cultured in system 2 for 2-15 days all was higher than that of cells cutured in system 1 and 3 (P＜0.05). The flow cytometry detection showed that the expression of CD71 and CD235a on surface of cells cultured in system 3 was the highest, the CD235a percentage on day 15 of differentiation in system 3 was (92.33±3.89)%, that in system 2 was (84.67±3.12)%, while that in system 1 was (72.17±6.83)% (P＜0.05). Cell morplologic detection showed that throid differentiation was accelerated on day 12, the percentage of orthochromatic erythrocytes in system 3 was (67.67±2.08)% which was 10.69 and 25.34 times higher than that in system 2 and 1 respectively (P＜0.05). The colony-forming test showed the ratio of BFU-E in system 3 increased gradually on day 3-9 (r=0.99, P＜0.05), which was significanlly higher than that in system 2 and 1 on day 9 (90.35±5.52% vs 77.06±2.26% and 74.50±3.95%). CONCLUSION Culture system 3 is the most effective serum-free erythroid differentiation system, and the culture system 2 is the most powerful HSPC proliferation system. This study results provide a technical basis for further efficiently increasing and inducing the erythroid proliferation and differentiation of HSPC, and also provide culture system in vitro for the clinical application and basic research.
Antigens, CD34 ; Cell Differentiation ; Cells, Cultured ; Culture Media, Serum-Free ; Erythroid Precursor Cells ; Fetal Blood ; Humans

BACKGROUND: The development of a safe and convenient agent that can promote hair growth in patients with androgenetic alopecia remains challenging. OBJECTIVE: This study was designed to investigate the efficacy of a newly developed hair tonic containing a human umbilical cord blood mesenchymal stem cell (hUCB-MSC)-derived conditioned medium in promoting hair growth. METHODS: This double-blind, placebo-controlled clinical study investigated the efficacy of a hair tonic containing an hUCB-MSC-derived conditioned medium in 30 patients with patterned hair loss. Treatment efficacy was determined using phototrichograms to evaluate the density, diameter, and hair growth rate at baseline levels and after 4, 8, and 16 weeks of treatment. RESULTS: The hair density in the group treated with the hair tonic significantly increased from 125.2 to 134.6 hairs/cm2 (p<0.05). In this same group, the thickness of hair also increased from 0.083 to 0.110 mm (p<0.05). Additionally, the hair growth rate increased from 0.285 to 0.338 mm/day (p<0.05). No severe adverse reactions were reported. CONCLUSION: A hair tonic containing an hUCB-MSC-derived conditioned medium could be a new effective alternative to treat patients with androgenetic alopecia.
Alopecia ; Clinical Study ; Culture Media, Conditioned ; Fetal Blood ; Hair Preparations ; Hair ; Humans ; Mesenchymal Stromal Cells ; Treatment Outcome ; Umbilical Cord

BACKGROUND: The fabrication of microchannels in hydrogel can facilitate the perfusion of nutrients and oxygen, which leads to guidance cues for vasculogenesis. Microchannel patterning in biomimetic hydrogels is a challenging issue for tissue regeneration because of the inherent low formability of hydrogels in a complex configuration. We fabricated microchannels using wire network molding and immobilized the angiogenic factors in the hydrogel and evaluated the vasculogenesis in vitro and in vivo. METHODS: Microchannels were fabricated in a hyaluronic acid-based biomimetic hydrogel by using “wire network molding” technology. Substance P was immobilized in acrylated hyaluronic acid for angiogenic cues using Michael type addition reaction. In vitro and in vivo angiogenic activities of hydrogel with microchannels were evaluated. RESULTS: In vitro cell culture experiment shows that cell viability in two experimental biomimetic hydrogels (with microchannels and microchannels + SP) was higher than that of a biomimetic hydrogel without microchannels (bulk group). Evaluation on differentiation of human mesenchymal stem cells (hMSCs) in biomimetic hydrogels with fabricated microchannels shows that the differentiation of hMSC into endothelial cells was significantly increased compared with that of the bulk group. In vivo angiogenesis analysis shows that thin blood vessels of approximately 25–30 µm in diameter were observed in the microchannel group and microchannel + SP group, whereas not seen in the bulk group. CONCLUSION: The strategy of fabricating microchannels in a biomimetic hydrogel and simultaneously providing a chemical cue for angiogenesis is a promising formula for large-scale tissue regeneration.
Angiogenesis Inducing Agents ; Biomimetics* ; Blood Vessels ; Cell Culture Techniques ; Cell Survival ; Cues ; Endothelial Cells ; Fungi ; Humans ; Hyaluronic Acid ; Hydrogel* ; Hydrogels* ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Oxygen ; Perfusion ; Regeneration ; Substance P