Objective:To study the risk factors and the molecular epidemiology characteristics for Carbapenem-resistant Enterobacteriaceae(CRE) colonization in neonatal inpatients in Shenzhen region, China, which provide reference for the prevention and control of clinical CRE infection.Methods:This study is a prospective case-control study.Anal samples from inpatients between January 2023 and December 2023 at Longgang Maternity and Child Institute of Shantou University Medical College and Shenzhen Children's Hospital were collected for screening CRE strain. Drug susceptibility test, modified Carbapenem Inactivation Method (mCIM) test, drug resistance-related gene sequencing and multilocus sequence typing (MLST) were performed for isolated CRE strains.Meanwhile, the clinical data were collected for analyzing the risk factors of CRE intestinal colonization by multivariate regression analysis.Results:A total of 1 517 patients were screened, 26 CRE(1.7%, 26/1 517) were identified which including 14 Escherichia coli(53.8%, 14/26), 11 Klebsiella pneumoniae(42.3%, 11/26), 1 Enterobacter cloacae(3.9%, 1/26). The predominant carbapenemase gene was New Delhi Metallo(NDM) (92.4%, 24/26), followed by Imipenem (IMP) (3.8%, 1/26) and Guiana extended spectrum gene (GES) (3.8%, 1/26).Among the carried NDM resistance genes, New Delhi Metallo 5 (NDM5) was the main one, accounting for 84.6% (22/26).The MLST typing of Escherichia coli was mainly Sequence Type 48 (ST48) (6/14), while that of Klebsiella pneumoniae was mainly Sequence Type 35 (ST35) (10/11). All CRE isolates were resistant to penicillin, penicillinase inhibitors, cephalosporins, ertapenem and imipenem.The resistance rates of Escherichia coli to amikacin, levofloxacin was 1/14, 4/14, respectively. All isolates of Klebsiella pneumoniae were sensitive to amikacin, and the resistance rate to levofloxacin is 1/11. Risk factors for CRE colonization include the older age, length of hospital stay, tracheal intubation, invasive respiration, lumbar puncture, Apgar <7 score, and exposure to antibiotics.Conclusions:NDM5 is the predominant resistant gene in CRE isolated from neonatal patients feces in Shenzhen region.It is necessary to strengthen the screening of CRE colonization in neonate for prevention and control of CRE infection.

Objective:To study the risk factors and the molecular epidemiology characteristics for Carbapenem-resistant Enterobacteriaceae(CRE) colonization in neonatal inpatients in Shenzhen region, China, which provide reference for the prevention and control of clinical CRE infection.Methods:This study is a prospective case-control study.Anal samples from inpatients between January 2023 and December 2023 at Longgang Maternity and Child Institute of Shantou University Medical College and Shenzhen Children's Hospital were collected for screening CRE strain. Drug susceptibility test, modified Carbapenem Inactivation Method (mCIM) test, drug resistance-related gene sequencing and multilocus sequence typing (MLST) were performed for isolated CRE strains.Meanwhile, the clinical data were collected for analyzing the risk factors of CRE intestinal colonization by multivariate regression analysis.Results:A total of 1 517 patients were screened, 26 CRE(1.7%, 26/1 517) were identified which including 14 Escherichia coli(53.8%, 14/26), 11 Klebsiella pneumoniae(42.3%, 11/26), 1 Enterobacter cloacae(3.9%, 1/26). The predominant carbapenemase gene was New Delhi Metallo(NDM) (92.4%, 24/26), followed by Imipenem (IMP) (3.8%, 1/26) and Guiana extended spectrum gene (GES) (3.8%, 1/26).Among the carried NDM resistance genes, New Delhi Metallo 5 (NDM5) was the main one, accounting for 84.6% (22/26).The MLST typing of Escherichia coli was mainly Sequence Type 48 (ST48) (6/14), while that of Klebsiella pneumoniae was mainly Sequence Type 35 (ST35) (10/11). All CRE isolates were resistant to penicillin, penicillinase inhibitors, cephalosporins, ertapenem and imipenem.The resistance rates of Escherichia coli to amikacin, levofloxacin was 1/14, 4/14, respectively. All isolates of Klebsiella pneumoniae were sensitive to amikacin, and the resistance rate to levofloxacin is 1/11. Risk factors for CRE colonization include the older age, length of hospital stay, tracheal intubation, invasive respiration, lumbar puncture, Apgar <7 score, and exposure to antibiotics.Conclusions:NDM5 is the predominant resistant gene in CRE isolated from neonatal patients feces in Shenzhen region.It is necessary to strengthen the screening of CRE colonization in neonate for prevention and control of CRE infection.

Objective: To systematically evaluate the efficacy and safety of Bifidobacteria in preventing caries. Methods : Databases including PubMed, Embase, The Cochrane Library, Web of Science, Scopus, Clinicaltrials. gov, CNKI, WanFang Data and VIP were electronically searched from inception to April 2020 to collect randomized controlled trials of Bifidobacterium for caries. Meta-analysis was performed using Revman 5.4 software. Results: In total, 10 randomized controlled trials (RCT) of 518 patients, including 262 in the test group and 256 in the control group, were included. Meta-analysis results reveal no statistically significant differences in salivary Streptococcus mutans counts (SMD=-0.31, 95%CI -0.66 to 0.04, P=0.08) (RR=0.53, 95%CI 0.17 to 1.66, P=0.28) and salivary Lactobacilli counts (SMD=-0.07, 95%CI -0.39 to 0.26, P=0.69) (RR=0.87, 95%CI 0.59 to 1.29, P=0.50). No statistical differences in the counts of Streptococcus mutans and Lactobacillus counts were noted in dental plaque, and no statistical difference in the occurrence of caries in deciduous teeth. Three of the 10 RCTS included in this study did not report adverse events, 5 had no adverse reactions, and 2 reported gastrointestinal discomfort. Conclusion Current evidence suggests that Bifidobacteria do not effectively reduce Streptococcus mutans counts and Lactobacillus counts in saliva and dental plaque, or reduce the occurrence of caries in deciduous teeth. The safety of this treatment also requires further investigation.

Objective To make a further recongnizing of the manifestations of diffuse axonal injury (DAI)on CT images for the early accurate clinical diagnosis.Methods The CT image data and its correlated clinic features of 56 cases with diffuse axonal injury(44 male,12 female)were analyzed retrospectively.In this series,43 cases were caused by traffic accident,13 by falling from high place.Results 1. 44 cases had haemorrhage lesions(less than 2 cm in diameter)in brain parenchyma which were at the corticomedullary junction,corpus callosum,brain stem,basal ganglia,internal capsule.2. 41 cases had subarachnoid and/or intraventricular hemorrhage 3. 9 cases had acute generalized brain swelling 4. 5 cases were associated with epidural hematoma and 16 with subdural hematoma.Conclusion CT manifestation of DAI have some featrues,and can provide reliable evidence for accurate clinic diagnosis of DAI.