1.Pathological changes and macrophage polarization in the liver and spleen of mice infected with Angiostrongylus cantonensis
Xiaoyu QIN ; Yuchun CAI ; Yang HONG ; Fanna WEI ; Yahong HU ; Yumeng CAI ; Yuan HU ; Ting ZHANG ; Xiaojin MO ; Bin XU ; Yan LU ; Jiahui SUN ; Yan ZHOU ; Zelin ZHU ; Muxin CHEN
Chinese Journal of Schistosomiasis Control 2026;38(2):169-183
Objective To investigate the temporal changes in pathological damage and macrophage polarization in liver and spleen tissues of mice infected with Angiostrongylus cantonensis, and to preliminarily unravel the peripheral immune responses during the early stage of A. cantonensis infection. Methods Forty female BALB/c mice at ages of 6 to 8 weeks were randomly divided into four groups, including the control group and 7-, 14-, and 21-day infection groups, with 10 mice in each group. Each mouse in the infection groups was inoculated with 30 third-stage (L3) larvae of A. cantonensis by oral gavage, and five mice were randomly selected from each infection group on days 7, 14, and 21 post-infection, while mice in the control group were given the same volume of physiological saline and five mice were randomly selected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled. The histopathological changes of mouse liver and spleen tissues were observed using hematoxylin and eosin (HE) staining, and the percentage of positive staining area and the co-localization positive rates of the macrophage surface antigens F4/80, CD86, and CD206 were quantified in mouse liver and spleen tissues using immunohistochemical and immunofluorescence staining. In addition, five mice were collected from each infection group on days 7, 14, and 21 post-infection, and five mice were collected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled for detection of macrophage markers CD86 and CD206 and macrophage phenotyping using flow cytometry, and the expression of M1 macrophage markers, including inducible nitric oxide synthase (Nos2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and M2 markers, including arginase 1 (Arg1), mannose receptor C-type 1 (Mrc1) and chitinase-like protein 3 (Chil3) was quantified in mouse liver and spleen tissues using real-time quantitative PCR (RT-qPCR) assay. Results Proliferative lesions of the hepatocyte were observed in mouse liver tissues and the follicular structures of the mouse spleen white pulp were disrupted 21 days post-infection with A. cantonensis. Immunohistochemical staining showed that there were significant differences in the percentages of F4/80, CD86 and CD206 positive staining areas in the liver and spleen tissues among the four groups of mice (F = 242.40, 197.14, 183.19, 157.65, 242.35 and 146.24; all P values < 0.001), and the percentages of positive staining in the liver and spleen tissues of mice in the 14-day infection group [(4.45 ± 0.51)%, (3.74 ± 0.67)%, (8.32 ± 0.72)%, (16.56 ± 1.14)%, (11.62 ± 0.52)%, and (8.29 ± 0.72)%, respectively] and the 21-day infection group [(3.70 ± 0.11)%, (3.22 ± 0.43)%, (11.53 ± 1.03)%, (12.59 ± 1.05)%, (9.02 ± 0.83)%, and (11.67 ± 1.10)%, respectively] were higher than in the control group [(0.35 ± 0.16)%, (0.40 ± 0.02)%, (0.93 ± 0.05)%, (2.78 ± 0.26)%, (2.33 ± 0.20)%, and (1.85 ± 0.20)%, respectively] (all P values < 0.05). Immunofluorescence staining showed significant differences in the positive rates of F4/80 co-localization with CD86 and CD206 in mouse liver and spleen tissues among the four groups (F = 24.42, 25.28, 54.51 and 130.55; all P values < 0.001). Flow cytometry detected significant differences in the proportions of CD86+ and CD206+ macrophages in mouse liver and spleen tissues among the four groups (F = 67.98, 18.41, 29.77, 172.80; all P values < 0.001), and the proportions of CD206+ macrophages in the liver and spleen of the 21-day infection group were significantly higher than those in the control group [(9.25 ± 2.55)% vs (3.83 ± 0.72)%, and (4.22 ± 0.56)% vs (0.47 ± 0.18)%, respectively] (both P values < 0.05). In addition, RT-qPCR assay quantified significant differences in the relative mRNA expression of M1 macrophage markers (IL-1β, TNF-α and Nos2) and M2 macrophage markers (Arg1, Chil3 and Mrc1) in mouse liver and spleen tissues among the four groups (F = 41.30, 31.82, 199.33, 19.96, 62.01, 119.76, 23.67, 95.90, 72.27, 82.59, 123.41 and 29.75; all P values < 0.05). Conclusions A. cantonensis infection may cause progressive pathological damage in mouse liver and spleen tissues, accompanied by dynamic temporal changes in macrophage polarization. M1 macrophage polarization predominates at the early stage of A. cantonensis infection and shifts towards M2 polarization at the later stages, suggesting that M2 polarization may participate in immune regulation at late stages of A. cantonensis infection by suppressing excessive inflammatory responses and promoting tissue repair.
2.Establishment of UPLC characteristic spectrum of Liushenqu standard decoction and determination of related index components
Jiahui XIE ; Jiabao WEI ; Shuangyan TANG ; Kaiwei HUANG ; Weizhi ZHAO ; Yu HU ; Hui ZHANG
International Journal of Traditional Chinese Medicine 2025;47(5):669-675
Objective:To establish the characteristic spectrum of Liushenqu standard decoction using ultra-high performance liquid chromatography (UPLC); To determine the contents of related index components; To evaluate the quality of Liushenqu standard decoction.Methods:UPLC method was used to establish characteristic spectrum of Liushenqu standard decoction. Chromatographic Fingerprint Similarity Evaluation System (2012 edition) was used for similarity analysis, the characteristic peak was assigned, and the content of its index components was determined.Results:The characteristic peaks of Liushenqu standard decoction were calibrated and 8 components were identified, namely uridine, adenosine, guanosine, 5-hydroxymethylfurfural, tryptophan, vanillic acid, ferulic acid and shaftaside. The contents of uridine, adenosine, tryptophan ferulic acid and shaftaside in 10 batches of Liushenqu standard decoction were simultaneously determined, and ranged from 0.036 1~0.383 9 mg/g, 0.030 7~0.170 2 mg/g, 0.007 0~0.060 2 mg/g, 0.001 0~0.005 0 mg/g, 0.000 8~0.013 8 mg/g, respectively. The transfer rates ranged from 44.2% to 50.8%, 60.1% to 67.7%, 60.4% to 76.4%, 62.7% to 77.4%, 50.7% to 61.4%, respectively.Conclusion:The established UPLC characteristic spectrum and content determination method are accurate and repeatable, which can provide references for quality control of Liushenqu standard granules.
3.Complete transcatheter versus surgical aortic valve replacement for aortic valve stenosis with coronary artery disease: A propensity score matching study
Zhihua WANG ; Zeyuan ZHAO ; Junlong HU ; Yaojue SONG ; Chenyi CUI ; Jiahui LI ; Jianchao LI ; Zhaoyun CHENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(12):1708-1715
Objective To compare and analyze the early- to mid-term outcomes of transcatheter aortic valve replacement (TAVR) combined with percutaneous coronary intervention (PCI) versus surgical aortic valve replacement (SAVR) combined with coronary artery bypass grafting (CABG) for the treatment of significant aortic stenosis (AS) and coronary artery disease (CAD). Methods The data of patients with significant AS and CAD who underwent surgical treatment at Central China Fuwai Hospital of Zhengzhou University from January 2018 to July 2023 were collected. These patients were divided into a TAVR+PCI group and a SAVR+CABG group according to the operation method. Propensity score matching (PSM) was used to select patients with close clinical baseline characteristics, and the early- to mid-term outcomes of the two groups were compared. Results A total of 272 patients were enrolled, including 208 males and 64 females, with a mean age of (64.16±8.24) years. There were 47 patients in the TAVR+PCI group and 225 patients in the SAVR+CABG group. After 1 : 1 PSM, 32 pairs were selected. There was no statistical difference in baseline data between the two groups (P>0.05). Compared with the SAVR+CABG group, the TAVR+PCI group had significantly shorter operative time, mechanical ventilation time, ICU stay, postoperative hospital stay, and less intraoperative bleeding, and significantly lower postoperative transfusion and complete revascularization rates (P<0.05). The differences in the rates of postoperative in-hospital death, myocardial infarction, stroke, or other complications between the two groups were not statistically significant (P>0.05), and the differences in the rates of moderate-to-severe perivalvular leakage, death, or readmission in the mid-term follow-up were not statistically significant (P>0.05). Conclusion In patients with significant AS and CAD, the early- and mid-term rates of death and complications are similar between those treated with TAVR+PCI and SAVR+CABG, and TAVR+PCI is a safe alternative to SAVR+CABG.
4.Dynamics of eosinophil infiltration and microglia activation in brain tissues of mice infected with Angiostrongylus cantonensis
Fanna WEI ; Renjie ZHANG ; Yahong HU ; Xiaoyu QIN ; Yunhai GUO ; Xiaojin MO ; Yan LU ; Jiahui SUN ; Yan ZHOU ; Jiatian GUO ; Peng SONG ; Yanhong CHU ; Bin XU ; Ting ZHANG ; Yuchun CAI ; Muxin CHEN
Chinese Journal of Schistosomiasis Control 2025;37(2):163-175
Objective To investigate the changes in eosinophil counts and the activation of microglial cells in the brain tissues of mice at different stages of Angiostrongylus cantonensis infection, and to examine the role of microglia in regulating the progression of angiostrongyliasis and unravel the possible molecular mechanisms. Methods Fifty BALB/c mice were randomly divided into the control group and the 7-d, 14-d, 21-day and 25-d infection groups, of 10 mice in each group. All mice in infection groups were infected with 30 stage III A. cantonensis larvae by gavage, and animals in the control group was given an equal amount of physiological saline. Five mice were collected from each of infection groups on days 7, 14, 21 d and 25 d post-infection, and 5 mice were collected from the control group on the day of oral gavage. The general and focal functional impairment was scored using the Clark scoring method to assess the degree of mouse neurological impairment. Five mice from each of infection groups were sacrificed on days 7, 14, 21 d and 25 d post-infection, and 5 mice from the control group were sacrificed on the day of oral gavage. Mouse brain tissues were sampled, and the pathological changes of brain tissues were dynamically observed using hematoxylin and eosin (HE) staining. Immunofluorescence staining with eosinophilic cationic protein (ECP) and ionized calcium binding adaptor molecule 1 (Iba1) was used to assess the degree of eosinophil infiltration and the counts of microglial cells in mouse brain tissues in each group, and the morphological parameters of microglial cells (skeleton analysis and fractal analysis) were quantified by using Image J software to determine the morphological changes of microglial cells. In addition, the expression of M1 microglia markers Fcγ receptor III (Fcgr3), Fcγ receptor IIb (Fcgr2b) and CD86 antigen (Cd86), M2 microglia markers Arginase 1 (Arg1), macrophage mannose receptor C-type 1 (Mrc1), chitinase-like 3 (Chil3), and phagocytosis genes myeloid cell triggering receptor expressed on myeloid cells 2 (Trem2), CD68 antigen (Cd68), and apolipoprotein E (Apoe) was quantified using real-time quantitative reverse transcription PCR (RT-qPCR) assay in the mouse cerebral cortex of mice post-infection. Results A large number of A. cantonensis larvae were seen on the mouse meninges surface post-infection, and many neuronal nuclei were crumpled and deeply stained, with a large number of bleeding points in the meninges. The median Clark scores of mouse general functional impairment were 0 (interquartile range, 0), 0 (interquartile range, 0.5), 6 (interquartile range, 1.0), 14 (interquartile range, 8.5) points and 20 (interquartile range, 9.0) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.45, P < 0.01), and the median Clark scores of mouse focal functional impairment were 0 (interquartile range, 0), 2 (interquartile range, 2.5), 7 (interquartile range, 3.0), 18 (interquartile range, 5.0) points and 25 (interquartile range, 6.5) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.72, P < 0.01). The mean scores of mice general and focal functional impairment were all higher in the infection groups than in the control group (all P values < 0.05). Immunofluorescence staining showed a significant difference in the eosinophil counts in mouse brain tissues among the five groups (F = 40.05, P < 0.000 1), and the eosinophil counts were significantly higher in mouse brain tissues in the 14-d (3.08 ± 0.78) and 21-d infection groups (5.97 ± 1.37) than in the control group (1.00 ± 0.28) (both P values < 0.05). Semi-quantitative analysis of microglia immunofluorescence showed a significant difference in the counts of microglial cells among the five groups (F = 17.66, P < 0.000 1), and higher Iba1 levels were detected in mouse brain tissues in 14-d (5.75 ± 1.28), 21-d (6.23 ± 1.89) and 25-d infection groups (3.70 ± 1.30) than in the control group (1.00 ± 0.30) (all P values < 0.05). Skeleton and fractal analyses showed that the branch length [(162.04 ± 34.10) μm vs. (395.37 ± 64.11) μm; t = 5.566, P < 0.05] and fractal dimension of microglial cells (1.30 ± 0.01 vs. 1.41 ± 0.03; t = 5.266, P < 0.05) were reduced in mouse brain tissues in the 21-d infection group relative to the control group. In addition, there were significant differences among the 5 groups in terms of M1 and M2 microglia markers Fcgr3 (F = 48.34, P < 0.05), Fcgr2b (F = 55.46, P < 0.05), Cd86 (F = 24.44, P < 0.05), Arg1 (F = 31.18, P < 0.05), Mrc1 (F = 15.42, P < 0.05) and Chil3 (F = 24.41, P < 0.05), as well as phagocytosis markers Trem2 (F = 21.19, P < 0.05), Cd68 (F = 43.95, P < 0.05) and Apoe (F = 7.12, P < 0.05) in mice brain tissues. Conclusions A. cantonensis infections may induce severe pathological injuries in mouse brain tissues that are characterized by massive eosinophil infiltration and persistent activation of microglia cells, thereby resulting in progressive deterioration of neurological functions.
5.Cloning and functional analysis of GmMAX2b involved in disease resistance.
Jiahui FU ; Lin ZUO ; Weiqun HUANG ; Song SUN ; Liangyu GUO ; Min HU ; Peilan LU ; Shanshan LIN ; Kangjing LIANG ; Xinli SUN ; Qi JIA
Chinese Journal of Biotechnology 2025;41(7):2803-2817
The plant F-box protein more axillary growth 2 (MAX2) is a key factor in the signal transduction of strigolactones (SLs) and karrinkins (KARs). As the main component of the SKP1-CUL1-FBX (SCF) complex ubiquitin ligase E3, MAX2 is responsible for specifically recognizing the target proteins, suppressor of MAX2 1/SMAX1-like proteins (SMAX1/SMXLs), which would be degraded after ubiquitination. It can thereby regulate plant morphogenesis and stress responses. There exist homologous genes of MAX2 in the important grain and oil crop soybean (Glycine max). However, its role in plant defense responses has not been investigated yet. Here, GmMAX2b, a homologous gene of MAX2, was successfully cloned from stressed soybean. Bioinformatics analysis revealed that there were two MAX2 homologous genes, GmMAX2a and GmMAX2b, with a similarity of 96.2% in soybean. Their F-box regions were highly conserved. The sequence alignment and cluster analysis of plant MAX2 homologous proteins basically reflected the evolutionary relationship of plants and also suggested that soybean MAX2 might be a multifunctional protein. Expression analysis showed that plant pathogen infection and salicylic acid treatment induced the expression of GmMAX2b in soybean, which is consistent with that of MAX2 in Arabidopsis. Ectopic expression of GmMAX2b compensated for the susceptibility of Arabidopsis max2-2 mutant to pathogen, indicating that GmMAX2b positively regulated plant disease resistance. In addition, yeast two hybrid technology was used to explore the potential target proteins of GmMAX2b. The results showed that GmMAX2b interacted with SMXL6 and weakly interacted with SMXL2. In summary, GmMAX2b is a positive regulator in plant defense responses, and its expression is induced by pathogen infection and salicylic acid treatment. GmMAX2b might exert its effect through interaction with SMXL6 and SMXL2. This study expands the theoretical exploration of soybean disease resistant F-box and provides a scientific basis for future soybean disease resistant breeding.
Glycine max/metabolism*
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Disease Resistance/genetics*
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Plant Diseases/immunology*
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Plant Proteins/genetics*
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Cloning, Molecular
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Gene Expression Regulation, Plant
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F-Box Proteins/genetics*
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Arabidopsis/genetics*
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Phylogeny
6.Imaging poly(ADP-ribose) polymerase-1 (PARP1) in vivo with 18F-labeled brain penetrant positron emission tomography (PET) ligand.
Xin ZHOU ; Jiahui CHEN ; Jimmy S PATEL ; Wenqing RAN ; Yinlong LI ; Richard S VAN ; Mostafa M H IBRAHIM ; Chunyu ZHAO ; Yabiao GAO ; Jian RONG ; Ahmad F CHAUDHARY ; Guocong LI ; Junqi HU ; April T DAVENPORT ; James B DAUNAIS ; Yihan SHAO ; Chongzhao RAN ; Thomas L COLLIER ; Achi HAIDER ; David M SCHUSTER ; Allan I LEVEY ; Lu WANG ; Gabriel CORFAS ; Steven H LIANG
Acta Pharmaceutica Sinica B 2025;15(10):5036-5049
Poly(ADP-ribose) polymerase 1 (PARP1) is a multifunctional protein involved in diverse cellular functions, notably DNA damage repair. Pharmacological inhibition of PARP1 has therapeutic benefits for various pathologies. Despite the increased use of PARP inhibitors, challenges persist in achieving PARP1 selectivity and effective blood-brain barrier (BBB) penetration. The development of a PARP1-specific positron emission tomography (PET) radioligand is crucial for understanding disease biology and performing target occupancy studies, which may aid in the development of PARP1-specific inhibitors. In this study, we leverage the recently identified PARP1 inhibitor, AZD9574, to introduce the design and development of its 18F-isotopologue ([18F]AZD9574). Our comprehensive approach, encompassing pharmacological, cellular, autoradiographic, and in vivo PET imaging evaluations in non-human primates, demonstrates the capacity of [18F]AZD9574 to specifically bind to PARP1 and to successfully penetrate the BBB. These findings position [18F]AZD9574 as a viable molecular imaging tool, poised to facilitate the exploration of pathophysiological changes in PARP1 tissue abundance across various diseases.
7.Association between dietary preferences and the risk of osteoarthritis in Europeans:analysis of human genome-wide association study data
Jiahui PANG ; Bo WANG ; Yingxuan HU ; Ziwei HU ; Wen WU
Chinese Journal of Tissue Engineering Research 2025;29(29):6333-6342
BACKGROUND:Some studies have shown a potential relationship between dietary intake and osteoarthritis,but whether there is a causal relationship between food preferences and osteoarthritis is still unknown.There is currently no large-scale genome-wide association study on dietary preferences and osteoarthritis in China.OBJECTIVE:To explore the causal association between dietary preferences and osteoarthritis in European populations,in order to provide a theoretical basis for the prevention of osteoarthritis and to provide reference data for the identification of high-risk groups for hip and knee osteoarthritis in China.METHODS:A total of 20 dietary preference genetic statistics datasets were selected to screen for exposure factor-related instrumental variables.The dataset for osteoarthritis was selected for the ending.After exclusion of the instrumental variables related to confounders,the two-sample Mendelian randomized causal association analysis was conducted mainly by inverse variance weighted analysis,and other four statistical methods were used as supplements.Sensitivity test was performed for the results.RESULTS AND CONCLUSION:(1)The results of the inverse variance weighted analysis showed that preference for barbecue(OR=1.204,95%CI:1.058-1.370,P=0.005),beef(OR=1.167,95%CI:1.034-1.317,P=0.012),chicken(OR=1.399,95%CI:1.119-1.749,P=0.003),pork chops(OR=1.218,95%CI:1.039-1.427,P=0.015)and coffee(OR=1.133,95%CI:1.037-1.238,P=0.006)were risk factors for osteoarthritis of the knee and hip joints,vegetables(OR=0.893,95%CI:0.827-0.964,P=0.004),and vinegar(OR=0.897,95%CI:0.812-0.991,P=0.032)were protective factors for knee-hip osteoarthritis.(2)The results of the sensitivity analysis showed that the instrumental variables included in the analysis without horizontal pleiotropy and bias,and the corresponding inverse variance weighted analysis of effects model was used according to the results of the heterogeneity analysis.(3)The results of this study provide certain reference value in the research on the relationship between dietary preferences and hip and knee osteoarthritis,but only included human whole genome association study data from European populations,and the validity of the research results in other races remains to be tested.Moreover,no stratification was performed on gender,age and other health status.It is difficult to completely rule out the bias from population stratification in the research results.In the future,larger-scale and more finely classified sample data are still needed to carry out relevant causal relationship research.
8.Research progress of antigen specific T cell detection technology
Mingzhe ZENG ; Jiahui DU ; Jiahao HU ; Ziqian HE ; Zeming LE ; Jingyi HUANG ; Zhiqing LI
Chinese Journal of Immunology 2025;41(6):1490-1496
T cell response plays an important role in anti-viral infection and anti-tumor immunity,and antigen-specific T cell detection is essential for study of T cell response.This article reviews progress of antigen-specific T cell detection technology,including enzyme-linked immunospot(ELISPOT)assay,intracellular cytokine staining(ICS)assay and activation-induced labeling(AIM)assay,which based on detection of cytokine secretion or activation phenotypes of specific T cells after stimulation and reactivation with antigen in vitro.Another class of methods include Tetramer technology based on known epitopes-human leukocyte antigen(HLA)restriction and recently developed single-cell transcriptomes and T-cell antigen receptor(TCR)sequencing technology.Application of the above methods has advanced our understanding of antigen specific T cell response:Strength and duration of the response,subpop-ulation information,epitopes and their associated HLA-restriction,TCR cloning information and transcriptome characteristic.
9.Clinical characteristics of adult patients with eosinophilic esophagitis in China
Jiahui HU ; Xiaoying ZHOU ; Fang YU ; Chengfu XU ; Zhe SHEN ; Han MA
Chinese Journal of Internal Medicine 2025;64(3):212-219
Objective:Eosinophilic esophagitis (EoE), an allergen/immune-mediated chronic disorder of the esophagus, is witnessing an incremental rise in its global incidence. However, data in China are very limited. This study aimed to clarify the characteristics of EoE in Chinese adults at our medical center.Methods:We collected information, including clinical characteristics and endoscopic findings, relative to all cases of adult patients who met the pathological diagnostic criteria for EoE at our institution from January 2019 to May 2024. Patients diagnosed with reflux esophagitis (RE) were matched in a 1∶1 ratio based on age and sex, and comparisons were made between the two groups.Results:The overall detection rate of EoE in our hospital was approximately 0.05%, with a trend increasing yearly. In total, 61 patients met the diagnostic criteria for EoE, of whom 42 (68.9%) were male. The median age was 53 years. The clinical manifestations of EoE patients were diverse, with common symptoms including dysphagia, acid reflux, and upper abdominal pain. Serological examination revealed that 23.1% (9/39) of patients had increased absolute eosinophil counts. Allergic diseases were observed in 73.8% (45/61) patients. Most patients exhibited typical mucosal changes in the esophagus during endoscopy, the median EREFS score was 3 points. The most commonly administered treatment included proton pump inhibitors, and 13 patients received steroid treatment. During a follow-up period, 42 patients (68.9%) exhibited clinical symptom improvement or pathological remission. In comparison to Western countries, patients with EoE in China typically presented with milder disease severity and a more favorable prognosis. No significant differences were observed between younger and older adult groups regarding clinical symptoms, the proportion of comorbid allergic diseases, medications, or the rate of improvement ( P for all>0.05). Additionally, patients with EoE more commonly presented with dysphagia (29.5% vs. 1.6%, χ2=15.96, P<0.001), comorbid allergic diseases (73.8% vs. 13.1%, χ2=45.67, P<0.001), increased eosinophil counts (23.1% vs. 3.3%, χ2=7.61, P<0.01), and a positive response to corticosteroids when compared to patients with RE. Conclusions:This study systematically determined the clinical characteristics of adult EoE patients in China. Compared to Western countries, patients from China typically presented with milder disease severity and a more favorable prognosis. No significant clinical manifestations or prognosis differences were observed between younger and older patients. EoE can be differentiated from RE based on symptoms, the presence of comorbid allergic diseases, and the degree of serum eosinophil infiltration. For patients suspected of EoE, endoscopic esophageal biopsy will facilitate early diagnosis.
10.Drug resistance and clinical characteristics of bloodstream infections caused by Enterobacter in children
Jianen YAN ; Chenglan YAN ; Jiahui LIANG ; Xuehua HU ; Minxue LIU ; Huan ZHANG ; Linlin LI
Chinese Journal of Nosocomiology 2025;35(19):2965-2969
OBJECTIVE To analyze the drug resistance,laboratory indicators and clinical characteristics of blood-stream infections caused by Enterobacter in children,providing references for early empirical treatment.METHODS A retrospective analysis was conducted on the clinical data of 302 children(aged 29 days to 12 years)with bloodstream infections caused by Enterobacter(monomicrobial infections)admitted to the Maternity and Child Health Care of Guangxi Zhuang Autonomous Region from Jan.2017 to Dec.2023.The drug resistance of Enterobacter and major pathogens were analyzed across different age groups of children.Based on prognosis,the children were divided into a favorable prognosis group(266 cases)and a poor prognosis group(36 cases),and their laboratory indicators and clinical characteristics were compared.Multivariate logistic regression was used to analyze the risk factors for poor prognosis.RESULTS The major pathogens causing infections were Salmonella,Escherichia coli and Klebsiella pneumoniae.The distribution difference of major pathogens across age groups(29 days-6 months,>6 months-1 year,>1-2 years,>2 years)was statistically significant(P<0.001).The drug resistance rates of Salmonella to ampicillin,chloramphenicol and sulfamethoxazole/trimethoprim were 68.61%,54.01%and 44.53%,respectively.E.coli exhibited drug resistance rates of 83.33%,52.22%and 47 78%to ampicillin,sulfamethoxazole/trimethoprim and cefazolin,respectively.K.pneumoniae showed drug resistance rates exceeding 50%to ampicillin/sulbactam,cefuroxime and cefazolin.Hypoalbuminemia(OR=3.319),sepsis(OR=3.122),ventricular purulent encephalitis(OR=5.104)and prior use of penicillin-class anti-bacterial drugs before culture positivity(OR=3.374)were identified as risk factors for poor prognosis of the chil-dren with Enterobacteriaceae bloodstream infections(P<0.05).CONCLUSIONS Bloodstream infections caused by Enterobacter in children predominantly occur in those under 2 years of age,with Salmonella,E.coli and K.pneumoniae as the major pathogens,exhibiting high drug resistance rates to penicillin and cephalosporin antibacte-rial drugs.Clinical therapeutic regimen should be adjusted early based on laboratory indicators and risk factors to improve prognosis.

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