OBJECTIVE To observe the detection and drug resistance of carbapenem-resistant Klebsiella pneumoni-ae(CRKP)strains causing hospital-acquired infections(HAI)and community-acquired infections(CAI)in recent years so as to provide bases for prevention and control of CRKP infection and reasonable clinical use of antibiotics.METHODS A total of 3444 patients who were diagnosed with Klebsiella pneumonia infection and were hospitalized in the 2nd Affiliated Hospital of Fujian Medical University from Jan.1,2017 to Dec.31,2023 were recruited as the research subjects.Totally 230 patients with CRKP infection were chosen based on the result of drug susceptibility testing,73 of whom had HAI,and 157 had CAI.The isolation rate of CRKP strains,popula-tion distribution,specimens sources and drug resistance rates were observed and compared between the patients with HAI and the patients with CAI.RESULTS The total isolation rate of CRKP strains was 6.68％(230/3444).There was no difference in the sex of the patients with CRKP infection between the HAI patients and the CAI patients,however,the isolation rate of the CRKP strains from the patients aged between 18 and 45 years old was higher in the HAI group than in the CAI group(P＜0.05).The isolation rates of CRKP strains causing the two types of infections increased year by year,showing a remarkable increasing amplitude in 2022-2023,with the HAI increasing from 9.33％to 20.67％,the CAI increasing from 5.54％to 15.03％.The lower respiratory tract,urinary tract and bacteremia were the most common infection sites,the detection rate of soft tissue infec-tions was higher among the patients with HAI than among the patients with CAI(P=0.047).CRKP strains cau-sing HAI showed the highest isolation rate(33.33％)in catheter specimens,and the isolation rate of CRKP strains in pus specimens was higher among the HAI patients than among the CAI patients(P=0.011).The isola-tion rate of CRKP strains in sputum specimens of the CAI patients raised four times in 2023 as compared with that in 2022.The drug resistance rates of the CRKP strains to 25 types of antibiotics were relatively high and showed upward trends;the drug resistance rate of the HAI-KPN strains to imipenem was 48.78％,higher than 7.09％of the CAI-KPN strains(P＜0.001),and there were no significant differences in the drug resistance rates to other carbapenems between the CAI-KPN strains and the HAI-KPN strains.CONCLUSIONS The isolation rates of the CRKP strains causing the HAI and CAI are increasing year by year.The clinical invasive procedures and community-acquired respiratory tract infections are the key points for prevention and control.It is necessary to in-tensify the hospital-community cooperative prevention and control system based on the isolation rates and drug re-sistance rates of the CRKP strains,and take comprehensive prevention and control measures so as to curb the transmission of the drug-resistant strains.

OBJECTIVE To observe the detection and drug resistance of carbapenem-resistant Klebsiella pneumoni-ae(CRKP)strains causing hospital-acquired infections(HAI)and community-acquired infections(CAI)in recent years so as to provide bases for prevention and control of CRKP infection and reasonable clinical use of antibiotics.METHODS A total of 3444 patients who were diagnosed with Klebsiella pneumonia infection and were hospitalized in the 2nd Affiliated Hospital of Fujian Medical University from Jan.1,2017 to Dec.31,2023 were recruited as the research subjects.Totally 230 patients with CRKP infection were chosen based on the result of drug susceptibility testing,73 of whom had HAI,and 157 had CAI.The isolation rate of CRKP strains,popula-tion distribution,specimens sources and drug resistance rates were observed and compared between the patients with HAI and the patients with CAI.RESULTS The total isolation rate of CRKP strains was 6.68％(230/3444).There was no difference in the sex of the patients with CRKP infection between the HAI patients and the CAI patients,however,the isolation rate of the CRKP strains from the patients aged between 18 and 45 years old was higher in the HAI group than in the CAI group(P＜0.05).The isolation rates of CRKP strains causing the two types of infections increased year by year,showing a remarkable increasing amplitude in 2022-2023,with the HAI increasing from 9.33％to 20.67％,the CAI increasing from 5.54％to 15.03％.The lower respiratory tract,urinary tract and bacteremia were the most common infection sites,the detection rate of soft tissue infec-tions was higher among the patients with HAI than among the patients with CAI(P=0.047).CRKP strains cau-sing HAI showed the highest isolation rate(33.33％)in catheter specimens,and the isolation rate of CRKP strains in pus specimens was higher among the HAI patients than among the CAI patients(P=0.011).The isola-tion rate of CRKP strains in sputum specimens of the CAI patients raised four times in 2023 as compared with that in 2022.The drug resistance rates of the CRKP strains to 25 types of antibiotics were relatively high and showed upward trends;the drug resistance rate of the HAI-KPN strains to imipenem was 48.78％,higher than 7.09％of the CAI-KPN strains(P＜0.001),and there were no significant differences in the drug resistance rates to other carbapenems between the CAI-KPN strains and the HAI-KPN strains.CONCLUSIONS The isolation rates of the CRKP strains causing the HAI and CAI are increasing year by year.The clinical invasive procedures and community-acquired respiratory tract infections are the key points for prevention and control.It is necessary to in-tensify the hospital-community cooperative prevention and control system based on the isolation rates and drug re-sistance rates of the CRKP strains,and take comprehensive prevention and control measures so as to curb the transmission of the drug-resistant strains.

The effects of black rice anthocyanidins (BRACs) on retinal damage induced by photochemical stress are not well known. In the present study, Sprague-Dawley rats were fed AIN-93M for 1 week, after which 80 rats were randomly divided into two groups and treated with (n = 40) or without BRACs (n = 40) for 15 days, respectively. After treatment, both groups were exposed to fluorescent light (3,000 +/- 200 lux; 25degrees C), and the protective effect of dietary BRACs were evaluated afterwards. Our results showed that dietary BRACs effectively prevented retinal photochemical damage and inhibited the retinal cells apoptosis induced by fluorescent light (p < 0.05). Moreover, dietary BRACs inhibited expression of AP-1 (c-fos/c-jun subunits), up-regulated NF-kappaB (p65) expression and phosphorylation of IkappaB-alpha, and decreased Caspase-1 expression (p < 0.05). These results suggest that BRACs improve retinal damage produced by photochemical stress in rats via AP-1/NF-kappaB/Caspase-1 apoptotic mechanisms.
Animal Feed/analysis ; Animals ; Anthocyanins/administration & dosage/*pharmacology ; Antioxidants/administration & dosage/*physiology ; Blotting, Western ; Caspase 1/*genetics/metabolism ; Diet ; Dietary Supplements/analysis ; I-kappa B Proteins/genetics/metabolism ; NF-kappa B/*genetics/metabolism ; Neoplasm Proteins/genetics/metabolism ; Nucleocytoplasmic Transport Proteins/genetics/metabolism ; Oryza sativa/chemistry ; Proto-Oncogene Proteins c-fos/genetics/metabolism ; Proto-Oncogene Proteins c-jun/genetics/metabolism ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Retinal Diseases/etiology/*prevention & control ; Signal Transduction/*drug effects/radiation effects ; Transcription Factor AP-1/*genetics/metabolism

ObjectiveTo investigate clinical effect of eradication of helicobacter pylori in patients with idiopathic thrombocytopenic purpura(ITP). Methods145 cases with HP-positive ITP paitients were divided into two groups( platelet counts results ＜ 50 × 109/L and platelet counts results ＞ 50 × 109/L). 95 cases with platelet counts ＜50 × 109/L were divided into two groups and treated with prednisone and Hp eradication(48 cases) or with prednisone without Hp eradication(47 cases). 95 cases with platelet counts ＞ 50 × 109/L were divided into two groups and treated with Hp eradication 25 cases)or follow-up without any treatment(25 cases). ResultsThe total effective rate in group treated with prednisone and Hp eradication was significantly higher than that in group with prednisone without Hp eradication( 92％ vd 75％, x2 ＝ 5.01 ,P ＜ 0.05 ). The recurrence rate in two year in group treated with prednisone and Hp eradication was significantly lower than that in group with prednisone without Hp eradication( 19％ vs 49％,x2 ＝ 9. 69, P ＜ 0. 01 ). HP eradicatiaon single can improve platelet counts in HP-positive ITP paitients.ConclusionThe detection and eradication of H pylori infection should be considered in patients with ITP. H. pylori eradication could be used for initial treatment in HP-positive ITP paitients.