OBJECTIVE T o analyze the distribution and clinical characteristics of carbapenem-resistant organisms(CRO)in the intestinal and respiratory tracts of high-risk ICU patients,and to evaluate the effectiveness of two screening methods:plate screening and Gene Xpert Carba(hereinafter referred to as Xpert Carba).METHODS In-testinal samples(anal swabs,feces)and respiratory samples(sputum,lavage fluid)from 320 patients admitted to the ICU ward of the Fourth Affiliated Hospital of Soochow University from Apr.2023 to Dec.2024 were collected.Plate screening and Xpert Carba methods were used for active screening of CRO strains,and clinical data of patients were collected through electronic medical records.RESULTS The plate screening results indicated that 70 out of 573 samples from 320 patients tested positive for CRO,with a positive rate of 12.22％(70/573).The positive rates for anal swabs,feces,sputum and lavage fluid were 9.26％(20/216),10.39％(8/77),13.02％(22/169)and 18.02％(20/111),respectively.There was no statistically significant difference in the positive rates among different sample types.The predominant CRO-positive organisms detected were Klebsiella pneumoniae in intestinal samples and Pseudomonas aeruginosa in respiratory samples.Among 361 intestinal and respiratory samples tested from 88 patients,plate screening and Xpert Carba screening showed the positive rates of 14.40％(52/361)and 6.37％(23/361),respectively.Analysis of the clinical characteristics of the 31 CRO-posi-tive patients revealed that they were predominantly elderly(average age 69 years),with 51.61％(16/31)having a history of interdepartmental transfers and 48.39％(15/31)having surgerical history.The mechanical ventilation usage rate in the respiratory positive group(58.82％,10/17)was higher than that in the intestinal positive group(0,0/7)and the dual positive group(14.28％,1/7).Compared with Xpert Carba,plate screening had lower screening costs,higher positive rates across different sample types and a broader range of detected bacterial species.CONCLUSIONS The ICU ward is a high-prevalence area for CRO strains,with K.pneumoniae(from in-testinal samples)and P.aeruginosa(from respiratory samples)showing the highest isolation rates.Plate screen-ing boasts lower costs,higher detection rate and broader bacterial species coverage for active screening of CRO strains in the intestinal and respiratory tracts of high-risk ICU patients.

OBJECTIVE T o analyze the distribution and clinical characteristics of carbapenem-resistant organisms(CRO)in the intestinal and respiratory tracts of high-risk ICU patients,and to evaluate the effectiveness of two screening methods:plate screening and Gene Xpert Carba(hereinafter referred to as Xpert Carba).METHODS In-testinal samples(anal swabs,feces)and respiratory samples(sputum,lavage fluid)from 320 patients admitted to the ICU ward of the Fourth Affiliated Hospital of Soochow University from Apr.2023 to Dec.2024 were collected.Plate screening and Xpert Carba methods were used for active screening of CRO strains,and clinical data of patients were collected through electronic medical records.RESULTS The plate screening results indicated that 70 out of 573 samples from 320 patients tested positive for CRO,with a positive rate of 12.22％(70/573).The positive rates for anal swabs,feces,sputum and lavage fluid were 9.26％(20/216),10.39％(8/77),13.02％(22/169)and 18.02％(20/111),respectively.There was no statistically significant difference in the positive rates among different sample types.The predominant CRO-positive organisms detected were Klebsiella pneumoniae in intestinal samples and Pseudomonas aeruginosa in respiratory samples.Among 361 intestinal and respiratory samples tested from 88 patients,plate screening and Xpert Carba screening showed the positive rates of 14.40％(52/361)and 6.37％(23/361),respectively.Analysis of the clinical characteristics of the 31 CRO-posi-tive patients revealed that they were predominantly elderly(average age 69 years),with 51.61％(16/31)having a history of interdepartmental transfers and 48.39％(15/31)having surgerical history.The mechanical ventilation usage rate in the respiratory positive group(58.82％,10/17)was higher than that in the intestinal positive group(0,0/7)and the dual positive group(14.28％,1/7).Compared with Xpert Carba,plate screening had lower screening costs,higher positive rates across different sample types and a broader range of detected bacterial species.CONCLUSIONS The ICU ward is a high-prevalence area for CRO strains,with K.pneumoniae(from in-testinal samples)and P.aeruginosa(from respiratory samples)showing the highest isolation rates.Plate screen-ing boasts lower costs,higher detection rate and broader bacterial species coverage for active screening of CRO strains in the intestinal and respiratory tracts of high-risk ICU patients.

Objective To understand the prevalence of resistance gene and homology of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from ICU of emergency.Methods A total of 19 CRKP isolates were obtained from emergency ICU of the Affiliated Hospital of Xuzhou Medical University from July 2015 to August 2016.PCR was performed to screen the genes encoding carbapenemase,extended spectrum beta-lactamase (ESBL) and AmpC.Pulsed field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were used for molecular typing of these bacterial strains.Results Among the 19 CRKP,carbapenemase-resistant genes were detectable in 18 CRKP isolates,including 17 isolates of harboring blaKPC gene and 1 strain of harboring blaNDM gene.All the 18 strains carried ESBLs genes which were identified as 8 blaSHV-12,3 blaSHV-11,5 blaSHV-2a,15 blaTEM-1,10 blaCTX-M-65,3 blaCTX-M-15,1 blaCTX-M-14 and 1 blaCTX-M-27.The 13 strains harboring cephalosporin-resistant genes were all identified as blaDHA-1.PFGE results revealed that the 19 CRKP strains were grouped into 4 types (A,B,C and D) and 4 subtypes(A1,2,3 and 4):A1 (n =12),A2(n =1),A3 (n=1),A4(n=1),B(n=2),C(n=1) and D(n=1).MLST showed that ST11 was the predominant sequence type (n=15) among the 19 CRKP strains,and ST48 (n =2),ST37 (n =1) and untyped (n =1) were also identified.The 15 blaKPC-2-producing CRKP ST11 clone shared the A type of PFGE pattern.Conclusion The report on CRKP suggested the dissemination of blaKPC-2-producing ST11 clone was existed in the ICU of emergency department in this hospital.The surveillance for drug-resistance and effective disinfectant quarantine measures should be strengthened.

There is growing interest in the whole saliva as a diagnostic fluid because of the relatively simple and non-invasive collection.Research on salivary proteomic and genomic has greatly facilitated the diagnosis and therapy of oral diseases,also revealed the molecular mechanism of the diseases.Saliva-derived exosome as a new source,with various molecular constituents of their cells of origin,including proteins,mRNA and miRNA might serve as potential biomarker.This article reviews the biological properties of saliva exosome,its separation and other aspects associated with disease.