To clarify the epidemiological characteristics of pertussis in children in Hanzhong during the nationwide surge in pertussis, this study retrospectively collected nucleic acid testing data of 4 565 children with pertussis from a tertiary hospital in Hanzhong City from September 2023 to August 2024, and collected demographic and clinical information of confirmed cases for analysis. The results showed that among 4 565 cases tested, there were 1 224 positive cases for pertussis nucleic acid testing, with a total positive rate of 26.81%. Since September 2023, the number of tests and positive cases had continuously increased, reaching a peak in May 2024, with 1 174 samples tested and 319 positive cases. Notably, the number of confirmed cases from April to July 2024 accounted for 82.03% (1 004/1 224) of the total confirmed cases during the study period. Among the 1 224 confirmed cases of pertussis, there were 647 male patients (52.86%) and 577 female patients (47.14%). The highest proportion of cases was found in school-age and preschool children, accounting for 88.81% (1 087/1 224). Among outpatients, school-age and preschool children accounted for 93.44% (897/960), while inpatient cases were mainly preschool, school-age children, and infants (94.32%, 249/264). The positive detection rates of outpatient and inpatient children in the same age group were compared. Except for the infant group, the positive rates of the other four groups were higher than those of the inpatient group (all P<0.05). Among 264 hospitalized children with pertussis, 70 cases (26.52%, 70/264) were infected with Bordetella pertussis alone, and 194 cases (73.48%, 194/264) had co-infections with other pathogens. Rhinovirus, Mycoplasma pneumoniae, and Staphylococcus aureus were the most common pathogens in co-infections.

Objective To understand the clinical characteristics of patients with Streptococcus anginosus group(SAG)pulmonary abscess and resistance of SAG.Methods 67 patients with pulmonary abscess admitted to a hos-pital from January 2018 to May 2022 were retrospectively analyzed,clinical data of patients with SAG pulmonary abscess were analyzed,and the minimum inhibitory concentration of antimicrobial agents to 18 SAG strains was de-tected by microbroth dilution method,the carriage of resistance genes and virulence genes of SAG were detected by high-throughput sequencing technology.Results Among 67 patients with pulmonary abscess,SAG accounted for 29.9％(20/67),out of which 2 were excluded due to bacterial inactivation,and 18 patients were included for fur-ther studies.18 patients with SAG pulmonary abscess were all community acquired,with an average age of(60.9±9.1)years.There were 13(72.2％)male patients,most patients(94.4％)complicated chronic pulmonary disease,with cough(94.4％)and expectoration(88.9％)as the initial symptoms,some patients(44.4％)had chest pain,and more than half(61.1％)didn't have fever.The proportion of neutrophils,erythrocyte sedimentation rate,and C-reactive protein were mostly elevated,while procalcitonin was normal.The resistance rate of 18 SAG strains to erythromycin,clindamycin,and tetracycline was＞65％,out of which 14 strains carried resistance gene ermB,13 strains carried resistance gene tetM,and 1 strain carried both resistance gene msrD and mefA.18 SAG strains were detected virulence gene psaA,out of which 3 strains were detected virulence gene nan A.Conclusion SAG is an im-portant pathogen that causes pulmonary abscess,and the patients'complications are mainly chronic pulmonary di-seases,with non-specific clinical manifestations;Most strains carry ermB and tetM genes,mediating resistance to macrolides,lincosamides,and tetracyclines.

Objective To understand the clinical characteristics of patients with Streptococcus anginosus group(SAG)pulmonary abscess and resistance of SAG.Methods 67 patients with pulmonary abscess admitted to a hos-pital from January 2018 to May 2022 were retrospectively analyzed,clinical data of patients with SAG pulmonary abscess were analyzed,and the minimum inhibitory concentration of antimicrobial agents to 18 SAG strains was de-tected by microbroth dilution method,the carriage of resistance genes and virulence genes of SAG were detected by high-throughput sequencing technology.Results Among 67 patients with pulmonary abscess,SAG accounted for 29.9％(20/67),out of which 2 were excluded due to bacterial inactivation,and 18 patients were included for fur-ther studies.18 patients with SAG pulmonary abscess were all community acquired,with an average age of(60.9±9.1)years.There were 13(72.2％)male patients,most patients(94.4％)complicated chronic pulmonary disease,with cough(94.4％)and expectoration(88.9％)as the initial symptoms,some patients(44.4％)had chest pain,and more than half(61.1％)didn't have fever.The proportion of neutrophils,erythrocyte sedimentation rate,and C-reactive protein were mostly elevated,while procalcitonin was normal.The resistance rate of 18 SAG strains to erythromycin,clindamycin,and tetracycline was＞65％,out of which 14 strains carried resistance gene ermB,13 strains carried resistance gene tetM,and 1 strain carried both resistance gene msrD and mefA.18 SAG strains were detected virulence gene psaA,out of which 3 strains were detected virulence gene nan A.Conclusion SAG is an im-portant pathogen that causes pulmonary abscess,and the patients'complications are mainly chronic pulmonary di-seases,with non-specific clinical manifestations;Most strains carry ermB and tetM genes,mediating resistance to macrolides,lincosamides,and tetracyclines.

To clarify the epidemiological characteristics of pertussis in children in Hanzhong during the nationwide surge in pertussis, this study retrospectively collected nucleic acid testing data of 4 565 children with pertussis from a tertiary hospital in Hanzhong City from September 2023 to August 2024, and collected demographic and clinical information of confirmed cases for analysis. The results showed that among 4 565 cases tested, there were 1 224 positive cases for pertussis nucleic acid testing, with a total positive rate of 26.81%. Since September 2023, the number of tests and positive cases had continuously increased, reaching a peak in May 2024, with 1 174 samples tested and 319 positive cases. Notably, the number of confirmed cases from April to July 2024 accounted for 82.03% (1 004/1 224) of the total confirmed cases during the study period. Among the 1 224 confirmed cases of pertussis, there were 647 male patients (52.86%) and 577 female patients (47.14%). The highest proportion of cases was found in school-age and preschool children, accounting for 88.81% (1 087/1 224). Among outpatients, school-age and preschool children accounted for 93.44% (897/960), while inpatient cases were mainly preschool, school-age children, and infants (94.32%, 249/264). The positive detection rates of outpatient and inpatient children in the same age group were compared. Except for the infant group, the positive rates of the other four groups were higher than those of the inpatient group (all P<0.05). Among 264 hospitalized children with pertussis, 70 cases (26.52%, 70/264) were infected with Bordetella pertussis alone, and 194 cases (73.48%, 194/264) had co-infections with other pathogens. Rhinovirus, Mycoplasma pneumoniae, and Staphylococcus aureus were the most common pathogens in co-infections.

To analyze the factors associated with infection and death of carbapenem-resistant Klebsiella pneumoniae (CRKP) in patients. Using a case-control study method, patients with CRKP infection from January 2019 to December 2021 in the 3201 Hospital were selected as the case group, and patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) infection in the same period were selected as the control group in a ratio of 1∶1. The study subjects were followed up for 30 days. The two groups of patients were categorized into survival and death groups based on whether they died or not, respectively, and the 30-day morbidity and mortality rates of the CRKP case group and the CSKP control group were compared. The logistic regression model was used to analyze the factors associated with CRKP infection and death after CRKP infection. This study included 59 cases in the CRKP case group and 59 in the CSKP control group. The 30-day mortality rate of CRKP-infected patients and CSKP-infected patients were 30.5% (18/59) and 5.1% (3/59), with statistically significant differences ( P<0.001). Surgery within three months prior to KP infection ( OR=17.285, P=0.001), use of carbapenems within three months prior to KP infection ( OR=11.235, P=0.002), use of more than three types of antibiotics ( OR=7.993, P=0.016), albumin<30 g/L in patients prior to KP infection ( OR=10.463, P=0.002), sex ( OR=0.078, P<0.001), and diabetes ( OR=0.076, P=0.011) were associated factors of CRKP infection. Higher age-corrected Charlson Comorbidity Index scores of patients ( OR=1.522, P=0.024) and use of carbapenems by the patients with in the first three months prior to the KP infection ( OR=4.902, P=0.029) were associated factors for the deaths of patients with CRKP. In conclusion, medical personnel should be cautious in performing invasive procedures, strictly control the use of antibiotics, and provide targeted protection and treatment for high-risk patients as soon as possible.

To analyze the factors associated with infection and death of carbapenem-resistant Klebsiella pneumoniae (CRKP) in patients. Using a case-control study method, patients with CRKP infection from January 2019 to December 2021 in the 3201 Hospital were selected as the case group, and patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) infection in the same period were selected as the control group in a ratio of 1∶1. The study subjects were followed up for 30 days. The two groups of patients were categorized into survival and death groups based on whether they died or not, respectively, and the 30-day morbidity and mortality rates of the CRKP case group and the CSKP control group were compared. The logistic regression model was used to analyze the factors associated with CRKP infection and death after CRKP infection. This study included 59 cases in the CRKP case group and 59 in the CSKP control group. The 30-day mortality rate of CRKP-infected patients and CSKP-infected patients were 30.5% (18/59) and 5.1% (3/59), with statistically significant differences ( P<0.001). Surgery within three months prior to KP infection ( OR=17.285, P=0.001), use of carbapenems within three months prior to KP infection ( OR=11.235, P=0.002), use of more than three types of antibiotics ( OR=7.993, P=0.016), albumin<30 g/L in patients prior to KP infection ( OR=10.463, P=0.002), sex ( OR=0.078, P<0.001), and diabetes ( OR=0.076, P=0.011) were associated factors of CRKP infection. Higher age-corrected Charlson Comorbidity Index scores of patients ( OR=1.522, P=0.024) and use of carbapenems by the patients with in the first three months prior to the KP infection ( OR=4.902, P=0.029) were associated factors for the deaths of patients with CRKP. In conclusion, medical personnel should be cautious in performing invasive procedures, strictly control the use of antibiotics, and provide targeted protection and treatment for high-risk patients as soon as possible.

OBJECTIVE：To provide reference for clinical empirical treatme nt of non-fermentative Gram-negative bacilli （NFGNB）infection. METHODS ：All kinds of clinical specimens were collected from Jan. 2010 to Dec. 2019 in a tertiary hospital from Hanzhong city of Shaanxi province ；the distribution and drug resistance of NFGNB were analyzed retrospectively. RESULTS ： A total of 26 386 strains of pathogenic bacteria were detected in the hospital during 2010-2019，including 4 077 strains of NFGNB （15.45％），mainly from patients ≥60 years old （1 836 strains，45.05％）. During the 10 years，the detection rate of NFGNB decreased from 20.14％ in 2010 to 15.36％ in 2019 （P＜0.001）. Acinetobacter baumannii （1 359 strains），Pseudomonas aeruginosa （1 269 strains），Stenotrophomonas maltophilia （447 strains） and Burkholderia cepacia （351 strains） were main pathogens. The detected NFGNB mainly came from hospitalized patients （4 001 strains），and most of them were found in ICU （17.05％），neurosurgery department （14.52％），respiratory department （12.41％），and respiratory tract （66.69％），secretion （7.80％）specimens. The detection rates of A. baumannii and P. aeruginosa in oncology department ，blood specimens and urine specimens showed an overall upward trend ，while the detection rates in ICU of the hospital showed a downward trend （P＜0.05）； the detection rate of P. aeruginosa in neurosurgery department showed an upward trend （P＜0.05），and that of A. baumannii in respiratory department showed an upward trend （P＜0.05）. The resistance rate of A. baumannii to carbapenems increased from about 10％ in 2010 to about 75％ in 2019，and the guyh3201@163.com resistance rate to cephalosporins exceeded 78％. The resistance rates of P. aeruginosa to imipenem and me ropenem were lower than 35％ and 30％ respectively，and the trend of drug resistance did not change significantly （P＞0.05）；the resistance rates to 12 kinds of clinically commonly used antibiotics as piperacillin and aztreonam were lower than 40％. The resistance rate of S. maltophilia to compound sulfamethoxazole showed a decreasing trend （P＜0.001），and the resistance rate to ceftazidime was high （54.70％-74.10％）. The resistance rates of B. cepacia to compound sulfamethoxazole，meropenem and ceftazidime showed a downward trend （P＜0.01），and were lower than 15％ after 2014. CONCLUSIONS：Although the detection rate of NFGNB in our hospital showed a downward trend ，the multi-drug resistance and pan-drug resistance of A. baumannii are serious ，and the resistance rate to carbapenems is increased. Sensitive drugs such as cefoperazone/sulbactam，amikacin，levofloxacin and ceftazidime should be selected for NFGNB infection according to the results of drug sensitivity tests.

Objective To investigate the role of early detecting macrophage inflammatory protein‐1β(MIP‐1β) and proealcitonin (PCT ) level for the diagnosis of spontaneous bacterial peritonitis (SBP) in the decompensated stage of liver cirrhosis .Methods 384 cases of decompensated stage of liver cirrhosis complicating SBP collected in the Affiliated 3201 Hospital of Xi ′an Jiaotong Univer‐sity from May 2011 to February 2015 were included into the SBP group ,while other 377 cases of decompensated stage of liver cir‐rhosis complicating ascites were included into the control group .The serum and ascites samples were collected for detecting PCT by using electrochemical luminescence method and MIP‐1β by using the enzyme‐linked immunoassay .The significance of these two in‐dicators was compared between the serum detection and ascites detection .At the same time the clinical application value of these two indicators was analyzed by using the receiver operating characteristic curve .Results The serum and ascites PCT and MIP‐1βlevels in the SBP group were significantly higher than those in the control group ,the difference was statistically significant (P<0 .05) ;the serum PCT level in the SBP group had statistical difference between the patients with Gram‐negative bacteria infection and the patients with Gram positive bacteria infection (P< 0 .05) ;the ascites MIP‐1β level in the patients with Gram‐negative bacte‐ria infection of the SBP group was higher than that with Gram positive bacteria infection ,the difference was statistically significant (P< 0 .05) .Conclusion The serum and ascites PCT and MIP‐1β detection can help to the differentiation diagnosis of early decom ‐pensated stage of liver cirrhosis complicating SBP ;the serum PCT detection is superior to the MIP‐1β detection ,while ascites MIP‐1β detection is superior to the PCT detection .

Objective To investigate the significance of procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC) and other inflammatory markers in the diagnosis of pediatric patients with HFMD.Methods 138 cases of pediatric patients with foot and mouth disease(study group)and 50 cases of healthy children(control group)were recruited in the study.Procalcitonin (PCT),white blood cell(WBC),neutrophil count(NC),lymphocyte count(Ly),immunoglobulins,C-reactive protein and other indi-cators were determined and compared.Results PCT,CRP,WBC,NC,Ly% and IgM levels were higher in study group than those in control group,the differences were all statistically significant(P <0.05 );IgG,IgA levels in control group were lower than that in control group,the differences were statistically significant(P <0.05).Conclusion PCT,WBC,NC,Ly,CRP and IgA,IgG,IgM can provide experimental evidence for diagnosis of children with hand foot and mouth disease.

Objective Previous studies have shown that genetic variants in the interferons regulatory factor 5 (IRF5) gene are associated with rheumatoid arthritis (RA) in European and Japanese, but not found in Han Chinese. We conducted this study to investigate whether genetic variants in the IRF5 gene are associated with RA in ShaanXi Han Chinese population. Methods This study was collected 576 RA patients and 768 normal controls. Six IRF5 gene polymorphisms (rs729302, rs2004640, rs752637, rs3807306, rs10954213 and rs2280714) were genotyped by the SNaPshot method. T-test and χ2 test were used for statistic analysis. The genotype and allele frequencies were evaluated using the chi square tests. Genotyping data were adjusted by Logistic regression method by age and gender. The linkage disequilibrium (LD) block structure was examined using Hapview 4.2 software. Results Six SNPs inspected complied with Hardy-weinberg equilibrium (P>0.05). Two SNPs were significantly associated with RA: rs729302 A risk allele [OR=1.29, 95%CI (1.10, 1.50), P=5.57×10-3];dominant model [OR=1.58, 95%CI (1.10, 2.27), P=0.024], recessive model [OR=1.31, 95%CI (1.17, 1.64), P=0.028]. rs2004640 T risk allele [OR=1.28, 95%CI (1.08, 1.54), P=0.039]; dominant model [OR=1.27, 95%CI (1.03, 1.58), P=0.036]. In addition, there was no significant difference in rs752637, rs3807306, rs10954213 and rs2280714 SNPs between RA group and control and genotyped polymorphisms were significantly associated with RA susceptibility. Conclusion The present study confirm that rs729302 and rs2004640 in the IRF5 gene is significantly associated with increased risk of RA in ShaanXi Han Chinese population.