1.Research progress on rat model of chronic thromboembolic pulmonary hypertension
Xuekai LIU ; Xiang ZHONG ; Juanjuan ZHANG ; Xiaolong SUN ; Pan WU ; Zhenchuan PANG ; Ping XIE
Acta Laboratorium Animalis Scientia Sinica 2025;33(10):1531-1538
Chronic thromboembolic pulmonary hypertension(CTEPH)is a severe form of pulmonary hypertension(PH),and is classified as the fourth major category of pulmonary arterial hypertension.CTEPH is primarily caused by chronic thrombosis,leading to the obstruction of blood flow in the pulmonary arteries and result ing in a sustained increase in pulmonary artery pressure.The unclear pathogenesis of CTEPH,however,means that its early diagnosis is challenging,treatment options are limited,and prognosis assessment is often inaccurate.In-depth research into these mechanisms will thus improve our understanding of the pathophysiological processes of CTEPH,and also provide a theoretical basis for developing new therapeutic strategies.This review focuses on the current method of establishing CTEPH rat models and their advantages and disadvantages,offering researchers a reference for selecting and constructing CTEPH rat models.
2.Mechanism of action of Qingjie Huagong decoction reducing inflammatory response of acute pancreatitis based on PI3K/AKT/NF-κB signaling pathway
Xiao-dong ZHU ; Min-chao FENG ; Kun-rong LIU ; Ying BAN ; Pan SU ; Chuan-feng XUAN ; Xiao-yi HUANG ; De-wen LI ; Xi-ping TANG ; Guo-zhong CHEN
Chinese Pharmacological Bulletin 2025;41(5):978-984
Aim To explore the therapeutic effect and mechanism of Qingjie Huagong decoction in modulating PI3K/AKT/NF-κB signaling pathway in inflammatory response of acute pancreatitis(AP)mice.Methods Twenty-four mice were randomly divided into Blank group,Model group,Ustekin group,and Qingjie Hua-gong decoction group,with six mice in each group.The AP model was prepared by using rain frogin.Serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α lev-els were detected by ELISA;the pancreatic pathology was detected by HE staining;the expressions of PI3K,AKT,and NF-κB-related proteins and mRNAs were de-tected by immunohistochemistry,Western blot,and RT-qPCR.Results Compared with the blank group,the model group showed obvious pathological damage to the pancreas,with significantly higher serum α-AMS,PN-LP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels(P<0.01),and significantly higher levels of PI3K,AKT,and NF-κB-related proteins and mRNA expression(P<0.01).Compared with the model group,both the Qingjie Huagong decoction group and the ustekin group improved the histopathological changes in the pancreas of AP mice,decreased the serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels,and down-reg-ulated the expression levels of pancreatic PI3K,AKT,NF-κB-related proteins and mRNA(P<0.05 or P<0.01).Conclusion Qingjie Huagong decoction may inhibit the inflammatory response and protect pancreat-ic tissues by regulating the expression of PI3K/AKT/NF-κB signaling pathway.
3.Research progress on rat model of chronic thromboembolic pulmonary hypertension
Xuekai LIU ; Xiang ZHONG ; Juanjuan ZHANG ; Xiaolong SUN ; Pan WU ; Zhenchuan PANG ; Ping XIE
Acta Laboratorium Animalis Scientia Sinica 2025;33(10):1531-1538
Chronic thromboembolic pulmonary hypertension(CTEPH)is a severe form of pulmonary hypertension(PH),and is classified as the fourth major category of pulmonary arterial hypertension.CTEPH is primarily caused by chronic thrombosis,leading to the obstruction of blood flow in the pulmonary arteries and result ing in a sustained increase in pulmonary artery pressure.The unclear pathogenesis of CTEPH,however,means that its early diagnosis is challenging,treatment options are limited,and prognosis assessment is often inaccurate.In-depth research into these mechanisms will thus improve our understanding of the pathophysiological processes of CTEPH,and also provide a theoretical basis for developing new therapeutic strategies.This review focuses on the current method of establishing CTEPH rat models and their advantages and disadvantages,offering researchers a reference for selecting and constructing CTEPH rat models.
4.(Meta)transcriptomic Insights into the Role of Ticks in Poxvirus Evolution and Transmission: A Multicontinental Analysis.
Yu Xi WANG ; Jing Jing HU ; Jing Jing HOU ; Xiao Jie YUAN ; Wei Jie CHEN ; Yan Jiao LI ; Qi le GAO ; Yue PAN ; Shui Ping LU ; Qi CHEN ; Si Ru HU ; Zhong Jun SHAO ; Cheng Long XIONG
Biomedical and Environmental Sciences 2025;38(9):1058-1070
OBJECTIVE:
Poxviruses are zoonotic pathogens that infect humans, mammals, vertebrates, and arthropods. However, the specific role of ticks in transmission and evolution of these viruses remains unclear.
METHODS:
Transcriptomic and metatranscriptomic raw data from 329 sampling pools of seven tick species across five continents were mined to assess the diversity and abundance of poxviruses. Chordopoxviral sequences were assembled and subjected to phylogenetic analysis to trace the origins of the unblasted fragments within these sequences.
RESULTS:
Fifty-eight poxvirus species, representing two subfamilies and 20 genera, were identified, with 212 poxviral sequences assembled. A substantial proportion of AT-rich fragments were detected in the assembled poxviral genomes. These genomic sequences contained fragments originating from rodents, archaea, and arthropods.
CONCLUSION
Our findings indicate that ticks play a significant role in the transmission and evolution of poxviruses. These viruses demonstrate the capacity to modulate virulence and adaptability through horizontal gene transfer, gene recombination, and gene mutations, thereby promoting co-existence and co-evolution with their hosts. This study advances understanding of the ecological dynamics of poxvirus transmission and evolution and highlights the potential role of ticks as vectors and vessels in these processes.
Animals
;
Poxviridae/physiology*
;
Ticks/virology*
;
Phylogeny
;
Transcriptome
;
Evolution, Molecular
;
Poxviridae Infections/virology*
;
Genome, Viral
5.Mechanism of action of Qingjie Huagong decoction reducing inflammatory response of acute pancreatitis based on PI3K/AKT/NF-κB signaling pathway
Xiao-dong ZHU ; Min-chao FENG ; Kun-rong LIU ; Ying BAN ; Pan SU ; Chuan-feng XUAN ; Xiao-yi HUANG ; De-wen LI ; Xi-ping TANG ; Guo-zhong CHEN
Chinese Pharmacological Bulletin 2025;41(5):978-984
Aim To explore the therapeutic effect and mechanism of Qingjie Huagong decoction in modulating PI3K/AKT/NF-κB signaling pathway in inflammatory response of acute pancreatitis(AP)mice.Methods Twenty-four mice were randomly divided into Blank group,Model group,Ustekin group,and Qingjie Hua-gong decoction group,with six mice in each group.The AP model was prepared by using rain frogin.Serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α lev-els were detected by ELISA;the pancreatic pathology was detected by HE staining;the expressions of PI3K,AKT,and NF-κB-related proteins and mRNAs were de-tected by immunohistochemistry,Western blot,and RT-qPCR.Results Compared with the blank group,the model group showed obvious pathological damage to the pancreas,with significantly higher serum α-AMS,PN-LP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels(P<0.01),and significantly higher levels of PI3K,AKT,and NF-κB-related proteins and mRNA expression(P<0.01).Compared with the model group,both the Qingjie Huagong decoction group and the ustekin group improved the histopathological changes in the pancreas of AP mice,decreased the serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels,and down-reg-ulated the expression levels of pancreatic PI3K,AKT,NF-κB-related proteins and mRNA(P<0.05 or P<0.01).Conclusion Qingjie Huagong decoction may inhibit the inflammatory response and protect pancreat-ic tissues by regulating the expression of PI3K/AKT/NF-κB signaling pathway.
6.Distribution and antimicrobial resistance profiles of clinical isolates from blood samples:results from China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021
Min ZHONG ; Xiangning HUANG ; Hua YU ; Yang YANG ; Fupin HU ; Demei ZHU ; Yi XIE ; Mei KANG ; Shanmei WANG ; Yafei CHU ; Wenen LIU ; Yanming LI ; Dawen GUO ; Jinying ZHAO ; Yuanhong XU ; Ying HUANG ; Yunzhuo CHU ; Sufei TIAN ; Ziyong SUN ; Zhongju CHEN ; Yunsong YU ; Jie LIN ; Jihong LI ; Yingchun XU ; Xiaojiang ZHANG ; Hui LI ; Ping JI ; Fang DONG ; Zhiyong LÜ ; Han SHEN ; Wanqing ZHOU ; Sufang GUO ; Zhidong HU ; Jin LI ; Chuanqing WANG ; Pan FU ; Hong ZHANG ; Chun WANG ; Chao ZHUO ; Danhong SU ; Bin SHAN ; Yan DU ; Lixia ZHANG ; Juan MA ; Yuxing NI ; Jingyong SUN ; Jinju DUAN ; Jianbang KANG ; Yan JIN ; Chunhong SHAO ; Wei JIA ; Gang LI ; Xuesong XU ; Chao YAN ; Yunjian HU ; Xiaoman AI ; Jinsong WU ; Yuemei LU ; Fangfang HU ; Lianhua WEI ; Fengmei ZOU ; Lei ZHU ; Jinhua MENG ; Shuping ZHOU ; Yan ZHOU ; Shifu WANG ; Xiaobo MA ; Yanping ZHENG ; Kaizhen WEN ; Yirong ZHANG ; Yunsheng CHEN ; Qing MENG ; Xuefei HU ; Ruizhong WANG ; Hua FANG ; Ruyi GUO ; Yan ZHU ; Jilu SHEN ; Wenhui HUANG ; Bixia YU ; Jiao FENG ; Yong ZHAO ; Ping GONG ; Shunhong XUE ; Hongqin GU ; Wen HE ; Jiangshan LIU ; Chunlei YUE ; Longfeng LIAO ; Lin JIANG
Chinese Journal of Infection and Chemotherapy 2024;24(6):664-677
Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8% of which were gram-positive bacteria and 51.2% were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2%),Escherichia coli (20.7%),Klebsiella (13.7%),Enterococcus (7.2%),and Staphylococcus aureus (6.6%).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0%,≥36.8% and ≥56.8% of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5% of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4% and 19.9% in 2015 to 25.7% and 26.6% in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9% and 73.2% respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7% and 22.9% in 2015 to 18.5% and 14.7% in 2021,respectively.The prevalence of PRSP was 1.5% in the isolaets from adults and and 0.8% in the isolates from children.Less than 3.0% of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1% and 81.0%,respectively.The prevalence of MRSA was relatively stable,28.5% in 2015 and 28.0% in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.
7.Correlation Analysis between Neutrophil-to-lymphocyte Ratio and the Risk of Malnutrition in Stage Ⅳ Primary Lung Cancer
XIAO PING ; PAN HAI ; MA QING ; SONG LIPING ; ZHONG DIANSHENG
Chinese Journal of Lung Cancer 2024;27(3):193-198
Background and objective Malnutrition is commonly associated with poor prognosis in patients with malignant tumors.The neutrophil-to-lymphocyte ratio(NLR)is an indicator of inflammation in the body and predicts the risk of malnutrition in a variety of diseases;however,its association with malnutrition in lung cancer patients is unclear.The aim of this study is to clarify the association between NLR and nutritional status in stage Ⅳ primary lung cancer and to further deter-mine the optimal NLR cut-off that best predicts the risk of malnutrition.Methods A retrospective analysis of 209 patients ad-mitted to the Department of Medical Oncology,Tianjin Medical University General Hospital with a primary diagnosis of stageⅣ lung cancer from May 2019 to February 2021 was performed,and the nutritional risk screening 2002(NRS 2002)was used to examine their nutritional status.Patient demographic information,pathology,Karnofsky performance status(KPS)score,body mass index(BMI),comorbidities and clinical biochemical indicators were also included.The correlation between NLR and NRS 2002 was investigated.Receiver operating characteristic(ROC)curve was used to determine the best NLR cut-off predi cting malnutrition risk.Multivariable Logistic regression was used to assess the association between NLR and malnutrition risk.Results The rate of patients with stage Ⅳ primary lung cancer at nutritional risk was 36.36%(76/209).A significant positive correlation was observed between NLR values and NRS 2002 risk score(r=0.765,P<0.001).The ROC curve analysis indicated that an NLR of 3.94 was the optimal cut-off for predicting malnutrition risk(area under the curve=0.747,95%CI:0.678-0.815,P<0.001),which showed a sensitivity of 55%,a specificity of 86%,a positive predictive value of 68%,and a negative predictive value of 77%.Patients in the NLR>3.94 group had a significantly higher risk of malnutrition compared to those in the NLR≤3.94 group(69.49%vs 23.33%,P<0.00 1).Furthermore,NLR was identified as a risk factor for malnutrition in stage Ⅳ primary lung cancer patients.Conclusion NLR is associated with the risk of malnutrition in stage Ⅳ primary lung cancer,and NLR can be used as one of the indicators for screening nutritional risk in patients with stage Ⅳ primary lung cancer
8.Distribution and antimicrobial resistance profiles of clinical isolates from blood samples:results from China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021
Min ZHONG ; Xiangning HUANG ; Hua YU ; Yang YANG ; Fupin HU ; Demei ZHU ; Yi XIE ; Mei KANG ; Shanmei WANG ; Yafei CHU ; Wenen LIU ; Yanming LI ; Dawen GUO ; Jinying ZHAO ; Yuanhong XU ; Ying HUANG ; Yunzhuo CHU ; Sufei TIAN ; Ziyong SUN ; Zhongju CHEN ; Yunsong YU ; Jie LIN ; Jihong LI ; Yingchun XU ; Xiaojiang ZHANG ; Hui LI ; Ping JI ; Fang DONG ; Zhiyong LÜ ; Han SHEN ; Wanqing ZHOU ; Sufang GUO ; Zhidong HU ; Jin LI ; Chuanqing WANG ; Pan FU ; Hong ZHANG ; Chun WANG ; Chao ZHUO ; Danhong SU ; Bin SHAN ; Yan DU ; Lixia ZHANG ; Juan MA ; Yuxing NI ; Jingyong SUN ; Jinju DUAN ; Jianbang KANG ; Yan JIN ; Chunhong SHAO ; Wei JIA ; Gang LI ; Xuesong XU ; Chao YAN ; Yunjian HU ; Xiaoman AI ; Jinsong WU ; Yuemei LU ; Fangfang HU ; Lianhua WEI ; Fengmei ZOU ; Lei ZHU ; Jinhua MENG ; Shuping ZHOU ; Yan ZHOU ; Shifu WANG ; Xiaobo MA ; Yanping ZHENG ; Kaizhen WEN ; Yirong ZHANG ; Yunsheng CHEN ; Qing MENG ; Xuefei HU ; Ruizhong WANG ; Hua FANG ; Ruyi GUO ; Yan ZHU ; Jilu SHEN ; Wenhui HUANG ; Bixia YU ; Jiao FENG ; Yong ZHAO ; Ping GONG ; Shunhong XUE ; Hongqin GU ; Wen HE ; Jiangshan LIU ; Chunlei YUE ; Longfeng LIAO ; Lin JIANG
Chinese Journal of Infection and Chemotherapy 2024;24(6):664-677
Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8% of which were gram-positive bacteria and 51.2% were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2%),Escherichia coli (20.7%),Klebsiella (13.7%),Enterococcus (7.2%),and Staphylococcus aureus (6.6%).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0%,≥36.8% and ≥56.8% of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5% of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4% and 19.9% in 2015 to 25.7% and 26.6% in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9% and 73.2% respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7% and 22.9% in 2015 to 18.5% and 14.7% in 2021,respectively.The prevalence of PRSP was 1.5% in the isolaets from adults and and 0.8% in the isolates from children.Less than 3.0% of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1% and 81.0%,respectively.The prevalence of MRSA was relatively stable,28.5% in 2015 and 28.0% in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.
9.The Distribution and Significance of Activated T Cells and Lymphocyte Subsets in Myelodysplastic Syndrome.
Zhong-Li HU ; Yan-Li YANG ; Ping-Ping ZHANG ; Shao-Jun PAN
Journal of Experimental Hematology 2023;31(2):469-475
OBJECTIVE:
To investigate the distribution of bone marrow lymphocyte subsets in patients with myelodysplastic syndrome(MDS),the proportion of activated T cells with immunophenotype CD3+HLA-DR+ in the lymphocytes and its clinical significance, and to understand the effects of different types of MDS, different immunophenotypes, and different expression levels of WT1 on the proportion of lymphocyte subsets and activated T cells.
METHODS:
The immunophenotypes of 96 MDS patients, the subsets of bone marrow lymphocytes and activated T cells were detected by flow cytometry. The relative expression of WT1 was detected by real-time fluorescent quantitative PCR, and the first induced remission rate (CR1) was calculated, the differences of lymphocyte subsets and activated T cells in MDS patients with different immunophenotype, different WT1 expression, and different course of disease were analyzed.
RESULTS:
The percentage of CD4+T lymphocyte in MDS-EB-2, IPSS high-risk, CD34+ cells >10%, and patients with CD34+CD7+ cell population and WT1 gene overexpression at intial diagnosis decreased significantly (P<0.05), and the percentage of NK cells and activated T cells increased significantly (P<0.05), but there was no significant difference in the ratio of B lymphocytes. Compared with the normal control group, the percentage of NK cells and activated T cells in IPSS-intermediate-2 group was significantly higher(P<0.05), but there was no significant difference in the percentage of CD3+T, CD4+T lymphocytes. The percentage of CD4+T cells in patients with complete remission after the first chemotherapy was significantly higher than in patients with incomplete remission(P<0.05), and the percentage of NK cells and activated T cells was significantly lower than that in patients with incomplete remission (P<0.05).
CONCLUSION
In MDS patients, the proportion of CD3+T and CD4+T lymphocytes decreased, and the proportion of activated T cells increased, indicating that the differentiation type of MDS is more primitive and the prognosis is worse.
Humans
;
Lymphocyte Subsets
;
Myelodysplastic Syndromes/diagnosis*
;
Bone Marrow
;
B-Lymphocytes
;
Killer Cells, Natural
;
Flow Cytometry
;
T-Lymphocyte Subsets
10.Status of fungal sepsis among preterm infants in 25 neonatal intensive care units of tertiary hospitals in China.
Xin Cheng CAO ; Si Yuan JIANG ; Shu Juan LI ; Jun Yan HAN ; Qi ZHOU ; Meng Meng LI ; Rui Miao BAI ; Shi Wen XIA ; Zu Ming YANG ; Jian Fang GE ; Bao Quan ZHANG ; Chuan Zhong YANG ; Jing YUAN ; Dan Dan PAN ; Jing Yun SHI ; Xue Feng HU ; Zhen Lang LIN ; Yang WANG ; Li Chun ZENG ; Yan Ping ZHU ; Qiu Fang WEI ; Yan GUO ; Ling CHEN ; Cui Qing LIU ; Shan Yu JIANG ; Xiao Ying LI ; Hui Qing SUN ; Yu Jie QI ; Ming Yan HEI ; Yun CAO
Chinese Journal of Pediatrics 2023;61(1):29-35
Objective: To analyze the prevalence and the risk factors of fungal sepsis in 25 neonatal intensive care units (NICU) among preterm infants in China, and to provide a basis for preventive strategies of fungal sepsis. Methods: This was a second-analysis of the data from the "reduction of infection in neonatal intensive care units using the evidence-based practice for improving quality" study. The current status of fungal sepsis of the 24 731 preterm infants with the gestational age of <34+0 weeks, who were admitted to 25 participating NICU within 7 days of birth between May 2015 and April 2018 were retrospectively analyzed. These preterm infants were divided into the fungal sepsis group and the without fungal sepsis group according to whether they developed fungal sepsis to analyze the incidences and the microbiology of fungal sepsis. Chi-square test was used to compare the incidences of fungal sepsis in preterm infants with different gestational ages and birth weights and in different NICU. Multivariate Logistic regression analysis was used to study the outcomes of preterm infants with fungal sepsis, which were further compared with those of preterm infants without fungal sepsis. The 144 preterm infants in the fungal sepsis group were matched with 288 preterm infants in the non-fungal sepsis group by propensity score-matched method. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of fungal sepsis. Results: In all, 166 (0.7%) of the 24 731 preterm infants developed fungal sepsis, with the gestational age of (29.7±2.0) weeks and the birth weight of (1 300±293) g. The incidence of fungal sepsis increased with decreasing gestational age and birth weight (both P<0.001). The preterm infants with gestational age of <32 weeks accounted for 87.3% (145/166). The incidence of fungal sepsis was 1.0% (117/11 438) in very preterm infants and 2.0% (28/1 401) in extremely preterm infants, and was 1.3% (103/8 060) in very low birth weight infants and 1.7% (21/1 211) in extremely low birth weight infants, respectively. There was no fungal sepsis in 3 NICU, and the incidences in the other 22 NICU ranged from 0.7% (10/1 397) to 2.9% (21/724), with significant statistical difference (P<0.001). The pathogens were mainly Candida (150/166, 90.4%), including 59 cases of Candida albicans and 91 cases of non-Candida albicans, of which Candida parapsilosis was the most common (41 cases). Fungal sepsis was independently associated with increased risk of moderate to severe bronchopulmonary dysplasia (BPD) (adjusted OR 1.52, 95%CI 1.04-2.22, P=0.030) and severe retinopathy of prematurity (ROP) (adjusted OR 2.55, 95%CI 1.12-5.80, P=0.025). Previous broad spectrum antibiotics exposure (adjusted OR=2.50, 95%CI 1.50-4.17, P<0.001), prolonged use of central line (adjusted OR=1.05, 95%CI 1.03-1.08, P<0.001) and previous total parenteral nutrition (TPN) duration (adjusted OR=1.04, 95%CI 1.02-1.06, P<0.001) were all independently associated with increasing risk of fungal sepsis. Conclusions: Candida albicans and Candida parapsilosis are the main pathogens of fungal sepsis among preterm infants in Chinese NICU. Preterm infants with fungal sepsis are at increased risk of moderate to severe BPD and severe ROP. Previous broad spectrum antibiotics exposure, prolonged use of central line and prolonged duration of TPN will increase the risk of fungal sepsis. Ongoing initiatives are needed to reduce fungal sepsis based on these risk factors.
Infant
;
Infant, Newborn
;
Humans
;
Birth Weight
;
Intensive Care Units, Neonatal
;
Retrospective Studies
;
Tertiary Care Centers
;
Infant, Extremely Low Birth Weight
;
Gestational Age
;
Infant, Extremely Premature
;
Sepsis/epidemiology*
;
Retinopathy of Prematurity/epidemiology*
;
Bronchopulmonary Dysplasia/epidemiology*

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