1.A single-center study on the distribution and antibiotic resistance of pathogens causing bloodstream infection in patients with hematological malignancies.
Lin Jing CAI ; Xiao Lei WEI ; Yong Qiang WEI ; Xu Tao GUO ; Xue Jie JIANG ; Yu ZHANG ; Guo pan YU ; Min DAI ; Jie Yu YE ; Hong Sheng ZHOU ; Dan XU ; Fen HUANG ; Zhi Ping FAN ; Na XU ; Peng Cheng SHI ; Li XUAN ; Ru FENG ; Xiao Li LIU ; Jing SUN ; Qi Fa LIU
Chinese Journal of Hematology 2023;44(6):479-483
Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.
Humans
;
Bacteremia/epidemiology*
;
Cefoperazone
;
Sulbactam
;
Retrospective Studies
;
Drug Resistance, Bacterial
;
Microbial Sensitivity Tests
;
Hematologic Neoplasms
;
Sepsis
;
Anti-Bacterial Agents/pharmacology*
;
Gram-Negative Bacteria
;
Gram-Positive Bacteria
;
Piperacillin, Tazobactam Drug Combination
;
Escherichia coli
2.Discussion on Supervision and Sampling of Biochemical Test Kits.
Chinese Journal of Medical Instrumentation 2022;46(2):216-218
As an important part of medical devices, in vitro diagnostic reagents are important means to prevent and diagnose and protect people's health. Supervision and sampling is an important and key supervision method to ensure the in vitro diagnostic reagent products are qualified. This paper summarizes the problems encountered in recent years in vitro diagnostic quantitative testing kit supervision sampling, analyzes the causes of these problems, and puts forward corresponding suggestions, hoping to provide constructive suggestions for supervision sampling.
Hematologic Tests
;
Humans
;
Reagent Kits, Diagnostic
;
Reference Standards
3.Diagnostic Value of HBA
Rong PENG ; Hua-Yan GU ; Mao QIN ; Hai-Yan ZHANG
Journal of Experimental Hematology 2021;29(1):217-220
OBJECTIVE:
To explore the diagnostic value of HBA
METHODS:
1 178 couples in the department of women's health of Chongqing maternal and child health hospital were selected for pregnancy examination. Peripheral venous blood was extracted and analyzed for parallel blood routine test, hemoglobin capillary electrophoresis and thalassemia gene detection.
RESULTS:
A total of 265 cases of thalassemia gene carriers were screened out in 1 178 couples; 91.3% β
CONCLUSION
HBA
Child
;
Female
;
Hematologic Tests
;
Hemoglobin A2/analysis*
;
Humans
;
Mass Screening
;
Pregnancy
;
alpha-Thalassemia/genetics*
;
beta-Thalassemia/diagnosis*
4.Single Center Analysis of Bloodstream Infection Clinical Characteristics and Prognosis in Patients with Hematological Malignancies in the Tropics.
Long-Can CHENG ; Ting YANG ; Hui-Hui KUANG ; Shuai YU ; Li-Xun GUAN ; Zhen-Yang GU ; Yuan-Yuan XU ; Wen-Shuai ZHENG ; Lu WANG ; Ya-Lei HU ; Xiao-Ning GAO ; Quan-Shun WANG
Journal of Experimental Hematology 2021;29(1):265-271
OBJECTIVE:
To analyze the characteristics, prognosis and risk factors of bloodstream infection in patients with hematological malignancies in the tropics, so as to provide evidence for the prevention and treatment of bloodstream infection.
METHODS:
The clinical features, blood culture results and prognosis of patients with bloodstream infection in patients with hematological malignancies admitted to Hainan Hospital of PLA General Hospital were retrospectively studied.
RESULTS:
The most common primary infection site of the 81 patients with hematological malignancies was lung (46.91%), followed by PICC (11.11%). The detection rate of Gram-positive bacteria and Gram-negative bacteria in the blood culture was 60.98% and 30.02%, respectively. Coagulase-negative staphylococci was the most common Gram-positive bacteria resulting in bloodstream infection in our study. Of the Gram-negatives, Klebsiella pneumoniae (34.38%) was predominant, followed by Escherichia coli (18.75%) and Pseudomonas aeruginosa (18.75%). Gram-positive bacteria was highly sensitive (100%) to vancomycin, linezolid and tigecycline. Study showed that Gram-negative bacteria had low sensitive to quinolones, in particular, the resistance rate of Escherichia coli to quinolones was as high as 83.33%. In terms of overall survival (OS), the 30-days OS of patients with Gram-negative and Gram-positive septicemia was 77.42% and 92.00%, respectively. There was no statistically significant difference between the two groups. Multivariate analysis revealed that septic shock (P=0.001, RR=269.27) was an independent risk factor for 30-day mortality, and remission status (P=0.027, RR=0.114) was an independent predictor of a favourable outcome of bloodstream infection in patients with hematological malignancies.
CONCLUSION
Gram-positive bacteria are the main pathogens causing bloodstream infections in patients with hematological malignancies in the tropics. Improving the care of PICC is an important measure to reduce the incidence of bloodstream infection in patients with hematological malignancies in the tropics. A correct treatment relieving disease and effective prevention and treatment of septic shock can reduce mortality of patients with bloodstream infection in patients with hematological malignancies in the tropics.
Anti-Bacterial Agents/therapeutic use*
;
Bacteremia/drug therapy*
;
Drug Resistance, Bacterial
;
Gram-Negative Bacteria
;
Hematologic Neoplasms/drug therapy*
;
Humans
;
Microbial Sensitivity Tests
;
Prognosis
;
Retrospective Studies
;
Sepsis
5.Pathogens in Bloodstream Infection in Patients with Hematological Diseases: Retrospective Analysis.
Mao-Quan WANG ; Ming-Yu JIA ; Yu JING ; Li YU
Journal of Experimental Hematology 2021;29(1):272-277
OBJECTIVE:
To analyze the distribution and drug resistance of pathogens sampled from the patients with bloodstream infection in the department of hematology of PLA General Hospital, so as to provide evidences for clinical prevention and control infection.
METHODS:
From January 2014 to December 2017, A total of 286 cases-time positive blood culture samples from 212 patients in the department of hematology of the General Hospital of Chinese PLA were collected. The clinical characteristics of patients and the distribution and drug resistance of pathogens were analyzed retrospectively.
RESULTS:
182(63.64%) bacterial strains were Gram-negative, and the other 104(36.36%) were Gram-positive. There were 88 strains of Escherichia coli(30.77%), 34 strains of Pseudomonas aeruginosa(11.89%), 26 strains of Klebsiella pneumoniae(9.09%), 25 strains of Staphylococcus epidermidis(8.74%), 20 strains of Gram-positive rods(6.99%), 16 strains of Staphylococcus hominis(5.59%), 11 strains of Etaphylococcus haemolyticus(3.85%), 10 strains of Staphylococcus aureus(3.50%), 6 strains of Staphylococcus capitis(2.10%), 5 strains of Acinetobacter baumannii(1.75%) and so on. Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae as Gram-negative bacteria were sensitive to amikacin. Staphylococcus epidermidis and Staphylococcus aureus as Gram-positive bacteria were sensitive to vancomycin and nitrofurantoin.
CONCLUSION
The blood culture patients with bloodstream infection in department of hematology of our hospital confirmed that more infections are Gram-negative. The clinicians should choose suitable antibiotics according to the results of bacterial culture and drug sensitive test.
Drug Resistance, Bacterial
;
Hematologic Diseases
;
Humans
;
Methicillin-Resistant Staphylococcus aureus
;
Microbial Sensitivity Tests
;
Retrospective Studies
;
Sepsis
6.The Blood Group Serology Combined Irregular Antibody Prenatal Screening Strategies for RhD
Hong FU ; Qing-Hua JIANG ; Shu-Ting LING
Journal of Experimental Hematology 2021;29(6):1940-1944
OBJECTIVE:
To investigate the distribution of Rh phenotype, irregular antibodies screenting and postpartum follow-up of RhD
METHODS:
The samples of 313 RhD
RESULTS:
The Rh serological phenotypes of 313 RhD
CONCLUSION
The Rh serological phenotype of RhD
Blood Group Antigens
;
Female
;
Hematologic Tests
;
Humans
;
Infant, Newborn
;
Pregnancy
;
Pregnant Women
;
Prenatal Diagnosis
;
Rh-Hr Blood-Group System
7.Evaluation of Drug-Induced Liver Injury Developed During Hospitalization Using Electronic Health Record (EHR)-Based Algorithm
Yewon KANG ; Sae Hoon KIM ; So Young PARK ; Bo Young PARK ; Ji Hyang LEE ; Jin AN ; Ha Kyeong WON ; Woo Jung SONG ; Hyouk Soo KWON ; You Sook CHO ; Hee Bom MOON ; Ju Hyun SHIM ; Min Suk YANG ; Tae Bum KIM
Allergy, Asthma & Immunology Research 2020;12(3):430-442
PURPOSE: The incidence of drug-induced liver injury (DILI) has been increasing; however, few algorithms are available to identify DILI in electronic health records (EHRs). We aimed to identify and evaluate DILI with an appropriate screening algorithm.METHODS: We collected data from 3 university hospitals between June 2015 and May 2016 using our newly developed algorithm for identifying DILI. Among patients with alanine transferase (ALT) ≤ 120 IU/L and total bilirubin (TB) ≤ 2.4 mg/dL in blood test results within 48 hours of admission, those who either had 1) ALT > 120 IU/L and TB > 2.4 mg/dL or 2) ALT > 200 IU/L at least once during hospitalization were identified. After excluding patients with liver disease-related diagnosis at discharge, medical records were retrospectively reviewed to evaluate epidemiological characteristics of DILI.RESULTS: The total number of inpatients was 256,598, of whom 1,100 (0.43%) were selected by the algorithm as suspected DILI. Subsequently, 365 cases (0.14% of total inpatients, 95% confidence interval, 0.13–0.16) were identified as DILI, yielding a positive predictive value of 33.1%. Antibiotics (n = 214, 47.2%) were the major class of causative drug followed by chemotherapeutic agents (n = 87, 19.2%). The most common causative drug was piperacillin-tazobactam (n = 38, 8.4%); the incidence of DILI by individual agent was highest for methotrexate (19.4 cases/1,000 patients administered the drug). Common reasons for excluding suspected DILI cases were ischemic hepatitis and postoperative liver dysfunction.CONCLUSIONS: Using our EHR-based algorithm, we identified that approximately 0.14% of patients developed DILI during hospitalization. Further studies are needed to modify criteria for more accurate identification of DILI.
Alanine
;
Anti-Bacterial Agents
;
Bilirubin
;
Diagnosis
;
Drug-Induced Liver Injury
;
Drug-Related Side Effects and Adverse Reactions
;
Electronic Health Records
;
Hematologic Tests
;
Hepatitis
;
Hospitalization
;
Hospitals, University
;
Humans
;
Incidence
;
Inpatients
;
Liver
;
Liver Diseases
;
Mass Screening
;
Medical Records
;
Methotrexate
;
Pharmacoepidemiology
;
Retrospective Studies
;
Transferases
8.An optimized BRCA1/2 next-generation sequencing for different clinical sample types
Yoonjung KIM ; Chi Heum CHO ; Jung Sook HA ; Do Hoon KIM ; Sun Young KWON ; Seoung Chul OH ; Kyung A LEE
Journal of Gynecologic Oncology 2020;31(1):9-
tests in a total of buffy coat, FF and FFPE was 0%, 8%, and 34%, respectively. The accuracy of BRCA1/2 NGS testing was 100.0%, 99.9% and 99.9% in buffy coat, FFPE and FF, respectively. However, due to the presence of variant allele frequency (VAF) shifted heterozygous variants, tumor materials (FFPE and FF) showed lower sensitivity (95.5%–99.0%) than buffy coat (100%). Furthermore, FFPE showed 51.4% of the positive predictive value (PPV) on account of sequence artifacts. When performed in the post-filtration process, PPV was increased by approximately 20% in FFPE. Buffy coat showed 100% of sensitivity, specificity and accuracy in BRCA1/2 NGS test.CONCLUSIONS: On the comparison of the analytical performance according to different sample types, the buffy coat was not affected by sequencing artifacts and VAF shifted variants. Therefore, the blood test should be given priority in detecting germline BRCA1/2 mutation, and tumor materials could be suitable to detect somatic mutations in OC patients without identifying germline BRCA1/2 mutation.]]>
Artifacts
;
Blood Buffy Coat
;
Gene Frequency
;
Hematologic Tests
;
High-Throughput Nucleotide Sequencing
;
Humans
;
Mass Screening
;
Ovarian Neoplasms
;
Sensitivity and Specificity
;
Tissue Preservation
10.Clinical characteristics of allergic rhinitis and nonallergic rhinitis in Korean children
Na Hae WON ; Sang Hyun PARK ; So Hyun AHN ; Chae Bong KIM ; Jung Hyun KWON ; Won Hee SEO ; Dae Jin SONG ; Young YOO
Allergy, Asthma & Respiratory Disease 2020;8(1):20-29
PURPOSE: Recently, the prevalence of allergic rhinitis (AR) in Korean children has been increased. The aim of this study was to investigate the clinical characteristics of rhinitis and to compare clinical parameters between AR and nonallergic rhinitis (NAR) in children.METHODS: We retrospectively reviewed the medical records of 1,034 children under 18 years of age who visited Korea University Anam Hospital for rhinitis symptoms from January 2008 to December 2017. Clinical data, including clinical features, comorbidities, blood test results, allergen sensitization profile, and pulmonary function test parameters, were collected.RESULTS: Among the 1,034 children with rhinitis, 737 (71.3%) were AR and 297 (28.7%) were NAR. The prevalence of AR gradually increased with age. The median levels of eosinophil count (4.1%), serum total IgE (204.4 IU/L), eosinophil cationic protein (ECP) concentration (17.9 µg/L), and fractional exhaled nitric oxide (FeNO) (22.0 ppb) were significantly higher in children with AR than in those with NAR. The sensitization rate to the inhalant allergens increased with age; however, food allergen sensitization rate tended to decrease. Median levels of eosinophil count, total IgE, ECP, and FeNO were significantly higher in the poly-sensitized group than in the mono-sensitized and nonsensitized groups.CONCLUSION: More than 70% of Korean children who have rhinitis symptoms are AR. Children with AR more likely to have higher levels of FeNO and bronchial asthma. Poly-sensitized children showed increased rates of atopic dermatitis and bronchial asthma.
Allergens
;
Asthma
;
Child
;
Comorbidity
;
Dermatitis, Atopic
;
Eosinophil Cationic Protein
;
Eosinophils
;
Hematologic Tests
;
Humans
;
Immunoglobulin E
;
Korea
;
Medical Records
;
Nitric Oxide
;
Prevalence
;
Respiratory Function Tests
;
Retrospective Studies
;
Rhinitis
;
Rhinitis, Allergic

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