20 March 2025, Volume 25 Issue 2

  

• Select all
  |

Original Article
• Select
  The association between clinical drug utilization and the risk of nosocomial infections among inpatients: a comprehensive dose-response analysis

  ZHANG Xiaoliang, LI Fangbin, YUAN Xiaolong, FENG Yujuan, WANG Haimo, LIN Xiaoyong, WEI Bingpeng, WANG Lei, ZHANG Haojun

  2025, 25(2): 121-126. https://doi.org/10.16718/j.1009-7708.2025.02.001

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the relationship between clinical drug utilization and the risk of nosocomial infections among hospitalized patients, and provide evidence for the prevention and control of nosocomial infections. Methods This study adopted a retrospective case-control design. The case group included 209 patients with nosocomial infection reported from January 2023 to December 2023 in a tertiary hospital. The control group included 209 patients without nosocomial infection during the same period. The patients in the control group were selected by stratified sampling based on Charlson Comorbidity Index (CCI). Results Univariate analysis showed that proton pump inhibitors, antacids, immunosuppressants and prior antimicrobial combination therapy increased the risk of nosocomial infection (P < 0.05). Multivariate log-binomial regression analysis showed that proton pump inhibitors, immunosuppressive drugs, and prior antimicrobial combination therapy were correlated with nosocomial infection. The corresponding relative risk (RR) was 1.31 (95% CI: 1.07-1.60), 1.40 (95% CI: 1.02-1.91), and 1.66 (95% CI: 1.01-2.74), respectively. Further analysis indicated that the patients with nosocomial infection had longer time in use of proton pump inhibitors and prior antimicrobial combination therapy than the patients in the control group (Z = –6.331, P < 0.001; Z = –2.667,P = 0.008). The trend Chi-square test showed that there was a dose-response relationship for proton pump inhibitors (χ² = 73.869, P < 0.001), immunosuppressive drugs (χ² = 16.530, P < 0.001), and prior antimicrobial combination therapy (χ² = 35.107, P < 0.001). Conclusions The use of immunosuppressants, proton pump inhibitors and antimicrobial combination therapy increases the risk of nosocomial infections in hospitalized patients. The prolonged use of these drugs will further increase the risk of nosocomial infection.
• Select
  Clinical characteristics of 21 cases of nocardiosis and antimicrobial resistance of Nocardia strains in a hospital in Henan Province

  LIANG Bing, YUAN Wenqing, ZHAO Liang, ZHANG Xinli, HU Chunxia, HU Jinghua, WANG Haichao

  2025, 25(2): 127-131. https://doi.org/10.16718/j.1009-7708.2025.02.002

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective The clinical characteristics of 21 cases of nocardiosis were reviewed and antimicrobial resistance of Nocardia strains was analyzed in order to improve the accuracy of clinical diagnosis and treatment of nocardiosis. Methods Clinical data of patients diagnosed with nocardiosis in Zhoukou Central Hospital from 2019-2023 and the corresponding results of antimicrobial susceptibility testing were retrospectively analyzed to summarize the clinical characteristics and outcomes of patients. Results Overall, the 21 cases of nocardiosis included 9 males and 12 females, aged 2-91 years. Underlying disease was reported in 15 patients. Most common type of nocardiosis was pulmonary nocardiosis in 15 cases, followed by skin and soft tissue infection, pleurisy, lymphadenitis, and disseminated nocardiosis. Laboratory tests showed increased levels of WBC, neutrophils percentage, erythrocyte sedimentation rate, C-reactive protein, and procalcitonin. The 21 strains of Nocardia included 4 strains of Nocardia cyriacigeorgica, 2 strains each of Nocardia brasiliensis, Nocardia abscessus, Nocardia asiatica, Nocardia otitidiscaviarum and Nocardia beijingensis, and 1 strain each of Nocardia puris, Nocardia asteroides, Nocardia farcinica, Nocardia pneumoniae, Nocardia amamiensis, and 2 strains of unclassified Nocardia. All of the Nocardia strains (100%) were susceptible to linezolid, amikacin, and trimethoprim-sulfamethoxazole, followed by various levels of susceptibility to cefotaxime, moxifloxacin, imipenem and ceftriaxone, and lower susceptibility rate to cefepime, minocycline, ciprofloxacin and clarithromycin. Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species. Of the 21 patients, two were referred to other hospitals, another two died, two patients received unknown treatment, and the remaining 15 patients were improved after antibiotic treatment, including sulfonamides combined with other antibiotics in 11 cases, other antibiotics in 4 cases. Conclusions Immunocompromised patients or those with underlying diseases are more susceptible to nocardiosis. The clinical features are complex and diverse. Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species. Accurate identification and antimicrobial susceptibility test are essential for prescribing effective antibiotic treatment.
• Select
  Efficacy of voriconazole in the treatment of pulmonary tuberculosis complicated with chronic pulmonary aspergillosis based on CYP2C19 gene polymorphism detection and the factors affecting the efficacy

  CHEN Yonggang, YU Mingli, LUO Ji, ZHANG Wenlin, HE Jintang, XIAO Qiqi, WANG Junlong, PENG Jiangli

  2025, 25(2): 132-139. https://doi.org/10.16718/j.1009-7708.2025.02.003

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the efficacy of voriconazole in the treatment of pulmonary tuberculosis complicated with chronic pulmonary aspergillosis (CPA) based on CYP2C19 gene polymorphism detection and examine the factors affecting the efficacy for improving targeted therapy in clinical practice. Methods A total of 207 patients with pulmonary tuberculosis complicated with CPA treated in the Third People's Hospital of Kunming from December 2018 to November 2022 were randomly assigned to an observation group (105 cases) or a control group (102 cases). The patients in the control group received standard voriconazole treatment, while the patients in the observation group had their voriconazole regimen tailored based on CYP2C19 genotyping results. Plasma drug concentration levels, efficacy, and safety were compared between the two groups and in terms of CYP2C19 genotypes. Logistic regression analysis was used to identify the factors affecting treatment efficacy. Results The observation group showed significantly higher plasma voriconazole concentrations and overall antifungal efficacy compared to the control group (P < 0.05). In the observation group, CYP2C19 genotyping identified 37 extensive metabolizers (EM), 47 intermediate metabolizers (IM), and 21 poor metabolizers (PM). Plasma concentration of voriconazole did not show significant difference between EM and IM (P > 0.05), but both PM and IM were associated with significantly lower plasma concentration of voriconazole than PM (P < 0.05). The clinical efficacy rate was 100% for PM, 91.5% for IM, and 83.8% for EM (P < 0.05). The incidence of adverse events did not show significant difference among the three genotypes (P > 0.05). Logistic regression analysis revealed that lung cavitation, hypoalbuminemia, and agranulosis were significantly correlated with therapeutic efficacy (P < 0.05). Conclusions CYP2C19 gene polymorphism detection is valuable in clinical practice. It can inform anti-aspergillus therapy with voriconazole to effectively improve symptoms and clinical efficacy in patients with pulmonary tuberculosis complicated with CPA. Meanwhile, clinicians should be aware of the factors such as hypoproteinemia, agranulocytosis, and lung cavitation that may affect the efficacy of voriconazole.
• Select
  Profiling of the risk factors and a prediction model for upper arm port related infections

  ZHANG Mengsu, XU Shengxi, ZHANG Jie, JIN Guangxin, ZHANG Xuebin, PU Jun

  2025, 25(2): 140-148. https://doi.org/10.16718/j.1009-7708.2025.02.004

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the risk factors for upper arm ports (UAP) related infections and develop a nomogram for predicting the UAP related infections. Methods Patients (n = 6 028) with UAP between 2014 and 2023 in Renji Hospital, Shanghai Jiao Tong University School of Medicine were included and assigned to a training set (n = 4 219) or a validation set (n = 1 809). Least Absolute Shrinkage and Selection Operator (LASSO) regression were built and non-zero factors were screened out. Multivariate logistic regression was performed for these non-zero factors to screen significant factors out for constructing a prediction model. The performance of the model was evaluated by the area under curve (AUC) of the receiver operating characteristic (ROC) curves, calibration curves, the decision curve analysis (DCA) curve, and clinical impact curves (CICs) in both training set and validation set. Results The model incorporated gender, venous access, venous status, catheter-related thrombosis (CRT), and diameter of catheter. The model performed well. The AUC of ROC was 0.801 in the training set and 0.746 in the validation set. The calibration curve was close to the ideal curve, indicating good discriminative ability of the model. The DCA curve suggested that the model could help make beneficial clinical decisions when the risk assessment value was 30%-41%. CICs proved that the model had good clinical value. Conclusions A model was successfully constructed to predict UAP-related infections. The brachial/basilic vein and 5F catheter was proposed as the first choice. Thicker catheter diameter, male, CRT, abnormal venous status, and axillary vein approach may increase the risk of UAP related infection.
• Select
  Value of neutrophil to lymphocyte ratio and lymphocyte to monocyte ratio in peripheral blood for diagnosis and prognosis in patients with sepsis

  ZHU Yiling, CUI Juanjuan, LI Yanshuang, ZHAO Weifeng

  2025, 25(2): 149-154. https://doi.org/10.16718/j.1009-7708.2025.02.005

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the value of neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ratio (LMR) in the diagnosis and prognosis of patients with sepsis. Methods From January 2022 to December 2022, patients in the First Affiliated Hospital of Soochow University were recruited in this study, including 47 patients with sepsis (sepsis group), 31 with infection but not diagnosed as sepsis (infection group), and 25 healthy individuals (control group) were simultaneously chosen. Patients with sepsis were assigned to non-shock group (32 cases) or shock group (15 cases), survivors group (38 cases) or deaths group (9 cases). Procalcitonin (PCT), C-reactive protein (CRP) and routine blood tests were analyzed and compared between groups. Spearman's correlation test was used to analyze the correlation among NLR, LMR and PCT, PCR, lymphocyte, monocyte, neutrophil, platelet and SOFA scores, the diagnostic value of NLR and LMR in sepsis was evaluated by plotting the receiver operating characteristic (ROC) curve. Results The NLR was 12.54 (7.53, 23.42) in sepsis group, 3.85 (1.83, 5.64) in infection group, and 1.71 (1.39, 2.20) in normal control group. The corresponding LMR was 1.58 (1.07, 3.03), 2.81 (1.53, 4.76), and 5.16 (4.04, 6.59), respectively. NLR was negatively correlated with LMR (r_s = –0.469, P < 0.05). The NLR on day 7 (NLR7) was 6.56 (3.90, 10.72) in the non-shock group and 15.20 (7.53, 27.31) in shock group. The corresponding ΔNLR7 was –1.64 (–5.75, 0.41) and 1.98 (–0.48, 13.79) in the two groups. The shock group had significantly higher ΔNLR7 than the non-shock group (P < 0.05). NLR7 was 7.10 (4.09, 12.96) in the survivors and 15.20 (10.45, 32.82) in the deaths group. The corresponding ΔNLR7 was –0.65 (–5.58, 1.58) and 5.02 (–1.12, 17.06) in the two groups. The deaths group had significantly higher ΔNLR7 than the survivors group (P < 0.05). The LMR on day 7 (LMR7) was 2.22 (1.64, 3.78) in the non-shock group and 1.29 (0.66, 2.03) in shock group. The corresponding ΔLMR7 was 0.38 (–0.37, 1.17) and –0.19(–0.78, 0.25) in the two groups. The shock group had significantly lower ΔLMR7 than the non-shock group (P < 0.05). LMR7 was 2.12 (1.49, 3.42) in the survivors group and 1.09 (0.53, 1.78) in the deaths group. The deaths group had significantly lower LMR7 than the survivors group (P < 0.05). The AUC of NLR was 0.959 1 (95% CI: 0.910 5-1.000 0) in diagnosis of sepsis. The best cut-off value was 4.16. The AUC of LMR was 0.913 6 (95% CI: 0.846 4-0.980 8) in diagnosis of sepsis. The best cut-off value was 3.21. Conclusions NLR and LMR can be used to evaluate the severity and prognosis of patients with sepsis. These two markers may play a role in the diagnosis of sepsis.
• Select
  Determination of polymyxin E in human plasma by LC-MS/MS and its application in therapeutic drug monitoring

  CHEN Yan, HUANG Xiaolan, LI Yi, LI Xin, GUO Beining, FAN Yaxin, WU Hailan, CHEN Mengting, LI Wanzhen, ZHANG Jing, LIU Xiaofen

  2025, 25(2): 155-161. https://doi.org/10.16718/j.1009-7708.2025.02.006

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To develop and validate an efficient and simple liquid chromatography with tandem mass spectrometry (LC-MS/MS) method for determination of polymyxin E in human plasma, and apply the established method in therapeutic drug monitoring (TDM) of polymyxin E. Methods The LC-MS/MS platform was based on AB SCIEX HPLC-4500MD system. Gradient elution was performed with 0.2% formic acid in water and 0.2% formic acid in acetonitrile. Phenomenex Kinetex XB-C18 column (100 mm × 2.1 mm, 2.6 μm) were used. The analytes were detected by electrospray ionization (ESI) positive multiple reaction monitoring mode. The ion pairs for analytes (polymyxins E1, E2) and internal standard (polymyxins B1) were m/z 390.7→101.3, m/z 386.0→101.2, and m/z 402.3→101.2, respectively. Plasma samples were processed with protein precipitation method. Results Polymyxin E1 and E2 showed good linearity in the range of 0.031 2 - 6.24 mg/L and 0.006 15 - 1.23 mg/L, respectively. The within-run accuracy of polymyxin E1 and E2 in plasma ranged from 89.4% to 99.8% and 91.5% to 108.2%, respectively, while the between-run accuracy ranged from 91.8% to 104.7% and 95.6% to 105.2%, respectively. The within-run precision of polymyxin E1 and E2 in plasma ranged from 4.9% to 8.9% and 2.8% to 8.5%, respectively, while the between-run precision ranged from 4.1% to 7.6% and 4.2% to 9.8%, respectively. The average internal standard normalized matrix effect factors of polymyxins E1 and E2 were 96.9%-111.2% and 106.1%-112.8% in blank plasma samples from 6 different sources, 102.5%-106.8% and 98.8%-105.2% in lipemic plasma, respectively, 107.8%-108.9% and 106.9%-107.4% in hemolyzed plasma, respectively. The precision of matrix effects was less than 15.0%. The average recovery rate was 102.9% - 107.5% for polymyxin E1 and E2, and 107.0% for internal standard polymyxin B1. The precision was less than 3.7%. Conclusions In this study, a simple and efficient LC-MS/MS method was established for determination of polymyxin E1 and E2 in human plasma, which is reliable in the therapeutic drug monitoring and pharmacokinetic study of polymyxin E.
• Select
  Effect of isoniazid and rifapentine anti-tuberculosis on the pharmacokinetics of efavirenz in people living with HIV

  HE Zhangyufan, RUAN Qiaoling, YANG Xinping, PU Linmei, SHAO Lingyun, ZHANG Wenhong, ZHANG Yungui, YANG Qingluan

  2025, 25(2): 162-167. https://doi.org/10.16718/j.1009-7708.2025.02.007

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective This study aimed to evaluate the interaction between antiretroviral drug efavirenz and anti-tuberculosis 1H3P3 (isoniazid plus rifapentine) in people living with HIV. Methods HIV-positive individuals on efavirenz-containing (600 mg) antiretroviral therapy (ART) received 1H3P3 regimen containing rifapentine (450 mg) plus isoniazid (400 mg) 3 times a week for 1 month. Efavirenz concentrations were measured at weeks 0, 2, 4, 8. Rifapentine concentration was determined at weeks 2 and 4. HIV RNA load was determined at weeks 0 and 8. Treatment target was efavirenz concentration > 1 mg/L. The anti-TB prevention was considered acceptable if the target of efavirenz concentration was achieved in more than 80% of participants. The participants were followed up for 18 months to evaluate the efficacy of treatment. Results Thirty-one participants living with HIV were enrolled in the study. Two participants were excluded from PK analysis because his/her baseline efavirenz concentration < 1 mg/L, suggesting poor treatment adherence. Evaluable PK data were available for 29 participants, including 23 (79.3%) males. The median [interquartile range (IQR)] age of the participants was 43.0 (32.5, 53.5) years. The median (IQR) efavirenz plasma concentration was 2.33 (1.96, 2.34) mg/L at week 0, 2.32 (1.90, 3.28) mg/L at week 2, 2.07 (1.83, 3.09) mg/L at week 4, and 2.71 (2.14, 3.33) mg/L at week 8. Efavirenz concentration did not show significant difference between the 4 time points (P > 0.05). Median (IQR) rifapentine concentration was 9.36 (6.23, 16.47) mg/L at week 2, and 9.36 (6.41, 15.56) mg/L at week 4. Rifapentine concentration did not show significant difference between week 2 and week 4 (P > 0.05). Efavirenz concentrations was > 1 mg/L in all participants at weeks 2, 4, and 8. Furthermore, efavirenz concentration was significantly higher in females and patients with body weight < 60 kg compared with males and those with body weight ≥60 kg (P < 0.05). None of the participants had symptoms or signs of active tuberculosis during 18-month follow-up. Conclusions Isoniazid plus rifapentine (1H3P3 regimen) did not have significant effect on the plasma concentrations of efavirenz.
• Select
  Application of MALDI-TOF MS combined with serum separator tube and turbidimetry for direct identification of pathogens in sterile body fluids

  ZHANG Xiao, CAI Hui

  2025, 25(2): 168-173. https://doi.org/10.16718/j.1009-7708.2025.02.008

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the application of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) combined with serum separator tube and turbidimetry in the direct identification of pathogens in sterile body fluids. Methods A total of 284 positive sterile body fluid specimens (blood, hydrothorax, ascites, bile, and cerebrospinal fluid) infected by a single pathogen with a blood culture instrument alarm time less than 48 h were collected from January to December 2023 in the Department of Laboratory Medicine at Suzhou Ninth People's Hospital. All the specimens were tested by turbidimeter for pathogen concentration. And the reliability of the identification results was judged by MALDI-TOF MS scores according to different concentrations of the main pathogens. Results The lowest concentration of microorganism for achieving reliable results was 3.0 mcf for Escherichia coli, 2.0 mcf for Klebsiella pneumoniae, 3.0 mcf for Staphylococcus aureus, 3.5 mcf for Enterococcus faecalis and 4.0 mcf for Candida when identified by MALDI-TOF MS. The results were compared between VITEK 2 identification, routine MALDI-TOF MS identification, and direct MALDI-TOF MS identification. The results of routine MALDI-TOF MS identification and VITEK identification were consistent in 282 cases. The concentration greater than 1.7 was found in 272 cases with direct MALDI-TOF MS, and the sensitivity of MALDI-TOF MS was 95.8% (272/284). The results did not show significant difference between the 3 identification methods (χ² = 2.09, P = 0.55). Conclusions MALDI-TOF MS combined with serum separator tube and turbidimetry is a reliable and innovative technique for identifying pathogens in sterile body fluids. It is rapid and accurate, and may be valuable for early etiological diagnosis in clinical practice.
• Select
  Distribution and antimicrobial resistance profiles of carbapenem-resistant Enterobacterales in Xinjiang Uygur Autonomous Region from 2017 to 2021

  JIANG Yan, CHEN Na, JI Ping, LI Hui

  2025, 25(2): 174-180. https://doi.org/10.16718/j.1009-7708.2025.02.009

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the changing prevalence and antimicrobial resistance profiles of carbapenem-resistant Enterobacterales (CRE) in Xinjiang Uygur Autonomous Region from 2017 to 2021. Methods Relevant CRE data in hospitals across Xinjiang from 2017 to 2021 were summarized according to the unified protocol of the National Antimicrobial Resistance Surveillance Network. The data were statistically analyzed by WHONET 5.6 software. Results A total of 5 071 CRE strains were identified from 165 786 strains of Enterobacterales in Xinjiang in the five-year period. The prevalence of CRE was 2.8% in 2017, 3.2% in 2018, 2.9% in 2019, 3.1% in 2020, and 3.2% in 2021. The highest prevalence (3.3%) was in northern Xinjiang and the lowest prevalence (0) was in eastern Xinjiang. The prevalence of CRE in tertiary hospitals was higher than that in secondary hospitals. The top three species among the 5 071 CRE strains were carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Escherichia coli, and carbapenem-resistant Enterobacter cloacae. The CRE strains were mainly isolated from the patients in ICU (34.6%), respiratory ICU (8.1%), neurosurgery (7.5%), and respiratory medicine (5.2%). The distribution of CRE species varied with patient age and gender. The carbapenem-susceptible Enterobacterales and CRE strains isolated from children were less resistant to the commonly used antibiotics in clinical practice than the corresponding strains isolated from adult patients. Conclusions The prevalent CRE strains from patients in Xinjiang are still serious. It is necessary to strengthen the surveillance of bacterial resistance and carry out multidisciplinary linkage to curb the spread and outbreak of CRE.
• Select
  Antimicrobial resistance patterns of carbapenem-resistant Klebsiella pneumoniae strains isolated from Hebei Children's Hospital from 2018 to 2020

  YU Wenjing, LI Mei, GUO Yinghui, XU Qianru, LI Yuanlong, WANG Qi

  2025, 25(2): 181-186. https://doi.org/10.16718/j.1009-7708.2025.02.010

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the antimicrobial resistance patterns of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains isolated from children for better prevention, treatment, and control of CRKP infections in children. Methods A total of 182 clinical CRKP strains were collected between January 2018 and December 2020 in Hebei Children's Hospital. All CRKP strains were identified by matrix-assisted laser desorption ionization - time of flight (MALDI-TOF) mass spectrometry. The common carbapenemase genes (bla_KPC, bla_NDM, bla_IMP, bla_VIM, bla_OXA-48) of CRKP isolates were studied by PCR. Multilocus sequence typing (MLST) was performed for homology analysis. Results The 182 children infected with CRKP were mainly infants (>28 days to <1 years), accounting for 49.45% (90/182), followed by newborns (≤28 days), accounting for 36.26% (66/182). The main source of the 182 CRKP isolates was sputum (50.55%, 92/182), blood (15.93%, 29/182), and urine (13.19%, 24/182). The strains were mainly isolated from patients in neonatology (30.22%, 55/182), general surgery (21.43%, 39/182), cardiac surgery (13.19%, 24/182), and intensive care unit (11.54%, 21/182). Antimicrobial susceptibility testing showed that all of the 182 CRKP strains were resistant to cefepime, ceftazidime, piperacillin-tazobactam, and cefoperazone-sulbactam (100%). Overall, 97.8%, 71.4%, 81.9%, 75.8%, 69.2%, and 2.7% of the strains were resistant to aztreonam, amikacin, ciprofloxacin, levofloxacin, doxycycline, and tigecycline, respectively. The prevalence of carbapenemase gene bla_KPC-2 was the highest (73.63%, 134/182), followed by bla_NDM-5 (15.38%, 28/182), and bla_NDM-1 (11.54%, 21/182). A total of 15 different sequence types (ST) were identified by MLST, of which ST11 was the most common type (72.53%, 132/182), followed by ST17 (11.54%, 21/182). Conclusions CRKP isolates in Hebei Children's Hospital showed high level resistance to antimicrobial agents. Antimicrobial therapy should be prescribed cautiously according to the results of antimicrobial susceptibility testing to avoid the emergence of resistant strains. KPC-2-producing ST11 type CRKP strains may be prevalent in this hospital. Effective control measures should be taken to avoid further spread of such CRKP strains.
• Select
  Surveillance of bacterial resistance in Traditional Chinese Medicine Hospital of Xinjiang Medical University, 2020-2023

  XIANG Xin, REZEWANGULI Ehmeti, WEI Hua, YANG Li, YIN Jian, MA Junjie, FENG Xue

  2025, 25(2): 187-194. https://doi.org/10.16718/j.1009-7708.2025.02.011

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the distribution and antibiotic resistance of clinical isolates in the Traditional Chinese Medicine Hospital of Xinjiang Medical University. Methods Bacterial strains were collected from January 1, 2020, to December 31, 2023, and tested for antimicrobial susceptibility using automated systems and disk diffusion methods. The results were interpreted according to the breakpoints recommended in the CLSI M100. Results Over the four-year period, 22 121 bacterial strains were analyzed, including Gram-positive bacteria (24.1%, 5 338/22 121) and Gram-negative bacteria (75.9%, 16 783/22 121). The prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) was 26.4% and 68.9%, respectively. MRSA and MRCNS strains showed higher resistance rates to most antimicrobial agents compared to methicillin-susceptible strains (MSSA and MSCNS). No Staphylococcus strains were found resistant to linezolid or vancomycin. E. faecium showed higher resistance rates to most of the antimicrobial agents tested than E. faecalis. A few vancomycin-resistant strains were identified in E. faecium and limited number of linezolid-resistant strains were identified in E. faecalis. All S. pneumoniae isolates were isolated from specimens other than cerebrospinal fluid. The prevalence of penicillin-resistant S. pneumoniae (PRSP) was 9.4%. Overall, 13.2% of Klebsiella isolates were resistant to imipenem and 13.1% to meropenem, while the prevalence of carbapenem-resistant strains was less than 10% in Escherichia coli or other genera of Enterobacterales. As for non-fermenting Gram-negative bacteria, P. aeruginosa was largely susceptible to most antimicrobial agents. Overall, 11.8% and 10.9% of P. aeruginosa strains were resistant rates to imipenem and meropenem, respectively. However, 47.1% of Acinetobacter strains were resistant to imipenem and 47.9% to meropenem, while 14.9% to 53.2% of the strains were resistant to other antimicrobial agents tested. Conclusions The clinical strains isolated in the Traditional Chinese Medicine Hospital of Xinjiang Medical University were predominantly Gram-negative bacteria. The prevalence of carbapenem-resistant strains in Klebsiella spp. was higher than that in other species of Enterobacterales. Acinetobacter spp. showed high resistance rate to carbapenems. The prevalence of methicillin-resistant strains was high in Staphylococcus. Vancomycin-resistant and linezolid-resistant strains were identified in Enterococcus spp. Infection prevention and control and stewardship of antimicrobial agents should be strengthened to contain the emergence and spread of resistant bacteria.
• Select
  Surveillance of bacterial resistance in Liuzhou Workers' Hospital, Guangxi from 2020 to 2022

  LI Mengwei, WEI Liuhua, LUO Guolan, ZHU Hongzhen, LIN Shengzhang, CHEN Likun, JIANG Lijun, WANG Haixia

  2025, 25(2): 195-202. https://doi.org/10.16718/j.1009-7708.2025.02.012

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To understand the changing profiles of antimicrobial susceptibility of the bacterial strains isolated from patients at Liuzhou Workers' Hospital in Guangxi from 2020 to 2022. Methods The bacteria were isolated, identified, and underwent antimicrobial susceptibility testing using VITEK 2 Compact, disk diffusion method, or E-test. The results were interpreted according to the breakpoints recommended by CLSI M100 32^nd Edition in 2022. The data were analyzed using WHONET 5.6 software. Results A total of 26 254 nonduplicate strains were collected from 2020 to 2022, including Gram-positive bacteria (27.9%) and gram-negative bacteria (72.1%). The prevalence of methicillin-resistant strains was 20.0% in S. aureus (MRSA), and 72.2% in coagulase-negative Staphylococcus (MRCNS). Methicillin-resistant staphylococcal strains were more resistant to most antimicrobial agents than methicillin-susceptible strains (MSSA and MSCNS). None of the staphylococcal strains was resistant to vancomycin, linezolid or tigecycline. Enterococcus faecium strains showed higher resistance rates to most antimicrobial agents than Enterococcus faecalis. None of enterococcal strains was resistant to vancomycin. A few enterococcal strains were resistant to linezolid. Overall, 691 strains of the non-meningitis Streptococcus pneumoniae were isolated from children and 123 strains were isolated from adults. The prevalence of penicillin-resistant S. pneumoniae (PRSP) was 0.4% in the strains from children and 1.6% in the strains from adults. None of S. pneumoniae strains was intermediate to penicillin. The prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKpn) was 1.2%, 1.2%, and 13.8% in 2020, 2021, and 2022, respectively. The prevalence of carbapenem-resistant P. aeruginosa (CRPae) and carbapenem-resistant Acinetobacter baumannii (CRAba) was 10.7% and 68.4% in 2020, 17.5% and 75.2% in 2021, 14.3% and 77.3% in 2022, respectively. About 84.6% of the 1 269 strains of Haemophilus influenzae were isolated from children and 15.4% isolated from adults. The prevalence of beta-lactamase-producing strains was 39.4% in the isolates from children and 46.8% in the isolates from adults. The β-lactamase-producing H. influenzae was resistant to ampicillin. Furthermore, some β-lactamase-nonproducing ampicillin-resistant (BLNAR) H. influenzae strains (27.0%) were also identified. Conclusions Antimicrobial resistance is still serious in this hospital, especially high prevalence of carbapenem-resistant organisms (CRO). Hospital infection prevention and control measures, antibiotic stewardship, and proactive CRO screening should be strengthened. More clinical specimens should be collected for suspected infections. Antimicrobial treatment should be prescribed empirically in time and adjusted when the results of antimicrobial susceptibility testing are available.
Case Report
• Select
  Corneal ulcer caused by Sarocladium kiliense: one case report

  XIE Qian, LI Zhangyong, JIANG Fulin, TANG Shi, LI Zhiyuan

  2025, 25(2): 203-207. https://doi.org/10.16718/j.1009-7708.2025.02.013

  Abstract ( ) Download PDF ( )   Knowledge map   Save
• Select
  Extensive necrotizing fasciitis caused by appendiceal perforation and peripheral abscess: a case report

  WANG Wenjuan, ZHANG Liqin, YUAN Yuan, MIAO Kaihui, ZHAO Jing, ZHANG Xue, ZHOU Huiru

  2025, 25(2): 208-211. https://doi.org/10.16718/j.1009-7708.2025.02.014

  Abstract ( ) Download PDF ( )   Knowledge map   Save
• Select
  Multiple organ dysfunction caused by Rickettsia japonica infection: a case report

  ZHANG Qingyong, GONG Ping

  2025, 25(2): 212-214. https://doi.org/10.16718/j.1009-7708.2025.02.015

  Abstract ( ) Download PDF ( )   Knowledge map   Save
• Select
  Cerebral toxoplasmosis associated with anti-interleukin-23 antibody: a case report

  HUO Xinmei, CAO Zhujun, AN Baoyan, XIE Qing, XIN Haiguang

  2025, 25(2): 215-217. https://doi.org/10.16718/j.1009-7708.2025.02.016

  Abstract ( ) Download PDF ( )   Knowledge map   Save
Review
• Select
  Research progress on predictors for efficacy of pegylated interferon in the treatment of chronic hepatitis B

  TANG Yao, QIN Bo

  2025, 25(2): 218-223. https://doi.org/10.16718/j.1009-7708.2025.02.017

  Abstract ( ) Download PDF ( )   Knowledge map   Save
• Select
  Research progress in the diagnosis and treatment of infective endocarditis

  CHEN Yue, PANG Chongjie

  2025, 25(2): 224-228. https://doi.org/10.16718/j.1009-7708.2025.02.018

  Abstract ( ) Download PDF ( )   Knowledge map   Save
• Select
  Research updates on the role of hepcidin in chronic viral hepatitis

  YANG Na, LUO Haiying, QIN Bo

  2025, 25(2): 229-232. https://doi.org/10.16718/j.1009-7708.2025.02.019

  Abstract ( ) Download PDF ( )   Knowledge map   Save
• Select
  Application of lefamulin, a novel oral and intravenous pleuromutilin, for the treatment of community-acquired pneumonia

  SU Jiachun, HUANG Haihui

  2025, 25(2): 233-240. https://doi.org/10.16718/j.1009-7708.2025.02.020

  Abstract ( ) Download PDF ( )   Knowledge map   Save