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2023 Vol.18 No.6
Published 2023-12-25


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331
Clinical characteristics and risk factors analysis of nosocomial infection caused by drug-resistant Staphylococcus aureus
Objective To analyze the clinical drug-sensitivity results, types of drug resistance S. aureus (Staphylococcus aureus) isolated from the patients of nosocomial infection and risk factors for nosocomial infection over two years, and to explore its reference value in clinical control of the occurrence of drug-resistant S. aureus, hospital infection and rational application of antimicrobial drugs. Methods The clinical characteristics and drug resistance of drug-resistant S. aureus isolated in 2020-2021 were analyzed, and independent risk factors of nosocomial infection caused by drug-resistant S. aureus were explored using univariate and logistic regression. Results Multi-drug resistant S. aureus accounted for 49.7% (69/139), MRSA (methicillin-resistant Staphylococcus aureus) strains accounted for 41.0% (57/139), β-lactamase-producing strains accounted for 72.7% (101/139), and clindamycin-induced resistant strains accounted for 15.1% (21/139). S. aureus was mainly isolated from respiratory and wound infection sites (36.0% and 48.9%), and it had a high rate of resistance to a variety of antimicrobial drugs, with 100% sensitivity to vancomycin and tigecycline, the sensitivity rate to linezolid and chloramphenicol was 99.28% and 93.85%. Regression analysis showed an OR of 3.184 for invasive manipulation, with a P value < 0.05. Conclusion S. aureus was mainly isolated from wound site specimens, with a high occupancy of clinical multi-drug resistant bacteria, mostly MRSA and β-lactamase-producing strains, and a high prevalence of common antibiotic resistance. Invasive manipulation was an independent risk factor for drug-resistant S. aureus infection.
2023 Vol. 18 (6): 331-337 [Abstract] ( 22 ) [HTML 1KB] [PDF 0KB] ( 9 )
338
Evaluation of the effect of in-hospital three-color zoning management mode in COVID-19 nucleic acid sample collection
Objective: To study the effect of in-hospital three-color zoning management mode in COVID-19 nucleic acid sample collection during the epidemic. Methods: Patients and staff involved in nucleic acid sample collection in our hospital during 1st to15th April 2022 were selected as the control group, and the original nucleic acid sample collection mode was adopted. During 16th to 30th April 2022, patients and staff involved in nucleic acid sample collection in our hospital were regarded as observation group which adopted the three-color zoning management mode. Results: Compared with the control group, the whole time of nucleic acid sampling-transport-testing in the red zone (all p<0.05), the detection time (P=0.024) and detection time (P<0.001) and the tracing time of patients with nucleic acid abnormalities (P<0.001) were significantly shortened in the observation group. Conditions of unqualified samples were significantly reduced (P=0.001), including sample leakage (P=0.018), lack of internal parameters (P=0.012), and information errors (P=0.014). Patient (P<0.001) and staff (P<0.001) satisfaction increased significantly. Conclusion: The three-color zoning management model can effectively shorten the time consumption of sampling-transporting-testing of nucleic acid sample collection, and of the tracing of patients with nucleic acid abnormalities. This mode improved work efficiency, and the quality of nucleic acid samples, and satisfaction of patients and staff.
2023 Vol. 18 (6): 338-345 [Abstract] ( 24 ) [HTML 1KB] [PDF 0KB] ( 6 )
346
Study on blood infection of Herbaspirillum huttiense in patient with lung adenocarcinoma
Abstract Objective:This report analyze the identification and antimicrobial susceptibility characteristics of Herbaspirillum huttiense which was isolated from a lung adenocarcinoma patient with bloodstream infection, and review the literature in search of any similar cases of this rare condition, so as to provide guidance for clinical treatment. Methods: Two aerobic blood culture bottle were respectively collected by intravenous catheter and peripheral vein from a patient with lung adenocarcinoma after radiotherapy,and the positive blood culture samples was smeared, gram stained and examined under microscope. At the same time, we use VITEK MS automatic microbial mass spectrometry system, VITEK 2 Compact automatic microbial analysis system and molecular sequencing technology to identify and analyze the isolate.And the antimicrobial susceptibility was determined by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines for non-fermented Gram-negative bacilli. Results: After incubating respectively for 20.8h and 14.2h, both aerobic bottles were positive. Gram-negative rods were detected in the sample. And the colonies on the blood plate were milky, gelatinous, raised and without hemolytic after incubation for 24h. Herbaspirillum huttiens was identified by VITEK MS mass spectrometer and molecular sequencing technology, but Burkholderia cepacia was identified by VITEK 2 Compact. The results of antimicrobial susceptibility showed that the strain was intermediate to amtronam,and sensitive to imipenem, meropenem, cefoperazone/sulbactam sodium, ceftazidime, cefepime, piperacillin/tazobactam and levofloxacin. Conclusion: Herbaspirillum huttiens is an important opportunistic pathogen which can cause a rare case of bacteremia in a patient with a history of tumour and immunodeficiency. In our case report, we describe the biological characteristics of Herbaspirillum huttiens, approach to diagnosis and treatment, which emphasizes the importance of multiplediagnostic techniques in the identification of rare bacteria.
2023 Vol. 18 (6): 346-352 [Abstract] ( 23 ) [HTML 1KB] [PDF 0KB] ( 7 )
353 qun WANG Xiao-Yu ZHANG
Thoracic Infections caused by Neisseria elongata: A case report
Abstract: This paper reports the first case of thoracic infection caused by Neisseria elongata in China. MALDI-TOF Vitek MS system, VITEK 2 Compact automatic microbial analysis system and molecular sequencing technology were used to identify and analyze the isolated strains. Antimicrobial Susceptibility Testing of the isolated strains was performed by KB method and E-Test method, and the break point interpretation was carried out according to the requirements of The Clinical and Laboratory Standards Institute (CLSI) for Neisseria meningitidis. The biological characteristics and diagnosis and treatment process of Neisseria elongata were analyzed to improve the attention of microbiological staff to rare pathogens, and to provide experimental evidences for clinical treatment.
2023 Vol. 18 (6): 353-357 [Abstract] ( 25 ) [HTML 1KB] [PDF 0KB] ( 7 )
358 Yu CAO Ya-Ting GONG Rui HUANG
Advances in studies on the role of NLRP6 in host immunity against bacterial infection
Nucleotide-binding oligomerization domain-like receptor family pyrin domain containing (NLRP) 6 is one of the important intracellular pattern recognition receptors of host innate immunity and is involved in the regulation of infection, inflammation, tumor and metabolic diseases. By sensing pathogenic organisms such as bacteria, viruses, fungi, parasites and their products, it can regulate the anti-infection immune effect of the body and affect the outcome. This article reviews the structure and function of NLRP6 and its role in host immunity against bacterial infection.
2023 Vol. 18 (6): 358-363 [Abstract] ( 20 ) [HTML 1KB] [PDF 0KB] ( 6 )
364
Research progress on the immune function changes of B lymphocytes induced by severe fever with thrombocytopenia syndrome virus infection
Abstract:Sever fever with thrombocytopenia syndrome virus (SFTSV) is a novel virus discovered in recent years. Sever fever with thrombocytopenia syndrome (SFTS) is caused by SFTSV infection, characterized by high fever, thrombocytopenia, leukopenia and multiple organ function damage, with a mortality rate of 5%-30%. There is no proven effective antiviral drugs and vaccine available now. SFTSV infection can cause immune dysfunction in patients, and B lymphocytes are one of the important target cells for SFTSV infection, but the impact of SFTSV infection on B lymphocyte function is still unclear. This article reviews research on the abnormalities and underlying mechanism of B lymphocyte functions caused by SFTSV infection, so as to promote the research progress of the immunopathological mechanism of SFTSV infection, providing a basis for a deeper understanding of the impact of SFTSV infection on B lymphocytes and the development of related diagnostic and therapeutic technologies.
2023 Vol. 18 (6): 364-369 [Abstract] ( 16 ) [HTML 1KB] [PDF 0KB] ( 4 )
370
Advancements in the Accurate Diagnosis of Viral Encephalitis /Meningitis
iral encephalitis/meningitis is a severe inflammatory disease of the central nervous system that poses a significant threat to public health. Despite the crucial role played by medical history, symptoms, routine tests, and imaging in its diagnosis, and continuous improvements in molecular diagnostic techniques, technical limitations, assay variability, sample types, and detection time windows still constrain its diagnosis. Moreover, the selection of appropriate diagnostic techniques depends on different clinical features, leaving 40% to 60% of patients with an unclear etiology. Timely and accurate diagnosis is fundamental for initiating targeted and appropriate treatment. Sixty to eighty percent of patients with viral encephalitis initially seek medical attention at primary healthcare institutions. However, due to technical constraints, the diagnostic rate in these institutions is below 20%. Therefore, establishing a standardized diagnostic pathway based on etiology and implementing a tiered diagnostic strategy are particularly necessary. In situations where resources are limited at primary healthcare institutions, the preliminary diagnosis can be established by detailed inquiry into medical history, comprehensive physical examination, and basic laboratory tests. Based on the suspected etiology, routine molecular biology techniques such as PCR can be employed for initial pathogen screening. In cases where PCR results are negative or not feasible, non-targeted broad-coverage techniques like metagenomic next-generation sequencing (mNGS) should be considered. The establishment of a multidisciplinary team for diagnosis and treatment, along with the creation of clinical diagnostic and treatment networks, is essential to enhance the diagnostic rate and improve clinical outcomes. With advancements in diagnostic technologies and the application of artificial intelligence, the diagnosis of viral encephalitis is expected to become more precise.
2023 Vol. 18 (6): 370-377 [Abstract] ( 18 ) [HTML 1KB] [PDF 0KB] ( 6 )
378
Examination papers analysis and teaching thinking of Medical Microbiology under the mode of online teaching and examination
Abstract: The purpose of this study is to evaluate the effect of online teaching of Medical Microbiology in Dalian Medical University, find and summarize the problems in online teaching in time, and provide a basis for teaching curriculum reform. The examination paper of 641 students who participated in the online teaching and examination of Medical Microbiology in 2021 was analyzed by using the network question bank and examination evaluation system of Dalian Medical University, including the accuracy rate of each chapter of the paper, difficulty coefficient, reliability and discrimination. The results showed that the score of this exam was normal distribution, the accuracy of each chapter was between 70% and 90%, the average score of the exam was 72.28, the pass rate was 85%, and the excellent rate was 4%. The overall quality of the examination paper was good. The difficulty of the examination paper was slightly easier, and the difficulty coefficient was 0.72. The discrimination was 0.29, the reliability was 0.9.This study confirms that the overall quality of the online examination paper is good, which can objectively reflect the teaching quality and students' academic level. The online teaching effect is basically satisfied. This study also compares the difficulty coefficient and differentiation of each question type in the test paper to provide the basis and reference for the development of scientific and reasonable online examination papers in the future.
2023 Vol. 18 (6): 378-384 [Abstract] ( 21 ) [HTML 1KB] [PDF 0KB] ( 9 )
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