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25 August 2022, Volume 17 Issue 4
    

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    Original Article
  • SUN Feng1, ZHANG Yilin1, LI Yang1, ZHANG Haocheng1, LIU Qihui1, AI Jingwen1, WANG Sen1, CUI Shuzheng2, SHI Liubin2, XUE Yu2, LONG Feng2, MA Ke2, QIN Lunxiu2, ZHANG Jiming1, ZHANG Wenhong1
    JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 209-219. https://doi.org/10.3969/j.issn.1673-6184.2022.04.001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    The purpose of the current study is to investigate the association between vaccination status and clinical outcomes in the elderly during the Omicron wave. A total of 1 029 patients aged 60 years or older were hospitalized in Huashan Hospital of Fudan University, Baoshan Campus from March 20 to May 6, 2022 (643 cases unvaccinated, 386 cases vaccinated). Demographic characteristics, clinical symptoms, laboratory findings, and clinical outcomes were compared, and multivariate regression was applied to determine association between vaccination status and clinical outcomes. Results indicated a significant difference in age, BMI, comorbidity (diabetes, cardiovascular disease, chronic kidney disease), number of comorbidities, and laboratory findings (lymphocyte counts, C-reactive protein, D-dimer, ALT, creatinine, pro-BNP and troponin) between unvaccinated and vaccinated patients (P<0.05). Unvaccinated patients were more likely to experience COVID-19-related outcomes, including pneumonia (51.6% vs 26.2%), respiratory support [40.7% vs 13.5%], invasive ventilation or death [6.2% vs 0.7%]. Multivariate regression analysis showed that vaccination was associated with early virus shedding [aHR=1.594, 95%CI (1.259, 2.017)], and protected against progression to pneumonia [aOR=0.501, 95%CI (0.370, 0.678)], respiratory support [aOR=0.336, 95%CI (0.232, 0.487)], invasive ventilation or death [aOR=0.190, 95%CI (0.052, 0.687)] in elderly patients. Our findings suggest that inactivated vaccine protects against COVID-19-related severe outcomes in individuals aged over 60 years.
  • DING Wenyi1, AN Zhiyuan2
    JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 220-226. https://doi.org/10.3969/j.issn.1673-6184.2022.04.002
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    The present paper aims to construct the eukaryotic overexpression vector and knockdown vector of LncRNA-GAS5 (long non-coding RNA-growth arrest-specific transcript 5), and to study its role in the expression of SNAP29 in HeLa cells infected by Acinetobacter baumannii (A. baumannii). LncRNA-GAS5 gene was amplified by polymerase chain reaction (PCR) and cloned into pcDNA3.1 (+) eukaryotic expression vector to form pcDNA3.1-GAS5 eukaryotic expression vector. Through RNA interference technology, the oligonucleotide sequences for knockdown of GAS5 were designed and constructed into pRNAT-U6.1/Neo vector to form pRNAT-U6.1-GAS5 knockdown vector. The expression of GAS5 was detected by real-time PCR to determine whether the overexpression and knockdown were successful or not. Western blotting was used to detect the changes of SNAP29 expression in HeLa cells after overexpression or knockdown of GAS5. In addition, the expression of SNAP29 in A. baumannii-infected HeLa cells at different times and the expression of SNAP29 in A. baumannii-reinfected HeLa cells after knockdown or overexpression of GAS5 were detected by Western blotting. The results showed that pcDNA3.1-GAS5 and pRNAT-U6.1-GAS5 were successfully constructed. pcDNA3.1-GAS5 could induce high expression of LncRNA-GAS5 in HeLa cells. pRNAT-U6.1-GAS5 significantly reduced the expression of GAS5 in HeLa cells. The overexpression of LncRNA-GAS5 decreased the expression of SNAP29 in HeLa cells, while the knockdown of LncRNA-GAS5 increased the expression of SNAP29 in HeLa cells. The expression of SNAP29 decreased progressively with A. baumannii infection time. The knockdown of LncRNA-GAS5 could restore the expression of SNAP29 degraded by A. baumannii, while the overexpression of LncRNA-GAS5 could aggravate the degradation of SNAP29 by A. baumannii. The results suggest that LncRNA-GAS5 has a negatively regulatory effect on SNAP29 expression, and the degradation of SNAP29 by A. baumannii depends on LncRNA-GAS5. It lays a theoretical foundation for further discovering the deep mechanism of autophagy degradation disorder caused by A. baumannii.
  • WANG Chun, RUAN Xiaoling, LIU Changqi, ZHANG Hong
    JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 227-234. https://doi.org/10.3969/j.issn.1673-6184.2022.04.003
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    This study aims to investigate the species distribution and drug resistance of pathogenic bacteria in the children with bloodstream infections in Shanghai Children’s Hospital from 2016 to 2018, and to provide rational drug use basis for clinical prevention and treatment of bloodstream infections. The automatic microbiological analysis system was used to identify the pathogenic bacteria isolated from the blood culture samples and conduct drug sensitivity test to analyze their distribution characteristics and drug resistance. A total of 24 687 samples were sent for examinations, finally 2 092 pathogenic bacteria were isolated with a positive detection rate of 8.5%. Gram-positive bacteria accounted for 84.4%, and Gram-negative bacteria accounted for 15.6%. The top five pathogens were coagulase-negative Staphylococcus (CoNS), Enterococcus, Klebsiella pneumoniae, Streptococcus and Escherichia coli. The positive detection rate of blood culture in Neonatal Department was 34.5%, and the isolation rate of CoNS was significantly higher than that in other departments. The average time to positivity of CoNS was (32.53±12.36) h. No Staphylococcus and Enterococcus resistant to vancomycin and linezolid were found. Imipenem, meropenem, amikacin, cefoperazone-sulbactam and piperacillin-tazobactam had strong antibacterial activity against Escherichia coli, and the drug resistance rate was less than 10%. The drug resistance rate of Klebsiella pneumoniae to third-generation cephalosporins reached more than 80%, and the drug resistance rate to carbapenems increased year by year, reaching 62.5% in 2018. The drug resistance rate of Pseudomonas aeruginosa to carbapenems was 9.1%. The drug resistance rate of Acinetobacter baumannii to most antimicrobial agents was more than 60%, and to carbapenems was 66.7%. It is shown that pathogenic bacteria from blood culture of children with bloodstream infections are complex, and CoNS accounts for a large proportion, which makes the diagnosis of bloodstream infections become more complicated. Therefore, understanding the distribution characteristics and drug resistance of pathogenic bacteria from blood culture of children with bloodstream infections is helpful to guide the rational use of antibiotics in clinical application.
  • JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 235-238.
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    【Abstract】Objective: To investigate the diagnosis and treatment of neonatal Acinetobocter johnsonii (AJ) infection by summarizing the clinical characteristics and treatment outcome of neonatal sepsis caused by AJ. Method: The clinical details of 2 cases of neonatal AJ sepsis were retrospectively analyzed, and the relevant literature was consulted for analysis. Result: Two cases with gestational age of 26+5 weeks and 34 weeks, birth weight of 1050 g and 1800 g, developed sepsis on postnatal days 21 and 23, separately, which were confirmed to have AJ infection by blood culture and were discharged uneventfully after 40 and 36 days of hospitalization after treatment. Conclusion: AJ is a rare human infectious pathogen. The diagnosis depends on blood culture. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry can help AJ identification. The selection of antibacterial drugs should be based on the results of drug susceptibility testing and MIC values, as well as the physiological state of the children themselves.
  • Review
  • SUN Zhiping1, QU Di1,2
    JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 239-252. https://doi.org/10.3969/j.issn.1673-6184.2022.04.005
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    Coronavirus disease 2019 (COVID-19) has spread all over the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mainly transmitted through respiratory droplets and close contact (directly or indirectly contact). The risk of infection by contacting fomite contaminated with the virus has attracted attention. This paper reviews the researches on the stability of SARS-COV-2 in the environment. Studies on the environmental stability of different variants and strains of SRAS-CoV-2 find that, the survival time of virus depends on viral titer under the condition of room temperature and conventional humidity. Virus with low titer (<104.0TCID50) can survive for 1 to 3 days on different surfaces, but virus with high titer (>105.0TCID50) can survive for 3 to 7 days. Variants of SARS-COV-2 are more stable at low temperature. In addition, variants of SARS-CoV-2 have the same sensitivity to disinfectants, and can be inactivated effectively by alcohols, chlorinated disinfectants and surfactants. When ones face an environment which may be contaminated by the virus, it is necessary to pay attention to personal protection,hand hygiene, as well as disinfection timely to reduce the infection risk.
  • MENG Qinghong, SHI wei, GAO Wei, YAO Kaihu
    JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 253-258. https://doi.org/10.3969/j.issn.1673-6184.2022.04.006
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    Pertussis has long been considered a childhood disease. Recently, studies from the developed world have shown that, unlike in the pre-vaccine era, adolescents and adults are the major population of current resurgence of pertussis. However, infants are still the absolute majority of reported cases in China, which is closely related to our lack of clinical understanding for adolescent and adult cases. In the vaccine era, most adolescent and adult pertussis cases are mild and do not seek medical attention. Due to lack of typical symptoms and laboratory tests, they are often misdiagnosed or never diagnosed. At present, Chinese doctors should pay more attention to pertussis among adolescents and adults, to carry out extensive and in-depth studies, then recognize the diversity of pertussis manifestations; Timely laboratory tests for suspected patients should be conducted to achieve early diagnosis. The infant could be protected from severe illness and death by promoting the management of the adolescent and adult pertussis cases.
  • BAI Yinlan, LU Yanzhi, NING Huanhuan, XU Zhikai
    JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 259-267. https://doi.org/10.3969/j.issn.1673-6184.2022.04.007
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    Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for the prevention of tuberculosis. In addition to tuberculosis, BCG has a non-specific protective effect on the prevention of non-homologous pathogens such as bacteria, viruses, parasites and so on. It is also used for immunotherapy of some tumors and autoimmune diseases. The non-specific protective mechanism of BCG is identified to be related to the induction of trained immunity. The mechanisms of BCG-induced trained immunity involve cell metabolism changes in host innate immune, epigenetic reprogramming, and enhanced immune responses to restimulation. BCG-induced trained immunity provides protective effects against multiple viral infections and is negatively associated with the mortality of coronavirus disease 2019 (COVID-19), which may have the impact on emerging pathogen pandemic in the future.
  • Medical Forum
  • WANG Zhouyu, CUI Shuzheng, XUAN Yujun, CAO Jipeng, LYU Xueying, SHI Liubin, ZHU Huigeng, WANG Huiying
    JOURNAL OF MICROBES AND INFECTIONS. 2022, 17(4): 268-272. https://doi.org/10.3969/j.issn.1673-6184.2022.04.008
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    The outbreak of Omicron variant infectious disease not only affects Shanghai’s overall medical operation mode, but also generates enormous challenges and roadblocks of the implementation of treatment work, the accomplishment of the core medical systems and regimes, and the protection of patient safety to designated hospitals in Shanghai. As one of designated hospitals of Shanghai, the Baoshan Campus of Huashan Hospital has formed various multi-level management systems under the current circumstance, including the “hospital-level medical core management work system”, “specialized treatment guarantee-related work system” and “new crown-related special work system”. With the limited medical resources, Huashan Hospital regards flexible and intelligent implementation of the core system as an important task, and has built a series of management models. This paper has illustrated practical experience, and has provided reference for the purpose of maximizing the protection of patient’s safety and properly reacting during the outbreak of epidemic.