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1.
Carlo A Fallone Alan N Barkun Andrew Szilagyi Karl M Herba Maida Sewitch Myriam Martel Stefanie S Fallone 《Journal canadien de gastroenterologie》2013,27(7):397-402
BACKGROUND:
Traditional seven-day proton pump inhibitor triple therapy for Helicobacter pylori eradication has recently shown disappointing results outside of Canada. Prolonging therapy may be associated with poorer compliance and, hence, may not have a better outcome in a real-world setting.OBJECTIVE:
To compare the outcomes of seven- and 14-day triple therapy for first-line treatment of H pylori infection in an effectiveness setting in Canada.METHODS:
A total of 314 consecutive treatment-naive, adult H pylori-infected patients were allocated to either a seven- or 14-day triple therapy regimen, with a subgroup of 172 consecutive patients quasi-randomized to treatment according to date of visit. Eradication was confirmed using either urea breath test or gastric biopsies. Analysis was by intention to treat.RESULTS:
Eradication was achieved in a higher proportion of patients who underwent 14-day versus seven-day treatment regimens (overall: 85% versus 70% [P≤0.001]; subgroup: 83% versus 64% [P≤0.01]). Although successful eradication was also associated with older age and a diagnosis of ulcer disease, multivariate analysis revealed only longer treatment duration and lack of yogurt ingestion as independent predictors of successful eradication. There was a trend toward reduced success in the latter years of the study. Side effects were similar in both groups and were not prevented by yogurt ingestion.CONCLUSIONS:
The currently recommended duration of proton pump inhibitor triple therapy in Canada should be increased from seven to 14 days, the latter having achieved an excellent result in this particular real-world setting. Yogurt added no benefit. Further study is required to compare 10-day with 14-day treatment regimens. 相似文献2.
Jennie Johnstone Gregory J Tyrrell Thomas J Marrie Sipi Garg James D Kellner the Streptococcus pneumoniae Alberta Team group 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2011,22(4):137-141
OBJECTIVE:
To describe the epidemiology, clinical characteristics, microbiology and outcomes of patients of all ages with Streptococcus pneumoniae meningitis two years pre- and postintroduction of a S pneumoniae 7-valent conjugate vaccine program in Alberta in children <2 years of age.METHODS:
Between 2000 and 2004, all cases of invasive pneumococcal disease in Alberta were identified. From this cohort, patients with S pneumoniae meningitis were identified by chart review. Clinical data, laboratory data and in-hospital outcomes were collected.RESULTS:
Of the 1768 cases of invasive pneumococcal disease identified between 2000 and 2004, 110 (6.2%) had S pneumoniae meningitis. The overall incidence was 0.7 per 100,000 persons and remained unchanged over the study period. The rate in children <2 years of age appeared to fall over time, from 10.5 per 100,000 persons in 2000 to five per 100,000 persons in 2004, although there was insufficient evidence of a statistically significant time trend within any age group. Overall, the mean age was 30 years and 47% were male. In-hospital mortality was 20%, ranging from 6% in those ≤2 years of age to 31% for those ≥18 years of age, despite appropriate antimicrobial therapy.CONCLUSION:
The high mortality rate associated with S pneumoniae meningitis suggests that prevention by vaccination is critical. In children <2 years of age, there was a downward trend in the rate of S pneumoniae meningitis after implementation of the S pneumoniae 7-valent conjugate vaccine program, but rates were still high. 相似文献3.
Background/Aims
The cytosolic host protein nucleotide binding oligomerization domain 1 (Nod1) has emerged as a key pathogen recognition molecule for innate immune responses in epithelial cells. The purpose of the study was to elucidate the mechanism by which Helicobacter pylori infection leads to transepithelial neutrophil migration in a Nod1-mediated manner.Methods
Human epithelial cell lines AGS and Caco-2 were grown and infected with H. pylori. Interleukin (IL)-8 mRNA expression and IL-8 secretion were assessed, and nuclear factor κB (NF-κB) activation was determined. Stable transfections of AGS and Caco-2 cells with dominant negative Nod1 were generated. Neutrophil migration across the monolayer was quantified.Results
Cytotoxin-associated gene pathogenicity island (cagPAI)(+) H. pylori infection upregulated IL-8 mRNA expression and IL-8 secretion in AGS and Caco-2 cells compared with controls. NF-κB activation, IL-8 mRNA expression and IL-8 secretion by cagPAI knockdown strains were reduced compared with those infected with the wild-type strain. NF-κB activation, IL-8 mRNA expression and IL-8 secretion in dominant-negative (DN)-Nod1 stably transfected cells were reduced compared with the controls. The transepithelial migration of neutrophils in DN-Nod1 stably transfected cells was reduced compared with that in controls.Conclusions
Signaling through Nod1 plays an essential role in neutrophil migration induced by the upregulated NF-κB activation and IL-8 expression in H. pylori-infected human epithelial cells. 相似文献4.
Background
This study investigated the correlation between the expression of the Las and Rhl quorum-sensing (QS) systems and the communal behavior (motility, biofilm formation, and pyocyanin production) of Pseudomonas aeruginosa (P. aeruginosa) isolated from patients with hospital-acquired pneumonia.Methods
We analyzed 138 P. aeruginosa isolates from 48 patients (30 men and 18 women; age 68.18±15.08 years). P. aeruginosa clinical isolates were assessed for Las and Rhl gene expression and bacterial motility, biofilm formation, and pyocyanin production.Results
P. aeruginosa swimming, twitching, and swarming motility positively correlated with the expression of LasI, LasR, and RhlI (P<0.05) but not with that of RhlR (P>0.05). At all analyzed time points, a significant positive correlation was found between biofilm formation and the expression of LasI, LasR (P<0.01), and RhlI (P<0.05 for day 1, P<0.01 for days 7 and 14), whereas RhlR expression positively correlated with biofilm formation only on day 14 (P<0.05). On days 1 and 7, positive correlation was observed between pyocyanin production and the levels of LasI and RhlI (P<0.05). In bacterial clearance cases, the expression of QS-related genes and the group behavior of the pathogen did not correlate (P>0.05). However, in cases of persistent P. aeruginosa infection, the changes in LasI and LasR gene expression were positively correlated with those in bacterial motility (P<0.05), and the changes in LasI, LasR, RhlI, and RhlR expression showed a significant positive association with those in biofilm formation (P<0.01).Conclusions
In patients with hospital-acquired pneumonia, the expression of the Las and Rhl QS genes was associated with bacterial motility, biofilm formation, and pyocyanin production, suggesting an involvement of the QS genes in the clearance of pathogenic P. aeruginosa in patients. 相似文献5.
Tajeldin Mohammedien Abdallah Hashim Balla Mohammed Mamoon Hassan Mohammed Abdel Aziem Abdalla Ali 《亚太热带病杂志(英文版)》2014,4(2):115-119
Objective
To investigate the prevalence of Helicobacter pylori (H. pylori) among patients with dyspepsia and to evaluate the correlation between H. pylori infection and socio-demographic factors.Methods
This cross-sectional hospital-based study, which ran from June to August 2012, determined seroprevalence of H. pylori among adult patients in Eastern Sudan. The presence of H. pylori was determined using ELISA.Results
A total of 225 adult Sudanese patients were enrolled in the study. Of these, 148 (65.8%) tested positive for H. pylori. In logistic regression analysis, rural residency (OR=3.933, CI=1.337-11.26, P=0.01) was the only socio-demographic factor that was associated with H. pylori infection. The most common symptoms among seropositive patients were heartburn (OR=30.442, CI=9.478-97.776, P≤0.001) and/or epigastria pain (OR=28.225, CI=4.365-182.508, P≤0.001).Conclusions
Clinical suspicion can facilitate the detection of H. pylori among patients with dyspeptic symptoms in a geographic area with high prevalence of H. pylori infection. 相似文献6.
Mabrouka EL Oudi Zied Aouni Chakib Mazigh Radhia Khochkar Ezzeddine Gazoueni Habib Haouela Salem Machghoul 《Experimental & Clinical Cardiology》2010,15(2):e25-e28
BACKGROUND:
An elevated level of homocysteine (Hcy) has been shown to be a cardiovascular risk factor in the majority of research studies. Recently, it was found to be associated with new risk factors such as inflammatory markers.OBJECTIVES:
To investigate the distribution of plasma total Hcy (tHcy) and the levels of inflammatory markers in patients with acute coronary syndrome (ACS), and to evaluate the association between these parameters and the severity of the disease.METHODS:
A total of 122 patients with ACS and 80 control subjects were recruited from the cardiac intensive care unit of the Military Hospital of Tunis, Tunisia. Lipid profile and the levels of tHcy, high-sensitivity C-reactive protein (HsCRP), interleukin (IL)-6, IL-8, IL-1β and tumour necrosis factor-alpha (TNFα) were determined for all participants. The distribution of these parameters were compared between groups and according to the number of diseased vessels in patients with ACS.RESULTS:
ACS patients had significantly elevated levels of tHcy (P<0.01), HsCRP (P<0.001), IL-6 (P<0.001), TNFα (P<0.001), folates (P<0.05) and vitamin B12 (P<0.001), but lower high-density lipoprotein cholesterol (P<0.05) levels. The analysis of the association between these parameters and the number of diseased vessels showed significant differences in tHcy, HsCRP, IL-6 and TNFα, with positive correlations. Significantly negative correlations were found between the number of diseased vessels and folate (r=−0.34; P<0.01), and vitamin B12 (r=−0.22; P<0.01).CONCLUSION:
Elevated levels of tHcy, IL-6, TNFα and HsCRP appear to be associated with a greater number of diseased arteries and, consequently, the severity of coronary artery disease. 相似文献7.
Yun-En Lin Qi-Nian Wu Xiao-Dong Lin Guang-Qiu Li Ya-Jie Zhang 《Journal of thoracic disease》2015,7(5):850-860
Background
Paired basic amino acid-cleaving enzyme 4 (PACE4) was shown to enhance tumor cells proliferation and invasive. This study provides the first investigation of PACE4 expression in non-small cell lung cancer (NSCLC) and the correlation with clinicopathologic features, prognostic indicators of 172 cases.Methods
Quantitative real-time PCR (RT-PCR) and immunofluorescence (IF) were applied to detect PACE4 expression in NSCLC and 16HBE cell lines, then 172 consecutive NSCLC and 15 normal lung tissues were studied through immunohistochemistry (IHC). The association between PACE4 expression and clinicopathological parameters was evaluated. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate the effect of PACE4 expression on survival.Results
PACE4 expression in NSCLC were significantly higher than normal lung cell and tissues (P<0.05). PACE4 had cytoplasmic expression and was observed in 111 of the 172 (64.5%) NSCLC patients. Clinicopathologically, PACE4 expression was significantly associated with lymph node metastasis (N stage) (P=0.007), and clinical stage (P=0.024). Multivariable analysis confirmed that PACE4 expression increased the hazard of death after adjusting for other clinicopathological factors [hazards ratio (HR): 1.584; 95% confidence interval (CI): 1.167-2.151; P<0.001]. Overall survival (OS) was significantly prolonged in PACE4 negative group when compared with PACE4 positive group (5-year survival rates, 23.1% vs. 54.5%, log-rank test, χ2=17.717, P<0.001), as was disease-free survival (DFS) (5-year survival rates, 23.4% vs. 55.4%, log-rank test, χ2=20.486, P<0.001).Conclusions
Our results suggest that positive expression of PACE4 is an independent factor for NSCLC patients and it might serve as a potential prognostic biomarker for patients with NSCLC. 相似文献8.
Ruoxi He Bailing Luo Chengping Hu Ying Li Ruichao Niu 《Journal of thoracic disease》2014,6(10):1403-1410
Background
Lower respiratory tract infections (LRTIs) are common among patients in hospitals worldwide, especially in patients over the age of 60. This study investigates the differences in distribution and drug sensitivity of pathogens in LRTIs.Methods
The clinical and laboratory data of 4,762 LRTI patients in the general ward and respiratory intensive care unit (RICU) of Xiangya Hospital (Changsha) were retrospectively analyzed.Results
The infection rate of Gram-negative bacteria was significantly higher than that of Gram-positive bacteria in both the general ward and RICU (P<0.05). The incidence of Gram-negative bacteria infection was significantly higher in the RICU than in the general ward (P<0.05), whereas the incidence of Gram-positive bacteria infection is less in the RICU than in the general ward (P<0.05). In the general ward, the incidence of Gram-negative bacteria infection significantly increased (P<0.05) over time, whereas the incidence of Gram-positive bacteria infection significantly decreased from 1996 to 2011 (P<0.05). In the RICU, the incidence of Gram-positive bacteria infection decreased, while Gram-negative bacteria infections increased without statistical significance (P>0.05). Staphylococcus pneumoniae and Staphylococcus aureus were found to be the predominant Gram-positive strains in the general ward (34.70-41.18%) and RICU (41.66-54.87%), respectively (P>0.05). Pseudomonas aeruginosa and Acinetobacter baumannii were the predominant gram negative strains in the general ward (19.17-21.09%) and RICU (29.60-33.88%), respectively (P>0.05). Streptococcus pneumoniae is sensitive to most antibiotics with a sensitivity of more than 70%. Staphylococcus aureus is highly sensitive to vancomycin (100%), linezolid (100%), chloramphenicol (74.36-82.19%), doxycycline (69.57-77.33%), and sulfamethoprim (67.83-72.46%); however, its sensitivity to other antibiotics is low and decreased each year. Sensitivity of Pseudomonas aeruginosa to most β-lactam, aminoglycoside, and quinolone group antibiotics decreased each year.Conclusions
The distribution and drug sensitivity of LRTI pathogens exhibit a high divergence between the general ward and RICU. Streptococcus pneumoniae may not be the predominant pathogen in LRTIs in some areas of China. 相似文献9.
DB Langille L Yates TJ Marrie 《The Canadian Journal of Infectious Diseases & Medical Microbiology》1993,4(6):328-332
Purpose:
To define the etiology of pneumonia, using a battery of serological tests, among patients presenting to physicians’ offices in Cumberland County, Nova Scotia from July 2, 1989 to July 1, 1990.Methods:
Patients presenting to their physician’s office with symptoms suggestive of pneumonia were invited to participate in the study by completing a questionnaire, having a chest radiograph and providing acute and convalescent phase serum samples. These serum samples were tested for antibodies to Mycoplasma pneumoniae, Coxiella burnetii, Legionella pneumophila, adenovirus, and influenza viruses A and B. Some of the samples were tested for antibodies to Chlamydia pneumoniae.Results:
Seventy-five of the inception cohort of 203 patients had a chest radiograph compatible with pneumonia, a completed questionnaire and acute and convalescent phase serum samples. There were 39 females and 36 males with a mean age of 41.7 years. Twenty-six (35%) were admitted to hospital. The mortality rate was 3%. Forty-five per cent had a diagnosis made by serology: M pneumoniae, 22 (29%); influenza A virus, five (7%); C burnetii, L pneumophila, adenovirus, two (3%) each.Conclusions:
While it is not possible to generalize about these findings because of ascertainment bias, the data suggest that M pneumoniae is a common cause of pneumonia presenting to a physician’s office and that mortality is low in this group of patients. 相似文献10.
Hee Young Yang You Sun Nam Hee Joo Lee 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2014,25(3):163-169
OBJECTIVES:
To analyze the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants in ciprofloxacin-nonsusceptible Escherichia coli and Klebsiella pneumoniae isolated from patients at a tertiary care hospital in Korea.METHODS:
A total of 102 nonduplicate isolates of ciprofloxacin-intermediate or ciprofloxacin-resistant E coli (n=80) and K pneumoniae (n=22) from blood cultures were obtained. The qnr (qnrA, qnrB, qnrS), aac(6′)-Ib-cr, qepA and oqxAB genes were detected using polymerase chain reaction (PCR) and confirmed using direct sequencing. To determine whether the PMQR-positive plasmid was horizontally transferable, conjugation experiments were performed.RESULTS:
Of the 102 isolates, 81 (79.4%) had one or more PMQR genes; these consisted of 59 (73.8%) E coli and 22 (100%) K pneumoniae isolates. The qnr genes were present in 15 isolates (14.7%): qnrB4 was detected in 10.8% and qnrS1 was detected in 3.9%. The aac(6′)-Ib-cr, qepA and oqxAB genes were detected in 77.5%, 3.9% and 10.8%, respectively. In conjugation experiments, PMQR genes were successfully transferred from seven (8.6%) isolates. The range of minimum inhibitory concentrations of ciprofloxacin for these seven transconjugants increased to 0.5 mg/L to 1 mg/L, which was 16- to 33-fold that of the recipient E coli J53 bacteria.CONCLUSIONS:
PMQR genes were highly prevalent among ciprofloxacin-nonsusceptible E coli and K pneumoniae from blood cultures in the authors’ hospital. Therefore, it is necessary to monitor for the spread of PMQR genes of clinical isolates and to ensure careful antibiotic use in a hospital setting. 相似文献11.
Huijun Dai Linghui Pan Fei Lin Wanyun Ge Wei Li Sheng He 《Journal of thoracic disease》2015,7(4):616-624
Objective
To investigate the role of Toll-like receptor 2 (TLR2), TLR4, TLR9 and myeloid differentiation factor 88 (MyD88) on alveolar macrophages in ventilator-induced lung injury (VILI).Methods
Male, adult pathogen-free Sprague-Dawley rats weighing 300-350 g were used in this study. Animals were tracheotomized and allowed to breathe spontaneously for 4 h or mechanically ventilated for 4 h with low or high tidal volume (7 or 40 mL/kg). TLR2, TLR4, and TLR9, MyD-88 and NF-κΒ of alveolar macrophages’ expression under the different ventilation conditions were detected. Pulmonary permeability, lung inflammatory, IL-6 and IL-1β were assessed as well.Results
Rats subjected to high tidal volume showed significantly greater pulmonary permeability and lung inflammatory than the control rats. Alveolar macrophages from rats subjected to high tidal volume also showed significantly higher protein expression of TLR2 (0.59±0.049 vs. 0.35±0.036 and 0.36±0.031, both P<0.001), TLR4 (0.845±0.0395 vs. 0.401±0.026 and 0.403±0.020, both P<0.001), TLR9 (0.727±0.074 vs. 0.383±0.039 and 0.367±0.043, both P<0.001), MyD-88 (1.01±0.060 vs. 0.485±0.045 and 0.507±0.046, both P<0.001) and NF-κΒ (0.776±0.067 vs. 0.448±0.043 and 0.481±0.047, both P<0.001), as well as significantly higher concentrations of IL-6 (7.32±0.24 vs. 2.42±0.13 and 2.44±0.32, both P<0.001) and IL-1β (139.95±9.37 vs. 53.63±5.26 and 53.55±6.63, both P<0.001) than the control and low tidal volume group.Conclusions
The overexpression of TLR2, TLR4, and TLR9 on alveolar macrophages and release of pro-inflammatory cytokines play a role in VILI. 相似文献12.
Carmen Pittman Sabrina Plitt Ted Birse Karen Doucette Barbara Romanowski Rya Cooper Stan Houston Stephen Shafran Ameeta E Singh 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2014,25(1):e8-e13
BACKGROUND:
HIV and hepatitis B virus (HBV) share transmission routes, and coinfection is associated with higher morbidity and mortality. To date, no Canadian studies have examined HIV-HBV coinfection.OBJECTIVES:
To examine the prevalence and correlates of HIV and HBV coinfections in Northern Alberta.METHODS:
The present study was a retrospective database review of all HIV-infected (HIV+) individuals in Northern Alberta from 1982 to 2010 and a chart review of HBV surface antigen-positive individuals for whom charts were available (46.2%).RESULTS:
Of 2844 HIV+ patients, 2579 (90.7%) had been tested for HBV surface antigen, and 143 (5.5%) of these were HBV coinfected. Coinfected males were primarily Caucasian (70.8%), and coinfected females were primarily black (56.4%) or Aboriginal (31.3%). Coinfected individuals were more likely to be male (88.1% versus 71.3%; P<0.001) and to have died (34.3% versus 17.9%; P<0.001).CONCLUSIONS:
The prevalence of coinfection with HBV in HIV-infected patients in Northern Alberta is lower than reported in other developed nations. The pattern of coinfections in Northern Alberta likely follows immigration trends. Recognition and management may be improving with time; however, further research and additional strategies are required to enhance the prevention, identification and management of HBV infection in HIV-infected individuals. 相似文献13.
Alon Vaisman Kevin Pivovarov Allison McGeer Barbara Willey Bjug Borgundvaag Vanessa Porter Piraveina Gnanasuntharam Yanliang Wei Geoffrey C Nguyen 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2013,24(4):e117-e121
BACKGROUND:
Patients with inflammatory bowel disease (IBD) experience frequent hospitalizations and use of immunosuppressive medications, which may predispose them to colonization with antimicrobial-resistant organisms (ARO).OBJECTIVE:
To determine the prevalence of ARO colonization on admission to hospital and the incidence of infection during hospitalization among hospitalized IBD patients.METHODS:
A chart review comparing the prevalence of colonization and incidence of infection with methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL) in hospitalized IBD patients with those of non-IBD controls was performed.RESULTS:
On admission, there were no significant differences between IBD inpatients and controls in the prevalence of colonization of methicillin-resistant S aureus (1.0% versus 1.2%; P=0.74), vancomycin-resistant enterococci (0.2% versus 0%; P=1.0) or ESBL (4.1% versus 5.5%; P=0.33). Pooling data from historical clinic-based cohorts, IBD patients were more likely than controls to have ESBL colonization (19% versus 6.6%; P<0.05). Antibiotic use on admission was associated with ESBL colonization among IBD inpatients (OR 4.2 [95% CI 1.4 to 12.6]). The incidence of ARO infections during hospitalization was not significantly different between IBD patients and controls. Among IBD patients who acquired ARO infections during hospitalizations, the mean time interval from admission to infection was shorter for those who were already colonized with ARO on admission.CONCLUSIONS:
This particular population of hospitalized IBD patients was not shown to have a higher prevalence or incidence of ARO colonization or infection compared with non-IBD inpatients. 相似文献14.
Nadia Fekih Hocine Allali Salima Merghache Fa?za Cha?b Djamila Merghache Mohamed El Amine Nassim Djabou Alain Muselli Boufeldja Tabti Jean Costa 《亚太热带病杂志(英文版)》2014,4(2):97-103
Objective
To find new bioactive natural products, the chemical composition and to sudy the antibacterial activity of essential oil components extracted from the aerial parts of the Algerian aromatic plant Pinus halepensis Miller (P. halepensis) (needles, twigs and buds).Methods
The essential oil used in this study was isolated by hydrodistillation using a Clevenger-type apparatus according to the European Pharmacopoeia. The chemical composition was investigated using GC-retention indices (RI) and GC-MS.Results
Forty-nine compounds, representing 97.9% of the total collective oil, were identified. Essential oil was dominated by hydrocarbon compounds (80.6%) especially monoterpenes (65.5%). The major compounds from ten oils stations were: myrcene (15.2%-32.0%), α-pinene (12.2%-24.5%), E-β-caryophyllene (7.0%-17.1%), terpinolene (1.8%-13.3%), 2-phenyl ethyl isovalerate (4.8%-10.9%), terpinene-4-ol (1.0%-8.2 %) and sabinene (1.5%-6.3%). The intra-species variations of the chemical compositions of P. halepensis aerial parts essential oils from ten Algerian sample locations were investigated using statistical analysis. Essential oil samples were clustered in 2 groups by hierarchical cluster analysis, according to their chemical composition. The essential oil revealed an interesting antimicrobial effect against Lysteria monocytogenes, Enterococcus faecalis, Pseudomonas aeruginosa, Acinetobacter baumanii, Citrobacter freundii and Klebsiella pneumoniae.Conclusions
These results suggest that the essential oil from P. halepensis may be a new potential source as natural antimicrobial applied in pharmaceutical and food industries. 相似文献15.
Denise Pires Machado Luciano Z Goldani Rodrigo Minuto Paiva Valério Rodrigues Aquino Fernanda de-Paris Thiago Lisboa Bruno Jung Rodrigo Pires dos Santos 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2013,24(3):e75-e79
BACKGROUND:
Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) infections; however, treatment failure is not uncommon, even when the minimum inhibitory concentration (MIC) of the MRSA strain is within the susceptible range for vancomycin.OBJECTIVE:
To describe the relationship between molecular markers such as the mecA and agrII genes, serum vancomycin levels and vancomycin MICs, and the 30-day mortality rate of patients with nosocomial MRSA pneumonia in an intensive care unit (ICU).METHODS:
The present study was a prospective cohort study including all patients with MRSA hospital-acquired pneumonia or ventilator-associated pneumonia who were admitted to the ICU of a tertiary care hospital between June 2009 and December 2011. The MIC for vancomycin was determined using the E-test and broth microdilution methods. Variables analyzed included age, sex, comorbid conditions, serum vancomycin trough concentration, the Acute Physiology and Chronic Health Evaluation II (APACHE) score and the presence of the agrII gene. The primary outcome was mortality at 30 days.RESULTS:
Thirty-six (42.4%) patients died within 30 days of the index MRSA culture. A multiple regression analysis that included the variables of MIC (determined using the E-test or broth microdilution methods), APACHE II score, serum vancomycin level and the presence of agrII revealed that only the APACHE II score was related to the 30-day mortality rate (P=0.03). Seven patients (9.0%) with isolates exhibiting an MIC ≥1.5 μg/mL according to the E-test method died, and nine patients (11.6%) survived (P=0.76). Of the patients for whom MICs were determined using the broth microdilution method, 11 (14.1%) patients with MICs of 1.0 μg/mL died, and 16 (20.5%) survived (P=0.92). The median APACHE II score of survivors was 22.5, and the median score of nonsurvivors was 25.0 (P=0.03). The presence of the agrII gene was not related to the 30-day mortality rate.CONCLUSIONS:
Patients with severe hospital-acquired pneumonia presented with MRSA isolates with low to intermediate vancomycin MICs in the ICU setting. At the Hospital de Clínicas de Porto Alegre (Porto Alegre, Brazil), the 30-day mortality rate was high, and was similar among patients with severe hospital-acquired pneumonia infected with MRSA isolates that exhibited MICs of ≤1.5 μg/mL determined using the E-test method and ≤1.0 μg/mL determined using the broth microdilution method in those who achieved optimal serum vancomycin levels. The APACHE II scores which provides an overall estimate of ICU mortality were independently associated with mortality in the present study, regardless of the MICs determined. Molecular markers, such as the agrII gene, were not associated with higher mortality in the present study. 相似文献16.
Background:
Hepatitis C virus infection is one of the leading causes of end stage liver diseases. The innate immune response slows down viral replication by activating cytokines such as type I interferon (IFN-α/β), which trigger the synthesis of antiviral proteins and modulate the adaptive immune system. Recently, leucine-rich repeat (in Flightless I) interacting protein-1 (LRRFIP1) was reported contributing to the production of interferon-β in macrophages.Objectives:
The aim of this study was to assess the role of LRRFIP1 in induction of IFN-β and inhibition of HCV infection in hepatocytes.Materials and Methods:
Induction of IFN-β by LRRFIP1 in Huh7 and Huh7.5.1 was determined by real-time PCR and western blotting in vitro. Inhibition of HCV replication by LRRFIP1 overexpression in hepatocytes was assessed.Results:
LRRFIP1 increased the expression of IFN-β in hepatocytes with or without HCV infection. Induction of IFN-β by LRRFIP1 was enhanced with the presence of hepatitis C virus. Overexpression of LRRFIP1 in hepatocytes inhibited HCV replication. However, HCV infection did not regulate intracellular expression of LRRFIP1.Conclusions:
LRRFIP1 and its mediated production of type I interferon play a role in controlling HCV infection. The findings of this study provide new target for HCV treatment and contribute to development of anti-HCV drugs. 相似文献17.
Wei-Jie Guan Yong-Hua Gao Gang Xu Zhi-Ya Lin Yan Tang Hui-Min Li Zhi-Min Li Jin-Ping Zheng Rong-Chang Chen Nan-Shan Zhong 《Journal of thoracic disease》2015,7(4):625-636
Background
Current status of Pseudomonas aeruginosa (PA) infection in clinically stable bronchiectasis in mainland China remains unclear.Objective
To compare the inflammation and lung function impairment in bronchiectasis patients isolated or infected with PA, potentially pathogenic microorganisms (PPMs) and commensals, and to identify factors associated with PA isolation and infection.Methods
Patients with steady-state bronchiectasis and healthy subjects were recruited. Peripheral blood and sputum were sampled to determine inflammatory markers and bacterial loads in steady-state bronchiectasis and health. Spirometry and diffusing capacity were also measured.Results
We enrolled 144 bronchiectasis patients and 23 healthy subjects. PA isolation and infection accounted for 44 and 39 patients, who demonstrated significant inflammatory responses and markedly impaired spirometry, but not diffusing capacity, compared with healthy subjects and patients isolated with other PPMs and commensals (all P<0.05). Except for heightened sputum inflammatory responses, there were no notable differences in serum inflammation and lung function as with the increased density of PA. Female gender [odds ratio (OR): 3.10 for PA isolation; OR: 3.74 for PA infection], 4 or more exacerbations within 2 years (OR: 3.74 for PA isolation, OR: 2.95 for PA infection) and cystic bronchiectasis (OR: 3.63 for PA isolation, OR: 4.47 for PA infection) were the factors consistently associated with PA isolation and infection.Conclusions
PA elicits intense inflammation and lung function impairment in steady-state bronchiectasis. The density of PA does not correlate with most clinical indices. PA infection is associated with females, frequent exacerbations and cystic bronchiectasis. 相似文献18.
Objective
To determine the mosquito repellent activity of herbal essential oils against female Aedes aegypti and Culex quinquefasciatus.Methods
On a volunteer''s forearm, 0.1 mL of each essential oil was applied to 3 cm×10 cm of exposed skin. The protection time was recorded for 3 min after every 30 min.Results
Essential oil from clove oil in olive oil and in coconut oil gave the longest lasting period of 76.50 min and 96.00 min respectively against Aedes aegypti. The citronella grass oil in olive oil, citronella grass oil in coconut oil and lemongrass oil in coconut oil exhibited protection against Culex quinquefasciatus at 165.00, 105.00, and 112.50 min respectively.Conclusions
The results clearly indicated that clove, citronella and lemongrass oil were the most promising for repellency against mosquito species. These oils could be used to develop a new formulation to control mosquitoes. 相似文献19.
Background
The importance of the interleukin (IL)-1 cytokine family in inflammation and immunity is well established as a result of extensive in vitro and in vivo studies. In fact, much of our understanding of the in vivo importance of interleukin-1beta (IL-1B) is the result of research utilizing transgenic mice, such as overexpression or deficiencies of the naturally occurring inhibitor of IL-1 known as interleukin-1 receptor antagonist (IL-1RA). For the present studies, we utilized these transgenic mice to determine the role of IL-1B in glucose sensor function in vivo.Methods
To investigate the role of IL-1B in glucose sensor function in vivo, we compared glucose sensor function in trans-genic mice that (1) overexpressed IL-1RA [B6.Cg-Tg(II1rn)1Dih/J] and (2) are deficient in IL-1RA (B6.129S-Il1rntm1Dih/J), with mice that have normal levels of IL-1RA (C57BL/6).Results
Our studies demonstrated that, during the first 7 days post-sensor implantation (PSI), mice deficient in IL-1RA had extensive inflammation and decreased sensor function when compared to normal or IL-1RA-overexpressing mice.Conclusion
These data directly support our hypothesis that the IL-1 family of cytokines and antagonists play a critical role in controlling tissue reactions and thereby sensor function in vivo during the first 7 days PSI. 相似文献20.
Omar M. Rashid Masayuki Nagahashi Suburamaniam Ramachandran Catherine I. Dumur Julia C. Schaum Akimitsu Yamada Tomoyoshi Aoyagi Sheldon Milstien Sarah Spiegel Kazuaki Takabe 《Journal of thoracic disease》2013,5(4):385-392