Clinical and molecular microbiological characteristics of carbapenem‐resistant Acinetobacter baumannii strains in an NICU

Background: Seventeen cases of Acinetobacter baumannii infection in a neonatal intensive care unit (NICU) were evaluated. The strains were characterized as resistant to carbapenems. The aim of the present study was therefore to investigate the clinical and molecular epidemiological characteristics of the 17 carbapenem‐resistant A. baumannii strains. Methods: Samples were isolated from blood or sputum from the patients in the NICU, cultured using conventional techniques and an automated system. Multiplex polymerase chain reaction (PCR) was used to detect blaOXA‐51‐like, blaOXA‐23‐like, OXA‐24, OXA‐58 and Ambler class B carbapenemases. The genotype of the strains was identified on pulsed‐field gel electrophoresis (PFGE). Results: BlaOXA‐23 was detected in all of the isolates. PFGE genotype analysis suggested three clones among the 17 strains. Two clones were isolated from other wards of the hospital including the adult ICU and Department of Pulmonology. The other clone was proved to be the first appearance in the hospital as genotype analysis. Conclusion: BlaOXA‐23 was the drug‐resistant gene that made A. baumannii resistant to carbepenem. The source of blaOXA‐23 in the 17 isolates was different.     

Telomere length regulators are activated in young men after pediatric kidney transplantation compared to healthy controls and survivors of childhood cancer—A cross‐sectional study

Chronic diseases are known to cause premature aging and frailty. Data about telomere length and telomere length‐regulating proteins after pediatric KTx are scarce. Leukocyte telomere length and gene expression level of eight telomere‐binding proteins were analyzed in 20 KTx recipients, eight childhood NBL survivors, and nine healthy controls. The influence of key clinical parameters on telomere length and on regulators of telomere length was evaluated. The telomere length in the KTx recipients tended to be shorter (0.53 AU) than in the healthy controls (0.64 AU) but longer than in the NBL survivors (0.38 AU). There was no significant difference in telomere length between the NBL survivors and the KTx recipients (P = .110). The gene expression level of telomere length‐preserving protein RPA1 was significantly higher in the KTx recipients than among the NBL survivors or healthy controls, while the expression of TRF2 and the tumor suppressor gene p16 was significantly higher in the KTX recipients when compared to the controls. TRF2 and TIN2 correlated significantly with hsCRP; additionally, TRF2 showed significant correlation with plasma creatinine and eGFR . KTx recipients have near to normal telomere length, but they have significantly higher gene expression levels of telomere regulatory proteins compared with healthy controls, suggesting activation of mechanisms preserving telomere length among KTx recipients. Our results suggest that declined graft function and consequent inflammatory response may have influence on telomerase activity.     

Prevalence of premastication among children aged 6–36 months and its association with health: A cross‐sectional study in eight cities of China

Premastication is thought to be an adaptive behavior in the introduction of complementary plant‐bassed food to infants. It arouses controversy, however, because of the potential for transmitting saliva‐born infectious diseases. The aim of this study was to explore whether premastication by healthy caregivers was associated with children's health and behavior. The data were collected as part of the Maternal and Infant Nutrition and Growth study. From 8 cities in China, 1341 pairs of infants/toddlers and their caregivers were recruited. An interviewer‐administrated questionnaire collected data on sociodemographic characteristics, feeding behaviors, and self‐reported health status. Anthropometric measurements were taken and blood samples were collected for analysis of hemoglobin levels. The overall prevalence of premastication was 26.9% and varies from 14–43% among the 8 cities. Premastication was not associated with occurrences of illness or with the nutritional indicators of height‐for‐age Z score, weight‐for‐age Z score, weight‐for‐height Z score, head circumference Z score and hemoglobin (P all >.05). Premastication occurred more often among infants who were raised by their parents (P = .005), whose mothers' education was lower (P < .001), who were subject to more concern from their parents (P = .022), and whose parents thought their children had an obesity problem (P = .001). Presmastication was not associated with food picky behaviors. Premastication is still a common feeding practice in China. More studies are needed to determine the biological, economic, and cultural benefits or harm from premastication.     

Intravoxel incoherent motion analysis of renal allograft diffusion with clinical and histopathological correlation in pediatric kidney transplant patients: A preliminary cross‐sectional observational study

The purpose of this study was to compare IVIM values in pediatric renal transplants with histopathology and clinical management change. Fifteen pediatric renal transplant recipients (mean 15.7±2.9 years) were prospectively scanned on a 3T MR scanner with multi‐b DTI, prior to same‐day transplant biopsy. IVIM maps from 14 subjects were analyzed (one excluded due to motion). Mean values were computed from cortical ROIs and medullary ROIs corresponding to the biopsy site. Subjects were also grouped according to whether or not the biopsy resulted in a change in clinical management. Cortico‐medullary IVIM estimates and histopathologic Banff scores were correlated with KT. Cortico‐medullary IVIM differences between the “change” and “no change” groups was compared with Mann‐Whitney U test. Cortical D_p showed significant moderate negative correlation with Banff t and ci scores (KT=?0.497, P=.035 and KT=?0.46, P=.046) and moderate positive correlation with Banff i score (KT=0.527, P=.028). Cortical P_f showed significant moderate correlation with ci and ct scores (KT=0.489, P=.035 and KT=0.457, P=.043). Tissue diffusivity, D_t, estimated with IVIM was significantly different between the “change” and “no change” groups in medullary ROIs (U=6, P=.021). IVIM analysis has potential as a noninvasive biomarker in assessment of pediatric renal allograft pathology.