The Application of Realtime Fluorescence Quantitative PCR for Prenatal Screening of Group B Streptococcal Infections

Objective: In the prenatal screening, several different methods were used to detect the presence of group B streptococcus (GBS) infection, in this assay, the diagnostic value and clinical significance of the application of realtime fluorescent PCR were explored. Methods: A total of 86 women with 35-37 weeks pregnancy were enrolled, vaginal secretion samples were collected. Fluorescence PCR, bacterial culture and gene sequencing were used to detect whether there was GBS infection, and the results obtained were compared and analyzed. Results: 10 subjects were detected to be positive for GBS by fluorescence PCR (the positive rate was 11.6%), however, only 4 cases were positive for GBS by bacterial culture method (the positive rate was 4.7%). There was a statistically significant difference in the positive rate between the two methods (P<0.01). Compared with the results of gene sequencing, the detection of GBS infection by fluorescence PCR has an accuracy of 95.2%, and the sensitivity was 90.9% with 100% specificity. Conclusion: The application of realtime fluorescence quantitative PCR for the detection of GBS infection is significantly better than the use of bacterial culture method. Compared with the gold standard method (gene sequencing method), its detection efficiency, accuracy, sensitivity and specificity are relatively high. In summary, PCR for prenatal screening of GBS is worthy of promotion in clinical practice.

In Vitro Antibacterial Activity of Galla Chinensis Combined with Different Antibacterial Drugs against Carbapenem-Resistant E.Coli

Objective:To evaluate the antibacterial effects of meropenem and levofloxacin respectively combined with Galla chinensis on carbapenem-resistant Escherichia coli in vitro.Methods:The protocol was designed with checkerboard method and the carbapenem-resistant E.coli was isolated in our hospital.The minimum inhibitory concentrations(MICs)of G.chinensis alone and combined with 2 antimicrobial agents against carbapenem-resistant E.coli were determined by broth dilution method and the fractional inhibitory concentration index(FICI)was calculated according to MICs results.Result:the combined use of G.chinensis and meropenem(or levofloxacin)significantly decreased both MIC50 and MIC90;After the combination of G.chinensis and meropenem,the synergistic effect was 86.7%,and the additive effect was 13.3%,no irrelevant and antagonistic effects.After combined use of G.chinensis and levofloxacin,the synergistic effect was 66.7%,and the additive effect was 33.3%.No irrelevant and antagonistic effects.Conclusion:Galla chinensis combined with meropenem or levofloxacin has synergistic and additive antibacterial effect,with certain combined antibacterial activity.

Combined Detection of Mean Platelet Volume and Immunoglobins as a Strategy for the Diagnosis of Systemic Lupus Erythematosus

Objective:To explore the possibility of diagnosing and monitoring patients with systemic lupus erythematosus(SLE)using the combination of mean platelet volume(MPV)and routine immunoglobulin test.Methods:116 patients with SLE were divided into 3 groups according to their clinical characteristics,including 29 patients with renal impairment,44 cases of active stage and 43 cases of inactive patients.40 healthy subjects were randomly selected as controls.Subjects were tested for routine blood test and plasma Immunoglobins,such as IgG,IgA,IgM,C3,C4,CH50,CRP.The results were analyzed and the characteristics of each group of subjects were determined,the correlation between test results and diagnosis were studied.Results:In comparison to the control group,the serum level of MPV,C3 and C4 were decreased(P<0.05),and C reactive protein level was elevated(P<0.001)in the three groups of SLE patients.The IgG level in active and inactive SLE patients was increased(P<0.0001),CH50 level was decreased in patients with inactive SLE(P<0.05),IgA level of active SLE subjects was found to be elevated(P<0.05),IgM in patients with renal impairment was decreased(P<0.05).Other than that,no other significant characteristic were found.Conclusion:The pathogenesis of SLE is a complex process involving multiple factors.The changes of MPV,IgG,IgA,IgM,C3,C4,CH50 and CRP in SLE patients are characteristic parameters.The combination of the above indicators can help to determine the diagnosis and staging of SLE.The timely diagnosis and treatment of SLE patients has important clinical significance in protecting the organ function of SLE patients and improving the prognosis.

NAT2 Involed in the Susceptibility to Antituberculosis Drug-Induced Liver Injury

Objective: To investigate whether the N-acetyltransferase 2 (NAT2) gene is involved in the development of susceptibility to antituberculosis drug-induced liver damage (ATDLI) in patients with pulmonary tuberculosis in the Han nationality. Methods: We retrospectively analyzed 300 cases of tuberculosis patients without liver damage (control group) and 221 cases of tuberculosis patients with liver damage after antituberculosis treatment (case group). After antituberculosis treatment, genetic polymorphisms of NAT2 were analyzed in those patients using MassARRAY method. Results: Of the 10 tagged SNPs selected, In the promoter area of NAT2, the frequencies of T allele in rs4646243 and A allele in rs4646246 were significantly higher in the patients with ATDLI than controls (0.569 vs. 0.483, p=0.0062 and 0.567 vs 0.487, p=0.0103). The A allele of rs1115784 in the intron area showed a significant association with the development of ATDLI (0.389 vs 0.305, p = 0.0043). The frequencies of the mutated genes T and A in rs1041983 and rs1799930 in the second exon region were significantly higher than those in the control group (0.491 vs 0.360, p<0.00001 and 0.336 vs 0.212, respectively;p<0.00001). Two monomer domains were found in the 10 tag SNP sites, haplotype ht [TGAA] in monomeric domain 1 and haplotype ht [TAG] in monomeric domain 2, both were significantly more likely to be detected in the liver injury group than in the control group(p=0.0038, p<0.001, respectively). Two haplotypes were also found on the NAT2 gene: haplotype ht [CGGG] in monomeric domain 1 and ht [CGG] in block 2, and their presence means a lower risk of liver damage. Conclusion: NAT2 genotypes might have significant association with the risk of ATDLI in the Chinese Han nationality. By detecting the NAT2 gene and its haplotype, we can screen patients with a higher risk of liver damage before anti-TB treatment and take measures for the protection of patients.

Relationship between CYP2E1 Gene Polymorphism and Anti-tuberculosis Drug-induced Liver Injury

Objective: To investigate the relationship between cytochrome P450 E1 (CYP2E1) gene polymorphisms and susceptibility to anti-tuberculosis drug-induced liver damage (ATDLI) in tuberculosis patients in the Chinese Han nationality. Methods: A retrospective analysis was performed on 360 patients with tuberculosis who had liver damage after tuberculosis treatment (case group) and 360 patients with tuberculosis who did not develop liver injury after treatment (control group). MassARRAY were used to detect CYP2E1 gene polymorphisms. Results: In a total of 8 tagged SNP loci selected, the rs8192773 locus failed to pass the test, and therefore, it is not included in subsequent analysis. At the remaining seven SNP sites, the difference in alleles was not statistically significant between the case group and the control group, suggesting that these sites may not be related to liver damage caused by anti-tuberculosis drugs. Three monomer domains were found in the seven tags SNP loci mentioned above. However, it was found that these haplotypes are not closely related to anti-tuberculosis drug-induced liver damage. Conclusion: The CYP2E1 gene polymorphism in the Chinese Han nationality is not related to the occurrence of anti-tuberculosis drug-induced liver injury.

Clinical Distribution and Drug Resistance of 224 Strains of Pseudomonas Aeruginosa

Objective:To provide evidence for a rational and effective prevention and treatment of Pseudomonas aeruginosa,the clinical characteristics and the resistance to various antibiotics of were investigated.Methods:A retrospective analysis of 224 strains of Pseudomonas aeruginosa isolated from various specimens from various clinical departments of our hospital(April 1,2018 to June 31,2019)were conducted.Identification and drug susceptibility test of isolated strains was performed using a fully automatic bacterial identification analyzer(MicroScan WalkAway-96 plus),and data analysis was performed using WH0NET5.6 software.Results:Among all the bacteria isolated in our hospital during the above period,Pseudomonas aeruginosa accounted for 10.09% of them all and 12.57% of Gram-negative bacilli,respectively.These isolates were mainly derived from sputum specimens(68.75%),mainly from male patients(70.54%),and mostly 61-70(27.23%)or 51-60(22.77%)years old.Pseudomonas aeruginosa isolates are mainly from Rehabilitation Ward,ICU,and Liver Transplantation Unit,accounted for 29.91%,12.95% and 10.27% of all isolates,respectively.The sensitivity of Pseudomonas aeruginosa to various antibacterial drugs,in the order of high to low were carbapenems,aztreonam,quinolones,cephalosporins,piperacillin/tazobactam,aminoglycoside,with a lowest resistance rate(2.4%)to amikacin and a highest resistance rate to imipenem(33.0%).Conclusion:The isolation rate of Pseudomonas aeruginosa was relatively stable during the study period,and among all the P.aeruginosa detected,most of them were from the respiratory secretions of elderly male patients.The resistance rate of Pseudomonas aeruginosa isolates to various antibiotics is mainly within 30%.Clinical units such as Rehabilitation Ward,ICU,and Liver Transplantation Unit have a high detection rate;therefore,these departments should be monitored in a focused manner.Our research provides a scientific basis for the rational use of antibiotics and a better control of Pseudomonas aeruginosa infection.

Isolates of Cryptococcus Neoformans from Non-HIV and Non-Transplant Hospitalized Patients

A retrospective cross-sectional study for patients with confirmed Cryptococcus neoformans meningitis(CM)in non-HIV-infected and non-transplant hosts in two class-A tertiary hospitals in Guangzhou,China is reported.181 CM patients were enrolled during the study period,48%(87/181)of which died.Underlying diseases were risk factor associated with higher mortality,among which diabetes mellitus ranked first for the incidence of CM.The mortality was not related to antifungal drug susceptibility.All strains were considered susceptible to amphotericin B,although interpretative breakpoints for amphotericin B have not yet been established.According to the CLSI guidelines,most of the strains in our study were susceptible to voriconazole,fluconazole,fluorocytosine and dose-dependently susceptible to itraconazle.