Epidemiologic Features, Radiological Findings and Clinical Outcomes of 19 Patients with COVID-19 in a Single Center in Beijing, China

Objective To describe the epidemiologic,clinical,laboratory,and radiological characteristics and prognoses of COVID-19 confirmed patients in a single center in Beijing,China.Methods The study retrospectively included 19 patients with nucleic acid-confirmed SARS-CoV^2 infection at our hospital from January 20 to March 5,2020.The final follow-up date was March 14,2020.The epidemiologic and clinical information was obtained through direct communication with the patients or their family members.Laboratory results retrieved from medical records and radiological images were analyzed both qualitatively by two senior chest radiologists as well as quantitatively via an artificial intelligence software.Results We identified 5 family clusters(13/19,68.4%)from the study cohort.All cases had good clinical prognoses and were either mild(3/19)or moderate(16/19)clinical types.Fever(15/19,78.9%)and dry cough(11/19,57.9%)were common symptoms,Two patients received negative results for more than three consecutive viral nucleic acid tests.The longest interval between an initial CT abnormal finding and a confirmed diagnosis was 30 days.One patient's nucleic acid test turned positive on the follow-up examination after discharge.The presence of radiological abnormalities was non-specific for the diagnosis of COVID-19.Conclusions COVID-19 patients with mild or no clinical symptoms are common in Beijing,China.Radiological abnormalities are mostly non-specific and massive CT examinations for COVID-19 screening should be avoided.Analyses of the contact histories of diagnosed cases in combination with clinical,radiological and laboratory findings are crucial for the early detection of COVID-19.Close monitoring after discharge is also recommended.

Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation

The polymyxins are important antimicrobial agents against antibiotic-resistant gram-negative bacilli.In 2020,the Clinical and Laboratory Standards Institute modified the clinical breakpoints for polymyxin susceptibility test by eliminating the"susceptible"interpretive category,only reporting intermediate(≤2 mg/L)and resistant(≥4 mg/L).However,the European Committee on Antimicrobial Susceptibility Testing recommended the use of clinical breakpoints of W2 mg/L as susceptible and>2 mg/L as resistant.The first-line laboratorians and clinicians in China have been perplexed by the inconsistence of international polymyxin clinical breakpoints and discouraged by the difficulty of conducting polymyxin susceptibility testing.Therefore,it is urgently needed to make it clear for the laboratorians in China to know how to accurately carry out polymyxin susceptibility testing and standardize the interpretation of susceptibility testing results.To this end,the experts from relevant fields were convened to formulate this consensus statement on the testing and clinical interpretation of polymyxin susceptibility.Relevant recommendations are proposed accordingly for laboratorians and clinicians to streamline their daily work.

Rapid, automated, and reliable antimicrobial susceptibility test from positive blood culture by CAST‐R

Antimicrobial susceptibility tests(ASTs)are pivotal in combating multidrug resistant pathogens,yet they can be time‐consuming,labor‐intensive,and unstable.Using the AST of tigecycline for sepsis as the main model,here we establish an automated system of Clinical Antimicrobials Susceptibility Test Ramanometry(CAST‐R),based on D2O‐probed Raman microspectroscopy.Featuring a liquid robot for sample pretreatment and a machine learning‐based control scheme for data acquisition and quality control,the 3‐h,automated CAST‐R process accelerates AST by>10‐fold,processes 96 paralleled antibiotic‐exposure reactions,and produces high‐quality Raman spectra.The Expedited Minimal Inhibitory Concentration via Metabolic Activity is proposed as a quantitative and broadly applicable parameter for metabolism‐based AST,which shows 99%essential agreement and 93%categorical agreement with the broth microdilution method(BMD)when tested on 100 Acinetobacter baumannii isolates.Further tests on 26 clinically positive blood samples for eight antimicrobials,including tigecycline,meropenem,ceftazidime,ampicillin/sulbactam,oxacillin,clindamycin,vancomycin,and levofloxacin reveal 93%categorical agreement with BMD‐based results.The automation,speed,reliability,and general applicability of CAST‐R suggest its potential utility for guiding the clinical administration of antimicrobials.

Diagnosis and Clinical Management of Acute Severe Hepatitis of Unknown Origin: Operational Recommendation of Peking Union Medical College Hospital

Around 450 cases of acute severe hepatitis of unknown origin in children have been reported in 21 countries and region globally since April 2022,which has exceeded the past annual incidences of related regions,and has aroused wide concern.Affected patients were predominantly children under 16years of age,presented with symptoms of acute hepatitis with markedly elevated liver enzymes,and had been ruled out of common viral infections such as hepatitis A,B,C,D,and E.Similar cases have not been reported in China yet.However,considering that the severe acute hepatitis has involved worldwide areas,still with unknown origin,and incidences of severity is relatively high,we formulated this recommendation to standardize diagnosis and treatment of acute severe hepatitis of unknown origin in Peking Union Medical College Hospital,to get fully prepared to the possible public health events.