Identifying genetic susceptibility to Aspergillus fumigatus infection using collaborative cross mice and RNA-Seq approach

Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidate genes associated with host susceptibility to Aspergillus fumigatus(Af)using an RNAseq approach in CC lines and hepatic gene expression.Methods:We studied 31 male mice from 25 CC lines at 8 weeks old;the mice were infected with Af.Liver tissues were extracted from these mice 5 days post-infection,and next-generation RNA-sequencing(RNAseq)was performed.The GENE-E analysis platform was used to generate a clustered heat map matrix.Results:Significant variation in body weight changes between CC lines was ob-served.Hepatic gene expression revealed 12 top prioritized candidate genes differ-entially expressed in resistant versus susceptible mice based on body weight changes.Interestingly,three candidate genes are located within genomic intervals of the previ-ously mapped quantitative trait loci(QTL),including Gm16270 and Stox1 on chromo-some 10 and Gm11033 on chromosome 8.Conclusions:Our findings emphasize the CC mouse model's power in fine mapping the genetic components underlying susceptibility towards Af.As a next step,eQTL analysis will be performed for our RNA-Seq data.Suggested candidate genes from our study will be further assessed with a human cohort with aspergillosis.

Factors Associated with Acute Respiratory Infections in Children Aged 0 - 5 Years in the Yénawa District of Cotonou (Benin) in 2023

Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in children 0 to 5 years old in Yénawa, Cotonou in 2023. Subjects and Method: It was an analytical cross-sectional study of children aged 0 - 5 years and their mothers in Yénawa, selected by four-degree random sampling. The sampling size, calculated using the Schwartz formula, was 126 children and 126 mothers. The dependent variable was the occurrence of acute respiratory infections. The independent variables were classified into four groups: socio-demographic and economic characteristics, behavioral factors, child-related factors, and environmental factors. Data collected by observation and questionnaire survey were analyzed using STATA version 15 software. Associated factors were investigated by bivariate analysis and multiple logistic regression, at the 5% significance level. Results: A total of 126 children aged 0 - 5 years and 126 mothers were surveyed, aged 23.5 (11 - 36) months and 30 (18 - 48) years respectively. The prevalence of acute respiratory infections was 74.60% (CI95% = 66.89 to 82.30). The associated factors were the mother’s age between 18 and 28 (OR = 10.77;CI95% = 1.89 to 61.27;p = 0.007), the use of charcoal/wood for cooking (OR = 7.36;IC = 1.99 to 27.10;p = 0.003)), children's poor personal hygiene (OR = 8.87;IC = 2.92 to 26.97;p 0.001)), and cohabitation with domestic animals (OR = 7.27;IC = 1.67 to 31.71;p = 0.015). Conclusion: Communicating with mothers about the factors identified will help reduce the prevalence of acute respiratory infections in children aged 0 to 5.

Follow-up study of hepatitis C virus infection in uremic patients on maintenance hemodialysis for 30 months

INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission

Nosocomial infection and spread of SARS-CoV-2 infection among hospital staff,patients and caregivers

BACKGROUND There are difficulties in diagnosing nosocomial transmission of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in hospital settings. Furthermore, mortality of cases of nosocomial infection(NI) with SARS-CoV-2 is higher than that of the general infected population. In the early stage of the pandemic in Taiwan, as patients were not tested for SARS-CoV-2 at admission, NIs often go undetected. Strictly applying the systematic polymerase chain reaction(PCR) screening, as a standard infection control measure was subsequently implemented to reduce NI incidence. However, evidence on risk factors for SARS-CoV-2 NIs among healthcare workers(HCWs) and caregivers is limited.AIM To assess NI incidence of SARS-CoV-2 among hospital staff, hospitalized patients, and caregivers, and the transmission routes of clusters of infection.METHODS This descriptive retrospective analysis at our hospital from May 15 to August 15, 2021 included data on 132 SARS-CoV-2 NIs cases among hospital staff, inpatients, and caregivers who previously tested negative but subsequently identified with a positive SARS-CoV-2 reverse transcriptase-PCR(RT-PCR) test results, or a hospital staff who tested positive following routine SARS-CoV-2 RT-PCR test. Chi-square tests were performed to compare the differences between hospital staff and private caregivers, and between clusters and sporadic infections.RESULTS Overall, 9149 patients and 2005 hospital staff members underwent routine SARS-CoV-2 RT-PCR testing, resulting in 12 confirmed cluster and 23 sporadic infections. Among the index cases of the clusters, three(25%) cases were among hospital staff and nine(75%) cases were among other contacts. Among sporadic infections, 21(91%) cases were among hospital staff and two(9%) cases were among other contacts(P < 0.001). There was an average of 8.08 infections per cluster. The secondary cases of cluster infection were inpatients(45%), hospital staff(30%), and caregivers(25%). Private caregivers constituted 27% and 4% of the clusters and sporadic infections, respectively(P = 0.024);92.3% of them were infected in the clusters. The mortality rate was 0.0%.CONCLUSION The incidence of SARS-CoV-2 infection was relatively high among private caregivers, indicating a need for infection control education in this group, such as social distancing, frequent handwashing, and wearing PPE.

Interferon-free treatments in patients with hepatitis C genotype 1-4 infections in a real-world setting

AIM To investigated the real-world effectiveness and safety of various regimens of interferon-free treatments in patients infected with hepatitis C virus(HCV).METHODS We performed an observational study to analyze different antiviral treatments administered to 462 HCV-infected patients, of which 56.7% had liver cirrhosis. HCV RNA after 4 wk of treatment and at 12 wk after treatment sustained virologic response(SVR) as well as serious adverse events(SAEs) was analyzed first for the whole cohort and then separately in patients who met or did not meet the inclusion criteria of a clinical trial(CT-met and CT-unmet, respectively).RESULTS The most frequently prescribed treatment was simeprevir/sofosbuvir(36.4%), followed by sofosbuvir/ledipasvir(24.9%) and ombitasvir/paritaprevir/ritonavir(r)/dasabuvir(19.9%). Ribavirin(RBV) was administered in 198 patients(42.9%). SVRs occurred in 437/462 patients(94.6%). The SVRs ranged between 93.3% and 100% for genotypes 1-4. SVRs were achieved in 96.2% patients in the CTmet group vs 91.9% patients in the CT-unmet group(P = 0.049). Undetectable HCV RNA at week 4 occurred in 72.9% of the patients. In the univariate analysis, the factors associated with SVRs were lower liver stiffness, absence of cirrhosis, higher platelet count, higher albumin levels, no RBV dose reduction, undetectable HCV RNA at week 4 and CT-met group. In the multivariate analysis, only albumin was an independent predictor of treatment failure(P = 0.04). Eleven patients(2.4%) developed SAEs; 5.2% and 0.7% of the patients in the CT-unmet and CT-met groups, respectively(P = 0.003).CONCLUSION A high proportion of patients with HCV infection achieved SVRs. For patients who did not meet the CT criteria, treatment regimens must be optimized.

Infections Related to Health Care in Newborns: Documental Study Based on Analysis of Research Database

This documentary research aimed to describe the results of an epidemiological survey that sought to determine the prevalence of Infections Related to Health Care (IRHC) in newborns admitted to a Neonatal Intensive Care Unit (NICU) at the city of Rio de Janeiro. For methodology, the existing data in the original research database were used as the primary source. The method used was the case study in a quantitative approach. The data have been statistically arranged by odds ratio, which measured the possibility of IRHC development at the 102 newborns, by exposition at the risk factors. Results: IRHC prevalence with pneumonias, sepsis, navel’s infection and ocular infections predominance rises. Prematures are 4.10 more susceptible. Twelve hours after amniotic rupture there are 1.77 more chances of infections. Babies with more than 10 days of hospitalization are 4.70 more susceptible than those with 10 days. The registers examined were incipient at the IRHC’s characterization, beginning and duration, which make the IRHC’s diagnostic/notification difficult.

Variance Reduction Technique for Estimating Value-at-Risk based on the Cross - Entropy

Value-at-Risk （VaR） estimation via Monte Carlo （MC） simulation is studied here. The variance reduction technique is proposed in order to speed up MC algorithm. The algorithm for estimating the probability of high portfolio losses （more general risk measure） based on the Cross - Entropy importance sampling is developed. This algorithm can easily be applied in any light- or heavy-tailed case without an extra adaptation. Besides, it does not loose in the performance in comparison to other known methods. A numerical study in both cases is performed and the variance reduction rate is compared with other known methods. The problem of VaR estimation using procedures for estimating the probability of high portfolio losses is also discussed.

IGF-1、β-CTX与胫骨平台骨折术后感染及骨痂X线评分的关系

目的分析血清胰岛素样生长因子-1(IGF-1)、β-Ⅰ型胶原羧基端肽(β-CTX)水平与胫骨平台骨折患者术后感染及骨痂X线评分的关系。方法回顾性分析2020年1月至2023年1月北京市仁和医院收治的90例胫骨平台骨折患者的临床资料,根据术后感染情况分为感染组(n=23例)和未感染组(n=67例)。对比两组的临床资料,应用二元Logistic回归模型分析胫骨平台骨折患者术后感染影响因素;采用Spearman相关系数分析IGF-1、β-CTX与术后3个月的骨痂X线评分的相关性,绘制受试者工作特征(ROC)曲线分析IGF-1和β-CTX对患者术后骨折愈合情况的预测价值。结果两组一般资料中性别、损伤机制、骨质疏松情况、合并糖尿病情况、手术时间、联合应用抗生素情况以及住院天数比较差异均无统计学意义(P>0.05);感染组中年龄≥60岁、开放性骨折损伤类型、有遗留死腔的比例均高于未感染组,血清IGF-1和β-CTX水平均低于未感染组,差异有统计学意义(P<0.05);骨痂X线分级Ⅰ~Ⅱ级患者的血清IGF-1和β-CTX水平低于骨痂X线分级Ⅲ~Ⅳ级患者,差异有统计学意义(P<0.05);年龄≥60岁(OR=3.840,95%CI:1.803~8.178)、开放行骨折损伤类型(OR=3.656,95%CI:1.705~7.834)、有遗留死腔(OR=3.407,95%CI:1.670~6.955)、<中位数水平的血清IGF-1(OR=2.578,95%CI:1.388~4.789)和β-CTX(OR=2.550,95%CI:1.262~5.153)的胫骨平台骨折患者术后感染风险更高(P<0.05);血清IGF-1和β-CTX水平与胫骨平台骨折患者术后骨痂X线评分均呈正相关(r=0.671、0.699,P<0.05);血清IGF-1、β-CTX水平及二者联合预测胫骨平台骨折患者术后骨折愈合情况的AUC分别为0.799、0.832、0.884,敏感度分别为0.727、0.727、0.909,特异性分别为0.785、0.798、0.772。结论胫骨平台骨折患者术后感染情况与年龄、损伤类型、遗留死腔、血清IGF-1和β-CTX水平有关,临床可通过检测IGF-1和β-CTX水平变化预测患者术后骨折愈合情况。

精神分裂症合并医院感染患者血清T-AOC、CAT、NO、GSH-Px水平变化及临床意义

【目的】探讨精神分裂症(SP)合并医院感染患者血清总抗氧化能力(T-AOC)、过氧化氢酶(CAT)、一氧化氮(NO)、谷胱甘肽过氧化物酶(GSH-Px)水平变化及临床意义。【方法】选取2019年6月至2021年2月本院收治的114例SP患者(观察组),依据感染情况将患者分为感染组(n=52)和未感染组(n=62)。依据感染组患者严重程度,将患者分为轻度组(n=12)、中度组(n=25)、重度组(n=15)。同时,选取于本院同期进行体检的健康志愿者为对照组(n=71)。对比研究对象血清T-AOC、CAT、NO、GSH-Px水平,分析其与感染组病情严重程度相关性,采用受试者工作特征(ROC)曲线分析其对SP患者发生医院感染的诊断价值,采用Logistic回归方程分析SP患者发生医院感染的影响因素。【结果】观察组白细胞计数、中性粒细胞数、血小板、单核细胞数、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、NO高于对照组,淋巴细胞数、脑源性神经营养因子(BDNF)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、T-AOC、GSH-Px、CAT水平低于对照组,差异有统计学意义(P<0.05)。感染组LDL-C、NO高于未感染组,BDNF、HDL-C、CAT、T-AOC、GSH-Px水平低于对照组,差异有统计学意义(P<0.05)。血清T-AOC、CAT、GSH-Px水平比较:重度组<中度组<轻度组,差异有统计学意义(P<0.05);血清NO水平比较:重度组>中度组>轻度组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,血清T-AOC、CAT、GSH-Px水平与病情严重程度呈负相关(P<0.01),血清NO水平与病情严重程度呈正相关(P<0.01)。Logistic回归方程分析显示,T-AOC<10.03 U/mL、CAT<5.34 U/mL、NO≥30.31μmol/L、GSH-Px<42.36 U/L是SP患者发生医院感染的独立危险因素(P<0.05)。ROC曲线分析显示,T-AOC、CAT、GSH-Px、NO联合检测诊断SP患者发生医院感染时曲线下面积、敏感度、特异度均优于单项检测(P<0.05)。【结论】SP发生医院感染患者血清T-AOC、CAT、GSH-Px水平降低,血清NO水平升高,可作为反映SP患者病情的生物学指标,有助于临床及时制定治疗方案,改善患者预后。

马铃薯及番茄晚疫病菌的核糖体DNA-ITS区段序列分析

取3个不侵染马铃薯的番茄晚疫病菌菌株和3个不侵染番茄的马铃薯晚疫病菌菌株,以及2个可交叉侵染马铃薯和番茄的菌株,提取DNA全基因组后,用引物ITS1和ITS4进行扩增,得到约850bp左右的扩增产物并进行测序,比较同源性,结果显示这些菌株的全基因组DNA序列与Genebank上登录的3个序列AF228084,AF228083,AY269995 1的同源性均为100%。3个番茄菌株之间的同源性大小为98 22%,3个马铃薯菌株之间的为99 52%,较番茄菌株的同源性高。不可交叉的两类菌株间的同源性为98 28%,可交叉侵染的番茄菌株和马铃薯菌株之间的同源性为99 17%,比不可交叉侵染的菌株间的同源性高,说明相似的序列使得生物学特性也很相似,反之,同源性有差异的,在生物特性上也表现出一定差异。

介入手术室空气压力设计与COVID-19感染控制探讨

目的探讨如何避免COVID-19在介入手术室交叉感染。方法2020年2月7至28日对国内16个省、市、自治区68所三级医院介入手术室净化空调系统空气压力设计情况进行调查,结合介入手术实际及COVID-19防控现状进行分析。结果68所医院介入手术室净化空调系统均无空气负压设计,不具备呼吸道传染病专业防护条件。结论疫情期间增强防控风险意识、加强医疗环境管理、强化感染防护措施、筹划改造、扩建及新建负压介入手术室,有助于降低COVID-19在介入手术室交叉感染风险。

2010-2014年湖北省医院感染现患率与抗菌药物使用变化趋势

目的了解湖北省医疗机构住院患者医院感染和抗菌药物使用的变化趋势,为提高医院感染管理水平提供科学依据。方法对2010、2012、2014年湖北省医院感染横断面调查结果进行分析。结果2010、2012、2014年医院感染现患率分别为3.48%(1 526/43 909)、3.03%(1 919/63 320)和2.86%(2 174/76 145),总体呈下降趋势,差异有统计学意义(χ2=36.44,P<0.01)。抗菌药物使用率逐年下降,从2010年的54.29%(23 838/43 909)下降至2014年的41.02%(31 238/76 145),差异有统计学意义(χ2=2 194.09,P<0.01)。治疗使用抗菌药物患者的细菌培养送检率逐年提高,从2010年的30.49%(4 297/14 091)提高至2014年的52.13%(10 556/20 248)(χ2=1 593.98,P<0.01)。结论湖北省医院感染现患率呈下降趋势,横断面抗菌药物使用率逐步下降。

医院感染产β-内酰胺酶金黄色葡萄球菌的耐药分析

目的分析2014年首都医科大学附属北京中医医院产β-内酰胺酶金黄色葡萄球菌的分布特点及耐药性。方法收集送检标本15 620例,对产β-内酰胺酶金黄色葡萄球菌进行分离,观察其临床分布特征及耐药性。结果共分离非重复病原菌5075株,其中金黄色葡萄球菌526株(10.4%),包括产β-内酰胺酶金黄色葡萄球菌301株(57.2%),其来源主要为创口分泌液和痰液,分布科室主要有重症监护病房、皮肤科和疮疡外科,对青霉素、红霉素、环丙沙星和苯唑西林等耐药率较高,对呋喃妥因、利奈唑胺和万古霉素的耐药率均为0;多引起呼吸机相关感染、下呼吸道感染和皮肤化脓性感染等。结论产β-内酰胺酶金黄色葡萄球菌分布广泛,其对多种抗生素耐药率高,临床应高度重视。

舒巴坦-头孢哌酮治疗医院获得性肺炎的效果观察

①目的 探讨舒巴坦 头孢哌酮对医院获得性肺炎的效果。②方法 将 6 3例医院获得性肺炎病人随机分为两组 :治疗组 32例 ,采用舒巴坦 头孢哌酮 2 g静脉滴注 ,每 8～ 12h 1次 ;对照组 31例 ,采用头孢噻肟 2 g静脉滴注 ,每 8～ 12h 1次。两组疗程均为 7～ 14d .③结果 治疗组治疗有效率为 87.5 % ,细菌清除率为 86 .7% ;对照组有效率为 83.9% ,细菌清除率为 84 .6 % ,两组比较差异无显著性 (χ2 =0 .15 2 ,0 .184 ,P >0 .0 5 )。两组病人共分离出病原菌 5 6株 ,药敏试验显示对舒巴坦 头孢哌酮敏感率为 89.3% ,高于头孢噻肟的 6 9.6 %和头孢哌酮的6 6 .1% ,差异有显著性 (χ2 =5 .83,5 .4 2 ,P <0 .0 5 )。④结论 舒巴坦 头孢哌酮治疗医院获得性肺炎疗效良好 ,使用安全。

MALDI-TOF质谱在院内感染致病菌检测中的应用

目的采用MALDI-TOF质谱分析方法鉴定院内感染致病菌。方法同步使用VITEK-2和MALDI-TOF质谱鉴定院内感染致病菌。从检测时间、鉴定率及检出数量进行两种方法的对比。将微生物大分子指纹图谱进行共性峰比对计算,获得院内感染致病菌株间同源性结构关系的差异。结果共检出31株大肠埃希氏菌、28株肺炎克雷伯氏菌及解鸟苷酸拉乌尔菌等罕见致病菌9株。MALDI-TOF质谱检测能够在1h内检出所有的致病菌,且鉴定率和检出数量高于VITEK-2。结论致病菌的院内感染呈现科室为中心点源传播的模式。MALDI-TOF质谱检测速度快、准确率高,能够进行临床耐药菌的聚类分析,有望成为致病菌鉴定和临床耐药菌风险监测工作的主要技术力量。

β-内酰胺类抗生素对院内感染菌体外抗菌活性的比较

目的：监测常见院内感染菌对７种β－内酰胺类抗生素的耐药性，以指导临床用药。方法：采用双倍肉汤稀释法测定从我院重症监护病房及其它地方病房分离的６种革兰氏阴性杆菌和２种革兰氏阳性球菌共２８０株细菌的最低抑菌浓度（ＭＩＣ）。结果：头孢哌酮／舒巴坦（ＣＰＺ／ＳＢ）对革兰氏阴性杆菌的总耐药率最低为１２．７％，其次是亚胺培南（ＩＰＭ）为１３．６％和头孢他啶（ＣＡＺ）２８．６％。除嗜麦芽黄单胞菌外，亚胺配能对其它革兰氏阴性菌的耐药率最低仅为４．５％。大肠埃希氏菌和肺炎克雷伯氏菌产生超广谱β－内酰胺酶（ＥＳＢＬ）为１１．９％。葡萄球菌和肠球菌对第三代头孢菌素的耐药率＞７０％。结论：院内感染菌对头孢哌酮／舒巴坦、亚胺培南和头孢他啶耐药率最低，氨曲南和第三代头孢菌素对革兰氏阴性产酶菌呈现交叉耐药性。

医院床单位管理新模式-床单位消毒中心

通过成立床单位消毒中心对床单位实行集中管理。从而避免了患者在住院期间因床单位处理不规范而发生的交叉感染,受到广大患者的欢迎,也提高了医院的竞争力。

2011-2013年医院感染横断面调查变化趋势分析

目的：评价某三级综合医院近3年医院感染横断面调查结果的变化趋势。方法对2011—2013年医院感染横断面调查医院感染、抗菌药物使用及病原学监测资料进行趋势分析。结果2011年医院感染现患率为5.28%，明显高于2012年现患率3.63%和2013年现患率3.69%，存在统计学差异（P〈0.01）；呼吸道、手术部位和泌尿道为常见医院感染部位；调查日抗菌药物使用率由28.31%下降至21.34%（P〈0.05），预防用药比例由27.54%下降至18.97%，一联抗菌药物使用构成比由86.05%上升至90.44%，二联、三联及以上抗菌药物使用构成比下降（P〈0.05）。结论近3年医院感染管理工作取得较好成效，仍需加强重点人群及重点部位感染风险管理。

85354例住院和门诊患者抗-HIV检测的结果分析

目的了解住院及门诊患者人免疫缺陷病毒(HIV)感染情况并探讨其防范措施。方法对2009～2011年85354例住院及门诊患者进行HIV抗体检测,并分析其阳性结果。结果初筛阳性190例,确认阳性188例,符合率为98.95%,阳性率为0.22%。188例感染者中男141例,女47例,年龄0～80岁,其中60岁以上最多(0.61%)。科室分布为内科0.11%,外科0.39%,妇科0.12%,门诊0.28%。结论常规对住院患者进行HIV抗体检测对预防医源性感染、减少医疗纠纷、防止医务人员职业暴露有重要意义。

COVID-19疫情期间预检分诊流程及优化

为提高COVID-19患者的预检分诊效率与准确性,降低交叉感染率,根据《传染病防治法》《医疗机构传染病预检分诊管理办法》及相关文件规定,结合医院自身人员、设备、场地等特点,采用"先室外初级预检分诊分流,后专项次级分诊"流程。在医院门诊部室外设立预检分诊处,初步分流三类患者:有流行病学史或/和有发热、呼吸道症状者;无流行病学史,有呼吸道症状者;其他患者。患者依据分诊类别分别进入相应诊疗通道,第一类患者直接从室外分诊处引导至发热门诊室外,进行次级疑似COVID-19专项分诊;第二类仅有呼吸道症状的患者,引导至门诊指定区域候诊,避免与普通门诊病人混合;第三类普通病患者进入门诊科室。可以有效保障门诊医疗安全。