Clinical Efficacy and Safety Analysis of Tigecycline in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Combined with Multidrug-Resistant Acinetobacter baumannii Infection

Objective:To study the clinical efficacy and safety of tigecycline in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)combined with multidrug-resistant Acinetobacter baumannii infection.Methods:113 patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection were recruited between January 2021 and January 2023,and given tigecycline treatment.The total effective rate,lung function indexes,related biochemical index levels,and the incidence rate of adverse reactions were observed after the treatment.Results:After the treatment,100 patients were cured,1 case with apparent effect,2 cases were effective,10 cases were ineffective,and the total effective rate was 91.15%.The post-treatment CRP(21.22±3.35 mg/L),PCT(3.18±1.11 ng/L),CRE(76.36±9.24μmol/L),and ALT(37.76±6.99 U/L)were significantly improved as compared to the pre-treatment(P<0.05).After treatment,10 cases of vomiting(8.85%),13 cases of nausea(11.50%),4 cases of diarrhea(3.53%),1 case of abdominal pain(0.88%),and 2 cases of allergy(1.77%)were observed in 113 patients.Conclusion:Tigecycline therapy for patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection not only has significant therapeutic efficacy but also has a high degree of safety.

Successful treatment of Purpureocillium lilacinum pulmonary infection with isavuconazole: A case report

BACKGROUND Purpureocillium lilacinum(P.lilacinum)is a saprophytic fungus widespread in soil and vegetation.As a causative agent,it is very rarely detected in humans,most commonly in the skin.CASE SUMMARY In this article,we reported the case of a 72-year-old patient with chronic lymphocytic leukemia who was admitted with cough and fever.Computed tomography revealed an infection in the right lower lobe.Bronchoalveolar lavage fluid culture and metagenomic next-generation sequencing were ultimately confirmed to have a pulmonary infection with P.lilacinum.She was eventually discharged with good outcomes after treatment with isavuconazole.CONCLUSION Pulmonary infection with P.lilacinum was exceedingly rare.While currently there are no definitive therapeutic agents,there are reports of high resistance to amphotericin B and fluconazole and good sensitivity to second-generation triazoles.The present report is the first known use of isavuconazole for pulmonary P.lilacinum infection.It provides new evidence for the characterization and treatment of clinical P.lilacinum lung infections.

Analysis of bacterial spectrum,activin A,and CD64 in chronic obstructive pulmonary disease patients complicated with pulmonary infections

BACKGROUND Pulmonary infections often lead to poor prognoses in patients with chronic obstructive pulmonary disease(COPD).Activin A and CD64 play crucial pathological roles in the development of COPD.AIM To explore the bacterial spectrum via analysis of activing A levels,CD64 index,and related mechanisms in COPD patients complicated with pulmonary infection.METHODS Between March 2015 and January 2018,a total of 85 patients with COPD,who also suffered from pulmonary infections,were enrolled in this study as the pulmonary infection group.In addition,a total of 96 COPD patients,without pulmonary infection,were selected as the control group.Sputum samples of patients in the pulmonary infection group were cultivated for bacterial identification prior to administration of antibiotics.The neutrophil CD64 index was measured using flow cytometry,serum activin A levels were detected via an enzyme-linked immunosorbent assay,and activin A,Smad3,TLR4,My D88,and NFκB protein expression was analyzed by Western blotting.RESULTS Gram-negative bacteria were identified in 57.65%of the sputum samples in the pulmonary infection group.The most prevalent Gram-negative species were Pseudomonas aeruginosa and Klebsiella pneumoniae.Conversely,Gram-positive bacteria were identified in 41.18%of the sputum samples in the pulmonary infection group.The most common Gram-positive species was Streptococcus pneumoniae.Fungi were identified in 1.17%of the sputum samples in the pulmonary infection group.The CD64 index was significantly higher in the pulmonary infection group(0.91±0.38)than in the control group(0.23±0.14,P<0.001).The serum activin A levels were significantly higher in the pulmonary infection group(43.50±5.22 ng/m L),compared to the control group(34.82±4.16 ng/m L,P<0.001).The relative expression levels of activin A,Smad3,TLR4,My D88,and NFκB were all significantly higher in the pulmonary infection group,compared to the control group(all P<0.001).CONCLUSION Pulmonary infections in COPD patients are mainly caused by Streptococcus pneumoniae,Pseudomonas aeruginosa,and Klebsiella pneumoniae.Pulmonary infections can significantly increase neutrophil CD64 index and serum levels of activin A,thereby activating the activin A/Smad3 signaling pathway,which may positively regulate the TLR4/My D88/NFκB signaling pathway.

Diagnostic accuracy of C-reactive protein for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease: A meta-analysis

Objective:The clinical diagnostic accuracy of C-reactive protein(CRP)for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is still controversial.This study evaluated its accuracy through Meta-analysis.Methods:Studies on the diagnostic value of CRP for bacterial infections in AECOPD were searched form Web of Science,PubMed,Cochrane library,EMBASE,WANFANG DATA,CNKI and China Biology Medicine disc.The included studies were evaluated according to QUADAS-2 assessment tool.Stata 12.0 software was used for meta analyses to summarize the sensitivity and the specificity of the included studies,and the heterogeneity test was conducted.The symmetric receiver operating characteristic curves(SROC)was drawn and the area under the curve(AUC)was calculated,and the funnel plot was drawn to determine publication bias.Results:664 studies were initially identified,20 of which met the inclusion criteria(9 in English and 11 in Chinese).Meta-analysis results showed that the summary sensitivity and specificity of CRP in diagnosing bacterial infections in AECOPD were 0.84,95%CI(0.77-0.90)and 0.76,95%CI(0.67-0.82),respectively.The AUC of SROC was 0.87,95%CI(0.83-0.89).Conclusion:CRP has high accuracy,sensitivity and specificity in distinguishing AECOPD bacterial infections from non-bacterial infection.

Clinical analysis on nosocomial pulmonary infection in patients with indwelling tracheal tube

Tracheal intubation by tracheotomy or by placing a tracheal tube through larynx into trachea,is not only one of important measures which are taken to rescue critically ill patients with respiratory failure etc.,but a commonly used method to prevent patients from airway obstruction in the postoperative period and facilitate mechanical ventilation.Meanwhile,the incidence rate of pulmonary infection,a complication caused by indwelling tracheal tubes,especially the incidence rate of hospital acquired pulmonary infection is apparently increasing.Particularly,pulmonary infection of this kind has characteristics of easily recurrent seizures,long treatment period and high drug-resistance.Hence,it is required for medical personnel to summarize,analyze and study not only general nursing,airway nursing and prevention of pulmonary infection,but also antibiotic selection as well as how and when to use those drugs after the incidence of pulmonary infection for the benefit of patients with indwelling tracheal tube.This article is based on a case collected from Comprehensive Surgery Department of the Third Affiliated Hospital of Inner Mongolia Medical University.The patient’s history is as follows:1.Pulmonary infection;2.Indwelling tracheal catheter after tracheotomy;3.Carbon monoxide toxic cerebrosis,mute state.By means of this case analysis,it is expected to make an early detection,and give an early and proper treatment to patients with pulmonary infection caused by indwelling tracheal tubes in clinical practice.

A pulmonary source of infection in patients with sepsis-associated acute kidney injury leads to a worse outcome and poor recovery of kidney function

BACKGROUND:Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury(SA-AKI)than among patients with sepsis.However,the pathogenesis underlying SA-AKI remains unclear.We hypothesized that the source of infection affects development of SA-AKI.We aim to explore the relationship between the anatomical source of infection and outcome in patients with SA-AKI.METHODS:Between January 2013 and January 2018,113 patients with SA-AKI admitted to our Emergency Center were identifi ed and divided into two groups:those with pulmonary infections and those with other sources of infection.For each patient,we collected data from admission until either discharge or death.We also recorded the clinical outcome after 90 days for the discharged patients.RESULTS:The most common source of infection was the lung(52/113 cases,46%),followed by gastrointestinal(GI)(25/113 cases,22.1%)and urinary(22/113,19.5%)sources.Our analysis showed that patients with SA-AKI had a significantly worse outcome(30/52 cases,P<0.001)and poorer kidney recovery(P=0.015)with pulmonary sources of infection than those infected by another source.Data also showed that patients not infected by a pulmonary source more likely experienced shock(28/61 cases,P=0.037).CONCLUSION:This study demonstrated that the source of infection infl uenced the outcome of SA-AKI patients in an independent manner.Lung injury may influence renal function in an asyet undetermined manner as the recovery of kidney function was poorer in SA-AKI patients with a pulmonary source of infection.

A case report of pulmonary coinfection of Strongyloides stercoralis and Pneumocystis jiroveci

A case of pulmonary coinfection by Strongyloides stercoralis and Pneumocystis jiroveci has been detected in an AIDS patient treated in the Respiratory Intensive Care Unit of the Muniz Hospital.At diagnosis,the patient presented cough with mucopurulent expectoration,dyspnea,fever,bilateral pulmonary infiltrates on the chest X-ray,negative bacilloscopy for acid fast bacteria and a CD4^+ T lymphocytes count of 52 cells/μ L.The microbiological diagnosis was achieved by microscopic observation of the respiratory secretions obtained by bronchoalveolar lavage,while the wet mount examination revealed rhabditiform and filariform larvae of the nematode and foamy exudates,pathognomonic of the pulmonary pneumocystosis.It was the unique case of this association among about 3 000 samples performed in our laboratory in the last 10 years and diagnosed by microscopy.Other complementary stains(a rapid modification of Grocott,Kinyoun and Giemsa) were applied to the smears after the diagnosis of mycotic and parasitary infections achieved by fresh microscopy.Both physicians and microbiologists should take into account the possible coexistence of respiratory pathogens in immunocompromised patients,such as those with AIDS.

Clinical Analysis of Pulmonary Nontuberculous Mycobacterial Disease Diagnosed as Coincidental Pulmonary Infection Due to <i>Mycobacterium</i>Species

Objectives: We analyzed the clinical characteristics of patients with pulmonary mycobacterial disease diagnosed as coincidental pulmonary infection due to Mycobacterium species. Materials and Methods: One hundred sixty patients satisfied the diagnostic criteria of nontuberculous mycobacterial disease proposed by American Thoracic Society during the last seven years. Six patients (3.8%) were coincidental pulmonary infection due to two Mycobacterium species. We investigated the background, laboratory findings, microbiological findings, radiological findings, treatment and prognosis. Results: There were six patients, 3 males and 3 females, with a mean age of 71.7 years. The causative microorganisms of coincidental pulmonary infection consisted of Mycobacterium avium + Mycobacterium intracellulare in two patients, Mycobacterium avium + Mycobacterium kansasii in one, Mycobacterium intracellulare + Mycobacterium chelonae in one, Mycobacterium intracellulare + Mycobacterium abscessus in one, and Mycobacterium intracellulare + Mycobacterium tuberculosis in one. Regarding the radiological findings, the distribution of the lesion was frequently shown in both the right middle and left lingula lobes, but the extent of the lesion was limited within the unilateral lung field. Centrilobular small nodules with bronchiectasis were recognized in all patients and cavities or infiltration shadows were recognized in half of them on chest computed tomography. A definite diagnosis was obtained by bronchoalveolar lavage fluid in four patients and expectorated sputum in two. Combined chemotherapy was performed for two patients and that for pulmonary tuberculosis in one. Conclusions: Coincidental pulmonary infection due to Mycobactterium species occurred at a low percentage. Although most patients were elderly with underlying disease and clinical features were compatible with pulmonary Mycobacterium avium complex disease, the prognosis was comparatively good with and without treatment.

Nocardia cyriacigeorgica infection in a patient with pulmonary sequestration: A case report

BACKGROUND Nocardia cyriacigeorgica (N. cyriacigeorgica) infection is uncommon in clinicalpractice. Pulmonary sequestration complicated with N. cyriacigeorgica has notbeen reported in the literature. Here, we present a case of pulmonary sequestrationcomplicated with N. cyriacigeorgica infection in an immunocom-petentwoman.CASE SUMMARYA 37-year-old woman complaining of a recurrent cough was admitted to ourhospital. Pulmonary sequestration in the lower lobe of the left lung wasdiagnosed by enhanced computed tomography. Bronchoalveolar lavage fluid wasthen collected, which showed gram positive bacilli with weakly positive modifiedacid-fast staining. The pathogen was identified as N. cyriacigeorgica after bacterialculture and mass spectrometry analysis. The patient was diagnosed withpulmonary sequestration complicated with N. cyriacigeorgica infection, and hersymptoms quickly improved following anti-infective therapy.CONCLUSION Nocardiosis is considered to be an opportunistic infection. This is the first reportof pulmonary sequestration complicated with N. cyriacigeorgica infection in apatient with normal immunity.

Role of MexA-MexB-OprM Efflux Pump System in Chronic Pseudomonas Aeruginosa Pulmonary Infection in Mice

In order to investigate the role of the MexA-MexB-OprM efflux pump system in the pathogenesis of Pseudomonas aeruginosa(PA)-induced pulmonary infection,pulmonary infection models were established by intratracheal injection of K767(wild type),nalB(MexA-MexB-OprM up-regulated mutant),and △m exB(knockout) strains,separately.All mice were treated with Meropenem(intraperitoneal injection,100 mg/kg body weight,twice every day),and strain-related pathology,bacteria count,cytokine level,myeloperoxidase(MPO,indicator of neutrophil recruitment) activity,and macrophage inflammatory protein-2(MIP-2) expression were evaluated at early(3rd day post-infection) and late(7th and 14th day post-infection) stages of infection.E-test showed that △mexB was more significantly sensitive to panipenan(ETP),meropenem(MP) and imipenem(IP) than K767 and nalB strains.There was no significant difference in sensitivity to cefepime(TM) among the three stains.In contrast to the K767 and nalB groups,the △ mexB group showed decreased bacteria burden over time and less extensive pathological change.Additionally,MPO activity and levels of inflammatory cytokines(IL-1b,IL-12,and TNF-α) were increased at the early stage(day 3) and decreased at the later stage(day 14).Serum MIP-2 expression level was steadily increased in all three groups from early to late stages,but significantly higher in △m exB group than in K767 and nalB groups(P<0.05).In conclusion,the MexA-MexB-OprM efflux pump system might play an important role in PA-induced chronic pulmonary infection.High expression of the MexA-MexB-OprM efflux pump could increase antibacterial resistance and promote infection.

Development and validation of a postoperative pulmonary infection prediction model for patients with primary hepatic carcinoma

BACKGROUND There are factors that significantly increase the risk of postoperative pulmonary infections in patients with primary hepatic carcinoma(PHC).Previous reports have shown that over 10%of patients with PHC experience postoperative pulmonary infections.Thus,it is crucial to prioritize the prevention and treatment of postoperative pulmonary infections in patients with PHC.AIM To identify the risk factors for postoperative pulmonary infection in patients with PHC and develop a prediction model to aid in postoperative management.METHODS We retrospectively collected data from 505 patients who underwent hepatobiliary surgery between January 2015 and February 2023 in the Department of Hepatobiliary and Pancreaticospleen Surgery.Radiomics data were selected for statistical analysis,and clinical pathological parameters and imaging data were included in the screening database as candidate predictive variables.We then developed a pulmonary infection prediction model using three different models:An artificial neural network model;a random forest model;and a generalized linear regression model.Finally,we evaluated the accuracy and robustness of the prediction model using the receiver operating characteristic curve and decision curve analyses.RESULTS Among the 505 patients,86 developed a postoperative pulmonary infection,resulting in an incidence rate of 17.03%.Based on the gray-level co-occurrence matrix,we identified 14 categories of radiomic data for variable screening of pulmonary infection prediction models.Among these,energy,contrast,the sum of squares(SOS),the inverse difference(IND),mean sum(MES),sum variance(SUV),sum entropy(SUE),and entropy were independent risk factors for pulmonary infection after hepatectomy and were listed as candidate variables of machine learning prediction models.The random forest model algorithm,in combination with IND,SOS,MES,SUE,SUV,and entropy,demonstrated the highest prediction efficiency in both the training and internal verification sets,with areas under the curve of 0.823 and 0.801 and a 95%confidence interval of 0.766-0.880 and 0.744-0.858,respectively.The other two types of prediction models had prediction efficiencies between areas under the curve of 0.734 and 0.815 and 95%confidence intervals of 0.677-0.791 and 0.766-0.864,respectively.CONCLUSION Postoperative pulmonary infection in patients undergoing hepatectomy may be related to risk factors such as IND,SOS,MES,SUE,SUV,energy,and entropy.The prediction model in this study based on diffusion-weighted images,especially the random forest model algorithm,can better predict and estimate the risk of pulmonary infection in patients undergoing hepatectomy,providing valuable guidance for postoperative management.

Furazolidone-induced pulmonary toxicity in Helicobacter pylori infection:Two case reports

BACKGROUND Helicobacter pylori(H.pylori)infection is a global problem,causing significant morbidity and mortality.Furazolidone is recommended to eradicate H.pylori infections in China owing to the highly associated antibiotic resistance.CASE SUMMARY This article presents two cases of lung injury caused by furazolidone treatment of H.pylori infection and the relevant literature review.Two patients developed symptoms,including fever,cough,and fatigue after receiving a course of furazolidone for H.pylori infection.Chest computed tomography showed bilateral interstitial infiltrates.Laboratory studies revealed elevated blood eosinophil count.After discontinuing furazolidone with or without the use of corticosteroids,the symptoms improved rapidly.A PubMed database literature search revealed three reported cases of lung injury suggestive of furazolidone-induced pulmonary toxicity.CONCLUSION Clinicians should be aware of the side effects associated with the administration of furazolidone to eradicate H.pylori infection.

Levels of Serum Procalcitonin and C-Reactive Protein for Evaluating Pulmonary Bacterial Infection in Patients with Lupus Erythematosus

The severity of systemic lupus erythematosus（SLE） patients with pulmonary bacterial infection varies widely. We investigated the significance of procalcitonin（PCT） and C-reactive protein（CRP） in evaluating the severity of pulmonary infection in SLE patients. This retrospective study contained a total of 117 patients（107 women and 10 men） with SLE from January 2010 to June 2011. Serum levels of PCT and CRP were measured by enzyme-linked immunosorbent assay. The severity of pulmonary bacterial infection（PBI） was evaluated using the pneumonia severity index（PSI）. SLE patients with PBI, particularly those with bacterial isolates, had significantly higher levels of serum PCT and CRP than those without PBI. Serum PCT and CRP were not associated with SLE disease activity, but positively with the values of PSI in active SLE patients with PBI. Serum levels of PCT and CRP may be additional biomarkers in evaluating the severity of PBI in lupus patients.

Authenticity of pulmonary Lophomonas blattarum infection: A case report

Pulmonary protozoal infections are rare. A 28-year-old woman was admitted to hospital with chief complains of cough, sputum, and dyspnea. The clinical laboratory tests for blood revealed an increased eosinophil percentage of 31.3%and significantly elevated total IgE. The chest computed tomography scan revealed that bilateral bronchial walls were thickening, accompanied with patchy spots scattered throughout bilateral lungs. A suspected multiflagellated protozoan was observed under a light microscope. But some different features were observed by electron microscopy, such as the orientation of flagella and nucleus. Besides, both bronchoalveolar lavage fluid and bronchoscopic brush smears underwent Gram staining and Pap staining, which revealed that numerous respiratory ciliated cells were scattered or accumulated in the sample.Finally, she was diagnosed with eosinophil pneumonia. Metronidazole,bronchodilators, and mucolytics were taken for 5 d and symptoms and pulmonary ventilation function improved. We herein report a case of chronic eosinophilic pneumonia, which was misdiagnosed as multiflagellated protozoan infection, and it is suggested that reliable diagnosis approaches are necessary,rather than clinical symptoms and morphological features.

Impact of urinary tract and pulmonary infection on mortality after intracerebral hemorrhage in Brazzaville

Objective: To evaluate the impact of urinary tract and pulmonary infection on mortality after cerebral hemorrhage. Method: We conducted at the University Hospital of Brazzaville, a cross-sectional study from January to August2012 inthe emergency department, neurology and intensive care unit. It included patients admitted for cerebral hemorrhage confirmed by CT-scan. A statistical analysis by logistic regression was carried out to evaluate the correlation between infection and death. Result: Among total of 261 patients for stroke, 82 admitted for cerebral hemorrhage (31.4%). The mean age was 55 ± 11 years (range 26 to 83 years). The sex ratio men/women was 1.7. Hypertension was the most important risk factor to 80.5%. The average intake in neurology time was 28 ± 13 hours. The average time for completion of the CT-scan was 2.4 ± 2 days. Thirty-eight (46.3%) patients had a fever linked to an infectious cause from the third day of hospitalization. The most frequent infectious complications were sepsis (n = 16%;42%), pulmonary infection (n = 14%;37%) and urinary tract infection (n = 8%;21%). Specific mortality of infection was 31.7% (n = 26). The multivariate analysis showed a positive correlation between the occurrence of infection and mortality (p = 0.002), specifically between sepsis and mortality (p = 0.0004), and an association between the time of admission late in neurology and the occurrence of infectious complications (p = 0.0001). Conclusion: Infection is one of the dreaded complications of cerebral hemorrhage. It is often associated with delayed care in specialized areas, and is thereby a preventable cause of death.

Prevalence of Latent Tuberculosis Infection (LTBI) among House Hold Contacts of Sudanese Patients with Pulmonary Tuberculosis in Eastern Sudan: Revisiting the Tuberculin Skin Test

A third of the world’s population is latently infected with TB with an increased risk of developing active TB. Household contacts (HHCs) of pulmonary TB cases are at a greater risk of developing disease. Early identification and treatment of latent TB infected individuals may reduce progression to active TB. This study aimed to determine latent TB infections (LTBI) point prevalence among HHCs and community contacts (CCs) using Tuberculin Skin Test (TST) and whole blood IFN-γ release assay in an area of high TB prevalence. In a prospective, longitudinal and community-based study and following informed consent, 768 volunteers (HHCs n = 245;CCs n = 523) were enrolled. Tuberculin Skin Test (TST), whole blood stimulation with PPD and IFN-γ levels determination using ELISA were performed. Mean ages of HHCs and the CCs were not significantly different (HHCs 35.6 ± 15.7 and CCs 30.6 ± 11.7 years;p = 0.99), with a Male:Female ratio of 1:2. Mean recruitment TST indurations were 4.6 ± 5.5 mm and 2.8 ± 3 mm for HHCs and CCs respectively (p = 0.000). Follow-up (Day 614) mean TST indurations increased significantly to 9.1 ± 7.2 mm and 4.4 ± 3.2 mm for HHCs and CCs respectively (p = 0.001). Using TST indurations ≥ 10 mm, LTBI point prevalence for HHCs and CCs was significantly different (HHCs 461/1000 and 367/1000 individuals, p = 0.03). The mean IFN-γ levels for HHCs and CCs at recruitment day (Day 0) were 0.66 ± 0.17 IU/ml and 0.06 ± 0.04 respectively. The mean of IFN-γ production levels dropped significantly at Day 614 for HHCs and CCs to 0.66 ± 0.15 IU/ml and 0.02 ± 0.02 respectively (p = 0.03) (p = 0.00001). Recruitment LTBI point prevalence using IFN-γ level ≥ 0.35 IU/ml for HHCs and CCs was 440/1000 and 203/1000 respectively (p = 0.000000001). No correlations between TST indurations and IFN-γ levels were detected among HHCs or CCs (p > 0.05). TST is a simple, efficient and cheap technique for LTBI diagnosis and triaging individuals for treatment.

Teicoplanin combined with conventional vancomycin therapy for the treatment of pulmonary methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis infections

BACKGROUND Vancomycin and teicoplanin are both antibiotics that have significant antimicrobial effects on Gram-positive cocci.AIM To explore the value of teicoplanin combined with conventional(vancomycin only)anti-infective therapy for the treatment of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis pulmonary infections.METHODS A total of 86 patients with methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis pulmonary infections,treated in our hospital between January 2018 and February 2020,were assigned to the study and control groups using a random number table method,with 43 patients in each group.The control group received conventional treatment(vancomycin),and the study group received both teicoplanin and conventional treatment.The following indicators were assessed in both groups:the time required for symptom relief,treatment effectiveness,serum levels of inflammatory factors(procalcitonin,interleukin-1β,tumor necrosis factor-α,C-reactive protein),clinical pulmonary infection scores before and after treatment,and the incidence of adverse reactions.RESULTS Patients in the study group were observed to have faster cough and expectoration resolution,white blood cell count normalization,body temperature normalization,and rales disappearance than patients in the control group(all P<0.05);the total rate of effectiveness was 93.02%in the study group,higher than the 76.74%in the control group(P<0.05).The pre-treatment serum levels of procalcitonin,interleukin-1β,tumor necrosis factor-α,and C-reactive protein as well as the clinical pulmonary infection scores were similar among the patients in both groups.However,the post-treatment serum levels of procalcitonin,interleukin-1β,tumor necrosis factor-α,and C-reactive protein as well as the clinical pulmonary infection scores were significantly lower in the study group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the groups.CONCLUSION Compared with conventional(vancomycin only)therapy,teicoplanin and vancomycin combination therapy for patients with pulmonary methicillinresistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis infections can improve patient clinical symptoms,modulate serum inflammatory factor levels,and improve treatment efficacy,without increasing the risk of adverse reactions.

Improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection

Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection.Methods:A total of 78 patients with lung cancer who received surgical treatment in our hospital between August 2013 and January 2015 and were with postoperative infection were selected as the research subjects and randomly divided into two groups, control group received mechanical ventilation therapy, observation group received bronchoalveolar lavage by bronchoscope combined with mechanical ventilation, and the inflammatory factor levels, RAAS system activity and respiratory mechanics indexes of two groups were determined after treatment.Results:3 d after treatment, serum hs-CRP, TNF-α, IL-8, PCT, renin, angiotensin II and aldosterone levels of observation group were lower than those of control group, and PIP, Raw and WOB values were lower than those of control group while Cdyn value was higher than that of control group.Conclusion:For lung cancer patients with postoperative pulmonary infection, bronchoalveolar lavage by bronchoscope combined with mechanical ventilation can optimize patients' condition, relieve systemic inflammatory response and improve respiratory function, and it has positive clinical significance.

Acute exacerbation of chronic obstructive pulmonary disease was associated with respiratory syncytial virus infection and the upregulation of TLR3

Respiratory syncytial virus(RSV)infection is known as a risk factor for chronic obstructive pulmonary disease(COPD).RSV infection induces the upregulation of Toll-like receptor 3(TLR3).This study aimed to investigate the association of TLR3 with RSV induced acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Serum/sputum samples from AECOPD patients,stable chronic obstructive pulmonary disease(SCOPD)patients,and healthy controls were collected.Nested PCR was used to detect RSV.The lung function parameters were assessed by blood gas and lung function analysis.The expression levels of inflammatory factors in sputum and serum samples were determined by enzyme-linked immunosorbent assay.BEAS-2B cell lines were infected with RSV,and the expression of TLR3 mRNA was determined by PCR and the levels of inflammatory factors were also investigated.The presence of RSV was detected in 3 SCOPD and 8 AECOPD patients,but not in healthy patients.The expression levels of TNF-αand IRF-3 in both sputum and serum samples of RSV-positive group were significantly higher than in RSV-negative group.TLR3 mRNA levels in RSV-positive group were significantly higher than those in RSVnegative group.Interestingly,the level of TLR3 mRNA expression was negatively correlated with oxygenation index and lung function parameters.Furthermore,BEAS-2B cells infected with RSV led to significant increase of the expression of TLR3 mRNA and inflammatory factors IFN-β,IL-13,IL-32,and TNF-α.Our observations indicate that AECOPD is associated with RSV infection and the upregulation of TLR3.

Nutritional status in chronically hospitalized stroke patients complicated with pulmonary infection

Complicated pulmonary infection following stroke has traditionally been considered an aspirated infection by many physicians, and little attention has been paid to concomitant protein-energy malnutrition. In the present study, we hypothesized that protein-energy malnutrition may be present in hospitalized chronic stroke patients complicated with pulmonary infection. The results revealed that body protein and fat stores were significantly depleted in stroke patients with pulmonary infection. Protein-energy malnutrition was present in 12 of 27 patients with pulmonary infection. In comparison, only eight of 42 stroke patients without pulmonary infection exhibited protein-energy malnutrition. A significantly higher prevalence of protein-energy malnutrition was found in the pulmonary infection group, suggesting that protein-energy malnutrition is more likely to be present in hospitalized chronic stroke patients with pulmonary infection.