Effectiveness of colonoscopy,immune fecal occult blood testing,and risk-graded screening strategies in colorectal cancer screening

BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.

Age,blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021.We calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts.We subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score performance.RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group.AIMS65 score had the best performance in the variceal bleeding group(AUROC=0.772;P<0.001),and ABC score(AUROC=0.775;P<0.001)in the non-variceal bleeding group.However,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both populations.PERS score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical intervention.Addition of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P<0.05)and by 12-fold if added to GBS score(P<0.003).No score proved to be a good predictor for length of admission.CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population.PERS and GBS should be used to determine need for endoscopic and surgical intervention,respectively.Lactate can be used as an additional tool to risk scores for predicting inhospital mortality.

Psychological problems related to capillary blood glucose testing and insulin injection among diabetes patients

Objective:This review is aimed at explaining the psychological problems related to capillary blood glucose(CBG)testing and insulin injection,as well as recommending essential strategies to solve the fear thereof.Methods:Databases,including PubMed,Cumulative Index of Nursing and Allied Health Literature(CINAHL),Scopus,and Google Scholar,were searched to extract the relevant articles.Initially,the terms used to retrieve related studies were"fear of blood glucose monitoring","anxiety capillary blood glucose testing and insulin injection","psychological problems on blood glucose monitoring and insulin injection","diabetes management",and"diabetes mellitus".Results:Results showed that the psychological problems related to CBG testing and insulin injection were associated with the stress and depression experienced during diabetes self-monitoring of blood glucose.This psychological issue has its impacts such as nonadherence to medication as well as a lack of self-discipline in terms of CBG testing and insulin injection.Inadequate information,inappropriate perception,and pain/discomfort during pricking of fingers were the main reasons for the psychological issues in CBG testing and self-injection of insulin.Conclusions:The expected benefits of this review include the explanation of the issues related to the psychological problems in CBG testing and insulin injection among type 2 diabetes mellitus(T2DM)patients.This review article also provides the recommendations on providing counseling and empowering the patients on CBG monitoring and insulin injection.Moreover,family members should provide psychological support to reduce fear,anxiety,and distress arising from CBG testing and insulin injection.

Effects of Antimicrobial Peptides on Production,Slaughter Performance and Blood Routine of Tan Sheep

[Objectives]This study was conducted to analyze effects of antimicrobial peptides added to the diet of Tan sheep on their production, slaughter performance and blood composition. [Methods] Ninety two four-month-old Tan sheep were randomly divided into two treatment groups according to their body weight, 46 in each group. The control check group(CK) was feed with conventional diet, and the experimental group was fed with the addition of antimicrobial peptide on the basis of the conventional diet, with the added amount of 2.5 g/sheep per day. The experimental period was 60 d. [Results] The incidence rate was 75.06% lower in the experimental group than in the CK. The average daily weight gain per sheep was 11.27% higher in the experimental group than in the CK(P<0.05). The feed conversion ratio was 8.45% lower in the experimental group than in the CK(P<0.05). The average daily gross profit per sheep was 12.12% higher in the experimental group than in the CK. For slaughter performance, the data difference of each item was not significant. The PH at 45 min and 24 h after slaughter was within the normal range of fresh mutton. The cooked meat percentage and water loss rate showed no significant differences(P>0.05). The marbling ranged from 2.45 to 2.50, indicating that the fat content was moderate, and the difference between groups was not significant(P>0.05). The flesh color ranged from 3.00 to 3.15, between light red and bright red, belonging to the normal color of mutton, and the difference between groups was not significant(P>0.05). The shear force was between 2.50 and 2.65, without a significant difference between groups(P>0.05). The white blood cells, lymphocytes and platelets in the experimental group were lower than those in the CK(P<0.01). The erythrocytes and hemoglobin in the erythrocyte group were higher than those in the CK(P<0.05). The neutrophils and monocytes in the experimental group were lower than those in the CK(P<0.05). [Conclusions] This study provides a technical basis for the rational use of antimicrobial peptides and their application in ruminants.

Evaluating the Efficacy of Fecal Occult Blood Test and Tumor Marker Combined Screening for Colorectal Cancer

Objective:To analyze the screening effectiveness of combining the fecal occult blood test with tumor marker detection for colorectal cancer.Methods:A total of thirty patients with colorectal cancer and thirty patients with benign colon hyperplasia who received treatment from January 2020 to January 2023 were selected.These patients were assigned to the observation group and the control group,respectively.All patients in both groups underwent both fecal occult blood tests and tumor marker detection.The levels of tumor markers between the two groups were compared,the tumor marker levels in different stages were assessed within the observation group,and the positive detection rates for single detection and combined detection were compared.Results:The levels of various tumor markers in the observation group were significantly higher than those in the control group(P<0.05).Furthermore,as the Duke stage increased within the observation group,the levels of various tumor markers also increased(P<0.05).The positive detection rate of the combined test was notably higher than that of single detection(P<0.05).Conclusion:Combining the fecal occult blood test with tumor marker detection in colorectal cancer screening can significantly improve the overall detection rate.

Early colorectal cancer screening–no time to lose

In this editorial,we comment on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al.Colorectal cancer(CRC)is emerging as an important health issue as its incidence continues to rise globally,adversely affecting the quality of life.Although the public has become more aware of CRC prevention,most patients lack screening awareness.Some poor lifestyle practices can lead to CRC and symptoms can appear in the early stages of CRC.However,due to the lack of awareness of the disease,most of the CRC patients are diagnosed already at an advanced stage and have a poor prognosis.

Investigation of the Clinical Diagnostic Significance of the T-Cell Test for Tuberculosis combined with Erythrocyte Sedimentation Test in Pulmonary Tuberculosis

Objective:To investigate the clinical diagnostic significance of peripheral blood T-cell test(T-spot test)for tuberculosis(TB)infection combined with erythrocyte sedimentation rate(ESR)in pulmonary TB.Methods:41 patients with a clinical diagnosis of TB during hospitalization from January 2020 to April 2023 in our hospital were selected as the experimental group,and 45 patients without TB(bronchopneumonia patients)were selected as the control group.The diagnostic specificity,sensitivity,and accuracy of the T-spot TB test,ESR test,and the combined test of the two were calculated respectively.Results:The sensitivity,specificity,and accuracy of the T-spot TB test combined with ESR for the diagnosis of TB in the experimental group were significantly higher than the individual results of the T-spot TB test and ESR test alone(P<0.05).Conclusion:The T-spot TB test combined with the ESR test for TB diagnosis has greater clinical value than carrying out the tests individually.

EVALUATION OF REVERSE PASSIVE HEMAGGLUTINATION （RPHA） FECAL OCCULT BLOOD TEST IN SCREENING OF COLORECTAL NEOPLASIA

A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994

To scope or not-the challenges of managing patients with positive fecal occult blood test after recent colonoscopy

BACKGROUND Colorectal cancer(CRC) is a major health problem. There is minimal consensus of the appropriate approach to manage patients with positive immunochemical fecal occult blood test(iFOBT), following a recent colonoscopy.AIM To determine the prevalence of advanced neoplasia in patients with a positive iFOBT after a recent colonoscopy, and clinical and endoscopic predictors for advanced neoplasia.METHODS The study recruited i FOBT positive patients who underwent colonoscopy between July 2015 to March 2020. Data collected included demographics, clinical characteristics, previous and current colonoscopy findings. Primary outcome was the prevalence of CRC and advanced neoplasia in a patient with positive iFOBT and previous colonoscopy. Secondary outcomes included identifying any clinical and endoscopic predictors for advanced neoplasia.RESULTS The study included 1051 patients(male 53.6%;median age 63). Forty-two(4.0%) patients were diagnosed with CRC, 513(48.8%) with adenoma/sessile serrated lesion(A-SSL) and 257(24.5%) with advanced A-SSL(AA-SSL). A previous colonoscopy had been performed in 319(30.3%). In this cohort, four(1.3%) were diagnosed with CRC, 146(45.8%) with A-SSL and 56(17.6%) with AA-SSL. Among those who had a colonoscopy within 4 years, none had CRC and 7 had AA-SSL. Of the 732 patients with no prior colonoscopy, there were 38 CRCs(5.2%). Independent predictors for advanced neoplasia were male [odds ratio(OR) = 1.80;95% confidence interval(CI): 1.35-2.40;P < 0.001), age(OR = 1.04;95%CI: 1.02-1.06;P < 0.001) and no previous colonoscopy(OR = 2.07;95%CI: 1.49-2.87;P < 0.001).CONCLUSION A previous colonoscopy, irrespective of its result, was associated with low prevalence of advanced neoplasia, and if performed within four years of a positive iFOBT result, was protective against CRC.

Preliminary study of abnormal increase of postexercise systolic blood pressure in the diagnosis of coronary artery disease

Objectives This study sought to evaluate the diagnostic value of abnormal increase of postexercise systolic blood pressure (SBP) for detecting coronary artery disease (CAD) in patients with or without hypertension. Methods Treadmill exercise testing (TET) was conducted in 88 patients (40 CAD patients, 48 control subjects) with or without hypertension, each of whom underwent selective coronary angiography (CAG). The abnormal increase of postexercise SBP was defined as 10mmHg higher than earlier periods during the recovery phase (6 minutes) of exercise testing. Results The abnormal increase of postexercise SBP had higher sensitivity, specificity, and accuracy for detecting CAD than those of ST - segment depression in patients with or without hypertension. Its accuracy increased with the severity of CAD while decreased in patients with hypertension, and the increase value of SBP had a positive correlation with the extent of coronary artery lesion. The combination of ST - segment depression and abnormal increase of postexercise SBP diagnosed CAD most accurately in patients with hypertension. Conclusions Abnormal increase of postexercise SBP may be a useful index for diagnosing CAD.

Supply and quality of colonoscopy according to the characteristics of gastroenterologists in the French population-based colorectalcancer screening program

BACKGROUND Since its complete roll-out in 2009,the French colorectal cancer screening program(CRCSP)experienced 3 major constraints[use of a less efficient Guaiac-test(gFOBT),stopping the supply of Fecal-Immunochemical-Test kits(FIT),and suspension of the program due to the coronavirus disease 2019(COVID-19)]affecting its effectiveness.AIM To describe the impact of the constraints in terms of changes in the quality of screeningcolonoscopy(Quali-Colo).METHODS This retrospective cohort study included screening-colonoscopies performed by gastroenterologists between Jan-2010 and Dec-2020 in people aged 50-74 living in Ile-de-France(France).The changes in Quali-colo(Proportion of colonoscopies performed beyond 7 mo(Colo_7 mo),Frequency of serious adverse events(SAE)and Colonoscopy detection rate)were described in a cohort of Gastroenterologists who performed at least one colonoscopy over each of the four periods defined according to the chronology of the constraints[gFOBT:Normal progress of the CRCSP using gFOBT(2010-2014);FIT:Normal progress of the CRCSP using FIT(2015-2018);STOP-FIT:Year(2019)during which the CRCSP experienced the cessation of the supply of test kits;COVID:Program suspension due to the COVID-19 health crisis(2020)].The link between each dependent variable(Colo_7 mo;SAE occurrence,neoplasm detection rate)and the predictive factors was analyzed in a two-level multivariate hierarchical model.RESULTS The 533 gastroenterologists(cohort)achieved 21509 screening colonoscopies over gFOBT period,38352 over FIT,7342 over STOP-FIT and 7995 over COVID period.The frequency of SAE did not change between periods(gFOBT:0.3%;FIT:0.3%;STOP-FIT:0.3%;and COVID:0.2%;P=0.10).The risk of Colo_7 mo doubled between FIT[adjusted odds ratio(aOR):1.2(1.1;1.2)]and STOPFIT[aOR:2.4(2.1;2.6)];then,decreased by 40%between STOP-FIT and COVID[aOR:2.0(1.8;2.2)].Regardless of the period,this Colo_7 mo’s risk was twice as high for screening colonoscopy performed in a public hospital[aOR:2.1(1.3;3.6)]compared to screening-colonoscopy performed in a private clinic.The neoplasm detection,which increased by 60%between gFOBT and FIT[aOR:1.6(1.5;1.7)],decreased by 40%between FIT and COVID[aOR:1.1(1.0;1.3)].CONCLUSION The constraints likely affected the time-to-colonoscopy as well as the colonoscopy detection rate without impacting the SAE’s occurrence,highlighting the need for a respectable reference time-tocolonoscopy in CRCSP.

Analysis of Clinical Characteristics of Patients with Different Types of Primary Hyperuricemia

Objective:This paper aims to study the clinical characteristics of patients with different types of primary hyperuricemia(HUA).Methods:Using a retrospective research method,200 patients with primary HUA in the hospital from June 2020 to January 2023 were selected as the research objects.Patients were grouped according to the detection results of 24-hour urinary uric acid excretion(UUE)and fractional excretion of uric acid(FEUA)(renal insufficiency type,renal overload type,mixed type,and other types).The general information of patients in the four groups(gender,age,body mass index,living habits,etc.),underlying diseases(hypertension,diabetes),blood test results[uric acid(UA),creatinine(Cre)],urine test results(24-hour urine UA,24-hour urine Cre)were summarized and the differences between the groups were analyzed.Results:The 200 cases of HUA patients were divided into 54.00%with renal insufficiency type,38.50%with mixed type,6.00%with renal overload type,and 1.50%with other types.The age of patients with mixed HUA was younger than that of patients with other types,renal overload type,and renal insufficiency type,and the difference was statistically significant(P<0.05).The UA level of patients with other types of HUA was lower than that of patients with mixed type HUA,and there was statistical significance(P<0.05).The Cre level of patients with mixed type HUA was lower than that of patients with renal insufficiency type and renal overload type,and the difference was statistically significant(P<0.05).The 24-hour urinary UA level in patients with renal insufficiency type HUA was lower than that in patients with renal overload type and mixed type HUA,and the difference was statistically significant(P<0.05).The 24-hour urinary Cre level of patients with other types of HUA was lower than that of patients with renal overload type and mixed HUA,the difference was statistically significant(P<0.05).The estimated glomerular filtration rate(eGFR)level of patients with other types of HUA was lower than that of patients with mixed type HUA,and the difference was statistically significant(P<0.05).There was no significant difference in the proportions of hypertension,diabetes,coronary heart disease,and urinary calculi among patients with renal insufficiency type,renal overload type,mixed type,and other types of HUA(P>0.05).Conclusion:The primary HUA patients are mainly of renal insufficiency type,followed by mixed type.There are significant differences in the clinical characteristics of patients with different types of HUA.Among them,patients with other types of HUA are the oldest and have the lowest uric acid levels.Patients with mixed HUA had the best renal function but the highest 24-hour urine creatinine level.This study can be used as a basis for rational selection of urate-lowering drugs for different HUA patients.

Primary stratification and identification of suspected corona virus disease 2019(COVID-19) from clinical perspective by a simple scoring proposal

In this Commentary,we would like to comment on the article titled"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)"as a featured article in Military Medical Research.In the guideline,except for"confirmed cases","suspected cases","close contact"and"suspicious exposure"were defined by clinical perspective based on epidemiological risk,clinical symptoms and auxiliary examination.Combined with our experience,we introduced a simple scoring proposal additionally based on not only CT imaging as strongly recommended by the guideline but also blood routine test,especially for primary screening of such patients in the out-patient department.

Kawasaki disease without changes in inflammatory biomarkers:A case report

BACKGROUND Kawasaki disease(KD)is diagnosed based on clinical features.Blood tests and other tests are auxiliary diagnostic tools.Since KD is a disease caused by arterial inflammation,many patients with KD have elevated levels of inflammatory biomarkers,such as C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and serum amyloid A protein(SAA)in blood tests.We report our experience of a patient with KD who did not have elevated levels of inflammatory biomarkers.CASE SUMMARY A 1-year-old boy presented with a 3-day history of fever.Five of the six symptoms of KD were observed,except for changes in the lips and oral cavity.Blood tests revealed no elevation in CRP,ESR,or SAA levels.Although the blood test results were atypical,the patient was diagnosed with KD based on clinical symptoms and was admitted to the hospital for treatment.The patient was administered intravenous immunoglobulin(IVIG)and aspirin.Despite commencing treatment,the fever persisted;therefore,additional IVIG was administered,the dosage of aspirin was increased,and ulinastatin was added.Three doses of IVIG were administered and the fever resolved on day 11 of KD symptoms started.Blood tests performed during hospitalization showed normal levels of inflammatory biomarkers.We examined leucine-rich alpha-2-glycoprotein 1-a protein that is elevated during the acute phase of KD.The protein levels did not increase during hospitalization.CONCLUSION This case suggests the need to identify criteria and biomarkers for detecting KD conditions that do not require KD treatment.

Optimal Noninvasive Colon Cancer Screening Modality in Patients Not Receiving Colonoscopy

Colon cancer is the third most common among cancer deaths in the US for both men and women. The incidence of colonoscopy has been soaring in younger patients, which led to changes in recent United States Preventive Services Task Force (USPSTF) guidelines to reduce the age for screening from 50 years to 45 years. Demand for colonoscopy services is surging due to increased incidences of colorectal cancer (CRC) in the both aging and younger population. Increased referrals have led to an insufficient workforce in hospitals and long waiting lists. Further, results from colonoscopy reveal a low percentage of CRC or another severe bowel disease (SBD). Therefore, colon cancer screening is a growing concern, particularly in patients who otherwise have a very long-life expectancy, and who are most likely to benefit from screening. Another reason to boost CRC screening is to minimize the load on hospitals by reducing the patients that undergo colonoscopy unnecessarily because only a low percentage of CRC occurrence is observed in individuals undergoing colonoscopy. In recent years, there are a variety of screening options available for CRC. Noninvasive alternatives include fecal immunochemical test (FIT), multitarget stool DNA testing (MT-sDNA, available under the brand name Cologuard), computed tomography (CT) colonography (previously called virtual colonoscopy), guaiac-based fecal occult blood testing (gFOBT), and capsule colonoscopy (CC). These tests have varied the degree of evidence supporting their use. This study focuses on the most recent survey and efficacy of noninvasive methods to prevent and detect colorectal cancer (CRC).

Epidemiology of Nosocomial Bacteremia Due to Bacteria from the “<i>Burkholderia cepacia</i>Complex” at Libreville University Hospital Center

Introduction: Burkholderia cepacia is a non-fermenting emergent bacterium common in nosocomial infections and can cause life-threatening infections whose multidrug resistance makes them a serious threat in hospitals. The aim of this study was to determine the prevalence of B. cepacia infections during nosocomial infections at Libreville University teaching hospital. Methodology: In this cross-sectional study, lasting 19 months, 412 blood cultures were analyzed. The BacT/ALERT 3D (Biomerieux, France) was used to detect the positivity of blood culture flasks and the Viteck 2 compact (Biomerieux, France) for the identification of germs and the study of their susceptibility to antibiotics. Results: Our study population consisted of 412 patients. The sex-ratio M/F was 1.06 in favor of the male gender (n = 201, 51%). The age of the patients varied between 0 and 82 years. The bacteremia of B. cepacia mainly affected children under 15 years of age with a prevalence of 7% (n = 28). The pediatric ward was more represented with a frequency of 36% (n = 10). The antibiotic sensitivity profile showed high resistance of 100% for aminoglycosides (amikacin, tobramycin, and gentamycin), tetracycline, beta-lactams (Amoxicillin, Imipenem, Ticarcillin, Cefoxitin and Cefotaxime), and ciprofloxacin. However, four molecules were active on B. cepacia (Levofloxacin 100%, Trimethoprim + sulfamethoxazole 92.3%, ceftazidime 80% and cefepime 35%). Conclusion: Ultimately, infection and multi-resistance due to Burkholderia cepacia calls for a review of hospital hygiene in the pediatric ward and a review of antibiotic therapy in young children.

Flexible,efficient,and accurate tests for epidemics

Group testing involves discovering a small subset of distinguished subjects from a large population while efficiently reducing the total number of tests.It has been widely used for industrial testing,information technology,and biology,especially epidemic screening.Tests,in reality,are noisy for the presence of false outcomes.Some tests are accurate but time-consuming,while others are cheaper but less accurate.Exactly which test to use is constrained by various considerations,such as availability,cost,accuracy,and efficiency.In this paper,we propose flexible,efficient,and accurate tests(FEATs).FEATs are based on group testing with simple but careful designs by incorporating ideas such as close contact cliques and repeated tests.FEATs could dramatically improve the efficiency or accuracy of existing tests.For example,for accurate but slow tests,the FEAT can improve efficiency multiple times without compromising accuracy.On the other hand,for fast but inaccurate tests,the FEAT can sharply reduce the false-negative rate(FNR)and significantly increase efficiency.Theoretical justifications are provided.We point out some scenarios where the FEAT can be effectively employed.