Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respir...Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respiratory bacteria detection methods, we developed a combination of multiplex polymerase chain reaction （PCR） and capillary electrophoresis （MPCE） assay to detect thirteen bacterial pathogens responsible for lower respiratory tract infections, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catorrholis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Mycoplasma pneumoniae, Legionella spp., Bordetella pertussis, Mycobacterium tuberculosis complex, Corynebactefium diphthefiae, and Streptococcus pyogenes. Methods Three multiplex PCR reactions were built, and the products were analyzed by capillary electrophoresis using the high-throughput DNA analyzer. The specificity of the MPCE assay was examined and the detection limit was evaluated using DNA samples from each bacterial strain and the simulative samples of each strain. This assay was further evaluated using 152 clinical specimens and compared with real-time PCR reactions. For this assay, three nested-multiplex-PCRs were used to detect these clinical specimens. Results The detection limits of the MPCE assay for the 13 pathogens were very low and ranged from 10-7 to 10-2 ng/μL. Furthermore, analysis of the 252 clinical specimens yielded a specificity ranging from 96.5%-100.0%, and a sensitivity of 100.0% for the 13 pathogens. Conclusion This study revealed that the MPCE with high specificity and sensitivity. This assay survey of respiratory pathogens. assay is a rapid, reliable, and high-throughput method has great potential in the molecular epidemiological.展开更多
Acute respiratory tract infection</span><span style="font-family:""><span style="font-family:Verdana;"> (ARTI) in children is the most common infectious disease in childhood,...Acute respiratory tract infection</span><span style="font-family:""><span style="font-family:Verdana;"> (ARTI) in children is the most common infectious disease in childhood, and its pathogens include viruses, bacteria and fungi, mycoplasma, chlamydia and rickettsia. In recent years, with the continuous development of pathogen detection methods, the diagnosis and treatment of acute respiratory infections has received more and more clinical attention. The clinical diagnosis and treatment characteristics of acute respira</span><span style="font-family:Verdana;">tory infections in children and the research of clinical laboratory detection </span><span style="font-family:Verdana;">methods have also been continuously developed. The author collected refer</span><span style="font-family:Verdana;">ences to review the clinical features and new developments in laboratory</span><span style="font-family:Verdana;"> testing of acute respiratory tract infection in children.展开更多
Background The emergence of bacterial resistance to commonly used antibiotics, such as macrolides, is complicating the management of respiratory tract infections （RTIs）. Telithromycin, a ketolide antimicrobial struc...Background The emergence of bacterial resistance to commonly used antibiotics, such as macrolides, is complicating the management of respiratory tract infections （RTIs）. Telithromycin, a ketolide antimicrobial structurally related to macrolides, is approved for the treatment of community-acquired RTIs, and shows lower pathogen resistance rates. The purpose of this study was to compare the efficacy and safety of telithromycin with clarithromycin, a macrolide routinely used as therapy for RTIs. Methods We performed a meta-analysis of relevant randomized-controlled trials （RCTs） identified in PubMed, the Cochrane Library, Embase, CNKI and VIP databases. The primary efficacy outcome was clinical treatment success assessed at the test-of-cure time in the per-protocol population, and the primary safety outcome was drug related adverse effects. Results Seven RCTs, involving 2845 patients with RTIs, were included in the meta-analysis. Oral telithromycin and clarithromycin showed a similar clinical treatment success in modified intention to treat and per-protocol population （cure and improvement） （odds ratios （ORs）： 0.84, 95% confidence intervals （C/）： 0.64-1.11 and OR： 1.14, 95% CI： 0.71-1.85, respectively）. Similar findings were obtained for secondary efficacy outcomes： clinical treatment success at a late post- therapy visit （OR： 0.92, 95% CI： 0.57-1.48） and microbiological treatment success at the test-of-cure time （OR： 1.14; 95% CI： 0.71-1.85）. The safety outcome analysis indicated telithromycin had a similar risk of drug-related adverse effect and serious adverse effect with clarithromycin. Conclusions Our findings indicate that oral telithromycin and clarithromycin have similar treatment efficacy and adverse effect. The advantages of lower antimicrobial resistance rates, once-daily short-duration dosing and reported lower health- care costs make oral telithromycin a useful option for the empiric management of mild-to-moderate RTIs.展开更多
基金supported by grants from the Priority Project on Infectious Disease Control and Prevention(2012ZX10004215,2013ZX10004610)from Ministry of Health,China,and the Science Foundation for the State Key Laboratory for Infectious Disease Prevention and Control from China(Grant No.2015SKLID508)the National Natural Science Foundation of China(Grant No.81671985)and(Grant No.81170009)
文摘Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respiratory bacteria detection methods, we developed a combination of multiplex polymerase chain reaction （PCR） and capillary electrophoresis （MPCE） assay to detect thirteen bacterial pathogens responsible for lower respiratory tract infections, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catorrholis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Mycoplasma pneumoniae, Legionella spp., Bordetella pertussis, Mycobacterium tuberculosis complex, Corynebactefium diphthefiae, and Streptococcus pyogenes. Methods Three multiplex PCR reactions were built, and the products were analyzed by capillary electrophoresis using the high-throughput DNA analyzer. The specificity of the MPCE assay was examined and the detection limit was evaluated using DNA samples from each bacterial strain and the simulative samples of each strain. This assay was further evaluated using 152 clinical specimens and compared with real-time PCR reactions. For this assay, three nested-multiplex-PCRs were used to detect these clinical specimens. Results The detection limits of the MPCE assay for the 13 pathogens were very low and ranged from 10-7 to 10-2 ng/μL. Furthermore, analysis of the 252 clinical specimens yielded a specificity ranging from 96.5%-100.0%, and a sensitivity of 100.0% for the 13 pathogens. Conclusion This study revealed that the MPCE with high specificity and sensitivity. This assay survey of respiratory pathogens. assay is a rapid, reliable, and high-throughput method has great potential in the molecular epidemiological.
文摘Acute respiratory tract infection</span><span style="font-family:""><span style="font-family:Verdana;"> (ARTI) in children is the most common infectious disease in childhood, and its pathogens include viruses, bacteria and fungi, mycoplasma, chlamydia and rickettsia. In recent years, with the continuous development of pathogen detection methods, the diagnosis and treatment of acute respiratory infections has received more and more clinical attention. The clinical diagnosis and treatment characteristics of acute respira</span><span style="font-family:Verdana;">tory infections in children and the research of clinical laboratory detection </span><span style="font-family:Verdana;">methods have also been continuously developed. The author collected refer</span><span style="font-family:Verdana;">ences to review the clinical features and new developments in laboratory</span><span style="font-family:Verdana;"> testing of acute respiratory tract infection in children.
文摘Background The emergence of bacterial resistance to commonly used antibiotics, such as macrolides, is complicating the management of respiratory tract infections （RTIs）. Telithromycin, a ketolide antimicrobial structurally related to macrolides, is approved for the treatment of community-acquired RTIs, and shows lower pathogen resistance rates. The purpose of this study was to compare the efficacy and safety of telithromycin with clarithromycin, a macrolide routinely used as therapy for RTIs. Methods We performed a meta-analysis of relevant randomized-controlled trials （RCTs） identified in PubMed, the Cochrane Library, Embase, CNKI and VIP databases. The primary efficacy outcome was clinical treatment success assessed at the test-of-cure time in the per-protocol population, and the primary safety outcome was drug related adverse effects. Results Seven RCTs, involving 2845 patients with RTIs, were included in the meta-analysis. Oral telithromycin and clarithromycin showed a similar clinical treatment success in modified intention to treat and per-protocol population （cure and improvement） （odds ratios （ORs）： 0.84, 95% confidence intervals （C/）： 0.64-1.11 and OR： 1.14, 95% CI： 0.71-1.85, respectively）. Similar findings were obtained for secondary efficacy outcomes： clinical treatment success at a late post- therapy visit （OR： 0.92, 95% CI： 0.57-1.48） and microbiological treatment success at the test-of-cure time （OR： 1.14; 95% CI： 0.71-1.85）. The safety outcome analysis indicated telithromycin had a similar risk of drug-related adverse effect and serious adverse effect with clarithromycin. Conclusions Our findings indicate that oral telithromycin and clarithromycin have similar treatment efficacy and adverse effect. The advantages of lower antimicrobial resistance rates, once-daily short-duration dosing and reported lower health- care costs make oral telithromycin a useful option for the empiric management of mild-to-moderate RTIs.
