Can we predict which patients with community-acquired pneumonia are likely to have positive blood cultures？

BACKGROUND： Blood cultures （BC ） are commonly ordered during the initial assessment ofpatients with community-acquired pneumonia （CAP）, yet their yield remains low. Selective use of BCwould allow the opportunity to save healthcare resources and avoid patient discomfort. The studywas to determine what demographic and clinical factors predict a greater likelihood of a positiveblood culture result in patients diagnosed with CAP.METHODS： A structured retrospective systematic chart audit was performed to comparerelevant demographic and clinical details of patients admitted with CAP, in whom blood culture resultswere positive, with those of age, sex, and date-matched control patients in whom blood cultureresults were negative.RESULTS： On univariate analysis, eight variables were associated with a positive BC result.After logistic regression analysis, however, the only variables statistically significantly associatedwith a positive BC were WBC less than 4.5 x 109/L [likelihood ratio （LR）： 7.75, 95% CI=2.89-30.39], creatinine 〉106 !mol/L （LR： 3.15, 95%CI=1.71-5.80）, serum glucose〈6.1 mmol/L （LR： 2.46,95%CI=1.14-5.32）, and temperature 〉 38 °C （LR： 2.25, 95% CI =1.21-4.20）. A patient with all of thesevariables had a LR of having a positive BC of 135.53 （95% CI=25.28-726.8） compared to patientswith none of these variables.CONCLUSIONS： Certain clinical variables in patients with CAP admitted to hospitals doappear to be associated with a higher probability of a positive yield of BC, with combinations of thesevariables increasing this likelihood. We have identified a subgroup of CAP patients in whom bloodcultures are more likely to be useful.

In vitro model of the blood-brain barrier established by co-culture of primary cerebral microvascular endothelial and astrocyte cells

Drugs for the treatment and prevention of nervous system diseases must permeate the bloodbrain barrier to take effect.In vitro models of the blood-brain barrier are therefore important in the investigation of drug permeation mechanisms.However,to date,no unified method has been described for establishing a blood-brain barrier model.Here,we modified an in vitro model of the blood-brain barrier by seeding brain microvascular endothelial cells and astrocytes from newborn rats on a polyester Transwell cell culture membrane with 0.4-μm pores,and conducted transepithelial electrical resistance measurements,leakage tests and assays for specific bloodbrain barrier enzymes.We show that the permeability of our model is as low as that of the bloodbrain barrier in vivo.Our model will be a valuable tool in the study of the mechanisms of action of neuroprotective drugs.

Transitioning to Automated Microbiologic Era: Blood Culture Isolates in Children and Adults in Federal Teaching Hospital in Gombe, North East Nigeria 2016-2020

Introduction: Automated blood culture systems for incubation and growth monitoring have become the standard in high-income countries (HICs), but are still relatively expensive and not universally available for implementation in most low- and middle-income countries (LMIC). We aimed to report blood culture isolates using Automated technique in children and adults admitted into the Federal Teaching Hospital Gombe from 2016 to 2020. Materials and Methods: Blood Culture Isolates in children (0 - 18 years) and adults (>19 yrs) by Bactec 9050 Automated culture system from 2016-2020 were retrieved from the medical and laboratory register. Information analyzed included, age, sex, month, and year and culture growth and reported antibiotic sensitivity. A Bactec Blood culture tests is $20 in this facility. In Nigeria, the minimum monthly wage is $70 (Official currency exchange rate is N423/US Dollar). Results: Of the 1713 blood cultures performed, children 0 - 18 years were 1322 (77.2%) and adult (19 years above) (22.8%). Overall positivity was 733 (42.2%) with males 385 (52.5%). Of the 1322 Blood cultures (BC) in children 615 (46.5%) were positive for isolates and adults 118 (30.2)%. Blood culture positivity decreased with increasing age with newborns 251 (34.5%) and adults > 65 years 18 (2.5%). Staphylococcus aureus constituted 61.3% of all isolates and was the leading isolates in all age groups;Alkaligenes (9.1%);Citrobacter 8.1%, Klebsiella 6.7%;Pseudomonas 6.1%;E. coli 2.7%;Enterococcus 2%;Proteus 1%. Of the Antimicrobial resistance priority isolates E. coli susceptibility ranged from 71% to Gentamycin and 100% to Cefixime;Klebsiella from 25% sensitivity to Amikacin to 78% each to chloramphenicol and ciprofloxacin;Salmonella was 100% sensitive to chloramphenicol, ciprofloxacin and cefuroxime. Klebsiella was 100% sensitive to Cefoxitin;Proteus sensitivity ranged from 35% to ampicillin and 100% to ciprofloxacin and cefuroxime. Staph aureus sensitivity was 35% to cefoxitin, 70% to amoxicillin/clavulanate and 70% to cefuroxime. Conclusion: Blood culture yield by Automated method was high. Staph aureus was the predominant pathogen and bacterial yield reduced with increasing age. Antibiotic sensitivity was variably reduced against gram negative bacteria.

Distribution and Drug Resistance Analysis of 2287 Strains of Pathogenic Bacteria in Children’s Blood Culture

Background: Bloodstream infection is a serious infectious disease. In recent years, the drug resistance of pathogenic bacteria to commonly used anti-infective drugs has been widely concerned, which also makes the treatment of bloodstream infection face severe challenges. Objective: To explore the distribution characteristics of blood culture-positive pathogens and the resistance to antibacterial drugs, so as to provide clinicians with accurate laboratory evidence, so as to guide clinicians to rationally apply antibiotics, improve clinical treatment effects, and reduce the emergence of drug-resistant strains. Methods: From January 2019 to June 2022, 2287 positive blood culture specimens of patients in Guangzhou Women and Children’s Medical Center were retrospectively analyzed, and the proportion of different pathogenic bacteria, the distribution of pathogenic bacteria in different departments, and the multi-drug resistance of different pathogenic bacteria were counted. Results: Among the 2287 blood culture positive samples, 1560 strains (68.20%) of gram-positive bacteria and 727 strains (31.80%) of gram-negative bacteria were strained. The top three departments in the distribution of pathogenic bacteria were pediatric intensive care unit (600 strains), pediatric internal medicine (514 strains), and pediatric emergency comprehensive ward (400 strains). The pathogens with high detection rates were: Staphylococcus epidermidis (24.09%), Staphylococcus humans (23.74%), Escherichia coli (13.21%) and Klebsiella pneumoniae (8.71%). The pathogens with high multi-drug resistance rates were: Streptococcus pneumoniae (93%), Staphylococcus epidermidis (83.76%), Enterobacter cloacae (75.61%) and Staphylococcus humans (62.43%). Conclusion: In our hospital, gram-positive bacteria were the main pathogenic bacteria in the blood culture of children patients. The children’s intensive care unit was the department with the largest distribution of pathogenic bacteria, and the multiple drug resistance rate of Streptococcus pneumoniae was the highest.

Environmental archaeology on Longshan Culture （4500-4000 aBP） at Yuhuicun Site in Bengbu, Anhui Province

Based on the samples collected from the west wall of the ABYT2004 at Yuhuicun Site in Bengbu, Anhui Province, the multi-environmental substitute indexes such as the grain-size, Rb/Sr, zircon crystal morphology and magnetic susceptibility were analyzed. The age of archaeological strata was determined by AMS^14C dating. According to the results, combined with the information of the ancient human activities and the cultural heritage data obtained from the Longshan cultural archaeological strata, it can be concluded that （1） Before 4500 aBP, the climate was humid and water level was high in the Huaihe River and its tributaries, the drainage basin and its surrounding areas were even flooded, so the site area was submerged and there were no human activities around the site. （2） About 4500 aBP, the climate began to become drier and water level of the Huaihe River and its tributaries began to decline, thus floodplain gradually appeared, Yuhuicun Site and Longshan Culture began to appear. （3） Around 4100 aBP, the climate was humid and rainfall was abundant, which resulted in frequent flood disasters in the whole Huaihe River Basin. （4） After 4100 aBP, the climate gradually transited to be cold and dry, agricultural production was constrained to reduce the food source, Yuhuicun Site was almost abandoned. （5） The environmental information in sedimentary strata and historical records based on ancient books agree with each other. In addition, Yuhuicun Site was related to Dayu Zhishui （Yu the Great in taming the floods） in ancient books.

A Retrospective Cross Sectional Study of Blood Culture Results in a Tertiary Hospital, Ekiti, Nigeria

The current study was conducted to determine the epidemiology and antibiotic sensitivity pattern of bacteria isolated from blood of septicemic patients for improved antibiotic therapy. A three-year descriptive study was done at Microbiology Laboratory, Ekiti State University Teaching Hospital, Ado Ekiti, from April 2012 to April 2015. Information compiled from patients’ records includes age, sex, isolated organisms and antibiotic susceptibility patterns. Three hundred and thirteen blood cultures were collected from neonatology and pediatrics wards, Out Patients’ Department (OPD) and from other adult patients. Forty one culture plates yielded mono microbial growth (no polymicrobial growth), giving an incidence of 13.1% positive blood culture (N = 41/313). There were 58.4% Gram negative bacilli and 41.6% Gram positive cocci in the microbial growth. Bacteria isolated were Staphylococcus aureus 34% (14/41), Klebsiella species 22% (9/41), Enterococci 17% (7/41), Proteus species 12% (5/41), Escherichia coli 7% (3/41) and Streptococcal pneumoniae 7% (3/41). There was a (35%) higher occurrence of septicemia in neonates than in any other age groups in the hospital. Bacterial sensitivity to 13 antibiotic agents was determined by antibiotics disc diffusion using modified Kirby Bauer’s method. Gram-positive organisms showed a higher antibiotic sensitivity ranging from 14% - 100% than the Gram-negative bacteria (11% - 80%). Staphylococcus aureus and Klebsiella species are the most prevalent organisms. The third generation Cephalosporins (Ceftriaxone) and Floroquinolone (Levofloxacin, Ofloxacin) have proved reliable for management of these blood infections.

Bacterial Blood Isolates in Children: Conventional vs. Bactec Automated Blood Culture System in a Tertiary Health Centre in Gombe, North East Nigeria

Background/Aim: Blood culture is critical in the diagnosis and treatment of blood stream infections (BSIs) especially in children. BSIs are among the most common cause of morbidity/mortality and blood culture has remained the gold standard for diagnosis. We sought to compare Blood Culture Isolates (BCI) from conventional and Bactec automated blood culture system (ABCS) among paediatric patients at the Federal Teaching Hospital Gombe (FTHG) Nigeria. Methods: BCI in children (0 - 18 years) by conventional method from 2008-2012 and Bactec Automated culture system from 2015-2020 were retrieved from the clinical microbiology laboratory register. Information analyzed included, age, sex, month, and year and blood culture isolates. Results: There were 5276 (56.9% males, 43.1% females) and 1169 (54% males, 46% females) Blood Culture Isolates by CM and ABCS respectively. Overall positive culture isolates were 9.7% (515/5276) in CM and 45.9% (536/1169) in ABCS (p = 0.01). Positivity rate in newborn was 13.3% (282/2114) by CM and 40.9% (219/263) by ABCS p = 0.01;under-5 was 10.5% (448/4253) vs. 37% (359/873) (p = 0.01);Gram positive 32.6% (172) vs. 65% (759) (p = 0.01;Gram negative 55% (2910) vs. 34% (397) (p = 0.01). Staph aureus 22% (114/515) by CM vs. 61.9% (332/536)) by ABCS (p = 0.01);Klebsiella 24.9% (128/515) by CM vs. 7.5% (40/536) p = 0.01) in ABCS, E. coli 8.9% (46/515) vs. 2.1% (11/536) p = 0.01;Proteus vs. 1.1% (6/515) by ABCS, Pseudomonas 3.3% (17/515) vs. 5.6% (30/536) p = 0.05, Alkaligenes 1% (5/515) vs. 8.2% (44/536) p = 0.01 and Citrobacter 1% (5/515) vs. 8.4% (45/536) p = 0.01. Conclusion: Blood culture yield was five times higher with Bactec compared with Conventional method.

Potential Pathogens among Fungi Identified as Nonsporulating Molds from Blood Cultures

Twenty-eight molds were isolated from clinical blood cultures and were unidentifiable by cellular morphology using conventional microscopy. Using the utility of amplification and direct sequencing of internal transcribed spacer region of ribosomal RNA gene, 93% of these fungi were identified. Seventy-one percents of the molds were found to be associated with plants or soil with no or few published cases of human disease. These include species of basidiomycetes and ascomycetes such as Botryosphaeria dothidea, Phomopsis flavodonflavus, Inonotus pachyphloeus, Earlilella scabrosa, Calocybe indica, Athelia pellicularis, Tinctoporellus epimiltinus, Trametes lactinea, Coprinellus aureogranulat and Xylaria feejeensis. Some of the nonsporulating molds were identified as pathogen or potential pathogens in immunocompetent or immunocompromised hosts. These include Schizophylum commune and hyphomycetes such as Cladosporium cladosporoides, Aspergillus niger and Fusarium equiseti. Basidiomycetes and hyphomycetes identified in the current study are ubiquitous in the environment and are almost similar to the species of molds reported from cutaneous and respiratory samples suggesting that the fungi may represent contaminants rather than true fangaemia. Results of this study emphasize the need of an effort to minimise blood culture contamination and support the recommendation to incorporate clinical, radiologic findings and positive blood culture for molds in the diagnosis and management of invasive mycosis.

Frequency of Blood Cultures Performed in a Community Hospital

Background: Blood cultures (BCs) are obtained to identify etiologic organisms, demonstrate antibiotic efficacy, determine duration of treatment, and/or suggest further interventions. Published guidelines do not clearly state indications and timing for obtaining BCs. As a result, clinicians may obtain too many BCs, increasing cost and patient discomfort. Objective: To determine frequency of BCs performed at our hospital as part of a quality improvement project. Design: Retrospective review of all BCs submitted during a randomly selected month. Setting: A New York City 535-bed, university-affiliated community hospital. Measurements: Patient demographics and BC data were obtained from medical and laboratory records. Results: During the selected month, 2280 BCs were performed for 379 patients. Negative BCs were seen in 221 patients (58%) with one-half having multiple BCs performed within 48 hours of admission and prior to obtaining results of initial BCs. Repeat BCs frequently did not reveal further pathogens among patients with either negative or positive initial BCs. Conclusions: Two-thirds of BCs were obtained from less than one-half of patients without added clinical utility. Often, BCs were repeated prior to results of initial BCs or repeated in patients receiving antibiotics in spite of known low yield following antibiotic initiation. Clinical assessment and review of initial BCs prior to obtaining further BCs is necessary. Staff education regarding appropriate clinical setting for BCs and indications for repeat BCs is required to maximize utilization of resources, improve diagnostic yield, and limit patient discomfort.

Trends in Bacterial Blood Culture Isolates and Resistance in Children in Two Microbiologic Eras from a Tertiary Health Facility in North East Nigeria

Introduction: Antimicrobial Resistance surveillance is predicated on blood culture as a priority clinical specimen in especially resource limited settings. Establishing trends in blood stream infections and resistance patterns can inform institutional and national policy on antimicrobial stewardship, surveillance, infection prevention and control. Methodology: Blood Culture isolates in children (0 - 18 years) by conventional method from 2008-2012 and Bactec Automated culture system from 2015-2020 were retrieved. Information analyzed included age, sex, month, and year and culture growth/identity of microorganisms and their sensitivity/resistance patterns. Clinical and Laboratory Standards Institute (CLSI) guideline for antibiotic susceptibility testing was used. Results: 20,540 children were admitted: 8964 (44.6%) and 11,630 (55.4%) in the Manual and Bactec blood culture era respectively. Blood cultures were done in 5271 in the manual culture era and 1077 in the Bactec culture era;of these cultures, 514 (9.7%) and 461 (42.8%) were positive for isolates in the respective era (p = 0.01). There were no statistically significant differences in trend between positive and negative blood cultures in males and females. Newborns, followed by children 1 - 5 years had more blood culture performed on them than other age categories. In general, there is no significant relationship in blood culture outcomes between the age categories and sex of the patients. The isolation of Staph aureus, Citrobacter and Alkaligenes increased two-fold with Bactec automated system. Resistance to the quinolones and the penicillin was high. Resistance trend to Genticin, an aminoglycoside was less than 40%. Resistance to Ceftazidime was high. Conclusion: Antimicrobial resistance surveillance is critical to reduce AMR related morbidity and mortality.

Culture Self- Consciousness in Transmission of Chinese Philosophy from the Perspective of English Globalization -- Taking the Belt and Road Initiative for Example

The Belt and Road Initiative contains the aspiration of Chinese nation to pursue ideological freedom and desire of strengthening international exchanges and cooperation. This paper takes the Belt and Road Initiative for example,emphasizing the interpretation of the inheritance and development of Chinese culture so as to study the importance of Culture Self-Consciousness in Chinese Philosophy,in the context of English globalization. That is to say,this paper stresses the spirits and the stand of nation 's demonstration on pursuing peace,cooperation and sustainable development in the civilization continuity from traditional China to the contemporary China,with practical philosophic view.

Repetitive administration of cultured human CD34+cells improve adenine-induced kidney injury in mice

BACKGROUND There is no established treatment to impede the progression or restore kidney function in human chronic kidney disease(CKD).AIM To examine the efficacy of cultured human CD34+cells with enhanced proliferating potential in kidney injury in mice.METHODS Human umbilical cord blood(UCB)-derived CD34+cells were incubated for one week in vasculogenic conditioning medium.Vasculogenic culture significantly increased the number of CD34+cells and their ability to form endothelial progenitor cell colony-forming units.Adenineinduced tubulointerstitial injury of the kidney was induced in immunodeficient non-obese diabetic/severe combined immunodeficiency mice,and cultured human UCB-CD34+cells were administered at a dose of 1×106/mouse on days 7,14,and 21 after the start of adenine diet.RESULTS Repetitive administration of cultured UCB-CD34+cells significantly improved the time-course of kidney dysfunction in the cell therapy group compared with that in the control group.Both interstitial fibrosis and tubular damage were significantly reduced in the cell therapy group compared with those in the control group(P<0.01).Microvasculature integrity was significantly preserved(P<0.01)and macrophage infiltration into kidney tissue was dramatically decreased in the cell therapy group compared with those in the control group(P<0.001).CONCLUSION Early intervention using human cultured CD34+cells significantly improved the progression of tubulointerstitial kidney injury.Repetitive administration of cultured human UCB-CD34+cells significantly improved tubulointerstitial damage in adenine-induced kidney injury in mice via vasculoprotective and anti-inflammatory effects.

Distribution and drug resistance of pathogens isolated from 4142 blood cultures

Objective:To investigate the distribution and drug resistance of pathogens isolated from 4142 blood cultures, and provide a scientific foundation for guiding clinical rational use of antimicrobial agents for bloodstream infections.Methods: Blood cultures obtained from 4142 inpatients and outpatients who were hospitalized from Jan 2015 to Dec 2016. The culture was detected by automatic BACT/ALERT 3D blood culture system of biomerieux. Bacteria isolated from positive blood cultures were further identified, and the drug susceptibility tests were conducted by VITEK-2 Compact automatic microbial analysis system and ATB Expression microbial analysis system. The drug susceptibility results were evaluated according to CLSI 2014 standard. Statistical analysis was performed by using WHONET 5.6 software. Results:A total of 396 unique strains were isolated from 4142 blood cultures, and the positive rate is 9.6%. Among the positive blood cultures, 194 (49.0%) strains were identified as Gram-positive, 185 (46.7%) strains were identified as Gram-negative, and 17(4.3%) strains were identified as fungi. The coagulase-negative Staphylococcus were the most frequently detectable (29.2%), followed by Escherichia coli (18.4%), Klebsiella pneumonia (7.3%), Staphylococcus aureus (5.1%), Acinetobacter baumannii(5.1%), and Enterococcus genera (5.1%). The incidences of methicillin resistant coagulase negative staphylococcus (MRCNS) and methicillin resistant staphylococcus aureus (MRSA) were 81.9% and 50.0% respectively. However, vancomycin resistant staphylococcus and enterococcus were not detected. The prevalence of extended spectrumβ lactamases (ESBLs) in E. coli and K. pneumoniae were 56.2% and 37.9%, respectively. All the E. coli strains were sensitive to amikacin, piperacillin/tazobactam, imipenem and meropenem, and the sensitive rate of K. pneumoniae strains to imipenem and meropenem were 93.1% and 89.7%, respectively.Conclusions MRCNS stains were the most frequently detected pathogens in blood cultures in the present study. The characteristic of drug resistance for the pathogens indicated that monitoring of imipenem and meropenem resistant K. pneumoniae should be underlined to prevent nosocomial outbreak. Fungi bloodstream infections of ward such as ICU and department of hemopathology should be enhanced monitored.

Differences in serum inflammatory mediators in early blood culture positive and negative patients with bacterial bloodstream infection

Objective: To study the differences in serum inflammatory mediators in early blood culture positive and negative patients with bacterial bloodstream infection. Methods: Patients who were hospitalized due to suspected bacterial bloodstream infection between December 2015 and September 2017 were divided into positive group and negative group according to the results of blood culture, and healthy volunteers who underwent medical examination during the same period were selected as control group. Peripheral blood specimens were collected from patients with suspected bacteremia on admission, the peripheral blood specimens were collected from the control group of volunteers during physical examination, and the levels of pro-inflammatory cytokines, anti-inflammatory cytokines, adhesion factors and chemokines were determined. Results: Serum PCT, CRP, IL-6, IL-17, IL-23, IL-4, IL-10, IL-13, sTM, ICAM-1, VCAM-1, EOTAXIN-3 and MCP-1 levels of positive group and negative group were significantly higher than those of control group, and serum PCT, CRP, IL-6, IL-17, IL-23, IL-4, IL-10, IL-13, sTM, ICAM-1, VCAM-1, EOTAXIN-3 and MCP-1 levels of positive group were significantly higher than those of negative group. Conclusions: Detection of serum inflammatory mediators can early predict the bacterial bloodstream infection.

Studies on blood stasis in the traditional medicine of the Li Culture

Blood stasis,or stagnation,is a pathological product formed in the course of certain diseases as well as a pathogenic factor of other diseases.The Li ethnic region is known as the“Natural Medicine Bank”and is the primary production base of South China’s medicinal plants.Hainan Island is the home to the vast majority of the Li Culture;the Hainan Li ethnic region is located on the northern edge of the tropics and mostly lies in the mountainous areas of Wuzhi Mountain.This region is frost-free and snow-free year-round,with plenty of heat and rain.Wuzhi Mountain’s terrain is mountainous:high and steep in the middle and low around the foothills.It has fertile soil,rich vegetation,and is rich in animal and plant medicinal materials.The traditional medicine of the Li Culture has named blood stasis“Tun Duo.”Because few studies have been conducted regarding the traditional medicine of the Li Culture in the field of blood stasis,this article began with the collection of commonly-used compound recipes of the Li Culture.It then discussed the differentiation of syndromes through these compound recipes to expand the research results in the field of blood stasis in the traditional medicine of the Li Culture.

iCubate-iC血培养快速检测系统与血培养传统鉴定药敏一致性评估

目的评估基于PCR扩增荧光探针捕获技术的iCubate-iC血培养快速检测系统与血培养传统鉴定药敏结果的一致性。方法本次评估入组了首都医科大学附属北京朝阳医院2017年11月26日至2018年4月18日的121例临床血液细菌培养阳性标本。以临床常规培养鉴定结果及体外药敏结果为参考方法,验证iCubate-iC系统鉴定结果及耐药位点检出的一致性。结果对比MALDI-TOF质谱鉴定结果,iCubate-iC系统鉴定符合率达到95.9%(116/121)。有4例假阴性结果,所有靶标显示“未检出”。iCubate-iC系统成功检出1例金黄色葡萄球菌和表皮葡萄球菌的混合样本,而1例大肠埃希菌和铜绿假单胞菌复合样本漏检了铜绿假单胞菌。iC-GPC检出的31例葡萄球菌中,有18例检出了mecA基因,其中有1例表皮葡萄球菌检出mecA,但其体外药敏结果显示对头孢西丁敏感。肠球菌中有1例检出vanA基因,但万古霉素体外药敏检测敏感。CTX-M group1基因检测与β内酰胺类药物的吻合性不理想,但革兰氏阴性菌碳青霉烯酶基因(KPC、NDM)检测结果与碳青霉烯类药物的药敏结果能够完全吻合。结论iCubate-iC检测系统对于临床常见引起血流感染细菌的检测结果可靠,且具有快速简便的优点,为引起血流感染细菌的快速诊断提供了有力工具。

湖南省细菌耐药监测网2012-2021年血标本分离细菌耐药性监测报告

目的了解湖南省血标本分离细菌的分布及耐药性变迁,为临床血流感染初始经验诊治提供依据。方法收集湖南省细菌耐药监测网2012—2021年各成员单位上报数据,细菌耐药监测方法参照全国细菌耐药监测网(CARSS)技术方案执行,应用WHONET 5.6软件和SPSS 27.0软件对血标本分离细菌及药敏试验结果进行分析。结果2012—2021年湖南省细菌耐药监测网成员单位血标本共分离细菌207054株,其中革兰阳性菌107135株(51.7%)、革兰阴性菌99919株(48.3%);2012—2021年居前6位的病原菌无变化,居首位的为大肠埃希菌(51537株,24.9%),其次分别为表皮葡萄球菌(29115株,14.1%)、金黄色葡萄球菌(17402株,8.4%)、肺炎克雷伯菌(17325株,8.4%)、铜绿假单胞菌(4010株,1.9%)和鲍曼不动杆菌(3598株,1.7%)。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率由2015年的30.3%下降至2021年的20.7%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率呈逐年上升趋势(57.9%~66.8%)。未发现对万古霉素、利奈唑胺和替考拉宁耐药的葡萄球菌。革兰阴性菌中,大肠埃希菌、肺炎克雷伯菌构成比分别为43.9%~53.9%、14.2%~19.5%,呈上升趋势(均P<0.001);铜绿假单胞菌、鲍曼不动杆菌的构成比分别为3.6%~5.1%、3.0%~4.5%,呈逐年下降趋势(均P<0.001)。2012—2021年大肠埃希菌对亚胺培南、厄他培南的耐药率分别为1.0%~2.0%、0.6%~1.1%,呈下降趋势(均P<0.001)。肺炎克雷伯菌对美罗培南、厄他培南的耐药率分别为7.4%~13.7%、4.8%~6.4%,呈下降趋势(均P<0.001)。铜绿假单胞菌、鲍曼不动杆菌对碳青霉烯类抗生素的耐药率分别为7.1%~15.6%、34.7%~45.7%,对碳青霉烯类抗生素的耐药性趋势相对稳定,但与2012—2016年相比均有下降。2012—2021年大肠埃希菌对第三代头孢菌素的耐药率为41.0%~65.4%,呈逐年下降趋势。结论湖南省血标本革兰阴性杆菌构成比逐年增高,耐碳青霉烯类革兰阴性杆菌的检出率近5年相对稳定,凝固酶阴性葡萄球菌检出率呈下降趋势。

Brain-derived neurotrophic factor induces neuron-like cellular differentiation of mesenchymal stem cells derived from human umbilical cord blood cells in vitro

Human umbilical cord blood was collected from full-term deliveries scheduled for cesarean section. Mononuclear cells were isolated, amplified and induced as mesenchymal stem cells. Isolated mesenchymal stem cells tested positive for the marker CD29, CD44 and CD105 and negative for typical hematopoietic and endothelial markers. Following treatment with neural induction medium containing brain-derived neurotrophic factor for 7 days, the adherent cells exhibited neuron-like cellular morphology. Immunohistochemical staining and reverse transcription-PCR revealed that the induced mesenchymal stem cells expressed the markers for neuron-specific enolase and neurofilament. The results demonstrated that human umbilical cord blood-derived mesenchymal stem cells can differentiate into neuron-like cells induced by brain-derived neurotrophic factor in vitro.

《我父亲的梦想》中文译本中的文化谬误--以White Blood为例

《我父亲的梦想》是美国前总统奥巴马的回忆录,该书中文版存在不少语言和文化方面的错误,其中一个典型例子就是译者把具有丰富文化信息的white blood(白人血统)误解为white blood cell(白血球)。在美国文化中,white blood被认为是白人种族的区别性特征。但对于不同类型的黑白混血儿来说,白人血统具有不同的象征意义。奴隶制下的黑白混血儿是性剥削的产物,反族际混血法存续期间出生的黑白混血儿被视为私生子,因此对于这两类黑白混血儿来说,其身上的白人血统是耻辱的标签。但随着1967年美国最高法院宣布反族际混血法违宪,黑白通婚现象合法化,以奥巴马为代表的黑白混血儿不再以自己身上的白人血统为耻。部分黑白混血儿甚至要求建立具有包容性、能够反映其血统混杂性的“多重种族身份”类别。