Records |
Author |
Ma, H.X.; He, L.; Cai, S.W.; Xin, X.L.; Shi, H.D.; Zhou, L.; Shi, X.J. |
Title |
[Analysis of the spectrum and resistance of pathogen causing sepsis in patients with severe acute pancreatitis] |
Type |
Journal Article |
Year |
2017 |
Publication |
Zhonghua wai ke za zhi [Chinese Journal of Surgery] |
Abbreviated Journal |
Zhonghua Wai Ke Za Zhi |
Volume |
55 |
Issue |
5 |
Pages |
378-383 |
Keywords |
Adult; Aged; Anti-Bacterial Agents/*therapeutic use; Cross Infection; *Drug Resistance, Bacterial; Escherichia coli; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pancreatitis/*complications; Retrospective Studies; Sepsis/*drug therapy; Vancomycin/therapeutic use; Young Adult; Bacteria spectrum; Drug resistance; Pancreatitis, acute necrotizing; Sepsis |
Abstract |
Objective: To investigate the characteristics of spectrum and drug resistance of pathogens causing sepsis in patients with severe acute pancreatitis(SAP). Methods: The clinical data of 63 SAP patients with sepsis admitted in Department of Hepatobiliary, People's Liberation Army General Hospital from January 2014 to December 2015 were retrospectively studied. There were 47 males and 16 females, aged from 22 to 73 years, with an average age of (52+/-11)years. Samples were collected mainly from: (1)pancreatic and peripancreatic necrosis and abdominal drainage; (2)bile; (3) blood or deep venous catheter; (4) sputum and tracheal catheter and thoracic drainage; (5) urine. Strain identification and drug-resistance test were preformed on positive specimens. Results: Of 244 pathogenic isolates, mainly derived from abdominal cavity(36.0%), blood stream (14.0%), central venous catheter(11.8%), necrotic tissue(9.1%) and sputum(8.1%); 154(63.1%) were gram-negative bacteria, 68 cases(27.9%) were gram-positive bacteria and 22 cases(9.0%) were fungi respectively. The top six common pathogens isolated were E. coli(16.0%), E.faecium and faecalis(15.2%), P.aeruginosa(10.7%), K.pneumonia(9.8%), Acinetobacter baumanni(8.2%), Stenotrophomonas maltophilia(5.3%)respectively. The detection rate of E. coli and K. pneumonia extended-spectrum beta-lactamases(ESBL) was 84.6%(33/39) and 70.8%(17/24), the resistance rate to imipeniem was 12.8% and 25.0%, to cefperazone-sulbactam was 28.2% and 29.2%. As to P. aeruginosa and Acinetobacter bacillus, the resistance rate to imipeniem was 50.0% and 75.0%, to cefperazone-sulbactam was 42.3% and 70.0%; Stenotrophomonas maltophilia was completely resistant to cefperazone-sulbactam, but sensitive to minocycline, SMZ-TMP with the resistance rate less than 40.0%. Gram-positive bacterium strains mainly included E. faecium(38.2%, 26/68), E.faecalis(16.2%, 11/68) and Staphylococcus(35.3%, 24/68) which maintained high sensitivity to vancomycin, teicoplanin and linezolid, there was only one isolate resistant to vancomycin. Candida were the sole pathogens of fungal infections, sensitive to common antifungal drugs overall. Conclusions: The gram-negative bacteria are the predominant pathogens mainly including ESBL-producing isolates(E.coli and K. pneumonia) and non-fermentation bacteria(P.aeruginosa and Acinetobacter bacillus) causing sepsis in SAP. The infection rate and drug-resistance rate of these two kinds of pathogens are relatively higher. |
Address  |
Department of Hepatobiliary, People's Liberation Army General Hospital, Beijing 100853, China |
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Chinese |
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0529-5815 |
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PMID:28464580 |
Approved |
no |
Call Number |
ref @ user @ |
Serial |
99094 |
Permanent link to this record |
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Author |
Ma, H.X.; He, L.; Cai, S.W.; Xin, X.L.; Shi, H.D.; Zhou, L.; Shi, X.J. |
Title |
[Analysis of the spectrum and resistance of pathogen causing sepsis in patients with severe acute pancreatitis] |
Type |
Journal Article |
Year |
2017 |
Publication |
Zhonghua wai ke za zhi [Chinese Journal of Surgery] |
Abbreviated Journal |
Zhonghua Wai Ke Za Zhi |
Volume |
55 |
Issue |
5 |
Pages |
378-383 |
Keywords |
Adult; Aged; Anti-Bacterial Agents/*therapeutic use; Cross Infection; *Drug Resistance, Bacterial; Escherichia coli; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pancreatitis/*complications; Retrospective Studies; Sepsis/*drug therapy; Vancomycin/therapeutic use; Young Adult; Bacteria spectrum; Drug resistance; Pancreatitis, acute necrotizing; Sepsis |
Abstract |
Objective: To investigate the characteristics of spectrum and drug resistance of pathogens causing sepsis in patients with severe acute pancreatitis(SAP). Methods: The clinical data of 63 SAP patients with sepsis admitted in Department of Hepatobiliary, People's Liberation Army General Hospital from January 2014 to December 2015 were retrospectively studied. There were 47 males and 16 females, aged from 22 to 73 years, with an average age of (52+/-11)years. Samples were collected mainly from: (1)pancreatic and peripancreatic necrosis and abdominal drainage; (2)bile; (3) blood or deep venous catheter; (4) sputum and tracheal catheter and thoracic drainage; (5) urine. Strain identification and drug-resistance test were preformed on positive specimens. Results: Of 244 pathogenic isolates, mainly derived from abdominal cavity(36.0%), blood stream (14.0%), central venous catheter(11.8%), necrotic tissue(9.1%) and sputum(8.1%); 154(63.1%) were gram-negative bacteria, 68 cases(27.9%) were gram-positive bacteria and 22 cases(9.0%) were fungi respectively. The top six common pathogens isolated were E. coli(16.0%), E.faecium and faecalis(15.2%), P.aeruginosa(10.7%), K.pneumonia(9.8%), Acinetobacter baumanni(8.2%), Stenotrophomonas maltophilia(5.3%)respectively. The detection rate of E. coli and K. pneumonia extended-spectrum beta-lactamases(ESBL) was 84.6%(33/39) and 70.8%(17/24), the resistance rate to imipeniem was 12.8% and 25.0%, to cefperazone-sulbactam was 28.2% and 29.2%. As to P. aeruginosa and Acinetobacter bacillus, the resistance rate to imipeniem was 50.0% and 75.0%, to cefperazone-sulbactam was 42.3% and 70.0%; Stenotrophomonas maltophilia was completely resistant to cefperazone-sulbactam, but sensitive to minocycline, SMZ-TMP with the resistance rate less than 40.0%. Gram-positive bacterium strains mainly included E. faecium(38.2%, 26/68), E.faecalis(16.2%, 11/68) and Staphylococcus(35.3%, 24/68) which maintained high sensitivity to vancomycin, teicoplanin and linezolid, there was only one isolate resistant to vancomycin. Candida were the sole pathogens of fungal infections, sensitive to common antifungal drugs overall. Conclusions: The gram-negative bacteria are the predominant pathogens mainly including ESBL-producing isolates(E.coli and K. pneumonia) and non-fermentation bacteria(P.aeruginosa and Acinetobacter bacillus) causing sepsis in SAP. The infection rate and drug-resistance rate of these two kinds of pathogens are relatively higher. |
Address  |
Department of Hepatobiliary, People's Liberation Army General Hospital, Beijing 100853, China |
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Place of Publication |
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Chinese |
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Series Editor |
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ISSN |
0529-5815 |
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Expedition |
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Conference |
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Notes |
PMID:28464580 |
Approved |
no |
Call Number |
ref @ user @ |
Serial |
100124 |
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Author |
Glaser, T.; Han, I.; Wu, L.; Zeng, X. |
Title |
Targeted Nanotechnology in Glioblastoma Multiforme |
Type |
Journal Article |
Year |
2017 |
Publication |
Frontiers in Pharmacology |
Abbreviated Journal |
Front Pharmacol |
Volume |
8 |
Issue |
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Pages |
166 |
Keywords |
blood-brain barrier; cancer stem cell; glioma; nanomedicine; nanotechnology; targeted therapy |
Abstract |
Gliomas, and in particular glioblastoma multiforme, are aggressive brain tumors characterized by a poor prognosis and high rates of recurrence. Current treatment strategies are based on open surgery, chemotherapy (temozolomide) and radiotherapy. However, none of these treatments, alone or in combination, are considered effective in managing this devastating disease, resulting in a median survival time of less than 15 months. The efficiency of chemotherapy is mainly compromised by the blood-brain barrier (BBB) that selectively inhibits drugs from infiltrating into the tumor mass. Cancer stem cells (CSCs), with their unique biology and their resistance to both radio- and chemotherapy, compound tumor aggressiveness and increase the chances of treatment failure. Therefore, more effective targeted therapeutic regimens are urgently required. In this article, some well-recognized biological features and biomarkers of this specific subgroup of tumor cells are profiled and new strategies and technologies in nanomedicine that explicitly target CSCs, after circumventing the BBB, are detailed. Major achievements in the development of nanotherapies, such as organic poly(propylene glycol) and poly(ethylene glycol) or inorganic (iron and gold) nanoparticles that can be conjugated to metal ions, liposomes, dendrimers and polymeric micelles, form the main scope of this summary. Moreover, novel biological strategies focused on manipulating gene expression (small interfering RNA and clustered regularly interspaced short palindromic repeats [CRISPR]/CRISPR associated protein 9 [Cas 9] technologies) for cancer therapy are also analyzed. The aim of this review is to analyze the gap between CSC biology and the development of targeted therapies. A better understanding of CSC properties could result in the development of precise nanotherapies to fulfill unmet clinical needs. |
Address  |
Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen UniversityGuangzhou, China |
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ISSN |
1663-9812 |
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Notes |
PMID:28408882 |
Approved |
no |
Call Number |
ref @ user @ |
Serial |
96596 |
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Author |
Rogers, A.E.J.; Eisenman, K.M.; Dolan, S.A.; Belderson, K.M.; Zauche, J.R.; Tong, S.; Gralla, J.; Hilden, J.M.; Wang, M.; Maloney, K.W.; Dominguez, S.R. |
Title |
Risk factors for bacteremia and central line-associated blood stream infections in children with acute myelogenous leukemia: A single-institution report |
Type |
Journal Article |
Year |
2017 |
Publication |
Pediatric Blood & Cancer |
Abbreviated Journal |
Pediatr Blood Cancer |
Volume |
64 |
Issue |
3 |
Pages |
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Keywords |
Adolescent; Bacteremia/*etiology; Bacteria/isolation & purification; Case-Control Studies; Catheter-Related Infections/*etiology; Catheterization, Central Venous/*adverse effects; Child; Child, Preschool; Cross Infection/*etiology; Female; Follow-Up Studies; Humans; Infant; Intensive Care Units, Pediatric; Leukemia, Myeloid, Acute/*complications/microbiology; Male; Prognosis; Retrospective Studies; Risk Factors; Clabsi; acute myelogenous leukemia; bacteremia; pediatric oncology |
Abstract |
BACKGROUND: Central line-associated blood stream infections (CLABSIs) are a source of high morbidity and mortality in children with acute myelogenous leukemia (AML). PROCEDURE: To understand the epidemiology and risk factors associated with the development of CLABSI in children with AML. METHODS: We retrospectively reviewed all patients with AML over a 5-year period between 2007 and 2011 at the Children's Hospital Colorado. Cases and controls were classified on the basis of the presence of a CLABSI as defined by the National Healthcare Safety Network. RESULTS: Of 40 patients in the study, 25 (62.5%) developed at least one CLABSI during therapy. The majority of CLABSIs were due to oral or gastrointestinal organisms (83.0%). Skin organisms accounted for 8.5%. In a multivariable analysis, the strongest risk factors associated with CLABSI were diarrhea (odds ratio [OR] 6.7, 95% confidence interval [CI] 1.6-28.7), receipt of blood products in the preceding 4-7 days (OR 10.0, 95%CI 3.2-31.0), not receiving antibiotics (OR 8.3, 95%CI 2.8-25.0), and chemotherapy cycle (OR 3.5, 95%CI 1.4-8.9). CLABSIs led to increased morbidity, with 13 cases (32.5%) versus two controls (1.9%) requiring transfer to the pediatric intensive care unit (P < 0.001). Three (7.5%) of 40 CLABSI events resulted in or contributed to death. CONCLUSIONS: Intensified line care efforts cannot eliminate all CLABSIs in the patients with AML. Exploring the role of mucosal barrier breakdown and/or the use of antibiotic prophylaxis may be effective strategies for further prevention of CLABSIs, supporting ongoing trials in this patient population. |
Address  |
Department of Infectious Disease, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, Colorado |
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English |
Summary Language |
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Series Editor |
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ISSN |
1545-5009 |
ISBN |
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Conference |
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Notes |
PMID:27616655 |
Approved |
no |
Call Number |
ref @ user @ |
Serial |
99291 |
Permanent link to this record |
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Author |
Rogers, A.E.J.; Eisenman, K.M.; Dolan, S.A.; Belderson, K.M.; Zauche, J.R.; Tong, S.; Gralla, J.; Hilden, J.M.; Wang, M.; Maloney, K.W.; Dominguez, S.R. |
Title |
Risk factors for bacteremia and central line-associated blood stream infections in children with acute myelogenous leukemia: A single-institution report |
Type |
Journal Article |
Year |
2017 |
Publication |
Pediatric Blood & Cancer |
Abbreviated Journal |
Pediatr Blood Cancer |
Volume |
64 |
Issue |
3 |
Pages |
|
Keywords |
Adolescent; Bacteremia/*etiology; Bacteria/isolation & purification; Case-Control Studies; Catheter-Related Infections/*etiology; Catheterization, Central Venous/*adverse effects; Child; Child, Preschool; Cross Infection/*etiology; Female; Follow-Up Studies; Humans; Infant; Intensive Care Units, Pediatric; Leukemia, Myeloid, Acute/*complications/microbiology; Male; Prognosis; Retrospective Studies; Risk Factors; Clabsi; acute myelogenous leukemia; bacteremia; pediatric oncology |
Abstract |
BACKGROUND: Central line-associated blood stream infections (CLABSIs) are a source of high morbidity and mortality in children with acute myelogenous leukemia (AML). PROCEDURE: To understand the epidemiology and risk factors associated with the development of CLABSI in children with AML. METHODS: We retrospectively reviewed all patients with AML over a 5-year period between 2007 and 2011 at the Children's Hospital Colorado. Cases and controls were classified on the basis of the presence of a CLABSI as defined by the National Healthcare Safety Network. RESULTS: Of 40 patients in the study, 25 (62.5%) developed at least one CLABSI during therapy. The majority of CLABSIs were due to oral or gastrointestinal organisms (83.0%). Skin organisms accounted for 8.5%. In a multivariable analysis, the strongest risk factors associated with CLABSI were diarrhea (odds ratio [OR] 6.7, 95% confidence interval [CI] 1.6-28.7), receipt of blood products in the preceding 4-7 days (OR 10.0, 95%CI 3.2-31.0), not receiving antibiotics (OR 8.3, 95%CI 2.8-25.0), and chemotherapy cycle (OR 3.5, 95%CI 1.4-8.9). CLABSIs led to increased morbidity, with 13 cases (32.5%) versus two controls (1.9%) requiring transfer to the pediatric intensive care unit (P < 0.001). Three (7.5%) of 40 CLABSI events resulted in or contributed to death. CONCLUSIONS: Intensified line care efforts cannot eliminate all CLABSIs in the patients with AML. Exploring the role of mucosal barrier breakdown and/or the use of antibiotic prophylaxis may be effective strategies for further prevention of CLABSIs, supporting ongoing trials in this patient population. |
Address  |
Department of Infectious Disease, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, Colorado |
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English |
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Abbreviated Series Title |
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Edition |
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ISSN |
1545-5009 |
ISBN |
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Notes |
PMID:27616655 |
Approved |
no |
Call Number |
ref @ user @ |
Serial |
100321 |
Permanent link to this record |