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The clinical differentiation of blood culture-positive and -negative sepsis in burn patients: a retrospective cohort stu

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Burns & Trauma 2023年第1期11卷 627-638页

作者： Jaechul Yoon Dohern Kym Jun Hur Jongsoo Park Myongjin Kim Yong Suk Cho Wook Chun Dogeon Yoon Department of Surgery and Critical Care Burn CenterHangang Sacred Heart HospitalHallym University Medical Center12Beodeunaru-ro 7-gilYoungdeungpo-guSeoul 07247Korea Graduate school of Medicine Kanwon National University1Kangwondaehak-gilChuncheon-siGangwon-doRepublic of Korea Burn Institutes Hangang Sacred Heart HospitalHallym University Medical Center12Beodeunaru-ro 7-gilYoungdeungpo-guSeoul 07247Korea

Background:Sepsis is a potentially life-threatening condition that occurs when the body’s response to infection leads to widespread inflammation and tissue *** cultures can make it difficult for clinicians to make a diagnosis and may raise questions about the validity of the definition of *** addition,the clinical distinctions between burn patients with blood culturepositive and-negative sepsis are also poorly ***,this study aimed to examine the clinical differences between blood culture-positive and-negative sepsis in burn patients in order to improve the understanding of the pathophysiology and epidemiology of sepsis in this ***:This study had a retrospective design,and the participants were adults aged≥18 *** diagnosed with sepsis were divided into two groups based on their blood culture results within 1 week of sepsis ***:We enrolled 1643 patients admitted to our institution’s burn intensive care unit between January 2010 and December ***,platelet count,bicarbonate and haematocrit were significant in both the positive and negative ***,lymphocyte,red cell distribution width and blood urea nitrogen were significant only in the positive group,whereas lactate dehydrogenase was significant only in the negative *** baumannii,Pseudomonas aeruginosa,and Klebsiella pneumonia are common gram-negative bacterial species,and Staphylococcus aureus and Staphylococcus epidermidis are common gram-positive bacterial species seen in burn patients with positive blood *** resistance was found to be associated with an unfavourable prognosis in gram-negative bacteria,with the exception of ***:pH,platelet count,bicarbonate and haematocrit were routine biomarkers that demon-strated statistical significance in both *** dehydrogenase was significant in the blood-negative group,while red cell distribution width,blood urea nitrogen and lym

关键词： Sepsis blood culture Longitudinal Resistance Antibiotics k-Means clustering

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blood collection procedures influence contamination rates in blood culture： a prospective study

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Chinese Medical Journal 2011年第23期124卷 4002-4006页

作者： GE Ying LIU Xiao-qing XU Ying-chun XU Shan YU Min-hong ZHANG Wei DENG Guo-hua Department of Infectious Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China

Background blood culture contamination is a significant adverse event. The aim of this project was to evaluate the efficacy of a strict blood collection procedure in reducing the blood culture contamination rate. Methods A prospectively controlled study was performed in two different medical areas in Peking Union Medical College Hospital （PUMCH） for 16 months （from May 2006 to September 2007）. In test group, a strict blood collection procedure was carried out by trained nurses with the veinpuncture sites were scrupulously disinfected with 2.5% tincture of iodine plus 70% alcohol. In control group, commonly used procedure in PUMCH was performed with 0.45% chlorhexidine acetate plus 0.2% iodine. blood culture positive results for 4 target organisms （Coagulase-negafive staphylococci, Propionibacterium acnes, physicians from infectious department to （contamination）. Corynebacterium species and Bacillus determine whether a sample was true species） were further assessed by positive （pathogen） or false positive Results Total 9321 blood culture collections were analyzed. The blood culture contamination rate in test group was significantly lower than that in control group （5/3177 （0.16%） vs. 77/6144 （1.25%）; x2=13.382, P 〈0.001）. The most common contaminant was Coagulase-negative staphylococcus （76.83%）. The average cultural time during which contaminated samples became positive was longer than that for true pathogen samples （42.0 hours vs. 13.9 hours, P=-0.041）. Conclusion Using a strict blood collection procedure can significantly reduce blood culture contamination rate.

关键词： blood culture contamination rate disinfection blood collection procedure

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

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Open Journal of Medical Microbiology 2022年第3期12卷 101-116页

作者： Elon Warnow Isaac Iliya Jalo Abubakar Joshua Difa Mercy Raymond Poksireni Oyeniyi Christianah Muhammad Saminu Charanci Ibrahim Mohammed Mohammed Mohammed Manga Department of Paediatrics College of Medical Sciences Gombe State University and Federal Teaching Gombe Nigeria Infectious Disease Training and Research Group Gombe Nigeria Department of Community Medicine College of Medical Sciences Gombe State University and Federal Teaching Gombe Nigeria Department of Medical Microbiology and Immunology Federal Teaching Hospital Gombe Nigeria Department of Medical Microbiology and Immunology College of Medical Sciences Gombe State University Gombe 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.

关键词： Children blood culture Isolates Manual Automated

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Impact of satellite blood culture on early diagnosis of sepsis

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Journal of Intensive Medicine 2022年第1期2卷 56-60页

作者： Ziqi Guo Bo Guo Shanmei Wang Huifeng Zhang Wenxiao Zhang Bingyu Qin Huanzhang Shao Department of Critical Care Medicine Henan University People’s HospitalZhengzhouHenan 455000China Department of Critical Care Medicine Henan Provincial People’s HospitalZhengzhouHenan 455000China Henan Key Laboratory for Critical Care Medicine Henan Provincial People’s HospitalZhengzhouHenan 455000China Department of Critical Care Medicine Zhengzhou University People’s HospitalZhengzhouHenan 455000China Department of Microbiology Laboratory Henan Provincial People’s HospitalZhengzhouHenan 455000China

Background:The aim of this study was to assess whether satellite blood culture(SBC)can improve turnaround times,antibiotic switching,and patient prognosis,relative to laboratory blood culture(LBC).Methods:Patients with sepsis treated in the intensive care units(ICUs)of Henan Provincial People’s Hospital from February 5,2018 to January 19,2019 who met the inclusion criteria were recruited to the study and divided into the SBC group and LBC group according to different blood culture *** demographics,blood culture,antibiotic adjustment,and prognosis data were collected and compared between the two ***:A total of 204 blood culture sets from 52 ICU patients,including 100 from the medical microbiology LBC group and 104 from the SBC group,were analyzed in this *** was no significant difference in the positive rates between the two *** from specimen collection to incubation was significantly shorter in the SBC group than that in the LBC group(1.65 h vs.3.51 h,z=−4.09,Pblood culture positivity was 24.83 h in the SBC group and 27.83 h in the LBC *** times from adjustment of antibiotics according to the first report were 26.05 h and 51.71 h in the SBC and LBC groups,respectively,while those according to the final report were 97.17 h and 111.45 h,*** ICU lengths of stay were 15.00 days and 17.00 days in the SBC and LBC groups,respectively,and median ICU lengths of stay were 18.00 days and 23.50 days,*** hospitalization costs were 157.99 and 186.73 thousand yuan in the SBC and LBC groups,***:SBC can significantly reduce blood culture turnaround times;however,there were no significant differences between the two blood culture methods in initial reporting of positive cultures,time to adjustment of antibiotic therapy,or medical costs,despite a trend toward improvement.

关键词： blood culture Sepsis Intensive care unit Antibiotic switching Turnaround time Gram stain

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Leptotrichia hongkongensis ***.,a novel Leptotrichia species with the oral cavity as its natural reservoir

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第6期11卷 391-401页

作者： Patrick C. Y. WOO Samson S. Y. WONG Jade L. L. TENG Kit-Wah LEUNG Antonio H. Y. NGAN Dong-qing ZHAO Herman TSE Susanna K. P. LAU Kwok-Yung YUEN State Key Laboratory of Emerging Infectious Diseases The University of Hong Kong Hong Kong China Research Centre of Infection and Immunology The University of Hong Kong Hong Kong China Department of Microbiology The University of Hong Kong Hong Kong China Carol Yu Centre for Infection The University of Hong Kong Hong Kong China

A straight, non-sporulating, Gram-variable bacillus (HKU24T) was recovered from the blood culture of a patient with metastatic breast carcinoma. After repeated subculturing in BACTEC Plus Anaerobic/F blood culture broth, HKU24T grew on brucella agar as non-hemolytic, pinpoint colonies after 96 h of incubation at 37 °C in an anaerobic environment and aerobic environment with 5% CO2. Growth was enhanced with a streak of Staphylococcus aureus. HKU24T was non-motile and catalase-negative, but positive for alkaline phosphatase, β-glucosidase, and α-glucosidase. It hydrolyzed phenylphosphonate and reduced resazurin. 16S rRNA, groEL, gyrB, recA, and rpoB sequencing showed that HKU24T occupies a distinct phylogenetic position among the Leptotrichia species, being most closely related to Leptotrichia trevisanii. Using HKU24T groEL, gyrB, recA, and rpoB gene-specific primers, fragments of these genes were amplified from one of 20 oral specimens. Based on phenotypic and genotypic characteristics, we propose a new species, Leptotrichia hongkongensis sp. nov., to describe this bacterium.

关键词： Leptotrichia hongkongensis Bacterium blood culture Anaerobic bacteria Novel species

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Application of Kaiser Sepsis Calculator in culture-positive infants with early onset sepsis

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World Journal of Pediatrics 2021年第4期17卷 429-433页

作者： Gretchen Kopec Marc Collin Anirudha Das Department of Neonatology University of Illinois College of MedicinePeoria campusPeoriaUSA Department of Neonatology MetroHealth Medical CenterClevelandUSA Department of Neonatology Cleveland Clinic Children’s Hospital9500 Euclid AvenueClevelandOH44195USA

Background Kaiser Sepsis Calculator(KSC)reduces antibiotic use,testing and intravenous infiltrates but there are concerns about the missed early onset sepsis(EOS)*** sought to apply the KSC score for culture-positive infants retrospectively in infants born in the last 10 years in our *** In a retrospective cohort study,the comparison groups were divided into Group A(no antibiotics recommended by KSC)and Group B(antibiotics recommended).Results Overall,17/24(71%)infants would have been started on antibiotics per KSC but 7/24(29%)would *** initial EOS risk was not significantly different between the groups(Group A *** B:0.44 vs.0.76,P=0.41),but the final risk score was(0.33 vs.9.41,P<0.001).In Group A(no antibiotics),3/7 infants became symptomatic between 9 and 42 *** There may be a potential delay in starting antibiotics in infants that are asymptomatic at birth while using KSC.

关键词： Early onset sepsis EOS Kaiser Sepsis Calculator Neonatal sepsis Neonate Newborn blood culture

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Retrospective Examination of Q Fever Endocarditis： An Underdiagnosed Disease in the Mainland of China

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Chinese Medical Journal 2017年第1期130卷 64-70页

作者： Xiao Han Jeffrey Hsu Qi Miao Bao-Tong Zhou Hong-Wei Fan Xiao-Lu Xiong Bo-Hai Wen Lian Wu Xiao-Wei Yan Quan Fang Wei Chen Department of Hematology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Cardiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Cardiac Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Infection Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China ing 100071 China Department of Internal Medicine Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730. China

Background： Q fever endocarditis, a chronic illness caused by Coxiella burnetii, can be fatal ifmisdiagnosed or left untreated. Despite a relatively high positive rate of Q fever serology in healthy individuals in the mainland of China, very few cases of Q fever endocarditis have been reported. This study summarized cases of Q fever endocarditis among blood culture negative endocarditis （BCNE） patients and discussed factors attributing to the low diagnostic rate. Methods： We identified confirmed cases of Q fever endocarditis among 637 consecutive patients with infective endocarditis （IE） in the Peking Union Medical College Hospital between 2006 and 2016. The clinical findings for each confirmed case were recorded. BCNE patients were also examined and each BCNE patient＇s Q fever risk factors were identified. The risk factors and presence of Q fever serologic testing between BCNE patients suspected and unsuspected of Q fever were compared using the Chi-squared or Chi-squared with Yates＇ correction for continuity. Results： Among the IE patients examined, there were 147 BCNE patients, of whom only 11 patients （7.5%） were suspected of Q fever and undergone serological testing for C. burnetii. Six out of 11 suspected cases were diagnosed as Q fever endocarditis. For the remaining 136 BCNE patients, none of them was suspected of Q fever nor underwent relevant testing. Risk factors for Q fever endocarditis were comparable between suspected and unsuspected patients, with the most common risk factors being valvulopathy in both groups. However, significantly more patients had consulted the Infectious Diseases Division and undergone comprehensive diagnostic tests in the suspected group than the unsuspected group （100% vs. 63%, P = 0.03）. Conclusions： Q fever endocarditis is a serious yet treatable condition. Lacking awareness of the disease may prevent BCNE patients from being identified, despite having Q fever risk factors. Increasing awareness and guideline adherence are cruc

关键词： blood culture Endocarditis Q Fever

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Neonatal sepsis: within and beyond China

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Chinese Medical Journal 2020年第18期133卷 2219-2228页

作者： Ying Dong Romain Basmaci Luigi Titomanlio Bo Sun Jean-Christophe Mercier Department of Neonatology Children’s Hospital of Fudan UniversityShanghai 201102China Universitéde Paris IAMEINSERM75018 ParisFrance Service de Pédiatrie-Urgences AP-HPHôpital Louis-Mourier92700 ColombesFrance Pediatric Emergency Department Robert Debre University Hospital75019 ParisFrance Departments of Pediatrics and Neonatology Children’s Hospital of Fudan UniversityShanghai 201102China Medical University of Paris 75018 ParisFrance

Sepsis remains a significant cause of neonatal morbidity and mortality in China.A better understanding of neonatal sepsis in China as compared with other industrialized and non-industrialized countries may help optimize neonatal health care both regionally and *** cited in this review was retrieved from PubMed using the keywords"neonatal sepsis,""early-onset(EOS)"and"late-onset(LOS)"in English,with the focus set on population-based *** review provides an updated summary regarding the epidemiology,pathogen profile,infectious work-up,and empirical treatment of neonatal sepsis within and beyond *** incidence of neonatal EOS and the proportion of Group B Streptococcus(GBS)within pathogens causing EOS in China seem to differ from those in developed countries,possibly due to different population characteristics and intrapartum/postnatal health care *** to adopt GBS screening and intrapartum antibiotic prophylaxis in China remains highly *** pathogen profile of LOS in China was shown to be similar to other ***,viruses as potential pathogens of neonatal LOS have been *** antimicrobial resistance in China reflects limitations in adapting antibiotic regimen to local microbial profile and timely cessation of treatment in non-proven bacterial *** review stresses that the local epidemiology of neonatal sepsis should be closely monitored in each institution.A prompt and adequate infectious work-up is critically important in diagnosing neonatal *** and appropriate antibiotic strategies must be overemphasized to prevent the emergence of multi-resistant bacteria in China.

关键词： Antibiotic resistance blood culture Early-onset sepsis Late-onset sepsis Neonatal sepsis Nosocomial neonatal sepsis

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Sensitivity of miRNA-181a,miRNA-23b and miRNA-16 in the Late-Onset Neonatal Sepsis:A Diagnostic Study

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Maternal-Fetal Medicine 2024年第4期6卷 243-248页

作者： Divya Katta Kopula Satyamoorthy Sridharan Uma Maheswari Balakrishnan Prakash Amboiram Kennedy Kumar Department of Microbiology Sri Ramachandra Institute of Higher Education and ResearchPorurChennai 600116India Department of Neonatology Sri Ramachandra Institute of Higher Education and ResearchPorurChennai 600116India

Objective: To evaluate the expression and diagnostic value of levels of the microRNAs(miRNAs),miRNA-181a,miRNA-23b,and miRNA-16,in late-onset neonatal sepsis(LOS)and compare them with the diagnostic utility of C-reactive protein(CRP)***: This was a prospective diagnostic study conducted between January 2021 and March 2023 at a tertiary care center(Sri Ramachandra Hospital)in *** real-time polymerase chain reaction was performed to determine miRNA-181a,miRNA-23b,and miRNA-16 expression levels,and CRP was measured by *** diagnostic value of miRNA and CRP levels were analyzed using receiver operating characteristic(ROC)*** curves were utilized to determine optimal cutoff points,and Mann–Whitney tests were performed using SPSS to ascertain P values,with statistical significance defined asculture-proven LOS(27 females,23 males)and 50 healthy controls(31 females,19 males).In LOS,miRNA-181a and miRNA-23b expression levels were significantly downregulated(P<0.001),with area under the curve(AUC)values of 0.83 and 0.92,respectively,whereas those of miRNA-16 were significantly upregulated(P<0.001;AUC=0.97).In comparison,CRP levels had an AUC value of 0.831(P<0.001).Further,miRNA-23b showed the highest sensitivity(98%)of markers tested,whereas miRNA-16 exhibited the highest specificity(96%).Conclusion: MiRNA,especially miRNA-16,shows diagnostic potential for neonatal sepsis compared with traditional biomarkers like CRP and procalcitonin,suggesting its use as an early marker for ***,further cohort studies are needed before practical application.

关键词： MicroRNAs Real-time PCR blood culture Biomarkers Late-onset sepsis

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Bacteremia in Subjects with Sickle Cell Disease: High Rate of Gram-Negative Isolates in the West African Context!

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Journal of Biosciences and Medicines 2023年第2期11卷 15-29页

作者： Papa Silman Diawara Sokhna Moumy Daffe Mamadou Wague Gueye Khadija Fall Moustapha Diop Aminata Diop Nakoulima Tagoutie Niang Mbene Fall Alice Ingabire Mor Ngom Maguette Ndoye Nata Dieng Bécaye Fall Macoura Gadji Meissa Ndew Seye Pape Samba Ba Yankhoba Diop Federation of Laboratories Dakar Principal Hospital Dakar Senegal Pediatrics Department Dakar Principal Hospital Dakar Senegal Infectious Diseases Department Dakar Principal Hospital Dakar Senegal Hematology Department Dakar Principal Hospital Dakar Senegal Department of Biological Hematology & Oncology-Hematology (HBOH) National Blood Transfusion Center (CNTS)/FMPOS-UCAD Dakar Senegal

Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functional asplenia (associated with repeated thrombosis of splenic vessels), resulting in increased susceptibility to infection. However, several studies have reported differences in the spectrum of bacterial infections in malaria-endemic areas. Therefore, we proposed to conduct a study to determine the rate of positive blood cultures and the bacteriological spectrum in sickle cell patients. Materials and Method: This is a descriptive cross-sectional study of blood culture samples from patients who received a request for hemoglobin electrophoresis as part of their treatment at the Principal’s hospital in Dakar. The study took place from January 2008 to December 2021. For each patient, we collect demographic information, including age, gender, and the service from which the analysis request originated. Data were collected in the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: Our study included 1419 patients. The most common types of hemoglobin profiles were: normal profile (n = 1025), AS profile (n = 283), SS profile (n = 104), SC profile (n = 7). This corresponds to the proportions of 72%, 20%, 0.5% and 7.5% for the profiles Normal, AS, SC and SS. The male proportion was 61.1%, 61.5%, 57.1, respectively %, 55.8% for Normal, SA, SC, and SS profiles. A total of 19,090 individual blood culture bottles were collected from 1419 impatient patients as follows: Normal profile (n = 18,042 bottles), AS profile (n = 677 culture bottles), SS profile (n = 362 bottles). The majority of blood culture orders come from pediatric services, accounting for 70% of the total number of orders. Of 19,090 vials examined in this current study, 19.6% developed a positive blood culture. Overal

关键词： Sickle Cell Disease Senegal Bacteremia blood culture Infection

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