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Characteristics of oral methicillin-resistant Staphylococcus epidermidis isolated from dental plaque

International Journal of Oral Science 2020年第2期12卷 152-161页

作者： Boyu Tang Tao Gong Yujia Cui Lingyun Wang Chao He Miao Lu Jiamin Chen Meiling Jing Anqi Zhang Yuqing Li State Key Laboratory of Oral diseases&National Clinical Research Center for Oral diseases&West China Hospital of Stomatology Sichuan UniversityChengduChina division of Infectious diseases Boston Children’s HospitalHarvard Medical SchoolBostonMAUSA Department of Laboratory Medicine West China HospitalSichuan UniversityChengduChina

The oral microbial community is widely regarded as a latent reservoir of antibiotic resistance genes. This study assessed the molecular epidemiology, susceptibility profile, and resistance mechanisms of 35 methicillin-resistant Staphylococcus epidermidis(MRSE) strains isolated from the dental plaque of a healthy human population. Broth microdilution minimum inhibitory concentrations(MICs) revealed that all the isolates were nonsusceptible to oxacillin and penicillin G. Most of them were also resistant to trimethoprim(65.7%) and erythromycin(54.3%). The resistance to multiple antibiotics was found to be largely due to the acquisition of plasmid-borne genes. The mec A and dfr A genes were found in all the isolates, mostly dfr G(80%), aac A-aph D(20%), aad D(28.6%), aph A3(22.9%), msr A(5.7%), and the erm C gene(14.3%). Classical mutational mechanisms found in these isolates were mainly efflux pumps such as qac A(31.4%), qac C(25.7%), tet K(17.1%), and nor A(8.6%). Multilocus sequence type analysis revealed that sequence type 59(ST59) strains comprised 71.43% of the typed isolates, and the e BURST algorithm clustered STs into the clonal complex 2-II(CC2-II). The staphyloccoccal cassette chromosome mec(SCCmec) type results showed that 25(71.43%) were assigned to type IV. Moreover, 88.66% of the isolates were found to harbor six or more biofilm-associated genes. The aap, atl E, embp, sdr F, and IS256 genes were detected in all 35 isolates. This research demonstrates that biofilm-positive multipleantibiotic-resistant ST59-SCCmec IV S. epidermidis strains exist in the dental plaque of healthy people and may be a potential risk for the transmission of antibiotic resistance.

关键词： epidemiology resistant reservoir

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Amoebic Dysentery-China,2005−2019

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China CDC weekly 2020年第42期2卷 811-814页

作者： Jilei Huang Yingdan Chen Junling Sun Zhongjie Li Shizhu Li Xiao-nong Zhou Men-bao Qian National Institute of Parasitic diseases Chinese Center for Disease Control and PreventionChinese Center for Tropical Diseases ResearchKey Laboratory of Parasite and Vector BiologyMinistry of HealthNational Center for International Research on Tropical DiseasesMinistry of Science and TechnologyWHO Collaborating Center for Tropical DiseasesShanghaiChina division of Infectious Disease Key Laboratory of Surveillance and Early Warning on Infectious DiseaseChinese Centre for Disease Control and PreventionBeijingChina School of Global Health Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of MedicineShanghaiChina.

Summary What is already known about this topic?Amebiasis is caused by infection with Entamoeba histolytica.As a severe sequence in amebiasis,amoebic dysentery is tracked by China’s National Notifiable Disease Reporting System.What is added by this report?From 2005 to 2019,a total of 28,229 cases of amoebic dysentery and 7 resulting deaths were reported in China.The annual incidence rate had significantly decreased from 0.26/100,000 in 2006 to 0.06/100,000 in 2019,and most cases were reported from southern China and in children.

关键词： cases China. infection

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Acute pancreatitis in liver transplant hospitalizations:Identifying national trends,clinical outcomes and healthcare burden in the United States

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World Journal of Hepatology 2023年第6期15卷 797-812页

作者： Dushyant Singh Dahiya Vinay Jahagirdar Saurabh Chandan Manesh Kumar Gangwani Nooraldin Merza Hassam Ali Smit Deliwala Muhammad Aziz Daryl Ramai Bhanu Siva Mohan Pinnam Jay Bapaye Chin-I Cheng Sumant Inamdar Neil R Sharma Mohammad Al-Haddad Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48601United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64110United States division of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68131United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Internal Medicine East Carolina UniversityGreenvilleNC 27858United States division of digestive diseases Emory University School of MedicineAtlantaGA 30322United States division of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States division of Gastroenterology and Hepatology The University of Utah School of MedicineSalt Lake CityUT 84112United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Statistics Actuarial and Data ScienceCentral Michigan UniversityMt.PleasantMI 48859United States division of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Interventional Oncology and Surgical Endoscopy Programs Parkview Cancer InstituteFort WayneIN 46845United States division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

BACKGROUND Acute pancreatitis(AP)in liver transplant(LT)recipients may lead to poor clinical outcomes and development of severe complications.AIM We aimed to assess national trends,clinical outcomes,and the healthcare burden of LT hospitalizations with AP in the United States(US).METHODS The National Inpatient Sample was utilized to identify all adult(≥18 years old)LT hospitalizations with AP in the US from 2007–2019.Non-LT AP hospitalizations served as controls for comparative analysis.National trends of hospitalization characteristics,clinical outcomes,complications,and healthcare burden for LT hospitalizations with AP were highlighted.Hospitalization characteristics,clinical outcomes,complications,and healthcare burden were also compared between the LT and non-LT cohorts.Furthermore,predictors of inpatient mortality for LT hospitalizations with AP were identified.All P values≤0.05 were considered statistically significant.RESULTS The total number of LT hospitalizations with AP increased from 305 in 2007 to 610 in 2019.There was a rising trend of Hispanic(16.5%in 2007 to 21.1%in 2018,P-trend=0.0009)and Asian(4.3%in 2007 to 7.4%in 2019,p-trend=0.0002)LT hospitalizations with AP,while a decline was noted for Blacks(11%in 2007 to 8.3%in 2019,P-trend=0.0004).Furthermore,LT hospitalizations with AP had an increasing comorbidity burden as the Charlson Comorbidity Index(CCI)score≥3 increased from 41.64%in 2007 to 62.30%in 2019(P-trend<0.0001).We did not find statistically significant trends in inpatient mortality,mean length of stay(LOS),and mean total healthcare charge(THC)for LT hospitalizations with AP despite rising trends of complications such as sepsis,acute kidney failure(AKF),acute respiratory failure(ARF),abdominal abscesses,portal vein thrombosis(PVT),and venous thromboembolism(VTE).Between 2007–2019,6863 LT hospitalizations with AP were compared to 5649980 non-LT AP hospitalizations.LT hospitalizations with AP were slightly older(53.5 vs 52.6 years,P=0.017)and had a higher proportion of patients with CCI≥3(

关键词： Liver transplantation Pancreatitis Mortality Cost Length of stay

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Colonoscopy procedural volume increases adenoma and polyp detection rates in gastroenterology trainees

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World Journal of Gastrointestinal Endoscopy 2017年第11期9卷 540-551页

作者： Emad Qayed Ravi Vora Sara Levy Roberd M Bostick Department of Medicine Division of Digestive diseases Emory University School of Medicine Grady Memorial Hospital Emory University Rollins School of Public Health Department of Epidemiology Emory University Winship Cancer Institute Atlanta

AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroenterologists.METHODS We reviewed colonoscopies from July 1, 2009 to June 30, 2014. Fellows' procedural logs were used to retrieve colonoscopy procedural volumes, and these were treated as the time variable. Findings from screening colonoscopies were used to calculate colonoscopy outcomes for each fellow for the prior 50 colonoscopies at each time point. ADR and PDR were plotted against colonoscopy procedural volumes to produce individual longitudinal graphs. Repeated measures linear mixed effects models were used to study the change of ADR and PDR with increasing procedural volume.RESULTS During the study period, 12 fellows completed full three years of training and were included in the analysis. The average ADR and PDR were, respectively, 31.5% and 41.9% for all fellows, and 28.9% and 38.2% for attendings alone. There was a statistically significant increase in ADR with increasing procedural volume(1.8%/100 colonoscopies, P = 0.002). Similarly, PDR increased 2.8%/100 colonoscopies(P = 0.0001), while there was no significant change in advanced ADR(0.04%/100 colonoscopies, P = 0.92). The ADR increase was limited to the right side of the colon, while the PDR increased in both the right and left colon. The adenoma per colon and polyp per colon also increased throughout training. Fellows reached the attendings' ADR and PDR after 265 and 292 colonoscopies, respectively.CONCLUSION We found that the ADR and PDR increase with increasing colonoscopy volume throughout fellowship. Our findings support recent recommendations of ≥ 275 colonoscopies for colonoscopy credentialing.

关键词：屏蔽 colonoscopy Colorectal 癌症息肉察觉率 Colonoscopy 体积腺瘤察觉率肠胃病学训练

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The SUMO E3 ligase CBX4 is identified as a poor prognostic marker of gastric cancer through multipronged OMIC analyses

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Genes & diseases 2021年第6期8卷 827-837页

作者： Yi Pan Qingshang Li Zhijun Cao Shuliang Zhao division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and HepatologyMinistry of HealthShanghai Institute of Digestive DiseaseRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200030PR China

Gastric cancer(GC)is one of the most common malignancies,with an everincreasing incidence and high mortality rate.Chromobox4(CBX4),also named hPC2,is a small ubiquitin-related modifier(SUMO)E3 ligase.Previous studies have found that high CBX4 expression is associated with tumor size,pathologic differentiation and decreased patient survival in hepatocellular carcinoma(HCC).However,the expression and prognostic value of CBX4 in GC have not been clarified.In our study,ONCOMINE,UALCAN,KaplanMeier Plotter,cBioPortal,DAVID 6.8 and TIMER were utilized.RT-PCR,immunohistochemistry(IHC),Western blot,CCK-8 assay,cell apoptosis assay,cell cycle assay were used to further verify in GC tissue samples or cell line.The transcriptional and protein level of CBX4 in GC tissues was found significantly elevated and a significant association between the expression of CBX4 and clinicopathological parameters was found in GC patients.Low expression of CBX4 in GC patients were correlated with a significantly improved prognosis.The functions of CBX4 are primarily related to the stem cell pluripotency signaling pathway,Hippo signaling pathway,HTLV-I infection,Notch signaling pathway,and N-glycan biosynthesis.Our results may provide novel insights for the selection of therapeutic targets and prognostic biomarkers for GC.

关键词： Bioinformatics analysis Chromobox4(CBX4) Gastric cancer Prognostic biomarker Therapeutic target

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Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

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Journal of Intensive Medicine 2024年第1期4卷 81-93页

作者： Marie Dejonckheere Massimo Antonelli Kostoula Arvaniti Koen Blot Ben CreaghBrown Dylan Wde Lange Jan De Waele Mieke Deschepper Yalim Dikmen George Dimopoulos Christian Eckmann Guy Francois Massimo Girardis Despoina Koulenti Sonia Labeau Jeffrey Lipman Fernando Lipovestky Emilio Maseda Philippe Montravers Adam Mikstacki JoseArtur Paiva Cecilia Pereyra Jordi Rello JeanFrancois Timsit Dirk Vogelaers Stijn Blot the Abdominal Sepsis Study(AbSeS)group on behalf of the Trials Group of the European Society of Intensive Care Medicine Department of Internal Medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium Department of Anesthesiology Intensive Care and Emergency MedicineFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly UniversitàCattolica del Sacro Cuore RomeItaly Intensive Care Unit Papageorgiou University Affiliated HospitalThessaloníkiGreece Department of Epidemiology and Public Health SciensanoIxellesBelgium Surrey Perioperative Anaesthetic Critical Care Collaborative Research Group(SPACeR) Royal Surrey County HospitalGuildfordUK Department of Clinical and Experimental Medicine University of SurreyGuildfordUK Department of Intensive Care Medicine University Medical Center UtrechtUniversity UtrechtUtrechtthe Netherlands Department of Intensive Care Medicine Ghent University HospitalGhentBelgium Data Science Institute Ghent University HospitalGhentBelgium Department of Anesthesiology and Reanimation Cerrahpasa School of MedicineIstanbul University-CerrahpasaIstanbulTurkey rd Department of Critical Care “EVGENIDIO”HospitalNational and Kapodistrian University of AthensAthensGreece Department of General Visceral and Thoracic SurgeryKlinikum Hannoversch-MuendenGoettingen UniversityGöttingenGermany division of Scientific Affairs-Research European Society of Intensive Care MedicineBrusselsBelgium Anesthesia and Intensive Care Department University Hospital of ModenaModenaItaly UQ Centre for Clinical Research Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia nd Critical Care Department Attikon University HospitalAthensGreece Department of Nursing Faculty of EducationHealth and Social WorkUniversity College GhentGhentBelgium Jamieson Trauma Institute The University of QueenslandBrisbaneQLDAustralia Nimes University Hospital University of MontpellierNimesFrance Critical Care Department Hospital of the Interamerican Open University(UAI)Buenos AiresArgentina Surgical Critical Care Department of AnesthesiaHospital Universitario

Background:The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)presence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal infection.This study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and mortality.Methods:This was a secondary analysis of an international observational study(“AbSeS”)investigating ICU patients with intra-abdominal infection.Only patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the ICU.Relationships with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95%confidence interval(CI).Results:The overall mortality was 35.2%(n=58).The independent risk factors for mortality included older age(OR=1.03,95%CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95%CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95%CI:3.8 to 23.9,P<0.001)or after the implementation of additional source control interventions within the first week(OR=4.0,95%CI:1.3 to 12.2,P=0.013).Gramnegative bacteria were most frequently isolated(n=58,49.2%)without clinically relevant differences in microbial etiology between survivors and non-survivors.Conclusions:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term outcome.In this limited series,essentials of the AbSeS-classification,such as the setting of infection onset,diffuse peritonitis,and severity of disease expression,

关键词： Pancreatic infection Intensive care unit Mortality Intra-abdominal infection Sepsis

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Diet and nutritional factors in inflammatory bowel diseases

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World Journal of Gastroenterology 2016年第3期22卷 895-905页

作者： Danuta Owczarek Tomasz Rodacki Renata Domagała-Rodacka Dorota Cibor Tomasz Mach Department of Gastroenterology Hepatology and Infectious DiseasesJagiellonian University Medical College31-531 CracowPoland Department of Food Chemistry and nutrition Jagiellonian University Medical College30-688 CracowPoland

Inflammatory bowel disease(IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular periods of the disease may facilitate achieving or prolonging remissions and most of all, improve the quality of life for patients. During disease exacerbation, a low fiber diet is recommended for most patients. In the remission time, an excessive consumption of alcohol and sulfur products may have a negative effect on the disease course. Attempts are also made at employing diets composed in detail in order to supplement IBD therapy. A diet with a modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols are under investigation. Due to chronic inflammation as well as side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It should also be remembered that there is no single common diet suitable for all IBD patients; each of them is unique and dietary recommendations must be individually developed for each patient, depending on the course of the disease, past surgical procedures and type of pharmacotherapy.

关键词： Crohn's disease Diet nutrition Supplementation Ulcerative colitis

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Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage

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World Journal of Gastroenterology 2014年第38期20卷 13993-13998页

作者： Marine Camus Dennis M Jensen Jason D Matthews Gordon V Ohning Thomas O Kovacs Rome Jutabha Kevin A Ghassemi Gustavo A Machicado Gareth S Dulai CURE Hemostasis Research Group CURE Digestive Diseases Research CenterDavid Geffen School of Medicine at University of California division of digestive diseases at University of California Los AngelesRonald Reagan Medical Center Department of Gastroenterology Lariboisiere Hospital CURE Hemostasis Research Group CURE Digestive Diseases Research CenterDavid Geffen School of Medicine at University of CaliforniaLos AngelesLos AngelesCA 90095United States Gastroenterology division at VA Greater Los Angeles Healthcare System Hunterdon Gastrointestinal Associates

AIM:To describe the prevalence,diagnosis,treatment,and outcomes of end stage liver disease(ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage(UGIH).METHODS:This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011.RESULTS:A total of 1249 patients were registered for severe UGIH in the data basis,461(36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen(75%) subjects required posterior nasal packing and 2(10%) embolization in addition to correction of coagulopathy. Five(25%) patients died in the hospital,12(60%) received orthotopic liver transplantation(OLT),and 3(15%) were discharged without OLT. The mortality rate was 63% in patients without OLT.CONCLUSION:Severe epistaxis in patients with ESLD is(1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH;and(2) associated with a high mortality rate in patients not receiving OLT.

关键词： Epistaxis Upper gastrointestinal bleeding End stag

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Energy Balance and Physical Activity

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Biomedical and Environmental Sciences 2001年第1期14卷 130-136页

作者： KALLAYA KIJBOONCHOO Institute of nutrition and Faculty of Graduate Studies

The prevalence of obesity is increasing in most parts of the world and becoming one of the major global public health problems. Although the components of energy balance have not been adequately estimated over time, available evidence suggests that the increase in obesity is the result of reduced physical activity.\;Increases in physical activity have been shown to be strongly associated with improving physical fitness and body composition, with probably a positive effect on resting metabolic rate. The Surgeon General's Report on Physical Activity and Health advocates that 30 min of regular, moderate_intensity physical activity is associated with decreases in the risk of chronic diseases and may contribute to quality of life. However, the small changes that contribute 10 min for 3 times a day for aerobic training, or one set instead of three sets of repetitions on resistance training will provide individuals with health benefits. Indeed, nutrition and physical activity should be considered an integral part of fitness and good health, and should be encouraged in all age groups, particularly early in life. The question is no longer centered around the health benefit of increasing physical activity, but rather creating self awareness and behavior changes in individuals. Hence, effective intervention programs are needed that foster long term changes in physical activity. Among various interventions, the Nutrifit program was recently conducted in Thailand and found to improve health related fitness in children. The development of more effective interventions and approaches is a major challenge in this field today.

关键词： HEALTH

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Practice patterns in FNA technique: A survey analysis

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World Journal of Gastrointestinal Endoscopy 2014年第10期6卷 499-505页

作者： Christopher J DiMaio Jonathan M Buscaglia Seth A Gross Harry R Aslanian Adam J Goodman Sammy Ho Michelle K Kim Shireen Pais Felice Schnoll-Sussman Amrita Sethi Uzma D Siddiqui David H Robbins Douglas G Adler Satish Nagula division of Gastroenterology Icahn School of Medicine at Mount Sinai Mount Sinai Medical CenterNew York NY 10029 United States division of Gastroenterology and Hepatology Stony Brook University School of MedicineStony BrookNew YorkNY 11794 United States division of Gastroenterology NYU School of Medicine New York NY 10016 United States Section of digestive diseases Yale School of Medicine New Haven Connecticut CT 06510 United States division of digestive and Liver diseases Montefiore Medical Center Bronx New York NY 10467 United States division of Gastroenterology and Hepatobiliary diseases New York Medical College Valhalla New York NY 10595 United States division of Gastroenterology and Hepatology Weill Cornell Medical College New York NY 10065 United States division of digestive and Liver diseases Columbia University Medical Center New York NY 10032 United States Section of Gastroenterology Hepatology and Nutrition University of Chicago Medicine Chicago Illinois IL 60637 United States division of Gastroenterology Lenox Hill Hospital New York NY 10075 United States division of Gastroenterology and Hepatology University of Utah School of Medicine Salt Lake City Utah UT 84132 United States

AIM: To ascertain fine needle aspiration(FNA) tech-niques by endosonographers with varying levels of ex-perience and environments.METHODS: A survey study was performed on United States based endosonographers. The subjects complet-ed an anonymous online electronic survey. The main outcome measurements were differences in needle choice, FNA technique, and clinical decision making among endosonographers and how this relates to years in practice, volume of EUS-FNA procedures, and prac-tice environment.RESULTS: A total of 210(30.8%) endosonographers completed the survey. Just over half(51.4%) identified themselves as academic/university-based practitioners. The vast majority of respondents(77.1%) identified themselves as high-volume endoscopic ultrasound(EUS)(> 150 EUS/year) and high-volume FNA(> 75 FNA/year) performers(73.3). If final cytology is non-diagnostic, high-volume EUS physicians were more likely than low volume physicians to repeat FNA with a core needle(60.5% vs 31.2%; P = 0.0004), and low volume physicians were more likely to refer patients for either surgical or percutaneous biopsy,(33.4% vs 4.9%, P < 0.0001). Academic physicians were more likely to repeat FNA with a core needle(66.7%) compared to community physicians(40.2%, P < 0.001). CONCLUSION: There is significant variation in EUS-FNA practices among United States endosonographers. Differences appear to be related to EUS volume and practice environment.

关键词： Endoscopic ultrasound Diagnostic procedures and techniques Fine needle biopsy Fine needle aspiration

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