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invasive candidiasis in critical care setting, updated recommendations from “invasive fungal infections-clinical forum”, Iran

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World Journal of Critical Care Medicine 2014年第4期3卷 102-112页

作者： Ashraf Elhoufi Arezoo Ahmadi Amir Mohammad Hashem Asnaashari Mohammad Ali Davarpanah Behrooz Farzanegan Bidgoli Omid Moradi Moghaddam Mohammad Torabi-Nami Saeed Abbasi Malak El-Sobky Ali Ghaziani Mohammad Hossein Jarrahzadeh Reza Shahrami Farzad Shirazian Farhad Soltani Homeira Yazdinejad Farid Zand Department of Critical Care Medicine Dubai Hospital Dubai Health Authority Department of Anesthesiology and Critical Care Sina Hospital Tehran University of Medical Sciences Department of Pulmonology and Critical Care Ghaem Hospital Mashhad University of Medical Sciences Department of Infectious Diseases and Tropical Medicine Shiraz University of Medical Sciences Tracheal Disease Research Center Shahid Behesti University of Medical Sciences Department of Anesthesiology and Critical Care Rasoul-e-Akram Hospital Iran University of Medical Sciences Department of Neuroscience School of Advanced Medical Sciences and Technologies Shiraz University of Medical Sciences Behphar Scientific Committee Behphar Group Anesthesiology and Critical Care Research Center Isfahan University of Medical Sciences invasive fungal infections-clinical forum Intensive Care and Burn Units Motahhari Hospital Intensive Care Unit Vali-e-Asr Hospital NAJA University Department of Anesthesiology and Critical Care Golestan Hospital Ahwaz Jundishapur University of Medical Sciences Department of Anesthesiology and Critical Care Taleghani Hospital Shahid Beheshti University of Medical Sciences Shiraz Anesthesiology and Critical Care Research Center Shiraz University of Medical Sciences

invasive candidiasis(IC) bears a high risk of morbidity and mortality in the intensive care units(ICU). With the current advances in critical care and the use of widespectrum antibiotics, invasive fungal infections(IFIs) and IC in particular, have turned into a growing concern in the ICU. Further to blood cultures, some auxil-iary laboratory tests and biomarkers are developed to enable an earlier detection of infection, however these test are neither consistently available nor validated in our setting. On the other hand, patients' clinical status and local epidemiology data may justify the empiric antifungal approach using the proper antifungal option. The clinical approach to the management of IC in febrile, non-neutropenic critically ill patients has been defined in available international guidelines; nevertheless such recommendations need to be customized when applied to our local practice. Over the past three years, Iranian experts from intensive care and infectious diseases disciplines have tried to draw a consensus on the management of IFI with a particular focus on IC in the ICU. The established IFI-clinical forum(IFI-CF), comprising the scientific leaders in the field, has recently come up with and updated recommendation on the same(June 2014). The purpose of this review is to put together literature insights and Iranian experts' opinion at the IFI-CF, to propose an updated practical overview on recommended approaches for the management of IC in the ICU.

关键词： invasive candidiasis Intensive care unit IFI-clinical forum Recommendations Iran

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Early diagnosis and management of neonatal sepsis:a perspective

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World Journal of Pediatrics 2024年第4期20卷 303-306页

作者： Li‑Zhong Du Neonatal Intensive Care Unit Children’s Hospital Zhejiang University School of MedicineNational Clinical Research Center for Child Health3333 Binsheng RoadHangzhou 310052China

Neonatal sepsis is an illness caused by bloodstream bacteria or fungal infections that affect newborn infants under 28 days of *** stands as a significant contributor to morbidity and mortality in neonatal intensive care units(NICUs).With the improved survival rates of very low-birth-weight or extremely premature infants,a growing number of these vulnerable infants are receiving intensive care and undergoing invasive procedures,making nosocomial infections a persistent challenge in *** mortality rate associated with neonatal sepsis varies depending on factors such as birth weight,gestational age,and other *** can also lead to a range of long-term health consequences,including neurodevelopmental disabilities like cerebral palsy,visual or hearing impairments,and cognitive ***,neonatal sepsis is linked to various adverse outcomes,including respiratory complications,bronchopulmonary dysplasia,nutritional and growth issues,and immunological dysfunction[1].Due to its atypical clinical presentation and the low rate of specific diagnostic indicators,such as a positive blood culture,accurately diagnosing neonatal sepsis is ***,the appropriateness of antibiotic treatment is often a matter of controversy.

关键词： neonatal mortality diagnosis

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Significance of neutralizing antibodies in COVID-19 therapy:progress and prospect

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Journal of Chinese Pharmaceutical Sciences 2021年第2期30卷 87-106页

作者： Zeqi Zhou Xiangbin Wang Xiqing Zhang Yuan Zhang Yankai Fu Zhixian Wang Yan Su He Wang Meng Xiao Changxiao Liu Dynamiker Sub-Center of Beijing Key Laboratoiy for Mechanisms Research and Precision Diagnosis of invasive fungal Disease Tianjin 300467China Tianjin Enterprise Key Laboratory for Precision Diagnosis Technology of invasive fungal Diseases Tianjin 300467China Beijing Antai Zhiyuan Technology Co. Ltd.Beijing 102206China clinical Laboratory Peking Union HospitalChinese Academy of Medical SciencesBeijing 100730China Beijing Key Laboratory Beijing for Mechanism Study and Precision Diagnosis of invasive fungal Diseases(bz0447) Beijing 100730China State Key Laboratory of Drug Delivery Technology and Pharmacokinetics Tianjin Institute of Pharmaceutical ResearchTianjin 300462China

SARS-CoV-2 infection is a serious threat to human life and health all over the world,and COVID-19 is a global epidemic caused by SARS-CoV-2 ***-CoV-2 is highly infectious,strange and ***,the treatment of COVID-19 must be urgent and ***,vaccines and currently used drugs generally do not have the above-mentioned *** convalescent plasma of COVID-19 has shown a clinical application value in the emergency treatment of critical patients,it shows great *** human recombinant multivalent neutralizing nano-antibodies may meet the deficiency of COVID-19 *** engineering technologies have been used to develop specific neutralizing antibody(nAB)drugs for the treatment of COVID-19 *** of the candidate nAB drugs have been entered the clinical trials and can be used for the therapy of COVID-19 *** the present review,we studied and analyzed n ABs for the treatment of COVID-19 and the progress and prospect from the following five aspects:1)The biological and clinical characteristics of SARS-CoV-2 infection;2)The feasibility of plasma therapy for convalescents with COVID-19;3)The technical routes of developing n Ab drugs;4)The current status of developing global COVID-19 antibodies;5)The difficulties and clinical use.

关键词： SARS-CoV-2 Neutralizing antibody(nAB) COVID-19

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Meningeal cryptococcosis in a pancreas transplant recipient requiring grafectomy: A case report

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 3032-3040页

作者： Ileana Lulic Gorana Fingler Dinka Lulic Jadranka Pavicic Saric Danko Mikulic Tajana Filipec Kanizaj Eleonora Goluza Department of Anaesthesiology Intensive Care and Pain MedicineClinical Hospital MerkurZagreb 10000Croatia Immediate Medical Care Unit Saint James HospitalSliema SLM-1030Malta Department of Surgery Clinical Hospital MerkurZagreb 10000Croatia Department of Gastroenterology Clinical Hospital MerkurZagreb 10000Croatia Department of Anesthesiology Intensive Care Medicine and Pain TherapyUniversity Hospital Center ZagrebZagreb 10000Croatia

BACKGROUND Through continuous improvement in transplantation medicine,a wider range of solid organ transplant(SOT)recipients is considered suitable for complex *** advances in modern transplantation practice,transpiring invasive fungal infections pose a substantial threat for SOT *** our knowledge,cryptococcal infection confined amidst sole pancreas SOT recipients has not been described to *** of a multidisciplinary transplant team approach in the management of pancreas SOT recipients presenting with complex cryptococcal complications is fundamental in improving patient *** SUMMARY We present the case of a female pancreas transplant recipient,with confirmed meningeal cryptococcosis,referred to our institution for further evaluation and treatment from the Regional Center for Infectious *** admission,the patient was weaned from the protocolized immunosuppression therapy for two consecutive weeks,in addition to tapering systemic corticosteroid remedial *** novel multidisciplinary transplant team approach embodied exhaustive discussions of possible complex and diverse multiple organ system physiologic and pathologic challenges associated with distinct management strategies in pancreas transplant *** to the potentially devastating impact of invasive cryptococcosis in terms of morbidity and mortality,a definitive surgical intervention of pancreas transplant grafectomy was reinforced,as a pathway towards secure access to early meaningful expertise *** patient was discharged to the Regional Center for Infectious Diseases 2 mo after the admittance further advancing to a clinical *** The precision transplantation approach by tailoring complex medical interventions to individual needs proved indispensable in improving our patient’s outcomes.

关键词： Solid organ transplantation Pancreas transplantation Complications Meningeal cryptococcosis Management Grafectomy Case report

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Pseudomonas aeruginosa infections and improper storage conditions influence the performance of 1,3‐β‐D‐glucan in diagnosis of invasive fungal infections

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iLABMED 2024年第1期2卷 53-59页

作者： Zilan Wei Jie Xu Fang Yuan Wendong Fang Jiahui Wu Youliang Wang Shuiping Chen Medical School of Chinese PLA BeijingChina Department of Laboratory Medicine 5th Medical Center of Chinese PLA General HospitalBeijingChina Department of Laboratory Medicine The PLA 307 Clinical College5th Clinical Medical College of Anhui Medical UniversityBeijingChina Beijing Institute of Biotechnology BeijingChina

Background:The association between 1,3-β-D-glucan(BDG)levels and in-fections caused by Pseudomonas aeruginosa or Streptococcus pneumoniae,and the stability of BDG under different storage conditions are ***:Strains of Pseudomonas aeruginosa and *** were grown in medium and human *** BDG concentrations in culture superna-tants were *** specificity and stability of BDG were also ***:*** produced high levels of BDG in Luria-Bertani medium(>4×10^(4)pg/mL)and human serum(527.0 pg/mL),whereas *** produced low levels of BDG in THY medium(175.6 pg/mL)and human serum(78.3 pg/mL).The BDG produced by these two bacteria was specifically degraded by 1,3-β-*** was degraded when stored at different temperatures,decreasing by 22.5%and 9.3%at−20℃and−70℃,respectively,for 63 days;by 30.7%at 4℃for 12 days;and by 12.6%and 22.0%at 37℃for 6 and 12 ***:BDG false-positivity must be considered in patients with bacteremia caused by *** when diagnosing invasive fungal *** serum samples for the BDG test in medical facilities should be tested as soon as possible or stored at low temperatures before testing.

关键词： 1,3‐β‐D‐glucan bacteremia false‐positivity Pseudomonas aeruginosa stability Streptococcus pneumoniae

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Letter to the editor: Neutralizing antibodies for the treatment of COVID-19

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Acta Pharmaceutica Sinica B 2021年第1期11卷 304-307页

作者： Zeqi Zhou Xiangbin Wang Yankai Fu Xiqing Zhang Changxiao Liu Dynamiker Biotechnology Sub-Center Beijing Key Laboratory for Mechanism Study and Precision Diagnosis of Invasive Fungal DiseasesTianjin 300467China Beijing Antai Zhiyuan Technology Co. Ltd.Beijing 102206China State Key Laboratory of Drug Delivery Technology and Pharmacokinetics Tianjin Institute of Pharmaceutical ResearchTianjin 300462China

To the Editor:Coronavirus disease 2019(COVID-19)is a global epidemic caused by the infection of severe acute respiratory coronavirus 2(SARS-Co V-2)and its mortality rate was up to 20 times higher than that of *** viru... 详细信息

关键词： SARS-CoV-2 Neutralizing antibody therapy COVID-19

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Causative Microorganisms Isolated from Patients with Intra-Abdominal infections and Their Drug Resistance Profiles:An 11-Year(2011–2021)Single-Center Retrospective Study

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生物医学与环境科学:英文版 2023年第8期36卷 732-742页

作者： DING Rui MA Rui Rui LIU Ya Li ZHAO Ying GUO Li Na DOU Hong Tao SUN Hong Li LIU Wen Jing ZHANG Li WANG Yao LI Ding Ding YI Qiao Lian XU Ying Chun Department of Laboratory Medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of invasive fungal Diseases Beijing 100730China Graduate School Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Objective To investigate the distribution and antimicrobial susceptibility of causative microorganisms recovered from patients with intra-abdominal infections(IAIs).Methods A total of 2,926 bacterial and fungal strains were identified in samples collected from 1,679 patients with IAIs at the Peking Union Medical College Hospital between 2011 and *** bacteria and fungi were identified using matrix-assisted laser desorption/ionization time-of-flight mass *** susceptibility testing(AST)was performed using the VITEK 2 compact system and the Kirby–Bauer *** results were interpreted based on the M100-Ed31 clinical breakpoints of the clinical and Laboratory Standards *** Of the 2,926 strains identified,49.2%,40.8%,and 9.5%were gram-negative bacteria,gram-positive bacteria,and fungi,*** coli was the most prevalent pathogen in intensive care unit(ICU)and non-ICU patients;however,a significant decrease was observed in the isolation of *** between 2011 and ***,significant decreases were observed between 2011 and 2021 in the levels of extended-spectrumβ-lactamase(ESBL)-producing ***(from 76.9%to 14.3%)and Klebsiella pneumoniae(from 45.8%to 4.8%).Polymicrobial infections,particularly those involving co-infection with gram-positive and gram-negative bacteria,were commonly observed in IAI ***,Candida albicans was more commonly isolated from hospital-associated IAI samples,while Staphylococcus epidermidis had a higher ratio in community-associated ***,AST results revealed that most antimicrobial agents performed better in non-ESBL-producers than in ESBL-producers,while the overall resistance rates(56.9%–76.8%)of Acinetobacter baumanmii were higher against all antimicrobial agents than those of other common gram-negative ***,Enterococcus faecium,Enterococcus faecalis,***,and *** were consistently found to be susceptible to vancomycin

关键词： Intra-abdominal infection Causative microorganisms Antimicrobial susceptibility testing Gram-negative bacteria Gram-positive bacteria

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Renal aspergillosis in a liver transplant patient: A case report and review of literature

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World Journal of clinical Cases 2018年第16期6卷 1155-1159页

作者： Brigita Smolovic Batric Vukcevic Damir Muhovic Marina Ratkovic Faculty of Medicine University of Montenegro Department of Gastroenterohepatology Clinical Center of Montenegro Department of Nephrology and Hemodialysis Clinical Center of Montenegro

BACKGROUND Aspergillosis is a frequent invasive fungal infection in liver recipients(affecting 1%-9.2% of all patients), second only to candidiasis. Significant risk factors for invasive aspergillosis in liver recipients include corticosteroid therapy, neutropenia, T-cell dysfunction, renal failure and requirement for renal replacement therapy. Aspergillus infection usually affects the lungs of liver recipients, with hematogenous dissemination occurring in 50%-60% of cases. Renal involvement is rare and is considered to occur in 0.4% of all cases of invasive *** SUMMARY This paper describes a case of a liver recipient presenting with a newly formed renal mass a year after liver transplantation. The patient underwent liver transplantation due to alcoholic liver cirrhosis, with preoperative corticosteroid therapy and postoperative immunosuppressants(tacrolimus and mycophenolate mofetil). His 1-year follow-up was uneventful, with a satisfying graft function and lack of any symptoms. During a routine follow-up abdominal ultrasound, he was diagnosed with a renal tumor. The renal ima-ging findings were inconclusive(with a differential diagnosis to renal cell carcinoma), while the computed tomography(CT) of the chest showed scar tissue in the lungs suggestive of previous inflammation. The patient underwent radical nephrectomy, with histopathological analysis showing renal aspergilloma, yielding postoperative treatment with voriconazole. His follow up was uneventful, and the chest CT did not show any change in pulmonary lesions. This case illustrates the possibility of aspergillosis affecting the lungs of liver recipients, subsequently affecting the kidney and forming an *** Clinicians should be aware of aspergilloma mimicking solid organ tumors in organ recipients.

关键词： Aspergillosis Immunosuppression Liver transplantation Nephrectomy Renal tumor Case report

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A forkhead transcription factor contributes to the regulatory differences of pathogenicity in closely related fungal pathogens

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mLife 2022年第1期1卷 79-91页

作者： Weixin Ke Yuyan Xie Yue Hu Hao Ding Xin Fan Jingjing Huang Xiuyun Tian Baokun Zhang Yingchun Xu Xiao Liu Ying Yang Linqi Wang State Key Laboratory of Mycology Institute of MicrobiologyChinese Academy of SciencesBeijingChina College of Life Sciences University of Chinese Academy of SciencesBeijingChina Department of Infectious Diseases and clinical Microbiology Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Department of clinical Laboratory Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijingChina Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of invasive fungal Diseases Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijingChina Graduate School Peking Union Medical CollegeChinese Academy of Medical SciencesBeijingChina Beijing Key Laboratory of New Molecular Diagnosis Technologies for Infectious Disease Department of BiotechnologyBeijing Institute of Radiation MedicineBeijingChina

Cryptococcus neoformans and its sister species Cryptococcus deuterogattii are important human fungal *** their phylogenetically close relationship,these two Cryptococcus pathogens are greatly different in their clinical ***,the determinants underlying the regulatory differences of their pathogenicity remain largely ***,we show that the forkhead transcription factor Hcm1 promotes infection in *** but not in *** in vitro and in vivo fitness outcomes of multiple clinical isolates from the two pathogens indicates that Hcm1 mediates pathogenicity in *** through its key involvement in oxidative stress *** comparison,Hcm1 is not critical for antioxidation in ***,we identified SRX1,which encodes the antioxidant sulfiredoxin,as a conserved target of Hcm1 in two Cryptococcus *** HCM1,SRX1 had a greater role in antioxidation in *** than in ***,overexpression of SRX1 can largely rescue the defective pathogenicity caused by the absence of Hcm1 in ***,Srx1 is dispensable for virulence in ***,our findings demonstrate that the difference in the contribution of the antioxidant sulfiredoxin to oxidative stress defense underlies the Hcm1-mediated regulatory differences of pathogenicity in two closely related pathogens.

关键词： Cryptococcus deuterogattii Cryptococcus neoformans forkhead transcription factor pathogenicity

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Hand Hygiene among Anesthesiologists and Microorganisms Contamination in Anesthesia Environments:A Single-Center Observational Study

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Biomedical and Environmental Sciences 2022年第11期35卷 992-1000页

作者： LIU Hong Lei LIU Ya Li SUN Fang Yan LI Zong Chao TAN Hong Yu XU Ying Chun Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education Beijing)Department of AnesthesiologyPeking University Cancer Hospital&InstituteBeijing 100142China Graduate School Capital Medical UniversityBeijing 100069China Department of Laboratory Medicine Peking Union Medical College HospitalPeking Union Medical CollegeBeijing 100730China Graduate School Peking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of invasive fungal Diseases(BZ0447) Beijing 100730China Infection Control Department Peking Union Medical College HospitalPeking Union Medical CollegeBeijing 100730China

Objective To investigate the baseline levels of microorganisms’growth on the hands of anesthesiologists and in the anesthesia environment at a cancer *** This study performed in nine operating rooms and among 25 anesthesiologists at a cancer *** of the hands of anesthesiologists and the anesthesia environment was performed at a ready-to-use operating room before patient contact began and after *** Microorganisms’growth results showed that 20%(5/25)of anesthesiologists’hands carried microorganisms(>10 CFU/cm^(2))before patient contact *** anesthesiologists performed hand hygiene better than did their male counterparts,with fewer CFUs(P=0.0069)and fewer species(P=0.0202).Our study also found that 55.6%(5/9)of ready-to-use operating rooms carried microorganisms(>5 CFU/cm^(2)).Microorganisms regrowth began quickly(1 hour)after disinfection,and increased gradually over time,reaching the threshold at 4 hours after *** aureus was isolated from the hands of 20%(5/25)of anesthesiologists and 33.3%(3/9)of operating *** Our study indicates that male anesthesiologists need to pay more attention to the standard operating procedures and effect evaluation of hand hygiene,daily cleaning rate of the operating room may be insufficient,and we would suggest that there should be a repeat cleaning every four hours.

关键词： Hand hygiene Anesthesiologists Contamination Anesthesia environments

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