To investigate the incidence and clinical features of non-Clostridium difficile (C. difficile) associated nosocomial diarrhea in intensive care unit (ICU) caused by Klebsiella oxytoca and Clostridium perfringens.
The faeces of 102 patients with non-C. difficile associated nosocomial diarrhea in ICU of West China Hospital, were collected during April to November, 2012. The target bacterial genes were detected by PCR amplification and sequencing, including toxic gene pehX of Klebsiella oxytoca, species-specific 16S rRNA gene and toxic gene cpa and cpe of Clostridium perfringens, species-specific 16S rRNA gene with mapA and toxic gene hipO of Campylobacter jejuni. Clinical features of the patients with positive results were summarized.
Among 102 patients with non-C. difficile associated nosocomial diarrhea, 4 patients (3.9%) were detected with toxic Klebsiella oxytoca while 4 patients (3.9%) were detected with toxic Clostridium perfringens. No toxic Campylobacter jejuni was detected. Most of the patients had severe underlying diseases and poor final outcome, accepted potent antibiotics which disturbed intestinal flora obviously..
Non-C. difficile associated nosocomial diarrhea in ICU caused by Klebsiella oxytoca is and Clostridium perfringens is associated with severe diseases and poor outcome, but the incidence in our hospital is relatively low in our hospital.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 07/2013; 44(4):637-40.
To investigate the clonal relatedness of local bla(OXA-58)-carrying Acinetobacter baumannii clinical isolates.
Non-duplicated isolates of Acinetobacter baumannii were collected in West China Hospital and verified by recA sequencing. Acquired bla(OXA-58) gene and natural bla(OXA51/66) genes were detected by PCR. Strain typing for bla(OXA-58)-carrying Acinetobacter baumannii isolates was performed by Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR), multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE).
A total of 115 Acinetobacter baumannii isolates were verified by recA gene and bla(OXA-51/6)6 detection. Among them, nine (7.8%) isolates carry bla(OXA-58) with reduced susceptibility to imipenem (MIC > or = 2 mg/L) were observed. ERIC-PCR fingerprints of nine bla(OXA-58)-carrying isolates were highly similar. MLST revealed that eight isolates were ST95 and one isolate was ST75. PFGE showed that eight isolates with the same sequence type were of the same fingerprint types, which were of two closely-related subtypes.
In West China Hospital, some Acinetobacter baumannii isolates with reduced susceptibility to carbapenem carried bla(OXA-58). The major spread way of bla(OXA-58)-carrying isolates was clonal dissemination.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 05/2013; 44(3):405-9.
To compare the value of the new national criteria (2 major or one major plus 3 minor criteria) with the Duke criteria for diagnosis of infective endocarditis (IE).
A total of 205 patients with clinical diagnosis of IE admitted at West China Hospital of Sichuan University were included in this study. Among them, IE was pathologically confirmed in 97 patients. The sensitivities of both criteria for the diagnosis of IE were compared.
In 205 cases, the same microorganisms were detected twice in blood cultures in 13 cases (8.3%). Vegetations were detected by echocardiography in 183 patients (89.3%). In 97 cases with pathologically confirmed IE, the same microorganisms were detected twice in blood cultures in 6 cases (6.2%). Vegetations were detected by echocardiography in 89 patients (91.8%). IE diagnose was made in 44 (45.5%) and 86 (88.7%, P < 0.05 vs. Duke criteria) out of 97 pathologically confirmed IE patients by the Duke criteria and new national criteria, respectively. The specificities were 100% and 95.7% by Duke and new national criteria, respectively (P > 0.05).
With the addition of echocardiographic evidence of endocardial involvement and 2 minor criteria as definite diagnostic criteria, the sensitivity of the new national criteria is superior to that of the Duke criteria for diagnosing IE and the specificity for the diagnosis of IE between the two criteria is similar.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 01/2010; 38(1):47-51.