Persistent Catheter-Related Staphylococcus aureus Bacteremia after Catheter Removal and Initiation of Antimicrobial Therapy

Objectives

Catheter-related Staphylococcus aureus bacteremia (CRSAB) occasionally persists despite catheter removal and initiation of appropriate antimicrobial therapy. The aim of this study was to determine the incidence, risk factors, and outcomes of persistent CRSAB after catheter removal and initiation of antimicrobial therapy.

Methods

Consecutive patients with CRSAB were prospectively included from over a 41-month period. We compared the clinical features, 40 bacterial virulence genes, and outcomes between patients with persistent CRSAB (i.e., bacteremia for >3 days after catheter removal and initiation of appropriate antimicrobial therapy) and non-persistent CRSAB.

Results

Among the 220 episodes of CRSAB, the catheter was kept in place in 17 (6%) and removed in 203 (94%) cases. In 43 (21%) of the 203 episodes, bacteremia persisted for >3 days after catheter removal and initiation of antimicrobial therapy. Methicillin resistance (Odds ratio [OR], 9.01; 95% confidence interval [CI], 3.05–26.61; P<0.001), non-catheter prosthetic devices (OR, 5.37; 95% CI, 1.62–17.80; P = 0.006), and renal failure (OR, 3.23; 95% CI, 1.48–7.08; P = 0.003) were independently associated with persistent CRSAB. Patients with persistent CRSAB were more like to experience complication than were those with non-persistent CRSAB (72% vs. 15%; P<0.001). Among all episodes due to methicillin-resistant S. aureus, persistent CRSAB isolates were associated with accessory gene regulator (agr) group II (P = .04), but presence of other bacterial virulence genes, distribution of vancomycin minimum inhibitory concentration distribution, and frequency of vancomycin heteroresistance did not differ between the groups.

Conclusions

In patients with CRSAB, bacteremia persisted in 21% of cases despite catheter removal and initiation of antimicrobial therapy. Methicillin resistance, renal failure, and non-catheter prosthetic devices were independent risk factors for persistent CRSAB, which was associated with a higher rate of complications.     

Characterization of FimA in Porphyromonas gingivalis genotype IV

It has been reported that a large majority of periodontitis patients carry organisms with either type II or IV-fimA, while type I is the most prevalent fimA genotype among Porphyromonas gingivalis-positive healthy adults. Here we report characterization of recombinant fimbrial protein (rFimA) produced in Escherichia coli from genotype IV-fimA. In SDS-PAGE and immunoblot analysis after partial dissociation, type IV-rFimA showed a ladder-like pattern representing oligomeric/polymeric forms of native fimbrial structure. Unlike anti-type I-native fimbriae which can only recognize conformational epitopes of the respective proteins, both anti-type IV-native fimbriae and anti-type IV-rFimA antibodies recognized conformational as well as linear epitopes in type IV-fimbriae. These results suggest that the type IV-rFimA proteins retain the native fimbrial antigenicity and the antigenicity of type IV-fimbriae is different from that of type I-fimbriae.     

苹果蠹蛾性信息素缓释剂的控害效果

2010年在甘肃、宁夏、黑龙江3地对苹果蠹蛾Cydia pomonella(L.)性信息素缓释剂(购自澳大利亚Bioglobal公司;性信息素含量为0.16g/根)对苹果蠹蛾的迷向防治效果进行了试验;观察了不同生态区设置不同缓释剂密度的防治效果和持效期。结果表明,在低虫口密度下,在不同生态区每公顷悬挂660、990和1320根性信息素迷向丝,均能取得较好的防治效果;在越冬代活动前处理,基本上可以控制整个生长期苹果蠹蛾对果实的为害。在新侵入的低密度果园,通过诱蛾监测、调查蛀果和树干绑诱虫带等验证方法,初步证明使用该性信息素缓释剂处理1年可以达到铲除的效果。依据本研究结果,结合防治成本,在苹果蠹蛾发生地区,采用660根/hm2的悬挂密度使用进口性信息素缓释剂处理果园可以达到良好的防治效果。     

阻断ERK1/2激酶可增强骨形态发生蛋白9诱导的间充质干细胞成骨分化

骨形态发生蛋白9(bone morphogenetic protein 9,BMP9)具有很强的诱导间充质干细胞定向成骨分化的能力.但对于其所涉及的相关分子机理了解并不深入.利用BMP9重组腺病毒感染间充质干细胞,Western blot检测ERK1/2激酶的磷酸化,ERK1/2的特异性抑制剂PD98059阻断ERK1/2活性,或以RNA干扰抑制ERK1/2表达,通过体外细胞实验和体内动物实验,初步分析和揭示ERK1/2对于BMP9诱导的间充质干细胞成骨分化的调控作用及其可能机制.结果发现:BMP9可以促进ERK1/2激酶的磷酸化,ERK1/2抑制剂PD98059可增强由BMP9诱导的碱性磷酸酶(alkaline phosphatase,ALP)活性、骨桥蛋白(osteopontin,OPN)表达和钙盐沉积,并促进由BMP9诱导的Runx2基因的表达和转录活性,以及Smad经典途径的活化;而RNA干扰导致ERK1/2基因沉默同样也可进一步促进BMP9诱导的ALP活性和钙盐沉积,并促进BMP9诱导的间充质干细胞在裸鼠皮下异位成骨.因此,BMP9可以促进ERK1/2蛋白激酶的活化,而阻断ERK1/2蛋白激酶可进一步增强BMP9诱导的成骨分化,ERK1/2极可能对于BMP9诱导的间充质干细胞成骨分化起着负向调控作用.     

Antibacterial effects of <Emphasis Type="Italic">N</Emphasis>-acetylcysteine against endodontic pathogens

The success of endodontic treatment depends on the eradication of microorganisms from the root canal system and the prevention of reinfection. The purpose of this investigation was to evaluate the antibacterial and antibiofilm efficacy of N-acetylcysteine (NAC), an antioxidant mucolytic agent, as an intracanal medicament against selected endodontic pathogens. Minimum inhibitory concentrations (MICs) of NAC for Actinomyces naeslundii, Lactobacillus salivarius, Streptococcus mutans, and Enterococcus faecalis were determined using the broth microdilution method. NAC showed antibacterial activity, with MIC values of 0.78–1.56 mg/ml. The effect of NAC on biofilm formation of each bacterium and a multispecies culture consisting of the four bacterial species was assessed by crystal violet staining. NAC significantly inhibited biofilm formation by all the monospecies and multispecies bacteria at minimum concentrations of 0.78–3.13 mg/ml. The efficacy of NAC for biofilm disruption was evaluated by scanning electron microscopy and ATP-bioluminescence quantification using mature multispecies biofilms. Preformed mature multispecies biofilms on saliva-coated hydroxyapatite disks were disrupted within 10 min by treatment with NAC at concentrations of 25 mg/ml or higher. After 24 h of treatment, the viability of mature biofilms was reduced by > 99% compared with the control. Moreover, the biofilm disrupting activity of NAC was significantly higher than that of saturated calcium hydroxide or 2% chlorhexidine solution. Within the limitations of this in vitro study, we conclude that NAC has excellent antibacterial and antibiofilm efficacy against endodontic pathogens and may be used as an alternative intracanal medicament in root canal therapies.     

Clinical and Virological Characteristics of Chronic Hepatitis B Patients with Coexistence of HBsAg and Anti-HBs

Coexistence of hepatitis B surface antigen (HBsAg) and antibody against HBsAg (anti-HBs) comprises an atypical serological profile in patients with chronic hepatitis B virus (HBV) infection. In this study, in total 94 patients with coexisting HBsAg and anti-HBs and 94 age- and sex-matched patients with positive HBsAg were characterized by quantitatively measuring HBsAg and HBV DNA, sequencing large S genes, and observing clinical features. Compared with common hepatitis B patients, the patients with coexisting HBsAg and anti-HBs had lower HBsAg and HBV DNA levels. These two groups had similar rate of pre-S deletion mutations. However, in patients with coexisting HBsAg and anti-HBs, more amino acid substitutions in the a determinant of S gene were observed in HBV genotype C, but not in genotype B. Fourteen patients with coexisting HBsAg and anti-HBs were followed up for an average of 15.5 months. There were no significant changes in the levels of HBsAg, anti-HBs, HBV DNA and ALT over the follow-up period. Compared with the baseline sequences, amino acid substitutions in the MHR of HBsAg occurred in 14.3% (2/14) patients. In conclusion, coexistence of HBsAg and anti-HBs may be associated with higher frequency of mutations in the a determinant of HBV genotype C.     

软枣猕猴桃‘天源红'离体再生体系的建立

为了建立快速高效的全红型软枣猕猴桃离体再生体系,该研究以果皮、果肉均为红色的软枣猕猴桃新品种‘天源红’( Actinidia arguta)带腋芽茎段和幼嫩叶片、叶柄为外植体材料,采用组织培养的方法,研究适合其离体再生的外植体类型以及最佳植物生长物质组合。结果表明：初春带腋芽的茎段是最好的获得无菌苗的外植体材料,诱导腋芽出芽的最佳植物生长物质组合为MS＋6－BA 0.5 mg·L-1＋IBA 1.0 mg·L-1;研究发现叶柄比叶片更适合进行‘天源红’愈伤组织诱导,叶柄诱导的最佳植物生长物质组合为MS＋ZT 0.5 mg·L-1;同时,研究了不定芽增殖的最佳植物生长物质组合为MS＋ZT 1.0 mg·L-1;此外使用6－BA也可以达到较高的不定芽增殖率,在生产上可以替代ZT进行不定芽分化,即MS＋6－BA 2.0 mg·L-1＋IBA 0.5 mg·L-1;较适宜的生根培养基为1/2 MS＋NAA 0.2 mg·L-1;生根后的组培苗在珍珠岩∶泥炭∶细沙＝1∶1∶1的基质配比中能够达到98％的移栽成活率。该研究结果建立了全红型软枣猕猴桃的离体再生体系,为全红型软枣猕猴桃苗木快繁、工厂化育苗提供了技术支持,同时建立的再生体系为软枣猕猴桃遗传转化研究提供了基础。     

鱼杯体虫(Apiosoma piscicola)的光镜及透射电镜观察

对洪泽湖地区鱼杯体虫（Apiosoma piscicola）的活体、固定染色标本形态及其超微结构进行了较为系统地观察、描述,发现虫体大小在南北地区存在显著差异并就这种现象产生的原因进行了讨论,认为这可能是由于南北地区在气候条件、水体生境等各个方面均存在着很大不同,相同祖先种在进行地域辐射时,对各自生存环境长期适应所产生的结果。在超微结构中对虫体表膜、口围纤毛、口围唇、漏斗、横纤毛带及内部胞器进行了仔细的观察,发现杯体虫体内尤其是口区具有很多细菌和有机颗粒,这就证明了其营养是来自于外界水环境而并非宿主,并从杯体虫食物来源的角度论证了杯体虫是一种体外共生体（ectocommensa｜）而非体外寄生体（ectoparasite）。另外,还观察到虫体尤其是口围唇部的表膜具有非常明显的褶皱,显示了其口区表膜极强的伸缩能力,这也是虫体在受到刺激或形成游泳体（telotroch或swarmer时能将整个口围盘缩进体内的原因。     

β-胡萝卜素抑制MCF-7细胞生长上调过氧化酶体增殖物激活受体γ（PPARγ）表达

为了研究过氧化酶体增殖物激活受体γ（PPARγ）表达在β 胡萝卜素影响乳腺癌MCF 7细胞活力中所起的作用,采用MTT法测定细胞活力、Western 印迹检测细胞中PPARγ的蛋白质水平,用RT-PCR从mRNA水平检测细胞内PPARγ、P21^WAF1/CIP1、COX-2和P27表达.研究发现,β 胡萝卜素显著抑制人乳腺癌细胞株MCF-7细胞的生长,β-胡萝卜素对细胞生长的抑制作用呈现出时间和计量依赖关系;β-胡萝卜素能够呈现时间效应地从mRNA和蛋白质水平显著上调PPARγ的表达,β-胡萝卜素能够通过PPARγ调节P21^WAF1/CIP1和COX-2mRNA水平;PPARγ的抑制剂GW9662和抗氧化剂还原型谷胱甘肽（GSH）都能部分阻止由β-胡萝卜素引起的细胞活力下降.研究结果提示,激活PPARγ途径和调制细胞氧化状态是β 胡萝卜素对乳腺癌细胞MCF-7的生长抑制效应原因之一.