A cross-sectional study of the antibiotic resistant prevalence of ESBL-producing Enterobacteriaceae in Vietnam

Introduction: Antibiotic resistance in Enterobacteriaceae producing extended spectrum beta-lactamase (ESBL) is increasing. Accurate evaluation of antibiotic resistance rates in various categories of bacteria assists medical physicians in recommending suitable indications for their medical problems, improving treatment efficiency, and minimizing dangers for patients. As a result, we undertook this research to assess the prevalence of ESBL-producing Enterobacteriaceae as well as the rate of antibiotic resistance in ESBL-producing Enterobacteriaceae. Methods: A cross-sectional study was conducted on 2716 patients at the An Giang Central General Hospital from June 2020 to June 2021. Data collection was based on interviews and used SPSS 18.0 and GraphPad Prism 9 for data analysis and presentation. Samples included urine, blood, sputum, and pus. Samples were treated with the Phoenix 100 automated machine to separate and identify samples. Results: The highest rate was 64.8% for Escherichia coli, followed by 30.2% for Klebsiella pneumoniae. Proteus mirabilis and Klebsiella oxytoca were found in 4.5% and 0.6% of the samples, respectively. Ampicillin resistance was greatest in E. coli (96.5%), K. pneumonia (92.4%), and K oxytoca (83.3%). The frequency of resistance to the other antibiotics was likewise extremely high, approaching 60%. Tobramycin, Amoxicillin/Clavulanate, Cefoxitin, and Nitrofurantoin were totally resistant to K. oxytoca in the ESBL-producing group. E. coli and K. pneumoniae with ESBL-producing genes also have a high antibiotic resistance rate of more than 50%. Conclusion: E. coli was the most common pathogenic bacteria. Most of the species of bacteria resisted Ampicillin

Physical security with power beacon assisted in half-duplex relaying networks over Rayleigh fading channel: performance analysis

In this research, we proposed and investigated physical security with power beacon assisted in half-duplex relaying networks over a Rayleigh fading channel. In this model, the source (S) node communicates with the destination (D) node via the helping of the intermediate relay (R) node. The D and R nodes harvest energy from the power beacon (PB) node in the presence of a passive eavesdropper (E) node. Then we derived the integral form of the system outage probability (OP) and closed form of the intercept probability (IP). The correctness of the analytical of the OP and IP is verified by the Monte Carlo simulation. The influence of the main system parameters on the OP and IP also is investigated. The research results indicated that the analytical results are the same as the simulation ones

The Situation of Antibiotic Resistance in Klebsiella Pneumoniae and Carbapenemase-Producing Klebsiella Pneumoniae in Vietnam: A Cross-Sectional Study

Objective: Klebsiella pneumoniae (K. pneumoniae) is one of the most prevalent human pathogens. Carbapenemaseproducing klebsiella pneumoniae (CPKP) has recently developed significant antibiotic resistance, not just to carbapenem antibiotics but also to the majority of other currently available antibiotics. Prior to this point, there have been few international studies or publications on the situation of CPKP in Vietnam. Hence, this study was conducted to determine the antibiotic resistance of K. pneumoniae and CPKP strains in Can Tho, Vietnam.  Material and Methods: In total, 345 K. pneumoniae strains were isolated. Antibiotic susceptibility was assessed via an automated microbiological system. A modified carbapenem inactivation assay was applied to identify CPKP strains, followed by the use of the MASTDISCS combi Carba plus disc system to classify certain carbapenemases.  Results: Of the 345 K. pneumoniae strains, 110 represented an isolation rate of 31.9%. There was a significant correlation (p-value<0.05) between the specimen type, hospital unit and CPKP ratio. All the examined CPKP strains exhibited complete resistance to penicillin and cefazolin. The CPKP strains were also significantly more resistant to PTZ, cefepime, ciprofloxacin and imipenem than the non-CPKP strains (p-value<0.05). Amikacin, gentamicin and TMP/SMX have been shown to be effective in treating patients infected with CPKP strains.  Conclusion: CPKP accounts for 31.9% of all K. pneumoniae infections. K. pneumoniae and CPKP exhibited the highest levels of resistance to ampicillin, cefazoline, ciprofloxacin, ceftriaxone and ceftazidime. Amikacin, gentamicin and TMP/ SMX were the least resistant antibiotics tested

Chemical profile and antibacterial activity of acetone extract of Homalomena cochinchinensis Engl. (Araceae)

Homalomena cochinchinensis Engl. is a rare species which is found in Southern China, Cambodia, Laos and Vietnam and its chemical constituents and bioactivity have not been determined yet. In this study, we identified 32 and 38 compounds in acetone extracts of H. cochinchinensis aerial part and rhizome, respectively via gas chromatography mass spectrometry (GC/MS). The main constituents of acetone extract of the aerial part were 3-((4Z,7Z)-Heptadeca-4,7-dien-1-yl)phenol (18.73%); cis-9,cis-12-Octadecadienoic acid (12.04%); linolenic acid (11.08%); n-Hexadecanoic acid (10.13%); (Z)-3-(Heptadec-10-en-1-yl)phenol (7.09%); ?-Sitosterol (5.58%) and linalool (5.56%). On the other hand, acetone extract of rhizome contained linalool (28.42%); 1,2,3-Propanetriol, 1-acetate (10.13%); 3-((4Z,7Z)-Heptadeca-4,7-dien-1-yl)phenol (5.28%); 3-Buten-2-one, 3-methyl-4-(1,3,3-trimethyl-7-oxabicyclo[4.1.0]heptan-1-yl)- (5.28%) and 4-(2,6,6-Trimethyl-cyclohex-1-enyl)-butyric acid (4.54%). Furthermore, this study has also proved the antibacterial activity of acetone extracts from the aerial part and the rhizome of this species for the first time using disk diffusion method. The results showed that the extract of the aerial part could inhibit the growth of 5 out of a total 6 bacterial strains, including Bacillus cereus, Escherichia coli, Pseudomonas aeruginosa, Salmonella enteritidis and Staphylococcus aureus; while the susceptible strains to the rhizome extract were 5 strains, such as B. cereus, E. coli, P. aeruginosa, Salmonella typhimurium and S. aureus. The findings suggest the further application of this species in pharmacology and medicine

Papillary thyroid carcinoma with tall cell features is as aggressive as tall cell variant: a meta-analysis

There are still ongoing debates as to which cut-off percentage of tall cell (TC) should be used to define tall cell variant (TCV) papillary thyroid carcinoma (PTC). In this meta-analysis, we aimed to investigate the clinicopathological significance of PTC with tall cell features (PTC-TCF, PTC with 10–50% of TCs) in comparison with classical PTC and TCVPTC (PTC with more than 50% of TCs) to clarify the controversial issue. Four electronic databases including PubMed, Web of Science, Scopus and Virtual Health Library were accessed to search for relevant articles. We extracted data from published studies and pooled into odds ratio (OR) and its corresponding 95% confidence intervals (CIs) using random-effect modeling. Nine studies comprising 403 TCVPTCs, 325 PTC-TCFs and 3552 classical PTCs were included for meta-analyses. Overall, the clinicopathological profiles of PTC-TCF including multifocality, extrathyroidal extension, lymph node metastasis, distant metastasis and patient mortality were not statistically different from those of TCVPTC. Additionally, PTC-TCF and TCVPTC were both associated with an increased risk for aggressive clinical courses as compared to classical PTC. The prevalence of BRAF mutation in PTC-TCF and TCVPTC was comparable and both were significantly higher than that in classical PTC. The present meta-analysis demonstrated that even a PTC comprising only 10% of TCs might be associated with a poor clinical outcome. Therefore, the proportions of PTC in PTC should be carefully estimated and reported even when the TC component is as little as 10%

Impact of Education and Network for Avian Influenza H5N1 in Human: Knowledge, Clinical Practice, and Motivation on Medical Providers in Vietnam

BACKGROUND: Knowledge, clinical practice, and professional motivation of medical providers relating to H5N1 infection have an important influence on care for H5N1 patients who require early diagnosis and early medical intervention. METHODS/PRINCIPAL FINDINGS: Novel educational programs including training and workshops for medical providers relating to H5N1 infection in Vietnam were originally created and implemented in 18 provincial hospitals in northern Vietnam between 2008 and 2010. A self-administered, structured questionnaire survey was conducted in 8 provincial hospitals where both educational training and workshops were previously provided. A total of 326 medical providers, including physicians, nurses, and laboratory technicians who attended or did not attend original programs were enrolled in the survey. Knowledge, clinical attitudes and practice (KAP), including motivation surrounding caring for H5N1 patients, were evaluated. The study indicated a high level of knowledge and motivation in all professional groups, with especially high levels in laboratory technicians. Conferences and educational programs were evaluated to be the main scientific information resources for physicians, along with information from colleagues. The chest radiographs and the initiation of antiviral treatment in the absence of RT-PCR result were identified as gaps in education. Factors possibly influencing professional motivation for caring for H5N1 patients included healthcare profession, the hospital where the respondents worked, age group, attendance at original educational programs and at educational programs which were conducted by international health-related organizations. CONCLUSIONS: Educational programs provide high knowledge and motivation for medical providers in Vietnam caring for H5N1 patients. Additional educational programs related to chest radiographs and an initiation of treatment in the absence of RT-PCR are needed. Networking is also necessary for sharing updated scientific information and practical experiences. These enhanced KAPs by educational programs and integrated systems among hospitals should result in appropriate care for H5N1 patients and may reduce morbidity and mortality

Emerging Role of Circulating Tumor Cells in Gastric Cancer

With over 1 million incidence cases and more than 780,000 deaths in 2018, gastric cancer (GC) was ranked as the 5th most common cancer and the 3rd leading cause of cancer deaths worldwide. Though several biomarkers, including carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), and cancer antigen 72-4 (CA72-4), have been identified, their diagnostic accuracies were modest. Circulating tumor cells (CTCs), cells derived from tumors and present in body fluids, have recently emerged as promising biomarkers, diagnostically and prognostically, of cancers, including GC. In this review, we present the landscape of CTCs from migration, to the presence in circulation, biologic properties, and morphologic heterogeneities. We evaluated clinical implications of CTCs in GC patients, including diagnosis, prognosis, and therapeutic management, as well as their application in immunotherapy. On the one hand, major challenges in using CTCs in GC were analyzed, from the differences of cut-off values of CTC positivity, to techniques used for sampling, storage conditions, and CTC molecular markers, as well as the unavailability of relevant enrichment and detection techniques. On the other hand, we discussed future perspectives of using CTCs in GC management and research, including the use of circulating tumor microembolies; of CTC checkpoint blockade in immunotherapy; and of organoid models. Despite the fact that there are remaining challenges in techniques, CTCs have potential as novel biomarkers and/or a non-invasive method for diagnostics, prognostics, and treatment monitoring of GC, particularly in the era of precision medicine

The association between diabetes and gastric cancer

Background: Prior epidemiologic studies on the association between diabetes and gastric cancer risk provided inconclusive findings, while traditional, aggregate data meta-analyses were characterized by high between-study heterogeneity. Objective: To investigate the association between type 2 diabetes and gastric cancer using data from the 'Stomach Cancer Pooling (StoP) Project', an international consortium of more than 30 case-control and nested case-control studies, which is large and provides harmonized definition of participants' characteristics across individual studies. The data have the potential to minimize between-study heterogeneity and provide greater statistical power for subgroup analysis. Methods: We included 5592 gastric cancer cases and 12 477 controls from 14 studies from Europe, Asia, North America, and South America in a two-stage individual-participant data meta-analysis. Random-effect models were used to estimate summary odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) by pooling study-specific ORs. Results: We did not find an overall association between diabetes and gastric cancer (pooled OR = 1.01, 95% CI, 0.94-1.07). However, the risk of cardia gastric cancer was significantly higher among individuals with type 2 diabetes (OR = 1.16, 95% CI, 1.02-1.33). There was no association between diabetes and gastric cancer risk in strata of Helicobacter pylori infection serostatus, age, sex, BMI, smoking status, alcohol consumption, fruit/vegetable intake, gastric cancer histologic type, and source of controls. Conclusion: This study provides additional evidence that diabetes is unrelated to gastric cancer overall but may be associated with excess cardia gastric cancer risk