Bloodstream infection, peritonitis, and pneumonia caused by Pasteurella multocida in a patient with liver cirrhosis despite no animal contact: case report and literature review

Pasteurella multocida is an opportunistic pathogen. Previously reported infections associated with P. multocida have often been linked to contact with cats, dogs, and other animals. Cases of systemic multiple-site infections following P. multocida infection are rare. This case study presents a 49-year-old middle-aged man with post-hepatitis B cirrhosis and no history of animal contact. The patient was admitted with symptoms of fever accompanied by diarrhea, abdominal distension, and cough. Blood tests showed elevated levels of CRP, PCT, and IL-6, and blood culture revealed the growth of P. multocida. CT scans revealed a large amount of abdominal effusion, a small amount of pleural effusion, and pulmonary infection foci. The patient’s condition improved after successive administration of ceftriaxone and levofloxacin to fight the infection, and abdominal puncture and drainage. Multiple-site infections caused by P. multocida are rarely encountered in patients with liver cirrhosis but without animal contact, which could be regarded as serious conditions warranting careful attention in terms of clinical diagnosis and treatment

A nomogram model to predict the risk of drug-induced liver injury in patients receiving anti-tuberculosis treatment

Objectives: To establish an individualized nomogram to predict the probability of drug-induced liver injury (DILI) in tuberculosis patients receiving anti-tuberculosis treatment.Methods: The clinical information of patients admitted to a tertiary hospital between January 2010 and December 2022 was retrospectively reviewed from the clinical records. Patients with baseline liver diseases (hepatis B or C infection and fatty liver) or taking liver protective drugs were excluded. The maximum values in liver function test within 180 days after anti-tuberculosis treatment were collected to determine the occurrence of DILI. The candidate variables used for establishing prediction model in this study were the last results within the 30 days before the treatment onset. The final variables were included after univariate and multivariate logistic regression analyses and applied to establish the nomogram model. The discrimination power and prediction accuracy of the prediction model were assessed using the area under the receiver operating characteristic (AUC) curve and a calibration chart. The clinical effectiveness was assessed via decision curve analysis (DCA). The established model was validated in two validation groups.Results: A total of 1979 patients with 25 variables were enrolled in this study, and the incidence of DILI was 4.2% (n = 83). The patients with complete variables were divided into training group (n = 1,121), validation group I (n = 492) and validation group II (n = 264). Five variables were independent factors for DILI and included in the final prediction model presented as nomogram: age (odds ratio [OR] 1.022, p = 0.023), total bilirubin ≥17.1 μmol/L (OR 11.714, p < 0.001), uric acid (OR 0.977, p = 0.047), neutrophil count (OR 2.145, 0.013) and alcohol consumption (OR 3.209, p = 0.002). The AUCs of the prediction model in the training group, validation group I and validation group II were 0.833, 0.668, and 0.753, respectively. The p-values of calibration charts in the three groups were 0.800, 0.996, and 0.853. The DCA curves of the prediction model were above the two extreme curves.Conclusion: The nomogram model in this study could effectively predict the DILI risk among patients under anti-tuberculosis drug treatment

Establishment and validation of a prediction nomogram for heart failure risk in patients with acute myocardial infarction during hospitalization

Abstract Background Acute myocardial infarction (AMI) with consequent heart failure is one of the leading causes of death in humans. The aim of this study was to develop a prediction model to identify heart failure risk in patients with AMI during hospitalization. Methods The data on hospitalized patients with AMI were retrospectively collected and divided randomly into modeling and validation groups at a ratio of 7:3. In the modeling group, the independent risk factors for heart failure during hospitalization were obtained to establish a logistic prediction model, and a nomogram was constructed. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the predictive performance and clinical value. Machine learning models with stacking method were also constructed and compared to logistic model. Results A total of 1875 patients with AMI were enrolled in this study, with a heart failure rate of 5.1% during hospitalization. The independent risk factors for heart failure were age, heart rate, systolic blood pressure, troponin T, left ventricular ejection fraction and pro-brain natriuretic peptide levels. The area under the curve (AUC) of the model in modeling group and validation group were 0.829 and 0.846, respectively. The calibration curve showed high prediction accuracy and the DCA curve showed good clinical value. The AUC value of the ensemble model by the stacking method in the validation group were 0.821, comparable to logistic prediction model. Conclusions This model, combining laboratory and clinical factors, has good efficacy in predicting heart failure during hospitalization in AMI patients

Electric Field Analysis of Press-Pack IGBTs

High voltage IGBT module is the ideal option for the VSC-HVDC power transmission application. At present, wire-bonded technology and press-pack technology are available packaging technologies for high voltage IGBT. The press-pack IGBTs have such advantages as low inductance, low thermal impedance and short circuit failure mode than the wire-bonded IGBT module, which especially suit for high voltage power transmission application by series connection. However, the electrical insulation failure modes of press-pack IGBTs are much less known with limited literature published. In this paper, we presented the electric field analysis of a 3D press-pack IGBT model under DC rating voltage test condition. The electric field distribution of the press-pack IGBT stack was solved as an electrostatic problem by employing the finite element method. The results revealed the potential electrical insulation failure modes of the press-pack IGBTs: corona discharge at the edge of silver plate, partial discharge at the micro gap between die and PEEK frame and creeping discharge at the surface of PEEK frame

Electric Field Analysis of Press-Pack IGBTs

High voltage IGBT module is the ideal option for the VSC-HVDC power transmission application. At present, wire-bonded technology and press-pack technology are available packaging technologies for high voltage IGBT. The press-pack IGBTs have such advantages as low inductance, low thermal impedance and short circuit failure mode than the wire-bonded IGBT module, which especially suit for high voltage power transmission application by series connection. However, the electrical insulation failure modes of press-pack IGBTs are much less known with limited literature published. In this paper, we presented the electric field analysis of a 3D press-pack IGBT model under DC rating voltage test condition. The electric field distribution of the press-pack IGBT stack was solved as an electrostatic problem by employing the finite element method. The results revealed the potential electrical insulation failure modes of the press-pack IGBTs: corona discharge at the edge of silver plate, partial discharge at the micro gap between die and PEEK frame and creeping discharge at the surface of PEEK frame

Tailoring the Luminescence Properties of Silver Clusters Confined in Faujasite Zeolite through Framework Modification

Faujasite zeolites with a regular micropore and mesopore structure have been considered desirable scaffolds to stabilize luminescent silver nanoclusters (Ag CLs), while turning of the emission properties of the confined Ag CLs is still under investigation. In this study, the desilicated and dealuminated faujasite zeolites were first prepared to modify the zeolite framework and Si/Al ratio before Ag+ loading. With thermal treatment on the thereafter Ag+-exchanged zeolites, the Ag CLs formatted inside the D6r cages showed red-shifted emission in the desilicated zeolites and blue-shifted emission in the dealuminated zeolites, so that a tunable emission in the wavelength range of 482–528 nm could be obtained. Meanwhile, the full width at half maximum of the emission spectra is also closely related with framework modification, which monotonously increases with enhancing Si/Al ratio of host zeolite. The XRD, XPS, and spectral measurements indicated that the tunable luminescence properties of Ag CLs result from the controlling of local crystal field and coupling between host lattice and luminescent center. This paper proposes an effective strategy to manipulate the emission properties of Ag CLs confined inside zeolites and may benefit the applications of noble metal clusters activated phosphors in imaging and tunable emission

Antibiotic resistance spectrum of E. coli strains from different samples and age-grouped patients: a 10-year retrospective study

Objective Escherichia coli (E. coli) is the most common opportunistic clinical micro-organism with high drug resistance. This study aimed to analyse the resistance pattern of E. coli according to patient age and clinical sample type.Design and setting This retrospective observational study was conducted in a tertiary hospital in southeastern China.Participants E. coli strains were isolated from blood, urine and sputum of infected inpatients. The patients were divided into four age groups: children (0–14 years old, including neonatal and non-neonatal groups), youths (15–40 years old), middle-aged (41–60 years old) and old (>60 years old).Results A total of 7165 E. coli strains were collected from all samples. Compared with urine and blood isolates, more sputum isolates were resistant against 12 tested antibiotics. Furthermore, urine isolates were more resistant to levofloxacin than sputum and blood isolates. Although the patients’ age was not associated with resistance rates of E. coli strains isolated from blood, a larger proportion of urine-derived strains from youths were resistant to sulfamethoxazole-trimethoprim and piperacillin-tazobactam than those from old people. The sputum strains from the elderly were more resistant to most of the tested antibiotics compared with sputum strains isolated from children.Conclusions The resistance profile of E. coli is different among age groups and specimen sources and should be considered during E. coli infection treatment

First case of bloodstream infection caused by NDM-positive Escherichia hermannii

Abstract Background Escherichia hermannii (E. hermanni) is always accompanied by other bacterial infections in humans. In previous reports, most E. hermannii-related infections were caused by sensitive strains. Here, for the first time, we report the case of a patient with New Delhi metallo-β-lactamase (NDM)-positive E. hermannii bloodstream infection. Case presentation The patient was a 70-year-old male admitted to our hospital due to a 4-day fever, with a history of malignant tumor, liver cirrhosis, and chronic obstructive pulmonary disease. After admission, his blood culture tested positive for E. hermannii. The drug resistance analysis showed positive for NDM resistance, with susceptibility to aztreonam, levofloxacin, and amikacin. The blood culture turned negative after 8 days of aztreonam treatment. The patient’s symptoms improved, and he was discharged after 14 days of hospitalization. Conclusions This is the first report of a bloodstream infection caused by an NDM-positive E. hermannii strain. The anti-infection regimen used in this case provides a new reference regimen for clinical practice

Univariate analysis between survivors and no survivors in training group^a.

Univariate analysis between survivors and no survivors in training groupa.</p

Nomogram graph established in this study.

Map, mean arterial pressure; pro.bnp, pro-brain natriuretic peptide.</p