Bacterial Profile and Antibiotic Resistance in Patients with Diabetic Foot Ulcer in Guangzhou, Southern China: Focus on the Differences among Different Wagner’s Grades, IDSA/IWGDF Grades, and Ulcer Types

Objective. To understand the bacterial profile and antibiotic resistance patterns in diabetic foot infection (DFI) in different Wagner’s grades, IDSA/IWGDF grades, and different ulcer types in Guangzhou, in order to provide more detailed suggestion to the clinician about the empirical antibiotic choice. Methods. 207 bacteria were collected from 117 DFIs in Sun Yat-sen Memorial Hospital from Jan.1, 2010, to Dec.31, 2015. The clinical data and microbial information were analyzed. Results. The proportion of Gram-negative bacteria (GNB) was higher than Gram-positive bacteria (GPB) (54.1% versus 45.9%), in which Enterobacteriaceae (73.2%) and Staphylococcus (65.2%) were predominant, respectively. With an increasing of Wagner’s grades and IDSA/IWGDF grades, the proportion of GNB bacterial infection, especially Pseudomonas, was increased. Neuro-ischemic ulcer (N-IFU) was more susceptible to GNB infection. Furthermore, with the aggravation of the wound and infection, the antibiotic resistance rates were obviously increased. GPB isolated in ischemic foot ulcer (IFU) showed more resistance than the N-IFU, while GNB isolates were on the opposite. Conclusions. Different bacterial profiles and antibiotic sensitivity were found in different DFU grades and types. Clinician should try to stay updated in antibiotic resistance pattern of common pathogens in their area. This paper provided them the detailed information in this region

High incidence of multiple viral infections identified in upper respiratory tract infected children under three years of age in Shanghai, China.

BACKGROUND: Upper respiratory tract infection (URTI) is a major reason for hospitalization in childhood. More than 80% of URTIs are viral. Etiological diagnosis of URTIs is important to make correct clinical decisions on treatment methods. However, data for viral spectrum of URTIs are very limited in Shanghai children. METHODS: Nasopharyngeal swabs were collected from a group of 164 children aged below 3 years who were hospitalized due to acute respiratory infection from May 2009 to July 2010 in Shanghai. A VRDAL multiplex PCR for 10 common respiratory viruses was performed on collected specimens compared with the Seeplex® RV15 ACE Detection kit for 15 respiratory viruses. RESULTS: Viruses were detected in 84 (51.2%) patients by VRDAL multiplex PCR, and 8 (4.9%) of cases were mixed infections. Using the Seeplex® RV15 ACE Detection kit, viruses were detected in 129 (78.7%) patients, 49 (29.9%) were co-infected cases. Identified viruses included 37 of human rhinovirus (22.6% of cases), 32 of influenza A virus (19.5%), 30 of parainfluenzavirus-2 (18.3%), 23 of parainfluenzavirus-3 (14.0%), 15 of human enterovirus (9.1%), 14 each of parainfluenzavirus-1, respiratory syncytial virus B and adenovirus (8.5%), 8 of coronavirus 229E/NL63 (4.9%), 6 of human bocavirus (3.7%), 5 each of influenza B virus and respiratory syncytial virus A (3.0%), 3 of parainfluenzavirus-4 (1.8%), 2 of coronavirus OC43/HKU1 (1.2%), and 1 human metapneumovirus (0.6%). CONCLUSIONS: A high frequency of respiratory infections (78.7%) and co-infections (29.9%) was detected in children with acute respiratory infection symptoms in Shanghai. The Seeplex® RV15 ACE detection method was found to be a more reliable high throughput tool than VRDAL method to simultaneously detect multiple respiratory viruses

Co-infection rate by virus.

<p>Co-infection rate by virus.</p

Positive samples detected by Seeplex® multiplex PCR by subgroup.

<p>URTIs: Upper respiratory tract infections.</p

Seasonal detection of five genre of viruses.

<p>“+”: numbers for positive samples, “−”: numbers for negative samples.</p

One example analyzed both by Seeplex® RV15 and VRDAL multiplex PCRs.

<p>lane “M”: molecular PCR marker, size of each bands were annotated in left; “IC”: 850 bp internal positive control, all presented in lane 1a–1c; “1”: one sample (A2-1319T) analyzed by Seeplex® RV15 method; lane “1a”, “1b”, “1c”: three individual reaction groups, showed a quartile infections included PIV2(264 bp, 1a), PIV3(189 bp, 1a), FluA(206 bp, 1b) and HboV(579 bp, 1c); “2”: same sample analyzed by VRDAL method; lane “2a”, “2b”, “2c”: three individual reaction groups, showed single FluA infection detected (196 bp, 2a) in lane 2a with negative results detected both in lane 2b and 2c.</p

Positive sample detections by two multiplex PCR tests.

a<p>the total number of hRV and hEV.</p>b<p>the total number of PIV1-3.</p>c<p>the total number of RSV A and RSV B.</p><p>“–”: not included tests. Multiple virus infections were detected in a single sample by both PCR tests.</p

Clinical Findings for Early Human Cases of Influenza A(H7N9) Virus Infection, Shanghai, China

A novel strain of influenza A(H7N9) virus has emerged in China and is causing mild to severe clinical symptoms in infected humans. Some case-patients have died. To further knowledge of this virus, we report the characteristics and clinical histories of 4 early case-patients