9%); piperacillin-tazobactam, meropenem, cefotaxime, and cefoperazone-sulbactam were all higher than 90%. There were 43 positive strains in the modified Hodge test (the positive rate was 79.63%) and 11 negative strains. A total of 40 strains with carbapenemase resistance were detected by PCR resistance gene detection. The detection rate of target drug-resistant genes was 74.07%. Among them, 35 strains carry the KPC-2 gene, 7 strains carry the OXA-48 gene, 4 strains carry the NDM-1 gene, and 1 strain carries the IMP gene. All strains carrying the OXA-48 gene also carried the KPC-2 gene, which was not detected. Strains carrying the VIM gene were identified, and the remaining 14 strains did not detect the target carbapenem gene. CONCLUSIONS The carbapenem-producing genes carried by CRKP in five hospitals in Qingdao City are mainly KPC-2, followed by OXA-48 and NDM-1.OBJECTIVE To observe the changing characteristics of pharmacokinetic and pharmacodynamic (PK-PD) parameters of vancomycin in critical patients under different drug regimens and to further explore the influencing factors. METHODS The clinical data of patients who treated with vancomycin and recorded by steady-state through concentration (Cmin) admitted to intensive care unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2011 to December 2018 were analyzed retrospectively. The patients were divided into three groups according to the dosing interval (groups of q12 h, q8 h and q6 h respectively) and Cmin was collected. The serum concentration of vancomycin before (0 hour) and 1, 2, 4, 6, 8, 12 and 24 hours after administration were estimated by JPKD Ver 3.1. Area under the curve (AUC0-24 h) was estimated by trapezoidal area method. Minimum inhibitory concentration (MIC) of pathogenic microorganisms in the same period was retrieved, thus AUC0-24 h/****was calcf vancomycin serum concentration, but AUC0-24 h/****is not affected. Vancomycin administration regimen in severe patients should be optimized according to CCr, CLvancomycin and age.OBJECTIVE To investigate the effect of terlipressin on prognosis of adult septic shock patients. METHODS All randomized controlled clinical trials (RCT) of terlipressin in the treatment of adult septic shock patients from January 1980 to December 2019 were retrieved from CNKI, Wanfang, SinoMed, PubMed, Embase, Springer Link, Cochrane Library, Google Scholar, and etc. Patients in the treatment group received terlipressin while patients in the control group received norepinephrine or other vasopressors. Main outcome indicator was mortality. Secondary outcome indicators included the incidence of severe adverse events, limb peripheral ischemic events and renal complications. Literature screening, data extraction and quality evaluation were conducted by two researchers respectively. Meta-analysis was performed with RevMan 5.3 software. Funnel plot was used to analyze the publication bias. RESULTS A total of 507 related literatures were retrieved. According to the inclusion and exclusion criteria, 8 RCT studies weral ischemic events and the incidence of kidney-related complications. CONCLUSIONS The available evidence suggests that terlipressin could not significantly improve mortality in adult's septic shock patients, but it may reduce the incidence of renal complications. A tendency to increase the incidence of limb peripheral ischemic events in the terlipressin-treated group needs to be emphasized.OBJECTIVE To explore the value of Sepsis-3 standard in diagnosis of patients with sepsis. METHODS Patients who were infected or suspected of infection in intensive care unit (ICU) of six hospitals in Jiangsu Province from September 2017 to August 2018 were enrolled. They were divided into four groups group A was in accordance with Sepsis-1 and Sepsis-3, group B only met the Sepsis-1 standard, group C only met the Sepsis-3 standard, and both Sepsis-1 and Sepsis-3 standard did not match in group D. The age, gender, underlying disease, diagnosis and source of infection, vital signs within 24 hours of ICU, systemic inflammatory response syndrome (SIRS) score, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score, quick sequential organ failure assessment (qSOFA) score, the length of ICU stay, total hospitalization time, 28-day mortality rate, etc. were recorded. The above collected data were compared and analyzed in groups, and the receiver operating scores were evaluated by ROC to predict the value of 28-day mortality. The results showed that AUC and 95% confidence interval of SOFA score was superior to qSOFA score and SIRS score [0.71 (0.66-0.76) vs. 0.59 (0.55-0.64), 0.57 (0.51-0.62), both P less then 0.01]. According to the Youden index, the best cut-off values for the 28-day mortality of SOFA, qSOFA and SIRS scores for sepsis were 7, 2 and 2, respectively, and the sensitivity was 69.4%, 60.1%, 53.6%, the specificity was 61.8%, 76.2%, 51.1%, respectively. CONCLUSIONS The Sepsis-3 standard is superior to the Sepsis-1 standard in the diagnosis and prediction of 28-day mortality in patients with sepsis. qSOFA can be used as an early tool for rapid screening of patients with high-risk sepsis in the ICU bedside.Aedes-transmitted diseases, especially dengue, are increasing throughout the world and the main preventive methods include vector control and the avoidance of mosquito bites. A simple Premise Condition Index (PCI) categorizing shade, house, and yard conditions was previously developed to help prioritize households or geographical areas where resources are limited. However, evidence about the accuracy of the PCI is mixed. The current study aimed to contribute to a better understanding of the relevance by collecting data from 2,400 premises at four time points over 1 year in Kampong Cham, Cambodia. https://www.selleckchem.com/products/ITF2357(Givinostat).html Regression models were then used to identify associations between PCI and Aedes adult female mosquitoes and pupae. In addition, receiver operating characteristic curves were used to measure the ability of PCI to identify premises in the top quartile of mosquito abundance. The density of adult Aedes females was positively associated with PCI at the household (ratio of means = 1.16 per point on the PCI scale) and cluster level (ratio of means = 1.
9%); piperacillin-tazobactam, meropenem, cefotaxime, and cefoperazone-sulbactam were all higher than 90%. There were 43 positive strains in the modified Hodge test (the positive rate was 79.63%) and 11 negative strains. A total of 40 strains with carbapenemase resistance were detected by PCR resistance gene detection. The detection rate of target drug-resistant genes was 74.07%. Among them, 35 strains carry the KPC-2 gene, 7 strains carry the OXA-48 gene, 4 strains carry the NDM-1 gene, and 1 strain carries the IMP gene. All strains carrying the OXA-48 gene also carried the KPC-2 gene, which was not detected. Strains carrying the VIM gene were identified, and the remaining 14 strains did not detect the target carbapenem gene. CONCLUSIONS The carbapenem-producing genes carried by CRKP in five hospitals in Qingdao City are mainly KPC-2, followed by OXA-48 and NDM-1.OBJECTIVE To observe the changing characteristics of pharmacokinetic and pharmacodynamic (PK-PD) parameters of vancomycin in critical patients under different drug regimens and to further explore the influencing factors. METHODS The clinical data of patients who treated with vancomycin and recorded by steady-state through concentration (Cmin) admitted to intensive care unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2011 to December 2018 were analyzed retrospectively. The patients were divided into three groups according to the dosing interval (groups of q12 h, q8 h and q6 h respectively) and Cmin was collected. The serum concentration of vancomycin before (0 hour) and 1, 2, 4, 6, 8, 12 and 24 hours after administration were estimated by JPKD Ver 3.1. Area under the curve (AUC0-24 h) was estimated by trapezoidal area method. Minimum inhibitory concentration (MIC) of pathogenic microorganisms in the same period was retrieved, thus AUC0-24 h/MIC was calcf vancomycin serum concentration, but AUC0-24 h/MIC is not affected. Vancomycin administration regimen in severe patients should be optimized according to CCr, CLvancomycin and age.OBJECTIVE To investigate the effect of terlipressin on prognosis of adult septic shock patients. METHODS All randomized controlled clinical trials (RCT) of terlipressin in the treatment of adult septic shock patients from January 1980 to December 2019 were retrieved from CNKI, Wanfang, SinoMed, PubMed, Embase, Springer Link, Cochrane Library, Google Scholar, and etc. Patients in the treatment group received terlipressin while patients in the control group received norepinephrine or other vasopressors. Main outcome indicator was mortality. Secondary outcome indicators included the incidence of severe adverse events, limb peripheral ischemic events and renal complications. Literature screening, data extraction and quality evaluation were conducted by two researchers respectively. Meta-analysis was performed with RevMan 5.3 software. Funnel plot was used to analyze the publication bias. RESULTS A total of 507 related literatures were retrieved. According to the inclusion and exclusion criteria, 8 RCT studies weral ischemic events and the incidence of kidney-related complications. CONCLUSIONS The available evidence suggests that terlipressin could not significantly improve mortality in adult's septic shock patients, but it may reduce the incidence of renal complications. A tendency to increase the incidence of limb peripheral ischemic events in the terlipressin-treated group needs to be emphasized.OBJECTIVE To explore the value of Sepsis-3 standard in diagnosis of patients with sepsis. METHODS Patients who were infected or suspected of infection in intensive care unit (ICU) of six hospitals in Jiangsu Province from September 2017 to August 2018 were enrolled. They were divided into four groups group A was in accordance with Sepsis-1 and Sepsis-3, group B only met the Sepsis-1 standard, group C only met the Sepsis-3 standard, and both Sepsis-1 and Sepsis-3 standard did not match in group D. The age, gender, underlying disease, diagnosis and source of infection, vital signs within 24 hours of ICU, systemic inflammatory response syndrome (SIRS) score, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score, quick sequential organ failure assessment (qSOFA) score, the length of ICU stay, total hospitalization time, 28-day mortality rate, etc. were recorded. The above collected data were compared and analyzed in groups, and the receiver operating scores were evaluated by ROC to predict the value of 28-day mortality. The results showed that AUC and 95% confidence interval of SOFA score was superior to qSOFA score and SIRS score [0.71 (0.66-0.76) vs. 0.59 (0.55-0.64), 0.57 (0.51-0.62), both P less then 0.01]. According to the Youden index, the best cut-off values for the 28-day mortality of SOFA, qSOFA and SIRS scores for sepsis were 7, 2 and 2, respectively, and the sensitivity was 69.4%, 60.1%, 53.6%, the specificity was 61.8%, 76.2%, 51.1%, respectively. CONCLUSIONS The Sepsis-3 standard is superior to the Sepsis-1 standard in the diagnosis and prediction of 28-day mortality in patients with sepsis. qSOFA can be used as an early tool for rapid screening of patients with high-risk sepsis in the ICU bedside.Aedes-transmitted diseases, especially dengue, are increasing throughout the world and the main preventive methods include vector control and the avoidance of mosquito bites. A simple Premise Condition Index (PCI) categorizing shade, house, and yard conditions was previously developed to help prioritize households or geographical areas where resources are limited. However, evidence about the accuracy of the PCI is mixed. The current study aimed to contribute to a better understanding of the relevance by collecting data from 2,400 premises at four time points over 1 year in Kampong Cham, Cambodia. https://www.selleckchem.com/products/ITF2357(Givinostat).html Regression models were then used to identify associations between PCI and Aedes adult female mosquitoes and pupae. In addition, receiver operating characteristic curves were used to measure the ability of PCI to identify premises in the top quartile of mosquito abundance. The density of adult Aedes females was positively associated with PCI at the household (ratio of means = 1.16 per point on the PCI scale) and cluster level (ratio of means = 1.
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