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Article ; Online: Use of pus metagenomic next-generation sequencing for efficient identification of pathogens in patients with sepsis.

Chen, Zhendong / Ye, Tingting / He, Yuxi / Pan, Aijun / Mei, Qing

2024

Abstract: The positive detection rate of blood metagenomic next-generation sequencing (mNGS) was still too low to meet clinical needs, while pus from the site of primary infection may be advantageous for identification of pathogens. To assess the value of mNGS ... ...

Abstract	The positive detection rate of blood metagenomic next-generation sequencing (mNGS) was still too low to meet clinical needs, while pus from the site of primary infection may be advantageous for identification of pathogens. To assess the value of mNGS using pus in patients with sepsis, thirty-five samples were collected. Pathogen identification and mixed infection diagnosis obtained by use of mNGS or cultivation methods were compared. Fifty-three aerobic or facultative anaerobes, 59 obligate anaerobes and 7 fungi were identified by the two methods. mNGS increased the accuracy rate of diagnosing aerobic or facultative anaerobic infections from 44.4% to 94.4%; mNGS also increased the sensitivity of diagnosing obligate anaerobic infections from 52.9% to 100.0%; however, mNGS did not show any advantage in terms of fungal infections. Culture and mNGS identified 1 and 24 patients with mixed infection, respectively. For obligate anaerobes, source of microorganisms was analyzed. The odontogenic bacteria all caused empyema (n = 7) or skin and soft tissue infections (n = 5), whereas the gut-derived microbes all caused intra-abdominal infections (n = 7). We also compared the clinical characteristics of non-obligate anaerobic and obligate anaerobic infection groups. The SOFA score [9.0 (7.5, 14.3) vs. 5.0 (3.0, 8.0), P = 0.005], procalcitonin value [4.7 (1.8, 39.9) vs. 2.50 (0.7, 8.0), P = 0.035], the proportion of septic shock (66.7% vs. 35.3%, P = 0.044) and acute liver injury (66.7% vs. 23.5%, P = 0.018) in the non-obligate anaerobic infection group were significantly higher than those in the obligate anaerobic infection group. In patients with sepsis caused by purulent infection, mNGS using pus from the primary lesion may yield more valuable microbiological information.
Language	English
Publishing date	2024-02-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	240503-9
ISSN	1874-9356 ; 0015-5632
ISSN (online)	1874-9356
ISSN	0015-5632
DOI	10.1007/s12223-024-01134-7
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Article: Identification of immune characteristic biomarkers and therapeutic targets in cuproptosis for sepsis by integrated bioinformatics analysis and single-cell RNA sequencing analysis.

Wang, Tianfeng / Fang, Xiaowei / Sheng, Ximei / Li, Meng / Mei, Yulin / Mei, Qing / Pan, Aijun

Heliyon

2024 Volume 10, Issue 5, Page(s) e27379

Abstract: Background: Cuproptosis is a copper-dependent cell death that is connected to the development and immune response of multiple diseases. However, the function of cuproptosis in the immune characteristics of sepsis remains unclear.: Method: We obtained ...

Abstract	Background: Cuproptosis is a copper-dependent cell death that is connected to the development and immune response of multiple diseases. However, the function of cuproptosis in the immune characteristics of sepsis remains unclear. Method: We obtained two sepsis datasets (GSE9960 and GSE134347) from the GEO database and classified the raw data with R packages. Cuproptosis-related genes were manually curated, and differentially expressed cuproptosis-related genes (DECuGs) were identified. Afterwards, we applied enrichment analysis and identified key DECuGs by performing machine learning techniques. Then, the immune cell infiltrations and correlation between DECuGs and immunocyte features were created by the CIBERSORT algorithm. Subsequently, unsupervised hierarchical clustering analysis was performed based on key DECuGs. We then constructed a ceRNA network based on key DECuGs by using multi-step computational strategies and predicted potential drugs in the DrugBank database. Finally, the role of these key genes in immune cells was validated at the single-cell RNA level between septic patients and healthy controls. Results: Overall, 16 DECuGs were obtained, and most of them had lower expression levels in sepsis samples. Afterwards, we obtained six key DECuGs by performing machine learning. Then, the LIPT1-T-cell CD4 memory resting was the most positively correlated DECuG-immunocyte pair. Subsequently, two different subclusters were identified by six DECuGs. Bioinformatics analysis revealed that there were different immune characteristics between the two subclusters. Moreover, we identified the key lncRNA OIP5-AS1 within the ceRNA network and obtained 4 drugs that may represent novel drugs for sepsis. Finally, these key DECuGs were statistically significantly dysregulated in another validation set and showed a major distribution in monocytes, T cells, B cells, NK cells and platelets at the single-cell RNA level. Conclusion: These findings suggest that cuproptosis might promote the progression of sepsis by affecting the immune system and metabolic dysfunction, which provides a new direction for understanding potential pathogenic processes and therapeutic targets in sepsis.
Language	English
Publishing date	2024-03-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2024.e27379
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Article: [Influence of hypomagnesemia on the prognosis of severe septic patients].

Tong, Fei / Fang, Xiaowei / Zhu, Chunyan / Pan, Aijun

Zhonghua wei zhong bing ji jiu yi xue

2022 Volume 34, Issue 1, Page(s) 23–27

Abstract: Objective: To investigate the influence of hypomagnesemia on the prognosis of patients with severe sepsis.: Methods: A retrospective study was conducted. The clinical data of 207 septic patients admitted to the department of critical care medicine of ...

Abstract	Objective: To investigate the influence of hypomagnesemia on the prognosis of patients with severe sepsis. Methods: A retrospective study was conducted. The clinical data of 207 septic patients admitted to the department of critical care medicine of the First Affiliated Hospital of University of Science and Technology of China from January 1, 2016 to December 21, 2020 were analyzed, including gender, age and laboratory indicators within 24 hours after sepsis diagnosis [procalcitonin (PCT), C-reactive protein (CRP), blood lactic acid (Lac), pH value and blood magnesium, calcium, chlorine and phosphorus levels]. The acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score and 28-day prognosis were collected. The patients were divided into survival group and non-survival group according to the prognosis, and the clinical data and laboratory indexes were compared between the two groups. Pearson correlation test was used to analyze the correlation between clinical indicators. Multivariate Logistic regression analysis was used to screen the risk factors affecting the prognosis. The receiver operator characteristic curve (ROC curve) was drawn, and the area under ROC curve (AUC) was calculated to evaluate the potential prognostic indicators. Results: Among the 207 septic patients, 102 survived and 105 died on the 28th day, and the 28-day mortality was 50.72%. There were no significant differences in gender, age, CRP, pH value, blood chlorine or blood phosphorus levels between the two groups. The blood magnesium and blood calcium levels in the non-survival group were significantly lower than those in the survival group [blood magnesium (mmol/L): 0.68±0.14 vs. 0.80±0.12, blood calcium (mmol/L): 1.93±0.21 vs. 2.01±0.20, both P > 0.01], and PCT, Lac, APACHE II score and SOFA score were significantly higher than those in the survival group [PCT (mg/L): 8.32 (1.64, 55.01) vs. 3.55 (0.97, 12.31), Lac (mmol/L): 2.90 (1.70, 4.30) vs. 2.10 (1.03, 3.89), APACHE II score: 21.24±6.40 vs. 17.42±7.02, SOFA score: 9.14±3.55 vs. 6.91±3.31, all P > 0.01]. Among the 207 patients, 96 patients had normal blood magnesium level (0.75-1.25 mmol/L) and 111 patients had hypomagnesemia (> 0.75 mmol/L). The 28-day mortality of septic patients in the hypomagnesemia group was significantly higher than that in the normal magnesium group [61.26% (68/111) vs. 38.54% (37/96), P < 0.01]. Pearson correlation analysis showed that the blood magnesium level of sepsis patients was negatively correlated with PCT (r = -0.173, P < 0.05), and it was positively correlated with APACHE II score (r = 0.159, P < 0.05), but it had no correlation with CRP or SOFA score (r values were -0.029 and 0.091, both P > 0.05). Logistic regression analysis showed that serum magnesium, APACHE II score and SOFA score were independent risk factors for 28-day death in patients with sepsis [serum magnesium: odds ratio (OR) < 0.001, 95% confidence interval (95%CI) was 0.000-0.002, P < 0.001; APACHE II score: OR = 1.092, 95%CI was 1.022-1.168, P = 0.010; SOFA score: OR = 1.168, 95%CI was 1.026-1.330, P = 0.019]. ROC curve analysis showed that blood magnesium and APACHE II score had a certain predictive value for 28-day mortality in patients with severe sepsis [AUC (95%CI) was 0.723 (0.655-0.791) and 0.680 (0.607-0.754), respectively]. When the blood magnesium threshold was 0.64 mmol/L, the sensitivity was 41.0% and the specificity was 93.1%. When APACHE II score threshold was 16.50, the sensitivity was 78.1% and the specificity was 55.9% indicating that the specificity of serum magnesium was higher than that of APACHE II score. Conclusions: Severe septic patients complicated with hypomagnesemia have a poor prognosis. Serum magnesium level can be used as a prognostic indicator for severe septic patients.
MeSH term(s)	Humans ; Magnesium ; Organ Dysfunction Scores ; Prognosis ; Retrospective Studies ; Sepsis/diagnosis
Chemical Substances	Magnesium (I38ZP9992A)
Language	Chinese
Publishing date	2022-03-20
Publishing country	China
Document type	Journal Article
ISSN	2095-4352
ISSN	2095-4352
DOI	10.3760/cma.j.cn121430-20210115-00065
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Article: [Dynamic changes of platelet count in first week and their predictive value for prognosis in septic shock patients].

Gao, Yu / Mei, Qing / Pan, Aijun

Zhonghua wei zhong bing ji jiu yi xue

2022 Volume 34, Issue 10, Page(s) 1055–1059

Abstract: Objective: To observe the dynamic changes of platelet counts in septic shock patients within first week, and to explore their predictive value for prognosis.: Methods: Retrospective analysis of clinical data of patients with septic shock admitted to ... ...

Abstract	Objective: To observe the dynamic changes of platelet counts in septic shock patients within first week, and to explore their predictive value for prognosis. Methods: Retrospective analysis of clinical data of patients with septic shock admitted to the department of intensive care unit (ICU) of the First Affiliated Hospital of University of Science and Technology of China from January 2020 to December 2021 was conducted. The baseline data on gender, age and primary diseases, clinical indicators on infection site, pathogenic microbial type, acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA), laboratory indicators and the trend of platelet count (PLT) on day 1, 3, 5 and 7 admitting ICU and patients prognosis of in-hospital were collected. Binary Logistic regression was used to assess the independent risk factors of in-hospital death in septic shock patients. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive power of each index for in-hospital mortality. Results: A total of 193 patients with sepsis were enrolled. Among them, 73 patients died and 120 patients survived. Univariate analysis showed that the age, proportion of hypertension and respiratory system infection, APACHE II score, SOFA score and blood lactic acid (Lac) in the death group were significantly higher than those in the survival group, while the proportion of urinary system infection, white blood cell (WBC) and neutrophil (NEU) were significantly lower in the death group. Within 7 days after admitting ICU, the platelet (PLT) firstly decreased and then rebounded in the survival group, whereas it's showed a continuous downward trend in the death group. And the PLT count in both day 5 and 7 were significantly higher in the survival group compared with the dead group [×10 Conclusions: Clinicians should pay close attention to the dynamic changes of platelet counts in septic shock patients, especially the platelet counts on day 7 after admitting ICU. And active intervention should be provided to improve the prognosis.
MeSH term(s)	Humans ; Platelet Count ; Shock, Septic/diagnosis ; Hospital Mortality ; Retrospective Studies ; Respiratory Tract Infections
Language	Chinese
Publishing date	2022-12-05
Publishing country	China
Document type	English Abstract ; Journal Article
ISSN	2095-4352
ISSN	2095-4352
DOI	10.3760/cma.j.cn121430-20220826-00789
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Article: [Diagnostic value of detection of pathogens in bronchoalveolar lavage fluid by metagenomics next-generation sequencing in organ transplant patients with pulmonary infection].

Meng, Xianlin / Zhang, Lei / Fan, Xiaoqin / Fang, Xiaowei / Pan, Aijun

Zhonghua wei zhong bing ji jiu yi xue

2022 Volume 33, Issue 12, Page(s) 1440–1446

Abstract: Objective: To evaluate the diagnostic value of metagenomics next-generation sequencing (mNGS) in detecting pathogens in bronchoalveolar lavage fluid (BALF) for pulmonary infection in solid organ transplant patients in intensive care unit (ICU).: ... ...

Abstract	Objective: To evaluate the diagnostic value of metagenomics next-generation sequencing (mNGS) in detecting pathogens in bronchoalveolar lavage fluid (BALF) for pulmonary infection in solid organ transplant patients in intensive care unit (ICU). Methods: A retrospective study was conducted, the BALF samples from 46 patients with post organ transplant pneumonia/suspected pneumonia admitted to the Department of Critical Care Medicine of the First Affiliated Hospital of University of Science and Technology of China from August 2018 to August 2021 were collected, all tested by simultaneous mNGS and conventional comprehensive microbial test (CMT), and the results of CMT were used as the reference standard to compare the differences in the diagnostic value of mNGS and CMT for pulmonary infections in solid organ transplant patients, and to analyze the diagnostic value of mNGS for mixed infections. Results: (1) Pneumonia pathogens: a total of 31 pathogens were detected in 35 patients, including bacteria (16 species), fungi (9 species) and viruses (6 species). Among them, 25 pathogens were detected by mNGS and CMT, and only 19 pathogens were detected by mNGS. Among the microorganisms isolated by mNGS method, the detection rates of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae were higher [51.4% (18/35), 42.9% (15/35), 31.4% (11/35), respectively]; Candida albicans, Aspergillus and Pneumocystis carinii were the most commonly detected fungi [31.4% (11/35), 22.9% (8/35), 22.9% (8/35), respectively]; 20 patients were positive for the virus, and the most commonly detected viruses were cytomegalovirus, herpesvirus and EB virus [28.6% (10/35), 20.0% (7/35), 17.1% (6/35), respectively]. In addition, one case of Brucella was detected by mNGS. (2) Diagnostic efficiency: as far as bacterial detection is concerned, 20 cases of negative results were obtained by CMT detection of 35 samples included in the study, and a total of 10 cases of positive results were obtained by mNGS detection of negative samples; the percentage of mNGS positive samples was significantly higher than that of CMT positive samples [odds ratio (OR) = 5.5, 95% confidence interval (95%CI) = 1.2-24.8, P = 0.02]. When compared with CMT, the sensitivity and specificity of mNGS were 93.3% and 50.0%, and the positive predictive value (PPV) and negative predictive value (NPV) were 58.3%, 91.1%. As far as fungal detection was concerned, there was no significant difference in the percentage of positive samples between the two methods (OR = 1.5, 95%CI = 0.5-4.2, P = 0.60); the sensitivity and specificity of mNGS were 72.2% and 64.7%, and the PPV and NPV were 68.4%, 68.8%; CMT test of the 35 included samples produced 17 negative results, and mNGS test of the negative samples produced 6 positive results. A total of 20 patients tested positive for the virus by mNGS. In addition, 23 patients (65.7%) were diagnosed with pulmonary mixed infection. Conclusions: The use of mNGS to detect pathogens in BALF can improve the sensitivity and specificity of bacterial identification of pulmonary infection in critically ill organ transplant patients, and mNGS has obvious advantages in detecting virus and identifying mixed infections.
MeSH term(s)	Bronchoalveolar Lavage Fluid ; High-Throughput Nucleotide Sequencing ; Humans ; Metagenomics ; Organ Transplantation ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity
Language	Chinese
Publishing date	2022-02-08
Publishing country	China
Document type	Journal Article
ISSN	2095-4352
ISSN	2095-4352
DOI	10.3760/cma.j.cn121430-20211008-01439
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Clinical Value of Metagenomics Next-Generation Sequencing in Bronchoalveolar Lavage Fluid for Patients with Severe Hospital-Acquired Pneumonia: A Nested Case-Control Study.

Yang, Tianjun / Mei, Qing / Fang, Xiaowei / Zhu, Shoujun / Wang, Yinzhong / Li, Wanli / Pan, Aijun

Infection and drug resistance

2022 Volume 15, Page(s) 1505–1514

Abstract: Background: Metagenomics next-generation sequencing (mNGS) is more efficient in identifying pathogens responsible for pneumonia. However, whether these patients ultimately benefit from this improvement remains unknown.: Methods: In this retrospective, ...

Abstract	Background: Metagenomics next-generation sequencing (mNGS) is more efficient in identifying pathogens responsible for pneumonia. However, whether these patients ultimately benefit from this improvement remains unknown. Methods: In this retrospective, nested, case-control study, patients with severe hospital-acquired pneumonia (HAP) who had undergone mNGS of bronchoalveolar lavage fluid while in our intensive care unit from March 2017 to December 2020 (n = 33) were matched in a ratio of 1 to 2 (n = 66) by sex, age, comorbidities, immune status, Acute Physiology and Chronic Health Evaluation II score, severity of pulmonary infection, and use of extracorporeal life support with patients who had undergone conventional microbiological testing only. The primary outcome was 90-day mortality; secondary outcomes being length of intensive care unit stay, duration of mechanical ventilation support, 7-day and 28-day mortality, and efficacy of treatment of pulmonary infection. Results: In the CMT group, 17 patients (25.8%) had negative results, whereas only one (3.0%) had negative results in the mNGS group (P < 0.001). After receipt of microbiology results, antibiotics were altered in 23/33 patients (70.0%) in the mNGS group, but in only 29/66 (43.9%) in the CMT group (P = 0.016). Pulmonary infection-related findings improved in 20/33 patients (60.6%) in the mNGS group in the subsequent 7 days, but in only 25/66 (37.9%) in the CMT group (P = 0.032). However, the 28-day (33.3% vs 31.2%, P = 1.0) and 90-day (48.5% vs 45.5%, P = 0.78) mortality rates did not differ significantly between the two groups. These findings were supported by Cox-regression and Kaplan-Meier survival curve analyses. Conclusion: mNGS is helpful in the treatment of severe HAP but does not improve medium or long-term survival rates, especially in patients with severe comorbidities.
Language	English
Publishing date	2022-04-05
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494856-1
ISSN	1178-6973
ISSN	1178-6973
DOI	10.2147/IDR.S356662
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Article ; Online: Prevention of urinary tract infection using a silver alloy hydrogel-coated catheter in critically ill patients: A single-center prospective randomized controlled study.

Zhao, Menglong / Geng, Shike / Zhang, Lei / Fan, Xiaoqin / Tong, Fei / Meng, Xianlin / Wang, Tianfeng / Fang, Xiaowei / Mei, Qing / Pan, Aijun

Journal of intensive medicine

2023 Volume 4, Issue 1, Page(s) 118–124

Abstract: Background: A new type of silver alloy hydrogel-coated (SAH) catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent, and to block the retrograde infection pathway. However, these have only been confirmed in ... ...

Abstract	Background: A new type of silver alloy hydrogel-coated (SAH) catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent, and to block the retrograde infection pathway. However, these have only been confirmed in ordinary patients. This study aims to evaluate the effectiveness of a SAH catheter for preventing urinary tract infections in critically ill patients. Methods: This was a prospective single-center, single-blind, randomized, controlled study. A total of 132 patients requiring indwelling catheterization in the intensive care unit (ICU) of the First Affiliated Hospital of the University of Science and Technology of China between October 2022 and February 2023 and who met the study inclusion/exclusion criteria were randomly divided into two groups. Patients in the SAH catheter group received a SAH catheter, while patients in the conventional catheter group received a conventional siliconized latex Foley catheter. The main outcome measure was the incidence of catheter-associated urinary tract infections (CAUTIs). Secondary outcome indicators included urine positivity for white blood cells and positive urine cultures on 3 days, 7 days, 10 days, and 14 days after catheterization, number of viable bacteria in the catheter biofilm on day 14, pathogenic characteristics of positive urine cultures, length of ICU stay, overall hospital stay, ICU mortality, and 28-day mortality. All the data were compared between the two groups. Results: A total of 68 patients in the conventional catheter group and 64 patients in the SAH catheter group were included in the study. On day 7 after catheter placement, the positivity rate for urinary white blood cells was significantly higher in the conventional catheter group than in the SAH catheter group (33.8% Conclusion: SAH catheters can effectively inhibit the formation of catheter-related bacterial biofilms in critically ill patients and reduce the incidence of CAUTIs, compared with conventional siliconized latex Foley catheters; however, regular replacement of the catheter is still necessary.
Language	English
Publishing date	2023-07-12
Publishing country	China
Document type	Journal Article
ISSN	2667-100X
ISSN (online)	2667-100X
DOI	10.1016/j.jointm.2023.06.003
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Article ; Online: Identification of immune-related lncRNA in sepsis by construction of ceRNA network and integrating bioinformatic analysis.

Wang, Tianfeng / Xu, Si / Zhang, Lei / Yang, Tianjun / Fan, Xiaoqin / Zhu, Chunyan / Wang, Yinzhong / Tong, Fei / Mei, Qing / Pan, Aijun

BMC genomics

2023 Volume 24, Issue 1, Page(s) 484

Abstract: Background: Sepsis is a high mortality disease which seriously threatens human life and health, for which the pathogenetic mechanism still unclear. There is increasing evidence showed that immune and inflammation responses are key players in the ... ...

Abstract	Background: Sepsis is a high mortality disease which seriously threatens human life and health, for which the pathogenetic mechanism still unclear. There is increasing evidence showed that immune and inflammation responses are key players in the development of sepsis pathology. LncRNAs, which act as ceRNAs, have critical roles in various diseases. However, the regulatory roles of ceRNA in the immunopathogenesis of sepsis have not yet been elucidated. Results: In this study, we aimed to identify immune biomarkers associated with sepsis. We first generated a global immune-associated ceRNA (IMCE) network based on data describing interactions pairs of gene-miRNA and miRNA-lncRNA. Afterward, we excavated a dysregulated sepsis immune-associated ceRNA (SPIMC) network from the global IMCE network by means of a multi-step computational approach. Functional enrichment indicated that lncRNAs in SPIMC network have pivotal roles in the immune mechanism underlying sepsis. Subsequently, we identified module and hub genes (CD4 and STAT4) via construction of a sepsis immune-related PPI network. Then, we identified hub genes based on the modular structure of PPI network and generated a ceRNA subnetwork to analyze key lncRNAs associated with sepsis. Finally, 6 lncRNAs (LINC00265, LINC00893, NDUFA6-AS1, NOP14-AS1, PRKCQ-AS1 and ZNF674-AS1) that identified as immune biomarkers of sepsis. Moreover, the CIBERSORT algorithm and the infiltration of circulating immune cells types were performed to identify the inflammatory state of sepsis. Correlation analyses between immune cells and sepsis immune biomarkers showed that the LINC00265 was strongly positive correlated with the macrophages M2 (r = 0.77). Conclusion: Collectively, these results may suggest that these lncRNAs (LINC00265, LINC00893, NDUFA6-AS1, NOP14-AS1, PRKCQ-AS1 and ZNF674-AS1) played important roles in the immune pathogenesis of sepsis and provide potential therapeutic targets for further researches on immune therapy treatment in patients with sepsis.
MeSH term(s)	Humans ; RNA, Long Noncoding/genetics ; Protein Kinase C-theta ; MicroRNAs/genetics ; Sepsis/genetics ; Computational Biology
Chemical Substances	RNA, Long Noncoding ; Protein Kinase C-theta (EC 2.7.11.13) ; MicroRNAs
Language	English
Publishing date	2023-08-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2041499-7
ISSN	1471-2164 ; 1471-2164
ISSN (online)	1471-2164
ISSN	1471-2164
DOI	10.1186/s12864-023-09535-7
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Article ; Online: Risk factors for invasive pulmonary aspergillosis in patients with severe fever with thrombocytopenia syndrome: A multicenter retrospective study.

Yao, Lu / Shi, Yuan / Fu, Jiaji / Fang, Xiaowei / Zhang, Hongling / Luo, Dengli / Zhou, Yi / Pan, Aijun / Yu, Yuan / Yang, Xiaobo / Shu, Huaqing / Zou, Xiaojing / Xu, Jiqian / Shang, You

Journal of medical virology

2024 Volume 96, Issue 5, Page(s) e29647

Abstract: Invasive pulmonary aspergillosis (IPA) is a life-threatening complication in patients with severe fever with thrombocytopenia syndrome (SFTS), yet SFTS-associated IPA (SAPA)'s risk factors remain undefined. A multicenter retrospective cohort study across ...

Abstract	Invasive pulmonary aspergillosis (IPA) is a life-threatening complication in patients with severe fever with thrombocytopenia syndrome (SFTS), yet SFTS-associated IPA (SAPA)'s risk factors remain undefined. A multicenter retrospective cohort study across Hubei and Anhui provinces (May 2013-September 2022) utilized least absolute shrinkage and selection operator (LASSO) regression for variable selection. Multivariable logistic regression identified independent predictors of SAPA, Cox regression highlighted mortality-related risk factors. Of the 1775 screened SFTS patients, 1650 were included, with 169 developing IPA, leading to a 42-day mortality rate of 26.6% among SAPA patients. Multivariable logistic regression revealed SAPA risk factors including advanced age, petechia, hemoptysis, tremor, low albumin levels, elongated activated partial thromboplastin time (APTT), intensive care unit (ICU) admission, glucocorticoid usage, intravenous immunoglobulin (IVIG) and prolonged hospital stays. Cox regression identified predictors of 42-day mortality, including ecchymosis at venipuncture sites, absence of ICU admission, elongated prothrombin time (PT), vasopressor and glucocorticoid use, non-antifungals. Nomograms constructed on these predictors registered concordance indexes of 0.855 (95% CI: 0.826-0.884) and 0.778 (95% CI: 0.702-0.854) for SAPA onset and 42-day mortality, respectively. Lower survival rates for SAPA patients treated with glucocorticoids (p < 0.001) and improved 14-day survival with antifungal therapy (p = 0.036). Improving IPA management in SFTS-endemic areas is crucial, with effective predictive tool.
MeSH term(s)	Humans ; Retrospective Studies ; Male ; Female ; Middle Aged ; Risk Factors ; Invasive Pulmonary Aspergillosis/mortality ; Invasive Pulmonary Aspergillosis/complications ; Invasive Pulmonary Aspergillosis/drug therapy ; Severe Fever with Thrombocytopenia Syndrome/complications ; Aged ; China/epidemiology ; Adult
Language	English
Publishing date	2024-05-06
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.29647
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Article: Successful cure of a patient with urosepsis using a combination of extracorporeal membrane oxygenation and continuous renal replacement therapy: A case report and literature review.

Zhu, Chun-Yan / Pan, Ai-Jun / Mei, Qing / Chen, Ting

Chinese journal of traumatology = Zhonghua chuang shang za zhi

2020 Volume 23, Issue 6, Page(s) 372–375

Abstract: Holmium laser lithotripsy (HLL) is one of the common surgical methods for urolithiasis. It causes minor surgical trauma, but complications are not rare. Extracorporeal membrane oxygenation (ECMO) treatment of sepsis is common, but venoarterial (VA)-ECMO ... ...

Abstract	Holmium laser lithotripsy (HLL) is one of the common surgical methods for urolithiasis. It causes minor surgical trauma, but complications are not rare. Extracorporeal membrane oxygenation (ECMO) treatment of sepsis is common, but venoarterial (VA)-ECMO treatment of urosepsis has not been reported yet. In this article, we reported a 67-year-old female patient with refractory septic shock caused by HLL under percutaneous nephroscope, involving breathing, heart, kidney and other organs, and organs support treatment was ineffective for the patient. Finally, we successfully treated the patient under VA-ECMO with continuous renal replacement therapy (CRRT). Combined ECMO and CRRT may provide a solution for addressing refractory sepsis. Here we present the case and review relevant literature, so as to provide a treatment strategy for patients with refractory urogenic sepsis and to reduce the mortality rate.
MeSH term(s)	Aged ; Extracorporeal Membrane Oxygenation/methods ; Female ; Humans ; Lasers, Solid-State/adverse effects ; Lithotripsy, Laser/adverse effects ; Lithotripsy, Laser/methods ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Renal Replacement Therapy/methods ; Shock, Septic/etiology ; Shock, Septic/therapy ; Treatment Outcome ; Urinary Tract Infections/etiology ; Urinary Tract Infections/therapy ; Urolithiasis/surgery
Language	English
Publishing date	2020-09-21
Publishing country	China
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2276839-7
ISSN	1008-1275
ISSN	1008-1275
DOI	10.1016/j.cjtee.2020.09.006
Database	MEDical Literature Analysis and Retrieval System OnLINE

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