Non-O1on-O139 Vibrio(V.)cholerae(NOVC)has emerged as a potential pathogen in patients with compromised health conditions[1].We report the whole genome sequencing(WGS)of a rare NOVC sepsis isolate(GenBank Accession:GCF...Non-O1on-O139 Vibrio(V.)cholerae(NOVC)has emerged as a potential pathogen in patients with compromised health conditions[1].We report the whole genome sequencing(WGS)of a rare NOVC sepsis isolate(GenBank Accession:GCF_051906115.1)from an 89-year-old male admitted to the Intensive Care Unit(ICU)with septic shock(lactate 6.61 mmol/L)digestive illness.展开更多
Background:Staphylococcus aureus bacteremia is associated with high mortality.Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S.aureus bacteremia ...Background:Staphylococcus aureus bacteremia is associated with high mortality.Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S.aureus bacteremia is unclear.Methods:In an ongoing international Bayesian adaptive platform trial,we conducted an open-label,randomized comparison of cefazolin with an antistaphylococcal penicillin(flucloxacillin or cloxacillin)in adult patients with penicillin-resistant,methicillin-susceptible S.aureus bacteremia.The primary outcome,which was evaluated with a hierarchical Bayesian logistic-regression model,was death from any cause within 90 days after enrollment in the platform.We assessed the posterior probability of the noninferiority of cefazolin to flucloxacillin or cloxacillin(with the criterion for noninferiority prespecified as an adjusted odds ratio of<1.2,which approximates an absolute difference in mortality of<2.5 percentage points if mortality in the antistaphylococcal-penicillin group is 15%),as well as the posterior probability of superiority(with the criterion of an adjusted odds ratio of<1.0).Secondary safety outcomes included the development of acute kidney injury within 14 days.Results:This domain of the ongoing trial was conducted between February 17,2022,and August 7,2024,by which time the criterion for noninferiority had been met.Mortality at 90 days among adults who could be evaluated was 15.0%(97 deaths among 645 patients)in the cefazolin group and 17.0%(109 deaths among 642 patients)in the antistaphylococcal-penicillin group(adjusted odds ratio,0.81;95%credible interval,0.59 to 1.12;probability of noninferiority,99.2%;probability of superiority,89.8%).Acute kidney injury occurred in 92 of 660 patients(13.9%)in the cefazolin group,as compared with 127 of 648(19.6%)in the antistaphylococcal-penicillin group(adjusted odds ratio,0.67;95%credible interval,0.50 to 0.89;probability of superiority,99.7%).Conclusions:In patients with methicillin-susceptible S.aureus bacteremia,cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury.(Funded by the National Health and Medical Research Council and others;SNAP ClinicalTrials.gov number,NCT05137119.).展开更多
目的探讨血常规指标联合C反应蛋白(C-reactive protein,CRP)检测对菌血症的早期诊断价值。方法回顾性分析2024年1月至2025年10月梧州市人民医院收治的368例住院患者的临床资料,将其分为菌血症组(n=170)、局部感染组(n=98)和非感染组(n=1...目的探讨血常规指标联合C反应蛋白(C-reactive protein,CRP)检测对菌血症的早期诊断价值。方法回顾性分析2024年1月至2025年10月梧州市人民医院收治的368例住院患者的临床资料,将其分为菌血症组(n=170)、局部感染组(n=98)和非感染组(n=100),收集所有患者血培养采样6h内的中性粒细胞(neutrophil,NEUT)、淋巴细胞(lymphocyte,LYM)、血小板(platelet,PLT)及CRP数据,并计算中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估各指标单独及联合应用的诊断效能。结果三组患者的NEUT、LYM、PLT、NLR、PLR及CRP水平比较差异均有统计学意义(P<0.05)。菌血症组患者的NEUT、NLR、PLR和CRP均显著高于其余两组(P<0.05),LYM、PLT均显著低于其余两组(P<0.05)。ROC曲线结果显示NLR+PLR+CRP联合诊断菌血症的效能最高[曲线下面积(area under the curve,AUC)=0.880,95%CI:0.847~0.914],敏感度85.3%,特异性74.7%,约登指数0.600。单一指标中NLR的诊断效能最佳(AUC=0.860)。结论NLR、PLR与CRP联合检测对菌血症早期识别具有较高的辅助诊断价值,可用于血培养结果回报前的快速筛查与临床决策支持。展开更多
摘要Non-O1on-O139 Vibrio(V.)cholerae(NOVC)has emerged as a potential pathogen in patients with compromised health conditions[1].We report the whole genome sequencing(WGS)of a rare NOVC sepsis isolate(GenBank Accession:GCF_051906115.1)from an 89-year-old male admitted to the Intensive Care Unit(ICU)with septic shock(lactate 6.61 mmol/L)digestive illness.
摘要Background:Staphylococcus aureus bacteremia is associated with high mortality.Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S.aureus bacteremia is unclear.Methods:In an ongoing international Bayesian adaptive platform trial,we conducted an open-label,randomized comparison of cefazolin with an antistaphylococcal penicillin(flucloxacillin or cloxacillin)in adult patients with penicillin-resistant,methicillin-susceptible S.aureus bacteremia.The primary outcome,which was evaluated with a hierarchical Bayesian logistic-regression model,was death from any cause within 90 days after enrollment in the platform.We assessed the posterior probability of the noninferiority of cefazolin to flucloxacillin or cloxacillin(with the criterion for noninferiority prespecified as an adjusted odds ratio of<1.2,which approximates an absolute difference in mortality of<2.5 percentage points if mortality in the antistaphylococcal-penicillin group is 15%),as well as the posterior probability of superiority(with the criterion of an adjusted odds ratio of<1.0).Secondary safety outcomes included the development of acute kidney injury within 14 days.Results:This domain of the ongoing trial was conducted between February 17,2022,and August 7,2024,by which time the criterion for noninferiority had been met.Mortality at 90 days among adults who could be evaluated was 15.0%(97 deaths among 645 patients)in the cefazolin group and 17.0%(109 deaths among 642 patients)in the antistaphylococcal-penicillin group(adjusted odds ratio,0.81;95%credible interval,0.59 to 1.12;probability of noninferiority,99.2%;probability of superiority,89.8%).Acute kidney injury occurred in 92 of 660 patients(13.9%)in the cefazolin group,as compared with 127 of 648(19.6%)in the antistaphylococcal-penicillin group(adjusted odds ratio,0.67;95%credible interval,0.50 to 0.89;probability of superiority,99.7%).Conclusions:In patients with methicillin-susceptible S.aureus bacteremia,cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury.(Funded by the National Health and Medical Research Council and others;SNAP ClinicalTrials.gov number,NCT05137119.).
摘要目的探讨血常规指标联合C反应蛋白(C-reactive protein,CRP)检测对菌血症的早期诊断价值。方法回顾性分析2024年1月至2025年10月梧州市人民医院收治的368例住院患者的临床资料,将其分为菌血症组(n=170)、局部感染组(n=98)和非感染组(n=100),收集所有患者血培养采样6h内的中性粒细胞(neutrophil,NEUT)、淋巴细胞(lymphocyte,LYM)、血小板(platelet,PLT)及CRP数据,并计算中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估各指标单独及联合应用的诊断效能。结果三组患者的NEUT、LYM、PLT、NLR、PLR及CRP水平比较差异均有统计学意义(P<0.05)。菌血症组患者的NEUT、NLR、PLR和CRP均显著高于其余两组(P<0.05),LYM、PLT均显著低于其余两组(P<0.05)。ROC曲线结果显示NLR+PLR+CRP联合诊断菌血症的效能最高[曲线下面积(area under the curve,AUC)=0.880,95%CI:0.847~0.914],敏感度85.3%,特异性74.7%,约登指数0.600。单一指标中NLR的诊断效能最佳(AUC=0.860)。结论NLR、PLR与CRP联合检测对菌血症早期识别具有较高的辅助诊断价值,可用于血培养结果回报前的快速筛查与临床决策支持。