Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

Abstract Background : Sichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB).This study aimed to analyze the epidemiological and clinical characteristics, as well as drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China. Materials and Methods: We performed a retrospective study on children (<14 years old) with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDST TM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory, and radiological features were recorded. Data were analyzed using SPSS Statistics Client 25.0, and the change in drug resistance rate was examined using the Cruskal-Wallis test. Results: Among 319 patients clinically diagnosed with TBM, 42 cases were Mycobacterial culture-positive, with a positive rate of 13.2 per 100 patients. Their median age was nine years, and the distribution was equal among female and male patients. Among 42 patients who were enrolled in the study, 1/42 (2.38%) passed away. Children with TBM were concentrated in the minority areas of western Sichuan, where 34/42 (81.0%) patients with TBM were ethnic minorities, and only 2/42 (4.76%) received BCG vaccination in the past. Chest X-rays changes were observed in all patients. Fever and headache were the most common presenting symptom. Thirty-five (83.3%) patients suffered from neck stiffness, and 30/42 (71.4%) had high CSF pressure. DST results showed that the resistance rate was high; resistance to any anti-tuberculosis drug (ATD) was observed in 13 (31.0%) patient isolates, while multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were found in 2 (4.8%) and 1 (2.4%) patients, respectively. Conclusions : TBM among children in Southwest China was mainly concentrated in the minority areas of western Sichuan. The most common symptoms were fever, headache, and neck stiffness and all patients had positive chest X-ray findings. In addition, high rates of drug resistance were found; and more than 95% of patients did not receive BCG vaccination at birth.ΦΦΦ

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Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

10.21203/rs.2.9479/v4 ◽

2020 ◽

Author(s):

Dong-Mei Wang ◽

Qing-Feng Li ◽

Ma Zhu ◽

Gui-Hui Wu ◽

Xi Li ◽

...

Keyword(s):

Drug Resistance ◽

Retrospective Study ◽

Clinical Characteristics ◽

Clinical Laboratory ◽

Resistance Rate ◽

X Rays ◽

Sensitivity Testing ◽

Neck Stiffness ◽

Western Sichuan ◽

Bcg Vaccination

Abstract Background : Sichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB).This study aimed to analyze the epidemiological and clinical characteristics, as well as drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China. Materials and Methods: We performed a retrospective study on children (<14 years old) with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDST TM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory, and radiological features were recorded. Data were analyzed using SPSS Statistics Client 25.0, and the change in drug resistance rate was examined using the Cruskal-Wallis test. Results: Among 319 patients clinically diagnosed with TBM, 42 cases were Mycobacterial culture-positive, with a positive rate of 13.2 per 100 patients. Their median age was nine years, and the distribution was equal among female and male patients. Among 42 patients who were enrolled in the study, 1/42 (2.38%) passed away. Children with TBM were concentrated in the minority areas of western Sichuan, where 34/42 (81.0%) patients with TBM were ethnic minorities, and only 2/42 (4.76%) received BCG vaccination in the past. Chest X-rays changes were observed in all patients. Fever and headache were the most common presenting symptom. Thirty-five (83.3%) patients suffered from neck stiffness, and 30/42 (71.4%) had high CSF pressure. DST results showed that the resistance rate was high; resistance to any anti-tuberculosis drug (ATD) was observed in 13 (31.0%) patient isolates, while multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were found in 2 (4.8%) and 1 (2.4%) patients, respectively. Conclusions : TBM among children in Southwest China was mainly concentrated in the minority areas of western Sichuan. The most common symptoms were fever, headache, and neck stiffness and all patients had positive chest X-ray findings. In addition, high rates of drug resistance were found; and more than 95% of patients did not receive BCG vaccination at birth.ΦΦΦ

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Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

10.21203/rs.2.9479/v1 ◽

2019 ◽

Author(s):

meidong Wang ◽

Yi Liao ◽

Feng-Qing Li ◽

Ma Zhu ◽

Hui-Gui Wu ◽

...

Keyword(s):

Drug Resistance ◽

Retrospective Study ◽

Clinical Characteristics ◽

Clinical Laboratory ◽

Resistance Rate ◽

X Rays ◽

Sensitivity Testing ◽

Neck Stiffness ◽

Western Sichuan ◽

Bcg Vaccination

Abstract Background: There are little data on the disease in children. This study aimed to analyze the epidemiological, clinical characteristics and drug resistance situation of culture-confirmed children TBM in Southwest of China，and hope this study will provide some recommendations to readers in clinical or related fields. Methods: We performed a retrospective study including children <14 years of age with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Nontuberculosis Mycobacteria (NTM) were excluded. Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDSTTM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory and radiological features were recorded. Data were analyzed using SPSS Statistics Client 19.0, and the change in drug resistance rate was analyzed using the chi-square (2) test. Results: From 3467 probable TBM patients recruited, 295 cases were Mycobacterial culture-positive, the positive rate of 8.5 per 100 patients, included 253 adults and 42 children. We included all the 42 children <14 years of age for this study, the median age was 9 years, sex distribution was equal, of which 1/42 (2.38%) died. The geographical distribution of children's TBM in southwest of China is mainly concentrated in the minority areas of western Sichuan. Thirty-four (81.0%) children TBM patients is the population of China's ethnic minorities, only 2/42 (4.76%) had BCG vaccination histories. All the 42 patients had varying degrees of Chest X-rays changes and 18/42(42.9%) merger of extracranial TB. Fever and headache are the most common presenting symptom. Thirty-five (83.3%) with neck stiffness and 30/42(71.4%) with high CSF pressure. DST results showed that the resistance rate was high, to any anti-tuberculosis drug (ATD) resistance was 18 (42.9%), to multidrug-resistant tuberculosis (MDR-TB) and pre-XDR rate were 1 (2.4%) respectively. Conclusions: TBM in Children in Southwest China were mainly concentrated in the minority areas of western Sichuan, presents with nonspecific clinical features and all with positive chest X-ray findings. High rates of drug resistance were founded. More than 95% of patients were lack of BCG vaccination at birth.

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Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

10.21203/rs.2.9479/v3 ◽

2019 ◽

Author(s):

Dong-Mei Wang(Former Corresponding Author) ◽

Qing-Feng Li ◽

Ma Zhu ◽

Gui-Hui Wu ◽

Xi Li ◽

...

Keyword(s):

Drug Resistance ◽

Retrospective Study ◽

Clinical Characteristics ◽

Clinical Laboratory ◽

Resistance Rate ◽

X Rays ◽

Sensitivity Testing ◽

Neck Stiffness ◽

Western Sichuan ◽

Bcg Vaccination

Abstract Background : Sichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB).This study aimed to analyze the epidemiological and clinical characteristics, as well as drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China. Materials and Methods: We performed a retrospective study on children (<14 years old) with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDST TM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory, and radiological features were recorded. Data were analyzed using SPSS Statistics Client 25.0, and the change in drug resistance rate was examined using the Cruskal-Wallis test. Results: Among 319 patients clinically diagnosed with TBM, 42 cases were Mycobacterial culture-positive, with a positive rate of 13.2 per 100 patients. Their median age was nine years, and the distribution was equal among female and male patients. Among 42 patients who were enrolled in the study, 1/42 (2.38%) passed away. Children with TBM were concentrated in the minority areas of western Sichuan, where 34/42 (81.0%) patients with TBM were ethnic minorities, and only 2/42 (4.76%) received BCG vaccination in the past. Chest X-rays changes were observed in all patients. Fever and headache were the most common presenting symptom. Thirty-five (83.3%) patients suffered from neck stiffness, and 30/42 (71.4%) had high CSF pressure. DST results showed that the resistance rate was high; resistance to any anti-tuberculosis drug (ATD) was observed in 13 (31.0%) patient isolates, while multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were found in 2 (4.8%) and 1 (2.4%) patients, respectively. Conclusions : TBM among children in Southwest China was mainly concentrated in the minority areas of western Sichuan. The most common symptoms were fever, headache, and neck stiffness and all patients had positive chest X-ray findings. In addition, high rates of drug resistance were found; and more than 95% of patients did not receive BCG vaccination at birth.ΦΦΦ

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The Role of Risk Factors in the Development of Tuberculosis in Children Exposed to Rifampicin Resistant Tuberculosis

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2021-99-7-18-25 ◽

2021 ◽

Vol 99 (7) ◽

pp. 18-25

Author(s):

N. A. Nikiforenko ◽

M. E. Lozovskaya ◽

G. А. Novik ◽

А. V. Derevyanko ◽

N. V. Kochmarev

Keyword(s):

Risk Factors ◽

Drug Resistance ◽

Retrospective Study ◽

Bcg Vaccination ◽

Resistant Tuberculosis ◽

Group 2 ◽

Tuberculosis In Children ◽

Index Cases ◽

Group 1

The objective: to identify factors of a higher risk to develop tuberculosis in children exposed to tuberculosis cases resistant or sensitive to rifampicin.Subjects 161 children under 6 years old exposed to tuberculosis in their families were enrolled in the retrospective study. The children were divided into 2 groups: Group 1 (n = 92) – children free of TB; Group 2 (n = 69) – children ill with TB. In each group, two subgroups were identified: those with index cases susceptible to rifampicin (RS) 1A (n = 40) and 2A (n = 43) and those with index cases resistant to rifampicin (RR) 1Б (n = 52) and 2Б (n = 26).Results. Exposure to isoniazid resistant tuberculosis increases the risk of TB in the child by 12 times, on the opposite, drug resistance to rifampicin provides no impact on the risk to develop tuberculosis. If the child is exposed to 2 cases of tuberculosis and more, the risk to develop tuberculosis increases by 2-14 times. BCG vaccination of the child exposed to tuberculosis reduces the risk to develop tuberculosis by 2-13 times.

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Clinical characteristics and drug sensitivity analysis of bloodstream infection caused by Klebsiella pneumoniae in the north of Henan province

10.1101/2021.06.15.21258957 ◽

2021 ◽

Author(s):

Yanchao Wang ◽

Shanmei Wang ◽

Wenjuan Wang ◽

Youhua Yuan ◽

Junzheng Yang

Keyword(s):

Drug Resistance ◽

Antibiotic Resistance ◽

Klebsiella Pneumoniae ◽

Bloodstream Infection ◽

Clinical Characteristics ◽

Drug Sensitivity ◽

Resistance Rate ◽

Henan Province ◽

The North ◽

Drug Sensitivity Test

Objectives To analyze clinical characteristics of bloodstream infection caused by Klebsiella pneumoniae and antibiotic resistance of Klebsiella pneumoniae in the north of Henan province, provide the basis for rational selection of antimicrobial drugs. Methods Klebsiella pneumoniae was isolated from 195 patients with bloodstream infection caused by Klebsiella pneumoniae in 2017 in the north of Henan Province, Phoenix100 blood culture and identification system were used for bacterial identification and drug sensitivity test was used for antibiotic resistance detection, and WHONET 5.6 software was used for data analysis of antibiotic resistance and antibiotic sensitivity; the medical history of patients, antibiotic use and laboratory examination results of 195 cases of patients with bloodstream infection caused by Klebsiella pneumoniae were also retrospectively analyzed. Results The patients with bloodstream infection caused by Klebsiella pneumoniae were mainly distributed in ICU, surgical department and Internal medicine department. There were 110 patients with bloodstream infection caused by Klebsiella pneumoniae accompanied with underlying diseases, accounting for 56.41% in 195 patients with bloodstream infection caused by Klebsiella pneumoniae, and 87 (87/110, 77.3%) patients accompanied with hypertension and diabetes. Drug sensitivity test showed that in 195 patients with bloodstream infection caused by Klebsiella pneumoniae, the top three antibiotics of the drug resistance rate of Klebsiella pneumoniae were cefazolin (74%), amoxicillin/clavulanic acid (70.1%), ampicillin /sulbactam (68.5%); the lower three antibiotics of drug resistance rate were imipenem (52%), cefepime (53%) and amikacin (33%); there were 81 strains of Klebsiella pneumoniae produced ESBLs, accounting for 41.53% in 195 strains of Klebsiella pneumoniae. The drug resistance rate of ESBLs positive strains was significantly higher than that of ESBL negative strains. It should be pointed out that the resistance of ESBLs positive strains of Klebsiella pneumoniae to cefazole reached 100%, followed by gentamicin (71.4%), ciprofloxacin (70.4%) and levofloxacin (69.1%); The resistance of ESBLs negative strains to cefazole was 18.2%, followed by gentamicin (3.5%), ciprofloxacin (3.0%) and levofloxacin (19.3%). Conclusions The number of total bacteria isolated from departments with large number of patients is relatively large, and the number of pneumonia patients caused by Klebsiella is also increased; ESBLs positive strains in this hospital are still the main reasons for the drug resistance of Klebsiella pneumoniae, reducing the antibiotics use of cefazol, gentamycin, ciprofloxacin and levofloxacin can effectively reduce the resistance of Klebsiella pneumoniae in the hospital. At the same time, we should pay attention to some contraindications for treating hypertension, diabetes drugs and antibiotics; the clinical staff should pay attention to the timely blood culture test, rational drug use can reduce the emergence of drug-resistant strains and prevent the outbreak of nosocomial infection.

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Epidemiological, clinical characteristics and drug resistance situation of culture-confirmed children TBM in southwest of China: a 6-year retrospective study

BMC Infectious Diseases ◽

10.1186/s12879-020-05041-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Dong-Mei Wang ◽

Qing-Feng Li ◽

Ma Zhu ◽

Gui-Hui Wu ◽

Xi Li ◽

...

Keyword(s):

Drug Resistance ◽

Retrospective Study ◽

Clinical Characteristics

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Comparison of clinical characteristics and outcomes of bloodstream infections due to multidrug-resistant Acinetobacter baumannii and other Gram-negative bacteria in ICU patients

10.21203/rs.2.20802/v1 ◽

2020 ◽

Author(s):

Ying Qian ◽

Yongpeng Xie ◽

Haifeng Mao ◽

Jiguang Li ◽

Caihong Gu ◽

...

Keyword(s):

Septic Shock ◽

Drug Resistance ◽

Acinetobacter Baumannii ◽

Clinical Characteristics ◽

Multidrug Resistant ◽

Resistance Rate ◽

Apache Ii Score ◽

Gram Negative Bacteria ◽

Gram Negative ◽

E Coli

Abstract Background: Multidrug-resistant (MDR) bloodstream infection (BSI) by Gram-negative bacteria (GNB) is an important cause of mortality in the intensive care unit (ICU). The purpose of this study was to compare the clinical characteristics of some GNB BSIs and to analyze their drug resistance, with an emphasis on the analysis of prognostic risk factors related to MDR-Acinetobacter baumannii (A. baumannii) BSI.Methods: A retrospective study was conducted in the ICU of lianyungang hospital in China. Patients with BSIs due to MDR-A. baumannii, MDR-Klebsiella pneumoniae (K. pneumoniae), MDR-Pseudomonas aeruginosa (P. aeruginosa) and MDR-Escherichia coli (E. coli) were included.Results: The overall drug resistance rate to imipenem of A. baumannii and K. pneumoniae was significantly higher than that of P. aeruginosa and E. coli (95.8% and 75.5% vs 44.6% and 9.2% respectively). The mortality rates were 71.9%, 63.3%, 41.5% and 38.1%, respectively. The multivariate analysis of MDR-A. baumannii BSI, APACHE II score, hormone use, development of septic shock were associated with the 30-day mortality, while high albumin level with survival.Conclusion: The treatment of MDR-A. baumannii and MDR-K. pneumoniae infection resulted difficult due to their high drug resistance rate. However, the understanding of the clinical characteristics of different BSIs might be helpful to predict, to some extent, the pathogenic bacteria involved so as to proceed with an early sensitive antibiotic treatment. The high mortality rate due to BSI MDR-A. baumannii might be correlated with APACHE II score, nutritional status, and hormone therapy, while septic shock was a warning sign of poor prognosis.

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