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Background: Invasive mold infection (IMI) is a major cause of infection-related mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: We retrospectively analyzed 190 allo-HSCT recipients at Changhai Hospital between the y 2000 and 2007. The survival rate was evaluated with Kaplan-Meier curves. Logistic and Cox regression models were used for multivariate analyses. Results: The 1st y cumulative incidence rate of IMI was 12.8%, and invasive aspergillosis was the most commonly observed IMI (85%). Multivariate logistic regression analyses showed that significant predictors of IMI were corticosteroid therapy (odds ratio (OR) 1.656, 95% confidence interval (CI) 1.047-2.621, p == 0.031), positive cytomegalovirus antigenemia (OR 5.301, 95% CI 1.902-14.772, p == 0.001), and secondary neutropenia (OR 5.250, 95% CI 1.741-15.834, p == 0.003). The mortality rate of IMI at 12 weeks after diagnosis was 60%. In Cox regression models, IMI-related mortality was related to the dose of corticosteroid (2 mg/kg/day or more) administered at the time of IMI diagnosis (hazards ratio (HR) 20.841, 95% CI 2.151-201.944, p == 0.009) and neutropenia (HR 7.043, 95% CI 1.186-41.827, p == 0.032). Conclusions: These data confirm previous findings that the incidence and mortality of IMI are mostly associated with immunodeficiency caused by immunosuppressive therapy or virus infection. [ABSTRACT FROM AUTHOR]

Background: Hemorrhagic fever with renal syndrome (HFRS) is a serious public health problem in China, and is primarily caused by either the Hantaan virus (HTNV) or Seoul virus (SEOV) strains. However, the causative hantavirus has only been definitively identified in a few HFRS cases, and detailed comparisons of patient data for the 2 strains are limited. Methods: We conducted a 1-y prospective study in Heilongjiang Province, China. A total of 152 patients from 3 hospitals met the HFRS diagnostic criteria used in China. The diagnosis was further confirmed by specific immunoglobulin M to HTNV or SEOV. In addition, serum samples were tested for the presence of HTNV or SEOV using a reverse transcription-polymerase chain reaction (RT-PCR). Clinical manifestations and laboratory findings in patients with the 2 hantaviruses were subsequently compared. Results: Eighty (61.1%) HTNV and 51 (38.9%) SEOV infections were identified. Fever and proteinuria, key to the diagnosis of HFRS, were observed in all patients. The clinical manifestations of hemorrhage and renal injury from SEOV infection were milder than those of HTNV infection. Interestingly, compared to patients with HTNV infection, patients with SEOV presented with a significantly longer febrile period, more normal white blood cell counts or even transient leukocytopenia, a higher incidence of liver injury related to disease severity, and a lower occurrence of the 5 typical phases of HFRS. The mortality was 6.3% in HTNV infections and 0% in SEOV infections. Conclusions: Clinical manifestations of SEOV infection appear to be milder and less typical than HTNV. This information may help us to improve the diagnosis of SEOV-infected patients. [ABSTRACT FROM AUTHOR]

Background: The community could be a reservoir of antibiotic resistance genes. The aim of this study was to investigate the prevalence and genetic environments of blaCTX-M among faecal Escherichia coli obtained from healthy persons in a region of China. Methods: Bacteria in stool specimens were screened for extended-spectrum ββ-lactamase (ESBL) production on 2 MacConkey agars, one with cefotaxime and one with ceftazidime. blaCTX-M and their genetic environments, as well as phylogenetic analysis and detection of the O25b-ST131 clone of E. coli, were characterized by polymerase chain reaction and sequencing. Pulsed field gel electrophoresis and conjugation assays were performed by standard procedures. Results: A surprisingly high number (50.5%, 55/109) of faecal samples showed the presence of ESBL-producing E. coli. blaCTX-M genes were detected in all of these strains. The CTX-M-9 group (41/55, 74.5%) was found most frequently, followed by the CTX-M-1 group (16/55, 29.1%). CTX-M-14 ( n == 39) was the predominant CTX-M enzyme in this study. However, the genes for the CTX-M-2 and CTX-M-8 groups were not observed. IS Ecp1 was detected in 90.9% of the strains, while IS 26 was observed upstream from blaCTX-M in only 1 strain. Phylogenetic groups A and D were found to predominate in commensal E. coli. High clonal diversity was observed and most blaCTX-M genes were transferable. The O25b-ST131 clone was found in 4 strains. Conclusions: This study reveals the wide dissemination of CTX-M ESBL-producing E. coli in the gut flora of healthy individuals in China. [ABSTRACT FROM AUTHOR]