<b><i>Background:</i></b> Acute acalculous cholecystitis (AAC) is characterized by acute necrotizing inflammation with no calculi and is diagnosed based on imaging, intraoperative, and pathological examinations. <b><i>Key Message:</i></b> Although AAC has been studied clinically for a long time, it remains difficult to diagnose and treat. The pathogenesis of AAC is still not fully understood, and it is often regarded as a relatively independent clinical disease that is different from acute calculous cholecystitis (ACC). Pathological studies suggest that AAC is the manifestation of a critical systemic disease, while ACC is a local disease of the gallbladder. <b><i>Summary:</i></b> Concerning the pathogenesis, diagnosis, and treatment of AAC, we reviewed the research progress of AAC, which will enhance the understanding of the early diagnosis and treatment of AAC.
The exact pathogenesis of gallbladder adenomyomatosis is still lacking and some
controversies over its diagnosis and treatment exist. Originally recognized as a
precancerous lesion, adenomyomatosis is currently recognized by recent studies
as a benign alteration of the gallbladder that is often associated with
cholecystitis and cholecystolithiasis. Gallbladder carcinoma is an extremely
malignant disease with a 5-year survival rate of less than 5%. Therefore, it is
important to diagnose, differentiate, and confirm the relationship between
adenomyomatosis and early-stage gallbladder carcinoma. However, the early
clinical symptoms of adenomyomatosis are extremely similar to those of
gallbladder stones and cholecystitis, increasing the difficulty to identify and
treat this disease. This article summarizes the research progress on gallbladder
adenomyomatosis, aiming to improve the understanding of the pathogenesis of
adenomyomatosis and further provide insight for its clinical diagnosis and
treatment.
Retail meat products could serve as an important medium for the transfer of multidrug resistant isolates from food-producing animals to the community. In this study, the prevalence and characteristics of cefotaxime and ciprofloxacin co-resistant Escherichia coli isolates were investigated in retail chicken and ground pork samples from four provinces of China. The isolates were subjected to phylogenetic group typing and antimicrobial susceptibility testing. All isolates were further characterized by pulsed-field gel electrophoresis to determine the genetic relatedness. These isolates were also screened for beta-lactamase genes, quinolone resistance determinants by PCR, and followed by DNA sequence analysis. Cefotaxime and ciprofloxacin co-resistant E. coli isolates with diverse genetic origins were recovered in 31.9% (106/332) of retail meat samples. E. coli isolates of phylogenetic group A were dominant (59.4%, 63/106), and all isolates showed multidrug resistant profiles. The dominant resistant profiles were AMP-CAZ-CTX-CIP-CHL-GEN-SXT-TET (n=43) and AMP-CAZ-CTX-CIP-CHL-SXT-TET (n=43). Point mutations in quinolone resistance determination regions of topoisomerases were identified in all the isolates, and most of the isolates accumulated three (n=78) or four (n=21) point mutations. Plasmid-mediated quinolone-resistant determinants were identified in 68 isolates, including oqxAB (n=66), qnrS1 (n=7), qnrS2 (n=4), and aac(6')-Ib-cr (n=9). Eight subtypes of bla(CTX-M) were identified in 103 E. coli isolates, and blaCTX-M-55 (n=90) was dominant. This study highlights that retail meat could serve as an important reservoir of cefotaxime and ciprofloxacin co-resistant E. coli isolates. It is necessary to evaluate their contribution in the community and hospital infections.
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