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Objective: To determine the minimum inhibitory concentration (MIC) distribution of antibacterial drugs and the susceptibility of non-tuberculous mycobacterial (NTM) isolates to provide a reference basis for the clinical selection of an effective starting regimen. Methods: The common clinical isolates of NTM in the respiratory tract, which met the standards of the American Thoracic Society for NTM lung disease, were collected. The MICs of 81 isolates were determined using the microbroth dilution method (Thermo Fisher Scientific, USA), as recommended by the Clinical and Laboratory Standards Institute, USA. Results: Included were 43 Mycobacterium avium complex (MAC) strains, 24 M. abscessus complex (MAB) strains, and 14 M. kansasii strains. The sensitivity rates of MAC to clarithromycin and amikacin were 81.4% and 79.1%, respectively, while the sensitivity rates to linezolid and moxifloxacin were only 20.9% and 9.3%; the MIC of rifabutin was the lowest (MIC50% was just 2 μg/mL). After incubation for 3–5 days, the sensitivity rate of MAB to clarithromycin was 87.5%; this decreased to 50% after 14 days’ incubation. Most of them were susceptible to amikacin (91.6%), and most were resistant to moxifloxacin (95.8%), ciprofloxacin (95.8%), imipenem (95.8%), amoxicillin/clavulanate (95.8%), tobramycin (79.1%), doxycycline (95.8%) and trimethoprim/sulfamethoxazole (95.8%). intermediate (83.3%) and resistant (16.7%) to cefoxitin. The susceptibility to linezolid was only 33.3%. The sensitivity and resistance breakpoints of tigecycline were set to ≤0.5 and ≥8 μg/mL, respectively, and the sensitivity and resistance rates were 50% and 0%, respectively. M. kansasii was susceptible to clarithromycin, amikacin, linezolid, moxifloxacin, rifampicin and rifabutin (100%). Discussion: In Wenzhou, clarithromycin, amikacin and rifabutin have good antibacterial activity against MAC, while linezolid and moxifloxacin have high resistance. Amikacin and tigecycline have strong antibacterial activity against MAB, while most other antibacterial drugs are resistant to varying degrees. Most antibacterial drugs are susceptible to M . kansasii and have good antibacterial activity. Conclusion: The identification of NTM species and the detection of their MICs have certain guiding values for the treatment of NTM lung disease. Key Message The three most common respiratory non-tuberculous mycobacterial (NTM) isolates with clinical significance in the Wenzhou area were tested for drug susceptibility. The broth microdilution method was used to determine the minimum inhibitory concentration distribution of antibacterial drugs and the susceptibility of NTM isolates to provide a reference basis for the clinical selection of an effective starting regimen. ...

Background: Although many studies have shown that erythropoietin plays an important role in the prognosis of traumatic brain injury (TBI) patients, the effective dose of erythropoietin has not been clearly defined. Our aim was to systematically elucidate the safety and efficacy of erythropoietin administration regimens in TBI patients.Methods: Data search included PubMed, the Cochrane Library, EMBASE and ClinicalTrials.gov for articles published before December, 2020, updated to June 2021. Network meta-analysis was performed when sufficient comparable evidence was available, and CINeMA tool was used to evaluated the quality of our evidence.Results: A total of 6 RCTs involving 981 patients were included in the network meta-analysis. All studies assessed the effect of erythropoietin on mortality. Erythropoietin reduced the mortality rate in patients with TBI, and the risk of death decreased with increasing dose, but the difference was not statistically significant (odd ratio of 12,000u vs Placebo=0.98, 95%CI, 0.03-40.34; odd ratio of group 30,000u vs Placebo=0.56, 95%CI, 0.06-5.88; odd ratio of 40,000u vs Placebo=0.35, 95%CI, 0.01-9.43; odd ratio of 70,000u vs Placebo=0.29, 95%CI, 0.01-9.26; odd ratio of group 80,000u vs Placebo=0.22, 95%CI, 0.00-7.45). Three studies involving 739 patients showed that erythropoietin did not increase the incidence of deep vein thrombosis in patients with TBI. However, the risk tended to rise as the dose increases. Two studies demonstrated that erythropoietin did not increase the incidence of pulmonary embolism. The evidential quality of all the results of the evidence ranged from low to medium.Conclusion: Although the efficacy of erythropoietin was not statistically demonstrated, we found a trend in the association of erythropoietin dose with reduced mortality and increased embolic events in TBI patients. We are looking forward to more high-quality original studies focusing on the dose and timing of erythropoietin for the treatment of TBI, in order to obtain stronger evidence on the optimal erythropoietin dose.Study Registration: PROSPERO (CRD42021272500).

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