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BackgroundThis study aimed to investigate the relationship between the rate of carbapenem-resistant Gram-negative bacteria and antibiotic consumption intensity in 153 tertiary hospitals from China in 2014.MethodsA retrospective study using national surveillance data from 2014 was conducted. Data on the annual consumption of each antibiotic, as well as the rate of carbapenem-resistant Gram-negative bacteria, were collected from each participating hospital, and the correlation between antibiotic consumption and carbapenem- resistant rate was analyzed.ResultsThe overall antibiotic consumption intensity among the hospitals varied between 23.93 and 86.80 defined daily dosages (DDDs) per 100 patient-days (median, 46.30 DDDs per 100 patient-days). Cephalosporins were the most commonly used antibiotic, followed by quinolones, penicillins, and carbapenems, and the rate of carbapenem-resistant Gram-negative bacteria from each hospital varied. The correlations between carbapenem consumption intensity and rate of carbapenem resistance revealed correlation factors of 0.271 for Escherichia coli (p < 0.01), 0.427 for Klebsiella pneumoniae (p < 0.01), 0.463 for Pseudomonas aeruginosa (p < 0.01), and 0.331 for Acinetobacter baumannii (p < 0.01).ConclusionsA significant relationship existed between the carbapenem consumption and the rates of carbapenem-resistant gram negative bacilli. Rational use of carbapenems should be implemented to address the issue of carbapenem resistance in hospitals.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0430-1) contains supplementary material, which is available to authorized users.

The relationships among potassium (K), calcium (Ca), sodium (Na), magnesium (Mg), iron (Fe), zinc (Zn), copper (Cu), and manganese (Mn) contents in milled rice (Oryza stavia L.) of 274 genotypes and the relationships between these mineral element contents and other rice quality traits including 3 cooking quality traits, 17 amino acid contents, and protein content were investigated. The results showed that there were significant correlations among most of mineral element contents. Mg, Fe, and Mn contents were significantly correlated with most of the other mineral element contents, while Cu content had significantly negative associations with the K and Mg contents of rice. The relationships between mineral element contents and cooking quality traits showed that gel consistency (GC) was significantly correlated with K, Cu, and Mn contents of rice. Amylose content (AC) was significantly associated with K, Na, Mg, Cu, and Mn contents. The alkali spreading value (ASV) had closely positive relationships with Ca, Mg, and Mn contents. In addition, 8 mineral element contents had obvious correlations with different amino acid contents. Mg, Ca, and Zn contents were significantly correlated with most of the 17 amino acid contents, but Na content did not correlate with amino acid contents except aspartic acid of rice. Furthermore, significant associations were found between protein content and Na, Mg, Zn, Cu, or Mn content. Six principal components were extracted to explain 84.50% of the total variances and contained the information provided by the original 29 variables according to the principal component analysis.

The development of drugs with rapid distribution in the kidney and long-term retention in the renal tubule is a breakthrough for enhanced treatment of acute kidney injury (AKI). Here, l-serine–modified chitosan (SC) was synthesized as a potential AKI kidney–targeting agent due to the native cationic property of chitosan and specific interaction between kidney injury molecule–1 (Kim-1) and serine. Results indicated that SC was rapidly accumulated and long-term retained in ischemia-reperfusion–induced AKI kidneys, especially in renal tubules, which was possibly due to the specific interactions between SC and Kim-1. SC-TK-SS31 was then prepared by conjugating SS31, a mitochondria-targeted antioxidant, to SC via reactive oxygen species (ROS)–sensitive thioketal linker. Because of the effective renal distribution combined with ROS-responsive drug release behavior, the administration of SC-TK-SS31 led to an enhanced therapeutic effect of SS31 by protecting mitochondria from damage and reducing the oxidative stress, inflammation, and cell apoptosis.

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Continuous Renal Replacement Therapy (CRRT) is more and more widely used in patients for various indications recent years. It is still intricate for clinicians to decide a suitable empiric antimicrobial dosing for patients receiving CRRT. Inappropriate doses of antimicrobial agents may lead to treatment failure or drug resistance of pathogens. CRRT factors, patient individual conditions and drug pharmacokinetics/pharmacodynamics are the main elements effecting the antimicrobial dosing adjustment. With the development of CRRT techniques, some antimicrobial dosing recommendations in earlier studies were no longer appropriate for clinical use now. Here, we reviewed the literatures involving in new progresses of antimicrobial dosages, and complied the updated empirical dosing strategies based on CRRT modalities and effluent flow rates. The following antimicrobial agents were included for review: