Background: The antimicrobial resistance of Bacteroides spp. isolates is reported to be increasing among different districts around the world, and few reports found that multi-antimicrobial resistant strains emerged. However, less is known about the prevalence of multi-antimicrobial resistant isolates in China, especially for carbapenem resistance. Methods: Bacteroides spp. clinical strains were isolated from inpatients at a 3000 bed tertiary teaching hospital , and were identified by MALDI-TOF MS and VITEK-2 anaerobes and corynebacterium (ANC) card. Broth microdilution method was employed to detect the antimicrobial sensitivities of Bacteroides spp. isolates and PCR method was used to detect the resistance genes, including cfxA, cepA, cfiA, ermF and nim. The upstream insertion sequence (IS) element of cfiA gene was further detected and verified. Results: Among 115 Bacteroides spp. strains enrolled in this study, 80 isolates were Bacteroides fragilis and 35 isolates were non-Bacteroides fragilis. The total resistance rates of 115 Bacteroides spp. isolates to ampicillin/sulbactam, amoxicillin/clavulanic, cefoxitin, piperacillin, piperacillin/tazobactam, moxifloxacin, clindamycin, metronidazole, imipenem and meropenem were 22.6%, 19.6%, 3.5%, 27.8%, 8.7%, 16.5%, 80.0%, 5.2%, 13.9% and 13.9% , respectively. Except cefoxitin and moxifloxacin, the resistance rates of B. fragilis isolates to the above antibiotics were all higher than those of non-B. fragilis isolates. The positive rates of carbapenem resistance gene cfiA were 38.9% and 8.6% for B. fragilis and non-B. fragilis isolates, respectively. For 15 carbapenem resistant B. fragilis isolates, the co-carrying rates of carbapenem resistance gene cfiA and its upstream IS element were 86.7% (13/15). Conclusions: The overall resistance rates of Bacteroides spp. isolates toward multiple antibiotics were at a higher level, especially for B. fragilis. CfiA gene carrying rate among B. fragilis isolates was high up to 38.9% and its mediated carbapenem resistance was a major resistance mechanism for B. fragilis. The findings of this study imply that the actual resistance tendency of Bacteroides spp. may be underestimated and need to be given more attention to.
Introduction Genetic landscape, disease characteristics and clinical outcomes of young adults with myeloproliferative neoplasms (MPNs) were reported. However, data on patient-reported outcomes (PROs) in young adults with MPNs were rare. Methods We conducted a multicenter, cross-sectional study to compared the PROs in respondents with thrombocythemia (ET), polycythemia vera (PV) and myelofibrosis (MF) by age at survey, including the young group (18-40 years), middle-aged group (41-60 years), and elderly group (> 60 years). Results Of the 1664 respondents with MPNs, 349 (21.0%) were young including 244 (69.9%) with ET, 34 (9.7%) with PV and 71 (20.3%) with MF. In multivariate analyses the young groups with ET and MF were associated with the lowest MPN-10 scores among the 3 age groups; those with MF, highest proportion of reporting negative impact of disease and therapy on their daily life and work. The young groups with MPNs had the highest physical component summary scores, but the lowest mental component summary scores in those with ET. The young groups with MPNs were most concerned about fertility; those with ET, treatment-related adverse events and long-term efficacy of treatment. Conclusions We concluded that young adults with MPNs have different PROs compared with middle-aged and elderly patients.
Background:Acalabrutinib (acala), a selective next-generation covalent Bruton tyrosine kinase inhibitor with minimal off-target activity, is approved in the United States and Europe for the treatment of chronic lymphocytic leukemia (CLL). The primary studies supporting the approval of acala in CLL were conducted predominantly in Europe and North America, with limited representation of Asian populations. This phase 1/2 study (NCT03932331) evaluated acala in Chinese patients (pts) with relapsed/refractory (R/R) CLL.
Background:Roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, has been used to treat anemia in patients with chronic kidney diseases by increasing erythroprotein(EPO) levels. EPO is an important cytokine required for hematopoiesis which is also secreted by bone marrow niche. Roxadustat is reported closed with the HIF signaling pathways, which is also important for regulation of EPO production. However, there is few data about the effects of roxadustat on the bone marrow microenvironment.
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