Drug sensitivity

药物敏感性
  • 文章类型: Journal Article
    本研究试图建立基于囊泡介导的转运蛋白相关基因(VMTGs)的胰腺癌(PC)患者的预后风险评分模型。我们最初进行了差异表达分析和Cox回归分析,然后构建风险评分模型,将PC患者分为高危组(HR)和低危组(LR).GEOGSE62452数据集进一步验证了该模型。采用Kaplan-Meier生存分析对HR组和LR组的生存率进行分析。Cox分析证实了风险评分模型的独立预后能力。此外,我们评估了HR和LR组的免疫状态,利用GDSC数据库中的数据预测PC患者的药物反应。我们从724个VMTG中鉴定了6个PC特异性基因。生存分析显示HR组生存率低于LR组(P<0.05)。Cox分析证实,预后风险评分模型可以独立预测PC患者的生存状况(P<0.001)。免疫学分析显示,估计评分,免疫评分,HR组的间质评分明显低于LR组,HR组肿瘤纯度评分较高。吉西他滨的IC50值,伊立替康,奥沙利铂,LR组的紫杉醇水平明显低于HR组(P<0.001)。总之,基于VMTG的预后风险评分模型可以对PC风险进行分层,并有效预测PC患者的生存率。
    This study attempted to build a prognostic riskscore model for pancreatic cancer (PC) patients based on vesicle-mediated transport protein-related genes (VMTGs). We initially conducted differential expression analysis and Cox regression analysis, followed by the construction of a riskscore model to classify PC patients into high-risk (HR) and low-risk (LR) groups. The GEO GSE62452 dataset further validated the model. Kaplan-Meier survival analysis was employed to analyze the survival rate of the HR group and LR group. Cox analysis confirmed the independent prognostic ability of the riskscore model. Additionally, we evaluated immune status in both HR and LR groups, utilizing data from the GDSC database to predict drug response among PC patients. We identified six PC-specific genes from 724 VMTGs. Survival analysis revealed that the survival rate of the HR group was lower than that of the LR group (P<0.05). Cox analysis confirmed that the prognostic riskscore model could independently predict the survival status of PC patients (P<0.001). Immunological analysis revealed that the ESTIMATE score, immune score, and stroma score of the HR group were considerably lower than those of the LR group, and the tumor purity score of the HR group was higher. The IC50 values of Gemcitabine, Irinotecan, Oxaliplatin, and Paclitaxel in the LR group were considerably lower than those in the HR group (P<0.001). In summary, the VMTG-based prognostic riskscore model could stratify PC risk and effectively predict the survival of PC patients.
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  • 文章类型: Journal Article
    胶质瘤,一种脑肿瘤,由于其异质性和有限的治疗选择,提出了重大挑战。干扰素相关基因(IRGs)已成为神经胶质瘤发病机制的潜在参与者,然而,它们的表达模式和临床意义仍有待完全阐明。我们进行了全面分析,以研究IRGs在胶质瘤中的表达模式和功能富集。这涉及构建蛋白质-蛋白质相互作用网络,热图分析,生存曲线绘图,诊断和预后评估,神经胶质瘤亚组差异表达分析,GSVA,免疫浸润分析,和药物敏感性分析。我们的分析揭示了神经胶质瘤中IRGs的不同表达模式和功能富集。值得注意的是,与正常组织相比,胶质瘤组织中IFNW1和IFNA21显著下调,更高的表达水平与总生存率和疾病特异性生存率的提高相关。此外,这些基因在区分神经胶质瘤组织和正常组织方面显示出诊断能力,并且在更高级别和更侵袭性的神经胶质瘤中显著下调.神经胶质瘤亚组的差异表达分析强调了IFNW1和IFNA21表达与关键通路和生物学过程的关联。包括代谢重编程和免疫调节。免疫浸润分析揭示了它们对肿瘤微环境中免疫细胞组成的影响。此外,表达水平升高与化疗药物耐药性增加相关.我们的发现强调了IFNW1和IFNA21作为神经胶质瘤诊断生物标志物和预后指标的潜力。它们在调节神经胶质瘤进展中的作用,免疫反应,药物敏感性凸显了它们作为潜在治疗靶点的重要性。这些结果有助于更深入地了解神经胶质瘤生物学,并可能为神经胶质瘤患者制定个性化治疗策略提供信息。
    Glioma, a type of brain tumor, poses significant challenges due to its heterogeneous nature and limited treatment options. Interferon-related genes (IRGs) have emerged as potential players in glioma pathogenesis, yet their expression patterns and clinical implications remain to be fully elucidated. We conducted a comprehensive analysis to investigate the expression patterns and functional enrichment of IRGs in glioma. This involved constructing protein-protein interaction networks, heatmap analysis, survival curve plotting, diagnostic and prognostic assessments, differential expression analysis across glioma subgroups, GSVA, immune infiltration analysis, and drug sensitivity analysis. Our analysis revealed distinct expression patterns and functional enrichment of IRGs in glioma. Notably, IFNW1 and IFNA21 were markedly downregulated in glioma tissues compared to normal tissues, and higher expression levels were associated with improved overall survival and disease-specific survival. Furthermore, these genes showed diagnostic capabilities in distinguishing glioma tissues from normal tissues and were significantly downregulated in higher-grade and more aggressive gliomas. Differential expression analysis across glioma subgroups highlighted the association of IFNW1 and IFNA21 expression with key pathways and biological processes, including metabolic reprogramming and immune regulation. Immune infiltration analysis revealed their influence on immune cell composition in the tumor microenvironment. Additionally, elevated expression levels were associated with increased resistance to chemotherapeutic agents. Our findings underscore the potential of IFNW1 and IFNA21 as diagnostic biomarkers and prognostic indicators in glioma. Their roles in modulating glioma progression, immune response, and drug sensitivity highlight their significance as potential therapeutic targets. These results contribute to a deeper understanding of glioma biology and may inform the development of personalized treatment strategies for glioma patients.
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  • 文章类型: Journal Article
    佩吉特的“种子和土壤”理论,1889年提出,强调了癌细胞在转移部位生长的微环境的重要性。一个多世纪后,这一概念仍然是理解癌症生物学和制定治疗策略的基石。“种子和土壤”理论,最初解释了癌症如何扩散到远处的器官,现在也适用于原发性肿瘤内的肿瘤微环境(TME)。该理论强调癌细胞(“种子”)与其周围环境(“土壤”)之间的关键相互作用,以及这种相互作用如何影响原发部位和转移部位的肿瘤进展。需要注意的重要一点是,TME的特性不是静态的,而是动态的,在肿瘤进展期间和治疗药物治疗后发生实质性变化。癌症相关成纤维细胞(CAFs),被认为是TME中主要的非癌细胞成分,在肿瘤进展中发挥多方面的作用,包括促进血管生成,重塑细胞外基质,和调节免疫反应。在这次全面审查中,我们关注的是CAFs动态如何促进癌症进展和药物敏感性的研究结果.了解CAFs的动力学可以为癌症病理学提供新的见解,并导致癌症研究和治疗的重要进展。
    Paget\'s \"Seed and Soil\" theory, proposed in 1889, emphasizes the importance of the microenvironment where cancer cells grow in metastatic sites. Over a century later, this concept remains a cornerstone in comprehending cancer biology and devising treatment strategies. The \"Seed and Soil\" theory, which initially explained how cancer spreads to distant organs, now also applies to the tumor microenvironment (TME) within primary tumors. This theory emphasizes the critical interaction between cancer cells (\"seeds\") and their surrounding environment (\"soil\") and how this interaction affects both tumor progression within the primary site and at metastatic sites. An important point to note is that the characteristics of the TME are not static but dynamic, undergoing substantial changes during tumor progression and after treatment with therapeutic drugs. Cancer-associated fibroblasts (CAFs), recognized as the principal noncancerous cellular component within the TME, play multifaceted roles in tumor progression including promoting angiogenesis, remodeling the extracellular matrix, and regulating immune responses. In this comprehensive review, we focus on the findings regarding how the dynamics of CAFs contribute to cancer progression and drug sensitivity. Understanding the dynamics of CAFs could provide new insights into cancer pathology and lead to important advancements in cancer research and treatment.
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  • 文章类型: Journal Article
    多发性骨髓瘤(MM)在治疗反应和生存率方面表现出相当大的异质性,即使实施标准化护理。正在进行的努力集中在开发预后模型以更准确地预测这些结果。最近,中性粒细胞胞外陷阱(NETs)已成为MM进展的潜在因素,引发了对它们在预测中的作用的调查。
    在这项研究中,使用NTE和差异表达基因(DEG)的交集构建了多基因风险评分模型,应用最小绝对收缩和选择算子(LASSO)Cox回归模型。建立了一个列线图,并通过Kaplan-Meier生存分析确定预后模型的有效性,接收机工作特性(ROC)曲线,和决策曲线分析(DCA)。采用ESTIMATE算法和免疫相关的单样本基因组富集分析(ssGSEA)评估免疫浸润水平。使用癌症药物敏感性基因组学(GDSC)数据库评估化疗药物的敏感性。最终,在MM细胞标本中通过定量实时聚合酶链反应(qRT-PCR)分析证实了检测到的基因的存在.
    生成了64个NET-DEG,通过单变量Cox回归和LASSO回归分析,我们构建了由六个基因组成的风险评分:CTSG,HSPE1,LDHA,MPO,PINK1和VCAM1。根据风险评分将三个独立数据集中的MM患者分为高危组和低危组。与低危组相比,高危组患者的总生存期(OS)显着降低。此外,风险评分是OS的独立预测因素.此外,风险评分之间的相互作用,免疫评分,和免疫细胞浸润进行了研究。进一步分析发现,高危人群患者对多种化疗药物和靶向药物更为敏感,包括硼替佐米.此外,这六个基因提供了对浆细胞疾病进展的见解。
    这项研究为NETs在预后预测中的作用提供了新的见解,免疫状态,和MM的药物敏感性,作为现有评分系统的宝贵补充和增强。
    UNASSIGNED: Multiple myeloma (MM) exhibits considerable heterogeneity in treatment responses and survival rates, even when standardized care is administered. Ongoing efforts are focused on developing prognostic models to predict these outcomes more accurately. Recently, neutrophil extracellular traps (NETs) have emerged as a potential factor in MM progression, sparking investigation into their role in prognostication.
    UNASSIGNED: In this study, a multi-gene risk scoring model was constructed using the intersection of NTEs and differentially expressed genes (DEGs), applying the least absolute shrinkage and selection operator (LASSO) Cox regression model. A nomogram was established, and the prognostic model\'s effectiveness was determined via Kaplan-Meier survival analysis, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). The ESTIMATE algorithm and immune-related single-sample gene set enrichment analysis (ssGSEA) were employed to evaluate the level of immune infiltration. The sensitivity of chemotherapy drugs was assessed using the Genomics of Drug Sensitivity in Cancer (GDSC) database. Ultimately, the presence of the detected genes was confirmed through quantitative real-time polymerase chain reaction (qRT-PCR) analysis in MM cell specimens.
    UNASSIGNED: 64 NETs-DEGs were yielded, and through univariate Cox regression and LASSO regression analysis, we constructed a risk score composed of six genes: CTSG, HSPE1, LDHA, MPO, PINK1, and VCAM1. MM patients in three independent datasets were classified into high- and low-risk groups according to the risk score. The overall survival (OS) of patients in the high-risk group was significantly reduced compared to the low-risk group. Furthermore, the risk score was an independent predictive factor for OS. In addition, interactions between the risk score, immune score, and immune cell infiltration were investigated. Further analysis indicated that patients in the high-risk group were more sensitive to a variety of chemotherapy and targeted drugs, including bortezomib. Moreover, the six genes provided insights into the progression of plasma cell disorders.
    UNASSIGNED: This study offers novel insights into the roles of NETs in prognostic prediction, immune status, and drug sensitivity in MM, serving as a valuable supplement and enhancement to existing grading systems.
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  • 文章类型: Journal Article
    背景:肝细胞癌(LIHC)是癌症相关死亡的主要原因之一。晚期LIHC患者的预后结果较差。因此,目前迫切需要可靠的LIHC预后生物标志物.方法:从338LIHC和从癌症基因组图谱(TCGA)下载的50个正常组织样品中分析囊泡介导的转运相关基因(VMTRG)的数据。进行单变量Cox回归和最小绝对收缩和选择算子(LASSO)回归分析以构建和优化预后风险模型。使用五个GEO数据集来验证风险模型。通过京都基因和基因组百科全书(KEGG)和基因本体论(GO)富集分析研究了差异表达基因(DEG)的作用。使用五种算法评估了高危组和低危组之间免疫细胞浸润的差异。使用“pRrophetic”计算两组的抗癌药物敏感性。进行Transwell和伤口愈合测定以评估GDP解离抑制剂2(GDI2)对LIHC细胞的作用。结果:共有166个与预后相关的VMTRGs被确定,并构建基于VMTRGs的风险模型对LIHC患者的预后进行评估。四个VMTRG(GDI2、DYNC1LI1、KIF2C、和RAB32)构成与LIHC临床结果相关的风险模型的主要成分。提取肿瘤分期和风险评分作为LIHC患者的主要预后指标。基于VMTRGs的风险模型与免疫应答和免疫检查点分子的高表达显著相关。高危患者对大多数化疗药物不太敏感,但受益于免疫疗法。体外细胞测定显示GDI2显著促进LIHC细胞的生长和迁移。结论:基于VMTRGs的风险模型可有效预测LIHC患者的预后。该风险模型与免疫浸润微环境密切相关。四个关键的VMTRG是LIHC的强大预后生物标志物和治疗靶标。
    Background: Liver hepatocellular carcinoma (LIHC) is one of the leading causes of cancer-related death. The prognostic outcomes of advanced LIHC patients are poor. Hence, reliable prognostic biomarkers for LIHC are urgently needed. Methods: Data for vesicle-mediated transport-related genes (VMTRGs) were profiled from 338 LIHC and 50 normal tissue samples downloaded from The Cancer Genome Atlas (TCGA). Univariate Cox regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression analyses were performed to construct and optimize the prognostic risk model. Five GEO datasets were used to validate the risk model. The roles of the differentially expressed genes (DEGs) were investigated via Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses. Differences in immune cell infiltration between the high- and low-risk groups were evaluated using five algorithms. The \"pRRophetic\" was used to calculate the anticancer drug sensitivity of the two groups. Transwell and wound healing assays were performed to assess the role of GDP dissociation inhibitor 2 (GDI2) on LIHC cells. Results: A total of 166 prognosis-associated VMTRGs were identified, and VMTRGs-based risk model was constructed for the prognosis of LIHC patients. Four VMTRGs (GDI2, DYNC1LI1, KIF2C, and RAB32) constitute the principal components of the risk model associated with the clinical outcomes of LIHC. Tumor stage and risk score were extracted as the main prognostic indicators for LIHC patients. The VMTRGs-based risk model was significantly associated with immune responses and high expression of immune checkpoint molecules. High-risk patients were less sensitive to most chemotherapeutic drugs but benefited from immunotherapies. In vitro cellular assays revealed that GDI2 significantly promoted the growth and migration of LIHC cells. Conclusions: A VMTRGs-based risk model was constructed to predict the prognosis of LIHC patients effectively. This risk model was closely associated with the immune infiltration microenvironment. The four key VMTRGs are powerful prognostic biomarkers and therapeutic targets for LIHC.
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  • 文章类型: Journal Article
    背景:宫颈癌(CC)是全球女性中第四大最常见的癌症。作为宿主和肿瘤之间快速交叉对话的一部分,预后可通过炎症反应或肿瘤微环境来影响。然而,进一步探索具有预后价值的炎症反应相关基因,微环境渗透,和化疗治疗CC是必要的。方法:本研究从公共数据库下载CC患者的临床数据和mRNA表达谱。在TCGA队列中,通过最小绝对收缩和选择算子(LASSO)和Cox分析构建多基因预后特征.来自GEO队列的CC患者用于验证。K-M分析用于比较高危组和低危组之间的总体生存率(OS)。应用单变量和多变量Cox分析来确定OS的独立预测因子。通过单样本基因集富集分析(GSEA)计算免疫细胞浸润和免疫相关功能评分。免疫组织化学用于验证CC组织中预后基因的蛋白质表达。结果:通过LASSOCox回归分析建立了与炎症反应相关的遗传特征模型。高风险组患者的OS率明显较低。通过受试者工作特征(ROC)曲线分析评估预后基因的预测能力。通过单变量和多变量Cox分析证实风险评分是OS的独立预测因子。高风险和低风险组之间的免疫状态不同,根据功能分析,在高危人群中富集了癌症相关通路。风险评分与肿瘤分期、免疫浸润类型显著相干。五个预后基因(LCK,GCH1、TNFRSF9、ITGA5、SLC7A1)与抗肿瘤药物敏理性呈正相干。此外,在单独的样本队列中,CC组织和肌瘤患者宫颈(非肿瘤)组织之间的预后基因表达存在显著差异.结论:由5个炎症相关基因组成的模型可用于预测CC患者的预后和影响免疫状态。此外,抑制或增强这些基因可能成为一种新的替代疗法。
    Background: Cervical cancer (CC) is the fourth most common cancer among women worldwide. As part of the brisk cross-talk between the host and the tumor, prognosis can be affected through inflammatory responses or the tumor microenvironment. However, further exploration of the inflammatory response-related genes that have prognostic value, microenvironment infiltration, and chemotherapeutic therapies in CC is needed. Methods: The clinical data and mRNA expression profiles of CC patients were downloaded from a public database for this study. In the TCGA cohort, a multigene prognostic signature was constructed by least absolute shrinkage and selection operator (LASSO) and Cox analyses. CC patients from the GEO cohort were used for validation. K‒M analysis was used to compare overall survival (OS) between the high- and low-risk groups. Univariate and multivariate Cox analyses were applied to determine the independent predictors of OS. The immune cell infiltration and immune-related functional score were calculated by single-sample gene set enrichment analysis (GSEA). Immunohistochemistry was utilized to validate the protein expression of prognostic genes in CC tissues. Results: A genetic signature model associated with the inflammatory response was built by LASSO Cox regression analysis. Patients in the high-risk group had a significantly lower OS rate. The predictive ability of the prognostic genes was evaluated by means of receiver operating characteristic (ROC) curve analysis. The risk score was confirmed to be an independent predictor of OS by univariate and multivariate Cox analyses. The immune status differed between the high-risk and low-risk groups, and the cancer-related pathways were enriched in the high-risk group according to functional analysis. The risk score was significantly related to tumor stage and immune infiltration type. The expression levels of five prognostic genes (LCK, GCH1, TNFRSF9, ITGA5, and SLC7A1) were positively related to sensitivity to antitumor drugs. Additionally, the expression of prognostic genes was significantly different between CC tissues and myoma patient cervix (non-tumorous) tissues in the separate sample cohort. Conclusion: A model consisting of 5 inflammation-related genes can be used to predict prognosis and influence immune status in CC patients. Furthermore, the inhibition or enhancement of these genes may become a novel alternative therapy.
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  • 文章类型: Journal Article
    背景:囊泡运输(VT)与肿瘤进展和免疫力有复杂的关系。但是室性心动过速在透明细胞肾细胞癌(ccRCC)中的预后意义尚不清楚。因此,我们旨在根据VT建立预后模型来预测ccRCC患者的总生存期。
    方法:我们使用来自TCGA数据库的患者数据,并通过差异表达分析建立了具有13个VT相关基因(VTRGs)的预后模型,LASSO回归,和单变量/多变量Cox分析。该模型进行了内部和外部验证,生存分析和ROC曲线显示出优异的预测能力。此外,更高的模型风险评分对应于更晚期的肿瘤进展.为了进一步了解患者不同预后的潜在原因,我们对该模型在风险组中鉴定的差异表达基因进行了富集分析.通过qRT-PCR和细胞功能实验验证了SAA1和KIF18B在ccRCC中的表达水平和作用。
    结果:体液免疫反应和cAMP信号通路可能是导致预后不良的生物学过程和通路。对免疫微环境的进一步分析表明,预后不良的ccRCC患者具有高度的免疫浸润特征。我们比较了GDSC数据库中来自不同预后患者的样品的药物反应数据,并确定了与预后相关的药物敏感性差异。最后,我们证明了SAA1和KIF18B可以增加增殖,迁移,细胞实验和ccRCC细胞的侵袭能力。
    结论:总之,我们进一步揭示了VTRGs在ccRCC预后中的重要性。
    BACKGROUND: Vesicular transport (VT) has a complex relationship with tumor progression and immunity. But prognostic significance of VT in clear cell renal cell carcinoma (ccRCC) is unclear. Thus, we aimed to establish a prognostic model according to VT to predict overall survival of ccRCC patients.
    METHODS: We used patient data from TCGA database and built a prognostic model with 13 VT-related genes (VTRGs) by differential expression analysis, LASSO regression, and univariate/multivariate Cox analysis. The model was validated internally and externally, and survival analysis and ROC curves depicted excellent predictive ability. Furthermore, higher modeled riskscores corresponded to more advanced tumor progression. To further understand the potential reasons for different prognoses in patients, we did enrichment analysis on differentially expressed genes identified by the model in risk groups. The expression levels and roles of SAA1 and KIF18B in ccRCC were verified by qRT-PCR and cell function experiments.
    RESULTS: Humoral immune response and cAMP signaling pathway may be the biological processes and pathways leading to poor prognosis. Further analysis of immune microenvironment presented that ccRCC patients with poor prognoses had highly immune-infiltrated characteristics. We compared the drug response data of samples from different prognostic patients in the GDSC database and identified drug sensitivity differences associated with prognosis. Finally, we demonstrated that SAA1 and KIF18B could increase the proliferation, migration, and invasion ability of ccRCC cells using cellular experiments.
    CONCLUSIONS: In summary, we further revealed the importance of VTRGs in ccRCC prognosis.
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  • 文章类型: Journal Article
    目的:探讨脑源性神经营养因子(BDNF)在结肠腺癌中的作用,特别是它对卡铂敏感性的影响。办法:从TCGA数据库获得结肠腺癌标本的mRNA和临床信息。差异表达分析,转录因子预测,在计算机上进行基因集富集分析。qRT-PCR,westernblot,采用CCK-8和CHIP测定。结果:BDNF在结肠腺癌中高表达。沉默BDNF可增强卡铂敏感性,同时对上皮-间质转化(EMT)产生相反的作用。BDNF富集在Hedgehog(HH)信号通路中。SALL4被鉴定为BDNF的上游调节剂。SALL4上调BDNF可促进EMT并抑制卡铂敏感性。结论:SALL4可促进BDNF的表达,促进结肠腺癌的侵袭性表型。
    [方框:见正文]。
    Aim: This study aimed to investigate the role of brain-derived neurotrophic factor (BDNF) in colon adenocarcinoma, specifically its impact on sensitivity to carboplatin. Methods: mRNA and clinical information of colon adenocarcinoma samples were obtained from TCGA database. Differential expression analysis, transcription factor prediction, gene set enrichment analysis were performed in silico. qRT-PCR, western blot, CCK-8 and CHIP assay were employed. Results: BDNF demonstrated high expression in colon adenocarcinoma. Silencing of BDNF enhanced carboplatin sensitivity, while exerting opposite effects on epithelial-mesenchymal transition (EMT). BDNF was enriched in Hedgehog (HH) signaling pathway. SALL4 was identified as an upstream regulator of BDNF. Upregulation of BDNF by SALL4 promoted EMT and inhibited carboplatin sensitivity. Conclusion: SALL4 promoted BDNF expression to facilitate the aggressive phenotypes of colon adenocarcinoma.
    [Box: see text].
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  • 文章类型: Journal Article
    目的:调查患病率,抗菌敏感性,以及围产期妇女阴道A组链球菌(GAS)感染对妊娠和新生儿结局的影响。
    方法:从2020年6月至2022年10月,270名围产期孕妇接受阴道拭子进行GAS培养。评估阳性菌株的抗生素敏感性。根据GAS检测结果,将患者分为观察组(GAS阳性)和对照组(GAS阴性)。收集两组的临床数据,比较阴道微生态变化。回顾性分析两组妊娠及婴儿的不良结局。使用单变量和多变量分析来确定不良结局的危险因素。
    结果:在270名孕妇中,30个GAS检测呈阳性,240个检测呈阴性,定殖率为11.1%。对青霉素没有抗药性,氨苄青霉素,利奈唑胺,万古霉素,或在GAS菌株中发现替加环素。对四环素和克林霉素的耐药率分别为73.3%和70.0%,分别。较高的阴道pH值(≥4.5),细菌性阴道炎的发病率增加,需氧性阴道炎,观察组微生态失衡与对照组比较差异均有统计学意义(均P<0.05)。观察组也经历了更多的不良妊娠和婴儿结局,比如绒毛膜羊膜炎,产后感染,胎儿窘迫,新生儿肺炎(均P<0.05)。单因素和多因素分析表明,GAS感染妇女的阴道pH≥4.5和微生态失衡与母婴结局不良呈正相关(均P<0.05)。
    结论:本研究未发现β-内酰胺耐药GAS菌株。此外,较高的阴道pH值(≥4.5)和微生态失衡与GAS感染女性的不良妊娠和婴儿结局风险增加相关.
    OBJECTIVE: To investigate the prevalence, antimicrobial susceptibility, and the effects on pregnancy and neonatal outcomes of Group A Streptococcal (GAS) infections in the vagina of perinatal women.
    METHODS: From June 2020 to October 2022, 270 perinatal pregnant women underwent vaginal swabs for GAS culture. The antibiotic sensitivity of the positive strains was assessed. Based on GAS detection results, the patients were divided into an observation group (GAS positive) and a control group (GAS negative). Clinical data from both groups were collected to compare the vaginal microecological changes. The adverse outcomes for pregnancy and infants in both groups were retrospectively analyzed. Univariate and multivariate analyses were used to identify the risk factors for adverse outcomes.
    RESULTS: Among the 270 pregnant women, 30 tested positive for GAS and 240 tested negative, with a colonization rate of 11.1%. No resistance to penicillin, ampicillin, linezolid, vancomycin, or tigecycline was found among the GAS strains. The resistance rates to tetracycline and clindamycin were 73.3% and 70.0%, respectively. Higher vaginal pH (≥4.5), and increased incidences of bacterial vaginitis, aerobic vaginitis, and microecological imbalances were observed in the observation group compared to the control group (all P<0.05). The observation group also experienced more adverse pregnancy and infant outcomes, such as chorioamnionitis, postpartum infections, fetal distress, and neonatal pneumonia (all P<0.05). Univariate and multivariate analyses indicated that a vaginal pH≥4.5 and microecological imbalance were positively associated with poor maternal and infant outcomes in women with GAS infections (all P<0.05).
    CONCLUSIONS: The study found no β-lactam resistant GAS strains. Additionally, a higher vaginal pH (≥4.5) and microecological imbalance were linked to an increased risk of adverse pregnancy and infant outcomes in women with GAS infections.
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  • 文章类型: Journal Article
    目的:慢性化脓性中耳炎(CSOM)是中耳裂隙粘膜骨膜衬里的慢性炎症,通过鼓膜穿孔表现为反复的耳部分泌物。本研究旨在评估CSOM病例中的细菌感染谱,并检测分离生物体的抗生素敏感性模式。
    方法:前瞻性医院观察性研究于2021年6月至2022年6月进行,包括94例CSOM病例。在无菌预防措施下从每位患者收集耳部分泌物的耳部拭子。拭子用于革兰氏染色和需氧细菌病原体培养。使用Kirby-Bauer圆盘扩散方法测试分离的生物体的抗生素敏感性。
    结果:受影响最大的年龄组是生命的第二个十年(27.7%,n=26),男女比例为1.35:1。耳放电的平均持续时间为24.0±14.7个月,主要是粘液样耳朵分泌物(39.4%,n=37)。在革兰氏阳性菌中,耐甲氧西林金黄色葡萄球菌16例(17.0%)。铜绿假单胞菌是26例(27.7%)中最分离的革兰氏阴性菌。复方新诺明(67.7%,n=21)对革兰氏阳性细菌分离株的敏感性最高。在革兰氏阴性细菌中,阿米卡星和环丙沙星最敏感,敏感性为78.0%(n=39)。
    结论:评估CSOM的感染菌谱及其抗生素敏感性可能有助于采用适当的抗生素方案进行及时治疗,从而防止未来的并发症。
    OBJECTIVE: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the mucoperiosteal lining of the middle ear cleft, presenting with recurrent ear discharge through a tympanic membrane perforation. The present study aims to assess the spectrum of bacterial infection among CSOM cases and detect the isolated organism\'s antibiotic sensitivity pattern.
    METHODS: The prospective hospital-based observational study was conducted from June 2021 to June 2022 and included 94 CSOM cases. An aural swab of the ear discharge was collected from each patient under aseptic precautions. The swab was utilized for Gram\'s staining and the aerobic bacterial pathogen culture. The organisms isolated were tested for antibiotic sensitivity using the Kirby-Bauer disc diffusion method.
    RESULTS: The most affected age group was the second decade of life (27.7%, n=26), with a male-to-female ratio of 1.35:1. The mean duration of ear discharge was 24.0±14.7 months, mostly mucoid ear discharge (39.4%, n=37). Among gram-positive bacteria, methicillin-resistant Staphylococcus aureus was isolated in 16 (17.0%) cases. Pseudomonas aeruginosa was the most isolated gram-negative bacteria strain in 26 (27.7%) cases. Cotrimoxazole (67.7%, n=21) had the highest sensitivity towards gram-positive bacteria isolates. Amongst gram-negative bacteria, amikacin and ciprofloxacin were the most sensitive, with 78.0% (n=39) susceptibility.
    CONCLUSIONS: Evaluating the spectrum of infecting organisms of CSOM and their antibiotic sensitivity may help initiate prompt treatment with the appropriate antibiotic regimen, thereby preventing future complications.
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