echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Infection > IDSC2021|Infected by multidisciplinary celebrities forming a group!

    IDSC2021|Infected by multidisciplinary celebrities forming a group!

    • Last Update: 2021-11-14
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com
    Physician News (Rong Media reporter Qiu Jia, Huang Lingling, Cai Zengrui) On October 29, the 7th Academic Conference of the Infectious Diseases Committee (IDSC) of the Chinese Medical Education Association was held in Guangzhou
    .

    The theme of this conference is "Disciplinary Union, Control of Sense and Anti-epidemic".
    The conference adopts a combination of offline and online methods.
    Authoritative experts in infection-related fields from China will discuss the latest developments in infection imaging, pathogen diagnosis and treatment.
    Hot topics such as infection and immunity, infection and microecology, important pathogens such as fungi and mycobacteria, and comprehensive clinical capabilities related to infection were shared and discussed
    .

    New trends in treatment Liu Youning Coping with drug resistance The future of phage therapy can be expected.
    Professor Liu Youning from the Department of Respiratory and Critical Care Medicine, PLA General Hospital, introduced the past and present of phage therapy
    .

    Bacteriophage is a virus that can infect other microorganisms such as bacteria, fungi, actinomycetes, or spirochetes, and is widespread in nature, with a total number of about 10 times that of bacteria
    .

    In 1919, bacteriophages were first used to treat bacillary dysentery in children
    .

    In the 1940s, the mass production and wide application of broad-spectrum antibacterial drugs brought the partially commercialized phage preparations to a halt, and only a few Eastern European countries continue to use them so far
    .

    With the increasingly prominent problem of pathogen resistance and the bottleneck in the development of antibacterial drugs, phage therapy has regained clinical attention
    .

    At present, there are more and more case reports of using phage therapy to obtain curative effects, involving infections of different parts and different pathogenic bacteria, such as Staphylococcus aureus and Pseudomonas aeruginosa
    .

    The lytic phage will produce depolymerase during the replication process, and it has become the main way to kill bacteria by adsorbing and releasing endolysin.
    At present, there have been many reports in the literature on the application of synthetic and purified recombinant endolysin to treat Staphylococcus aureus infection
    .

    Professor Liu’s team used hospital untreated sewage and clinically isolated drug-resistant strains to extract new phages, which are homologous to the reported phages: Pseudomonas aeruginosa (3%), Streptomonas maltophilia (0~2%) ), Acinetobacter (55%), Acinetobacter phage and its depolymerase will be the main research target in the future
    .

    Bacteriophages exist in the human body and are compatible with the human body.
    So far, no adverse human immune response has been found
    .

    Bacteriophages can destroy the biofilm and have a certain synergistic effect in combination with antibacterial drugs
    .

    The in vitro synthesis technology of depolymerase is not complicated, and the treatment of G+ cocci is better than G-bacillus
    .

    At present, the literature reports that the safety of clinical application is good, and some of them have begun phase I/II clinical trials (South Korea SAL200)
    .

    Combining genetic engineering technology, design and modification on the basis of existing depolymerases to make them more suitable for human applications, or one of the main research directions in the future
    .

    New progress in pathogen research Yu Yunsong is alert to the increase in types and drug resistance of Pseudomonas aeruginosa It is a common clinical pathogen and one of the important components of carbapenem-resistant gram-negative bacilli (CRO).
    It ranks third after Escherichia coli and Klebsiella pneumoniae
    .

    PA can be infected in every system of the body
    .

    The resistance mechanism of PA is very complicated, especially carbapenemase resistance.
    Metalloenzyme is the mainstream carbapenemase type of PA in the world, but it does not exceed 10% in China
    .

    Reports on the production of class A/D carbapenemase in China have gradually increased, especially the rapid spread of KPC-producing PA, and multiple copies of KPC-mediated ceftazidime/avibactam (CAZ/AVI) resistance have appeared
    .

    The prevalent clones of PA are increasing, and the newly popular drug-resistant clone in China is ST463
    .

    For MDR/XDR PA infection, according to the different resistance mechanisms, the recommended treatment options are different
    .

    The drugs currently available in China include polymyxin, ceftazidime/avibactam, aztreonam and amikacin
    .

    New antibacterial drugs have certain curative effects, including new β-lactam antibacterials CAZ/AVI, cefodil, etc.
    , as well as new non-β-lactam drugs
    .

    But it still needs to be confirmed by more clinical studies
    .

    Chen Baiyi Several problems with high virulence Klebsiella pneumoniae infection Professor Chen Baiyi Professor Chen Baiyi from the First Affiliated Hospital of China Medical University introduced that since the mid-1980s, Klebsiella pneumoniae evolved in two directions and gradually formed different In the clone group, one showed multi-drug resistance (MDR), namely classic lung gram (cKP); while the other showed high virulence, namely high virulence lung gram (hvKP)
    .

    It is currently believed that the prerequisite for hvKP infection is early exposure, acquisition and colonization
    .

    Most people with hvKP are immunologically normal, so there must be other factors (such as increased hvKP bacteria, virulence changes, and other host factors) that lead to the transformation of bacteria from colonization to infection
    .

    The clinical manifestations are "extraordinary
    .
    "
    The hvKP invasive infection syndrome is similar to the invasive infection of Staphylococcus aureus, which has largely changed the disease pattern and pathogenic distribution of community-acquired infections.
    The clinical differential diagnosis should be paid attention to
    .

    The best treatment is not yet known
    .

    "Beginning with experience and ending with goal" is still the best clinical practice at the moment
    .

    The hvKP strain remains highly sensitive to most antibacterial drugs, so even in empirical treatment, it is not difficult to be "correct"
    .

    How to achieve "full" should consider drugs on tissue penetration site of infection, infectious dose and other arrangements for the very period
    .

    Wang Minggui Looking at the "star" pathogens of various periods from the monitoring of bacterial resistance, Professor Wang Minggui, Professor Wang Minggui from the Institute of Antibiotics, Huashan Hospital, Fudan University, reviewed and described the tricky clinical isolates that have attracted special attention in each era
    .

    From the 1960s to the 1990s, MRSA and Pseudomonas aeruginosa were the most prominent
    .

    According to CHINET data, since 2005, the detection rate of MRSA and Pseudomonas aeruginosa has shown a downward trend
    .

    From 1990 to 2010, the detection rate of Acinetobacter gradually increased
    .

    According to CHINET data, Acinetobacter has a high rate of resistance to antibacterial drugs since 2005
    .

    Since 2010, Klebsiella pneumoniae has gradually emerged, and the resistance of carbapenem-resistant Klebsiella pneumonia (CRKP) has increased, with high virulence, high drug resistance + high virulence, drug resistance and sensitivity.
    Problems such as conversion and polyclonal coexistence have increased the difficulty of clinical response
    .

    Which bacteria will be the focus of attention in the future? Professor Wang boldly speculated that the "star" pathogen after Fei Ke might be Proteus
    .

    First of all, the treatment of Proteus infection is very difficult, and it is very easy to relapse
    .

    CHINET data show that Proteus mirabilis ranks 13th in the distribution of major clinical isolates in 2020
    .

    From 2005 to 2020, the resistance rate of Proteus mirabilis to cefotaxime and levofloxacin showed an obvious upward trend
    .

    And from the perspective of morphology, Proteus mirabilis has flagella all over the body, which is active in movement, or it is not easy to be cleared
    .

    Wu Depei The diagnosis and treatment of fungal infections in the Department of Hematology is facing challenges.
    Professor Wu Depei, the First Affiliated Hospital of Soochow University, said that the diagnosis and treatment of invasive mycosis (IFD) in the Department of Hematology still faces huge challenges
    .

    IFD diagnosis rate is still low, there are missed diagnosis and treatment delay
    .

    There are many high-risk factors for IFD in hematology patients, and the risk of fungal infection is throughout
    .

    Once a patient has invasive fungal disease, treatment is difficult, costly, long course of treatment, and poor prognosis, which is one of the important causes of death from hematological malignancies
    .

    Preventive antifungal therapy is an important strategy for the management of IFD in patients with high-risk blood diseases
    .

    Currently, it is recommended to adopt a hierarchical prevention strategy for chemotherapy patients based on risk factor scores; for transplant patients, different prevention programs should be adopted based on different transplantation plans and time intervals after transplantation
    .

    The preventive drugs for invasive fungal diseases are more optional, such as posaconazole, echinocandins and so on
    .

    The prevention of antifungal drugs emphasizes early and full prevention strategies until the high-risk factors are eliminated
    .

    With the widespread implementation of preventive strategies, the problem of induction of resistant strains in preventive antifungal treatment has gradually emerged
    .

    And because of the emergence of new therapies for the treatment of blood diseases, it is necessary to redefine the risk factors of this part of the population and determine the actual value of fungal prevention
    .

    In general, the current prevention of IFD in patients with hematological diseases needs to combine high-risk factors and immune status, and adopt individualized and stratified preventive treatment strategies based on local microbial epidemiological characteristics and guideline recommendations
    .

    Infection and immune control The clinical treatment of sepsis should emphasize immunoregulation, Professor Guan Xiangdong of the First Affiliated Hospital of Sun Yat-sen University introduced that the clinical treatment of sepsis should emphasize the immunoregulatory treatment of patients
    .

    The Shock and Sepsis Professional Committee of the Chinese Research Hospital Association, the Critical Care Medicine Professional Committee of the Chinese People's Liberation Army, and the Critical Immune Research Collaboration Group jointly formulated the "Expert Consensus on the Diagnosis and Treatment of Sepsis Immunosuppression" to help clinicians understand sepsis more deeply Induced immunosuppression
    .

    The consensus of experts suggests that attention should be paid to the immune indicators of patients with sepsis and monitoring and immuno-enhancement therapy should be carried out for patients with sepsis
    .

    An ideal biomarker must have four characteristics: (1) It can be used as a diagnostic tool to identify the patient's disease or disease state; (2) It can be used as a staging or classification tool for disease severity; (3) It can be used as an indicator of disease prognosis; (4) It can be used to predict and monitor the clinical response to intervention
    .

    The expert consensus emphasizes the status of mHLA-DR monitoring in prognostic evaluation
    .

    In addition, lymphocyte count is also a good indicator for immune monitoring of sepsis
    .

    The consensus suggests that immune-enhancing treatments for immunosuppressed patients include drugs that enhance natural immunity and drugs that enhance acquired immunity
    .

    Strengthening the research of immune-enhancing drugs may improve the immune function and prognosis of patients with immunosuppressive sepsis
    .

    Huang Xiaojun Severe Pneumonia Virus or Immunization After Transplantation, Professor Huang Xiaojun, Peking University People’s Hospital and Peking University Institute of Hematology, said that late onset of severe pneumonia (LOSP) after transplantation is a patient’s lung damage that occurs in allogeneic hematopoietic stem cell transplantation (allo-SCT) 3 Months later, a large area of ​​lung imaging infiltration or rapidly progressing hypoxemia appeared in the early onset of the disease, accompanied by respiratory failure, other organ dysfunction, or hemodynamic instability.
    The criteria for severe illness should refer to the American Academy of Infectious Diseases and Judgment criteria established by the American Thoracic Society (IDSA/ATS)
    .

    The lung imaging findings of patients with LOSP are mainly diffuse ground-glass or nodular lesions in both lungs, and are not accompanied by clinical manifestations such as yellow sputum and white sticky sputum, which are different from typical bacterial and fungal features
    .

    The study found that there was no significant difference between the composition of bronchoalveolar lavage fluid and viral pneumonia in patients with pneumonia of unknown pathogen after transplantation
    .

    In addition, it was also found that the timing and dosage of glucocorticoids are related to the prognosis of patients with LOSP
    .

    Based on clinical diagnosis and treatment experience, Professor Huang's team put forward a hypothesis that patients with LOSP may have an excessive immune response induced on the basis of infection, and this infection is highly suspected to be a virus
    .

    A series of studies are needed to verify this hypothesis in the future
    .

    The cognition of severe pneumonia after transplantation still needs to be continuously developed and improved in the exploration
    .

    Infection and Severe Disease Qiu Haibo Early Infection Diagnosis and Treatment and Organ Support Professor Qiu Haibo of Zhongda Hospital Affiliated to Southeast University said that the key to diagnosis and treatment of severe infection is early diagnosis and treatment of infection and organ function support
    .

    Clinically, there is an urgent need to improve the ability to diagnose severe infections, and there are both overdiagnosis and missed diagnosis of severe infections
    .

    At present, for the diagnosis and identification of severe infections, the early warning function of the electronic medical record system is helpful to the clinic
    .

    Early Sepsis screening and early warning system of artificial intelligence through predictive indicators has certain clinical significance
    .

    The Sepsis Team with nurses as the main body can help patients with severe infections to be treated earlier
    .

    On the other hand, rapid diagnosis of pathogenic microorganisms after diagnosis of infection is the most important thing
    .

    Although the specific microorganisms are not known using PCR, biomarkers, host gene expression, etc.
    , they have shown certain value in terms of whether they are infected, whether they are bacteria, fungi or viruses, and whether they are positive or negative bacteria
    .

    Another part of severe infection is life-threatening organ dysfunction
    .

    The longer the life-threatening organ damage, the higher the mortality rate
    .

    After the infection causes severe illness, it is necessary to race against time to monitor lactic acid and fluid as soon as possible, and early antibacterial treatment to prevent organ failure, including the treatment of respiratory function and AKI
    .

    Xie Lixin ICU's problems and ways out Professor Xie Lixin, director of the Department of Respiratory and Critical Care Medicine, PLA General Hospital, introduced some of the problems that are currently exposed in the Closed ICU
    .

    Infection is the main cause of ICU patients, and secondary infection in the hospital is the first cause of death in patients
    .

    How to make accurate early diagnosis, individualized treatment, and how to avoid nosocomial infections is imminent
    .

    Professor Xie introduced some explorations of the team's rapid bedside pathogen evaluation (M-ROSE) technology in the past two years
    .
    It has become a reality to identify the pathogen in critically ill patients within 2 hours .

    Regarding infection, another issue is to pay attention to the imbalance of the micro-ecological environment in the ICU.
    The regulation of the micro-ecological is a potential therapeutic target for severely ill patients in the ICU
    .

    In the ICU, unplanned accidents in equipment, medical care, and patients caused the ICU patients' condition to worsen by 40% to 70%
    .

    The current exploration is to establish a dynamic intelligent early warning system based on the seamless connection of HIS and ICU equipment, to assess the patient's condition and equipment conditions in the first time, remote monitoring, timely early warning, and effective intervention
    .

    The anxiety syndrome in ICU patients is almost 100%, the mortality rate is increased, the length of hospital stay is prolonged, and the later period of dysfunction
    .

    The most important thing we can do is to change the definition of ICU patients from a biological person to a humanistic person, and to think and improve more from the perspective of the patient
    .

    New Vision of Diagnosis Chen Liangan's three modern technologies help the diagnosis of infectious lung diseases The current status of disease diagnosis
    .

    In the past 20 years, genomics, transcriptomics, proteomics, metabolomics and other omics technologies have been widely used
    .

    Pathogen metagenomics second-generation sequencing (mNGS) can break through the limitations of different pathogen types and is comprehensive, fast and accurate
    .

    Third-generation sequencing can perform single-molecule sequencing, which removes the bias caused by the amplification process and significantly shortens the inspection time
    .

    Exhaled gasomics is a category of volatile organic compounds (VOC), which detects infectious diseases by detecting special components in breathing gas
    .

    Artificial intelligence is widely used in imaging omics technology
    .

    Through image recognition, image segmentation, feature extraction, model building, clinical application and other steps, the screening, differential diagnosis, early warning, and severity assessment of infectious diseases are carried out
    .

    At the same time, big data has been widely used clinically
    .

    At present, the development direction of infectious disease diagnosis is to use artificial intelligence systems to comprehensively make clinical decisions through patient big data, etiology big data, and pharmacology big data
    .

    Xu Yingchun The new crown epidemic has pushed the diagnosis of pathogens into the fast lane.
    Professor Xu Yingchun of Peking Union Medical College Hospital said that in the face of new infectious diseases, clinically higher requirements for the accuracy and timeliness of pathogenic microorganism diagnosis are put forward
    .

    With the continuous development of sequencing technology, the extended-spectrum pathogenic microorganism detection and diagnosis technology based on the metagenomic high-throughput sequencing platform has expanded clinical understanding of diseases and accelerated the discovery of pathogens of emerging infectious diseases
    .

    Real-time fluorescent polymerase chain reaction (PCR), digital PCR, molecular diagnostic real-time testing, next-generation sequencing, single-molecule sequencing, mass spectrometry and other technologies move from scientific research to clinical, providing a new solution for rapid screening and targeting of sources of infection in different application scenarios
    .

    Negative staining technology revealed the general appearance of the virus for the first time, and cryo-electron microscopy tomography analyzed the three-dimensional structure of the new coronavirus.
    The emergence of these new technologies has greatly promoted vaccine research and development, drug development and clinical treatment
    .

    The artificial intelligence diagnosis system based on chest radiograph can quickly diagnose viral and non-viral pneumonia
    .

    Cross-field exchanges, breakthroughs in multiple technologies, and detection methods that are blooming everywhere have helped clinicians get on the fast train in the discovery and understanding of pathogens, and have a faster response speed in the face of new infectious diseases
    .

    At that time, Professor Hu Bijie from Zhongshan Hospital of Fudan University said that the more internationally recognized term for infection control is nosocomial infection prevention and control
    .

    On the one hand, it is to prevent the occurrence of infection, on the other hand, after the infection occurs, control its spread
    .

    Including the prevention and control of infectious diseases, "three catheters" infections, surgical site infections, drug-resistant bacteria infections, postoperative pneumonia, and environmental related infections
    .

    China has done a good job in the prevention and control of blood-borne infections, and has paid more and more attention to the infection of the three catheters
    .

    With the development of treatment technology, more and more critically ill patients who were previously difficult to treat have been successfully treated.
    However, how the prevention and control of nosocomial infections keep pace with the times under the poor immunity of patients is worthy of attention
    .

    Since the COVID-19 pandemic, sensory control has received unprecedented attention and attention, which is both an opportunity and a challenge for the construction of sensory control disciplines
    .

    The cultivation of infection professionals is imminent
    .

    The focus of future sense control must be to construct professional things as a professional discipline
    .

    It is also hoped that government departments can increase investment in the construction of sensory control disciplines and personnel training, such as setting up special sensory control research funds, more policy inclination for disciplinary development, and attracting and training more sensory control talents
    .

    Typesetting: Xin Ya Editor: Qiu Jia Review: Qiu Jia to vote | "Long Vision Mu Guangming" 2021 most beautiful ophthalmologist is here, choose the most beautiful TA in your heart! The "Finding the Most Beautiful Ophthalmologists" activity has been successfully held for six sessions since its inception, and a total of 30 most beautiful ophthalmologists have been selected
    .

    In 2021, standing at the historical node of the 100th anniversary of the founding of the Communist Party of China and the first year of the "14th Five-Year Plan", the "Hundred Years of Struggle, Illuminating Humanities" sponsored by the "Physician Daily" and jointly undertaken by Eyebrow and Kanghong Biotechnology Co.
    , Ltd.
    "Light"-"Long Vision Mu Guangming" 2021 The Most Beautiful Ophthalmologist Activities Continued Excitingly
    .

    This selection will finally select 5 "outstanding ophthalmology Communist Party members" and 5 "most beautiful primary ophthalmologists" through preliminary review and voting
    .

    Click on the hyperlink to vote | "Long Vision Mu Guangming" 2021 most beautiful ophthalmologist is here, choose the most beautiful TA in your heart! Long press the QR code to enter the voting page.
    This activity does not charge any fees! Supervision telephone: (010)-58302970
    .

    Power to advance the industry | The 7th Medical Scientists Summit (2022) is here! For more information, please click: 2021 Great Wall Conference opens | Steady, refinement, and innovation.
    The cardiovascular field needs to embrace the era of innovation.
    | Wang Yongjun leads the research to reach the top of the New England Journal of Medicine again, CHANCE-2 research guides secondary stroke prevention New strategy "Physician Daily" submission public email: yishibao2017@163.
    com [Note] Some pictures are from the Internet and WeChat Moments.
    If there is any infringement, please contact to delete, thank you! Tel: 010-58302828-6808 Currently 1130000+ doctors have been following to join us              
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.