[Gastrointestinal infections]

Drug Resistance and Molecular Typing Characteristics of Diarrheagenic Escherichia coli in Patients with Diarrhea in Chifeng, China

Diarrheagenic Escherichia coli (DEC) can cause diarrhea and other gastrointestinal diseases, leading to severe dehydration, malnutrition, and even death. The increasing drug resistance and the emergence of multidrug-resistant bacteria present significant challenges to the public health. This study employed qPCR detection, the broth microdilution method, and pulsed-field gel electrophoresis (PFGE) technology to analyze virulence gene, drug resistance, and phylogenetic relationships in DEC isolated from 1,000 stool samples of patients with diarrhea in Chifeng City from 2021 to 2024. A total of 96 strains of DEC were detected, yielding a detection rate of 9.6%. Among these, enteroaggregative E. coli (EAEC) comprised 72.9% (70 strains), enteropathogenic E. coli accounted for 26.0% (25 strains), and enterohemorrhagic E. coli constituted 1.1% (1 strain). The resistance rates of DEC to tetracycline (TET), ampicillin, nalidixic acid, sulfamethoxazole, and streptomycin were recorded at 60.4%, 57.3%, 51.0%, 49.0%, and 42.7%, respectively, with 51.1% of DEC strains exhibiting multidrug resistance. The PFGE banding patterns of the 96 DEC strains were highly polymorphic, with similarity coefficients ranging from 33.6% to 100.0%. Notably, a higher similarity coefficient indicated greater similarity in drug resistance phenotypes among the strains. These results indicate that the predominant type of DEC infection in patients with diarrhea in Chifeng City is EAEC, with a TET resistance rate as high as 60.4%. Furthermore, the resistance spectrum is broad, and the DNA level exhibits significant polymorphism.

Expert consensus on the diagnosis and treatment of end-stage liver disease complicated by infections

End-stage liver disease (ESLD) is a life-threatening clinical syndrome and when complicated with infection the mortality is markedly increased. In patients with ESLD, bacterial or fungal infection can induce or aggravate the occurrence or progression of liver decompensation. Consequently, infections are among the most common complications of disease deterioration. There is an overwhelming need for standardized protocols for early diagnosis and appropriate management for patients with ESLD complicated by infections. Asia Pacific region has the largest number of ESLD patients, due to hepatitis B and the growing population of alcohol and NAFLD. Concomitant infections not only add to organ failure and high mortality but also to financial and healthcare burdens. This consensus document assembled up-to-date knowledge and experience from colleagues across the Asia-Pacific region, providing data on the principles as well as evidence-based current working protocols and practices for the diagnosis and treatment of patients with ESLD complicated by infections.

[Traveler's Diarrhea]

Travelers' diarrhea is the most common infectious disease in travel medicine. This article deals with epidemiology, diagnostics, prophylaxis and therapy. The causative pathogens, important differential diagnoses and indications for extended diagnostic measures are discussed in detail. Furthermore, aspects of travel medicine advice as well as the possibilities and limits of infection prevention are presented.