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Abstract Introduction: The evaluation of extracorporeal membrane oxygenation-related nosocomial infection (ECMO-related NI) in a homogeneous cohort remains scarce. This study analyzed ECMO-related NI in adult patients who have undergone cardiac surgery. Methods: From January 2012 to December 2017, 322 adult patients who have received ECMO support after cardiac surgery were divided into the infection group (n=131) and the non-infection group (n=191). ECMO-related NI was evaluated according to demographic data, surgical procedures, and ECMO parameters. Results: The incidence of ECMO-related NI was 85.4 cases per 1000 ECMO days. Acinetobacter baumannii was the most common pathogen causing blood stream infection and respiratory tract infection. Prolonged duration of surgery (P=0.042) and cardiopulmonary bypass assist (P=0.044) increased the risk of ECMO-related NI. Body mass index (odds ratio [OR]: 1.077; 95% confidence interval [CI]: 1.004-1.156; P=0.039) and duration of ECMO support (OR: 1.006; 95% CI: 1.003-1.009; P=0.0001) were the independent risk factors for ECMO-related NI. Duration of ECMO support > 144 hours (OR: 2.460; 95% CI: 1.155-7.238; P<0.0001) and ECMO-related NI (OR: 3.726; 95% CI: 1.274-10.895; P=0.016) increased significantly the risk of in-hospital death. Conclusion: Prolonged duration of ECMO support was an independent risk factor for NI. Surgical correcting latent causes of cardiopulmonary failure and shortening duration of ECMO whenever possible would reduce susceptibility to NI.
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Humanos , Adulto , Infección Hospitalaria/etiología , Infección Hospitalaria/epidemiología , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Puente Cardiopulmonar/efectos adversos , Oxigenación por Membrana Extracorpórea/efectos adversos , Estudios Retrospectivos , Factores de Riesgo , Mortalidad HospitalariaRESUMEN
The global outbreak of coronavirus disease 2019 (COVID-19) is greatly threatening the public health in the world. We reconstructed global transmissions and potential demographic expansions of severe acute respiratory syndrome coronavirus 2 based on genomic information. We found that intercontinental transmissions were rare in January and early February but drastically increased since late February. After world-wide implements of travel restrictions, the transmission frequencies decreased to a low level in April. We identified a total of 88 potential demographic expansions over the world based on the star-radiative networks and 75 of them were found in Europe and North America. The expansion numbers peaked in March and quickly dropped since April. These findings are highly concordant with epidemic reports and modelling results and highlight the significance of quarantine validity on the global spread of COVID-19. Our analyses indicate that the travel restrictions and social distancing measures are effective in containing the spread of COVID-19.
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COVID-19/epidemiología , Genoma Viral , Política Pública , SARS-CoV-2/genética , Viaje , África/epidemiología , Asia/epidemiología , Australia/epidemiología , COVID-19/transmisión , COVID-19/virología , Control de Enfermedades Transmisibles , Europa (Continente)/epidemiología , Genómica , Humanos , Internacionalidad , América del Norte/epidemiología , Filogenia , Distanciamiento Físico , América del Sur/epidemiologíaRESUMEN
INTRODUCTION: The evaluation of extracorporeal membrane oxygenation-related nosocomial infection (ECMO-related NI) in a homogeneous cohort remains scarce. This study analyzed ECMO-related NI in adult patients who have undergone cardiac surgery. METHODS: From January 2012 to December 2017, 322 adult patients who have received ECMO support after cardiac surgery were divided into the infection group (n=131) and the non-infection group (n=191). ECMO-related NI was evaluated according to demographic data, surgical procedures, and ECMO parameters. RESULTS: The incidence of ECMO-related NI was 85.4 cases per 1000 ECMO days. Acinetobacter baumannii was the most common pathogen causing blood stream infection and respiratory tract infection. Prolonged duration of surgery (P=0.042) and cardiopulmonary bypass assist (P=0.044) increased the risk of ECMO-related NI. Body mass index (odds ratio [OR]: 1.077; 95% confidence interval [CI]: 1.004-1.156; P=0.039) and duration of ECMO support (OR: 1.006; 95% CI: 1.003-1.009; P=0.0001) were the independent risk factors for ECMO-related NI. Duration of ECMO support > 144 hours (OR: 2.460; 95% CI: 1.155-7.238; P<0.0001) and ECMO-related NI (OR: 3.726; 95% CI: 1.274-10.895; P=0.016) increased significantly the risk of in-hospital death. CONCLUSION: Prolonged duration of ECMO support was an independent risk factor for NI. Surgical correcting latent causes of cardiopulmonary failure and shortening duration of ECMO whenever possible would reduce susceptibility to NI.
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Procedimientos Quirúrgicos Cardíacos , Infección Hospitalaria , Oxigenación por Membrana Extracorpórea , Adulto , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Puente Cardiopulmonar/efectos adversos , Infección Hospitalaria/epidemiología , Infección Hospitalaria/etiología , Oxigenación por Membrana Extracorpórea/efectos adversos , Mortalidad Hospitalaria , Humanos , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Maize was domesticated from lowland teosinte (Zea mays ssp. parviglumis), but the contribution of highland teosinte (Zea mays ssp. mexicana, hereafter mexicana) to modern maize is not clear. Here, two genomes for Mo17 (a modern maize inbred) and mexicana are assembled using a meta-assembly strategy after sequencing of 10 lines derived from a maize-teosinte cross. Comparative analyses reveal a high level of diversity between Mo17, B73, and mexicana, including three Mb-size structural rearrangements. The maize spontaneous mutation rate is estimated to be 2.17 × 10-8 ~3.87 × 10-8 per site per generation with a nonrandom distribution across the genome. A higher deleterious mutation rate is observed in the pericentromeric regions, and might be caused by differences in recombination frequency. Over 10% of the maize genome shows evidence of introgression from the mexicana genome, suggesting that mexicana contributed to maize adaptation and improvement. Our data offer a rich resource for constructing the pan-genome of Zea mays and genetic improvement of modern maize varieties.