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Purpose: Developing countries, invasive Salmonella infections can cause considerable morbidity and mortality. There is a relative lack of data on coinfection with Salmonella in HIV-infected patients in Hangzhou, China. Patients and Methods: In this study, we manually collected case data of patients aged >18 years with HIV combined with invasive Salmonella infections admitted to Xixi Hospital in Hangzhou from January 2012 to August 2023 by logging into the Hospital Information System, and identified 26 strains of invasive Salmonella using a fully automated microbiological identification system and mass spectrometer. Serotypes were determined using Salmonella diagnostic sera based on the White-Kauffmann-Le Minor scheme. Drug sensitivity tests were performed using the automated instrumental method of the MIC method. Results: A total of 26 HIV-infected patients with invasive Salmonella coinfections were identified over 11 years; Twenty-five of the 26 patients (96.2%) were males, with a mean age of 33.5 years (26.75, 46.75). The most common type of infection was bloodstream infection (92.3%). One patient also had concomitant meningitis and osteoarthritis, followed by pneumonia (7.7%). The presence of multiple bacterial infections or even multiple opportunistic pathogens was clearly established in 7 (26.9%) patients. Three (11.6%) patients were automatically discharged from the hospital with deterioration of their condition, and one (3.8%) patient died. Salmonella enteritidis was the most common serotype in 6 patients (23.2%), and Salmonella Dublin was the most common serotype in 6 patients (23.2%). Drug sensitivity results revealed multidrug resistance in a total of 8 (30.8%) patients. Conclusion: The clinical presentation of invasive Salmonella infection in HIV patients is nonspecific and easily masked by other mixed infections. A CD4+ count <100 cells/µL and comorbid intestinal lesions may be important susceptibility factors. Salmonella has a high rate of resistance to common antibiotics, and the risk of multidrug resistance should not be ignored.

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BACKGROUND: With the rapid growth of the demand for optically pure compounds in the fields of biology, medicine and stereospecific synthesis, it is of great importance to develop efficient, economical, simple enantioseparation and analysis methods. Open tubular capillary electrochromatography (OT-CEC) has attracted much attention in the field of chiral separation, but its column capacity and the sensitivity of common-used optical detection are relatively low. Zeolite beta nanomaterial is both enantioselective and size-selective, providing suitable chiral microenvironment for chiral recognition, and amperometric detection (AD) avoids the low sensitivity caused by the short optical path in optical detection to some extent. RESULTS: Zeolite beta nanomaterials with different particle sizes (25, 50 and 200 nm) were synthesized, and the morphology and structure were characterized by scanning electron microscopy and X-ray diffraction. Then, a novel chiral OT column was prepared by one-step method using zeolite beta nanomaterial as chiral stationary phase, and its separation performance was characterized by miniaturized CEC with AD (mini-CEC-AD) device. Under the optimum conditions, six groups of chiral drugs achieved baseline separation. Norepinephrine enantiomers were used for evaluating the inter-day, intra-day and inter-column reproducibility of the prepared open-tubular column. The relative standard deviations of migration time, peak area, resolution and selectivity factor were within 8.7 %. The limits of detection for norepinephrine enantiomers were 0.18 µg mL-1 (S/N = 3), and the average recoveries were in range of 96.7-105.0 %. This developed method has been successfully applied to the analysis of impurity enantiomer in potassium dichromate (+)-norepinephrine injection sample. SIGNIFICANCE: Zeolite beta nanomaterial was used as the stationary phase to prepare chiral OT columns for the first time, and this one-step preparation method is simple and easy. The introduction of zeolite beta enriches the types of chiral stationary phase materials in electrochromatographic columns, and mini-OT-CEC-AD system provides an alternative for fast enantioseparation of chiral compounds.

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Purpose: To report a rare case of tibial osteomyelitis caused by Mycobacterium aubagnense and its L-form, to systematically review non-tuberculous mycobacteria (NTM) infections of the bones, and to summarize the medication guidelines for infections with NTM and its L-forms. Methods: Case report and literature review. Results: We report a 31-year-old HIV-positive man who developed osteomyelitis caused by M. aubagnense and its L-form. Culture, electron microscopy, polymerase chain reaction assay, and a reversion test confirmed the existence of M. aubagnense. The patient was treated with surgical debridement and a combination of systemic antibiotics, and continued to take antiretroviral treatment. Some clinical improvement was noted shortly after the initiation of this treatment. Resolution of osteomyelitis was achieved after 10 months. We also systematically reviewed cases of NTM osteomyelitis in the PubMed database and compared antibiotic sensitivity between L-forms and their prototype bacteria. We have summarized the treatment regimens for infections of the bone and bone marrow caused by NTM and their L-forms. Conclusion: We have reported the first case of refractory osteomyelitis caused by M. aubagnense and its L-form in a patient with immune deficiency, reviewed the literature on NTM osteomyelitis, and compared the antibiotic sensitivity of L-forms and their prototype bacteria.

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Background: Due to the inability to be cultured in vitro, the biological characteristics and pathogenicity of Pneumocystis jirovecii remain unclear. Intestinal microflora disorder is related to the occurrence and development of various pulmonary diseases. This work explores the pathogenesis of pneumocystis pneumonia (PCP) in acquired immune deficiency syndrome (AIDS) patients from a microbiome perspective, to provide better strategies for the diagnosis, treatment, and prevention of PCP. Methods: Subjects were divided into three groups: human immunodeficiency virus (HIV)-infected patients combined with PCP, HIV-infected patients without PCP, and HIV-negative. Stool and bronchoalveolar lavage fluid (BALF) samples were collected, total DNA was extracted, and 16S rRNA high-throughput sequencing was performed using an Illumina MiSeq platform. PICRUSt and BugBase were used to predict microflora functions, and correlation analysis of intestinal and lung bacterial flora was conducted. Results: Compared with the HIV- group, prevotella and another 21 genera in the intestinal microbiome were statistically different in the HIV+ group; 25 genera including Escherichia-Shigella from HIV+PCP+ group were statistically different from HIV+PCP- group. The abundance of Genera such as Porphyromonas was positively or negatively correlated with CD16/CD56+ (µL). Compared with the HIV- group, identification efficiency based on area under the curve (AUC) >0.7 for the HIV+ group identified seven genera in the gut microbiota, including Enterococcus (total AUC = 0.9519). Compared with the HIV+PCP- group, there were no bacteria with AUC >0.7 in the lung or intestine of the HIV+PCP+ group. The number of shared bacteria between BALF and fecal samples was eight species in the HIV- group, 109 species in PCP- patients, and 228 species in PCP+ patients, according to Venn diagram analysis. Changes in various clinical indicators and blood parameters were also closely related to the increase or decrease in the abundance of intestinal and pulmonary bacteria, respectively. Conclusions: HIV infection and PCP significantly altered the species composition of lung and intestinal microbiomes, HIV infection also significantly affected intestinal microbiome gene functions, and PCP exacerbated the changes. The classification model can be used to distinguish HIV+ from HIV- patients, but the efficiency of bacterial classification was poor between PCP+ and PCP- groups. The microbiomes in the lung and gut were correlated to some extent, providing evidence for the existence of a lung-gut axis, revealing a potential therapeutic target in patients with HIV and PCP.

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In this work, novel stationary phase coatings by zeolite SiO2NPs coupled with ß-cyclodextrin (ß-CD) or ß-CD/L-phenylalanine were developed for chiral open-tubular capillary electrochromatography (OT-CEC). The OT columns were prepared taking advantage of the strong adhesion of polydopamine in one-step method. Scanning electron micrography and electroosmotic flow were used to characterize the prepared single/dual-selector OT columns. Chiral separation of four chiral analytes (catechin/epicatechin, ephedrine/pseudoephedrine, ritodrine and salbutamol) was carried out in order to evaluate the performance of the prepared columns in OT-CEC with amperometric detection system. In terms of migration time, peak area, resolution, and selectivity factor of catechin/epicatechin and salbutamol, the run-to-run, day-to-day, and column-to-column repeatability were within 8.9%. Under the optimum conditions, the developed methods were applied for the analyses of Chinese herbal medicine Catechu herbs and salbutamol aerosol samples.

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