某市幼儿腹泻患者圆孢子虫感染情况

目的探讨幼儿腹泻患者圆孢子虫感染情况,为控制该疾病提供依据。方法采集幼儿腹泻患者新鲜粪便,制片、固定后用金胺-酚染色和改良抗酸染色法复染,光镜下检查圆孢子虫卵囊。结果幼儿园儿童腹泻患者圆孢子虫卵囊检出率为6.39%。男女幼儿腹泻患者圆孢子虫卵囊检出率分别为6.20%和6.67%,差异无统计学意义(P>0.05);城乡幼儿腹泻患者圆孢子虫卵囊检出率分别为3.45%和9.71%,差异有统计学意义(P<0.01)。结论对一些不明原因、顽固性或免疫功能低下的幼儿腹泻患者应注意圆孢子虫病原体的检测。     

嗜水气单胞菌生态学及引起暴发的流行病学研究

近年来,国内外有关嗜水气单胞菌(Ａｈ)引起腹泻的报道不断增多,但造成暴发性流行当属罕见。秦皇岛市抚宁县北台庄村于1991年6月中、下旬发生一起暴发流行,即5月中、下旬及6月上旬出现散发病例,6月中旬病例数急剧增加,形成暴发性流行,6月中、下旬为流行高峰。全村共有204户780口人,本次调查178户677人,占全村人口的86.79%,查出病人408例,无死亡病例,罹患率达60.27%。7月4日采取措施后疫情得到控制。此后,1991～1999年进行该菌的生态学调查。1　调查方法1.1　病例调查　采用统一的流行病学调查表进行全村普查,逐户逐人调查登记,凡每日腹泻1次…     

2014-2015年麻疹病毒感染患儿的临床特征研究北大核心CSCD

目的通过对某院门诊及住院儿童麻疹病毒感染情况的调查,分析感染相关因素及预防措施。方法回顾性分析2014年1月-2015年12月于某院就诊的疑似感染麻疹病毒的儿童268例,分析患儿的一般资料,并对疑似麻疹病例血清标本进行采集,经酶联免疫吸附试验(ELISA)检测患儿麻疹病毒IgM。结果268例疑似麻疹患儿检出MV IgM抗体阳性120例,阳性率为44.8%;两年MV IgM抗体阳性检出率差异无统计学意义;根据季度不同发现,麻疹病毒感染各季度均有发生,第二季度MV感染患儿较多,为发病高峰期,MV阳性检出率可达49.3%,第三季度及第四季度MV阳性检出率较低;按照月份不同,发现发病高峰期集中于4~6月份,与季节分布一致;按照年龄分布,疑似麻疹病毒感染患儿集中于1~3岁,7~14岁年龄较少,但阳性检出率最高的年龄段集中在0~1岁,高达60.0%,根据年龄的增长MV阳性检出率逐渐降低;按照民族分布,汉族所占人数最多,阳性检出率为49.3%,少数民族阳性检出率低,为28.8%。结论患儿麻疹病毒感染在临床上应注重婴幼儿麻疹病毒感染的预防,继续做好适龄儿童的基础免疫工作,通过合理预防接种来有效预防麻疹暴发流行。     

北京地区婴幼儿急性腹泻病例5种腹泻相关病毒感染状况

目的了解北京地区婴幼儿急性腹泻病例5种腹泻相关病毒的感染状况。方法采集北京地区哨点医院2016年1~12月<60月龄急性腹泻患儿便标本,用实时荧光PCR对A组轮状病毒、诺如病毒、肠道腺病毒、星状病毒进行检测;同时用巢式PCR检测人博卡病毒。结果共采集354份粪便标本,A组轮状病毒检出率13.84%,诺如病毒检出率10.45%,肠道腺病毒检出率4.52%,星状病毒检出率3.95%,人博卡病毒检出率7.34%。混合感染18例,占5.08%。轮状病毒发病高峰为冬季,诺如病毒的发病高峰为春季,其他病毒感染无明显季节特征。2岁以内患儿5种病毒的检出率分别为81.63%、78.38%、81.25%、71.43%、84.62%。结论北京地区急性腹泻患儿5种腹泻相关病毒检出率从高到低依次为:A组轮状病毒、诺如病毒、人博卡病毒、肠道腺病毒、星状病毒;2岁以内患儿是病毒性腹泻的高发人群。     

2014-2015年麻疹病毒感染患儿的临床特征研究

目的通过对某院门诊及住院儿童麻疹病毒感染情况的调查,分析感染相关因素及预防措施。方法回顾性分析2014年1月-2015年12月于某院就诊的疑似感染麻疹病毒的儿童268例,分析患儿的一般资料,并对疑似麻疹病例血清标本进行采集,经酶联免疫吸附试验(ELISA)检测患儿麻疹病毒IgM。结果268例疑似麻疹患儿检出MV IgM抗体阳性120例,阳性率为44.8%;两年MV IgM抗体阳性检出率差异无统计学意义;根据季度不同发现,麻疹病毒感染各季度均有发生,第二季度MV感染患儿较多,为发病高峰期,MV阳性检出率可达49.3%,第三季度及第四季度MV阳性检出率较低;按照月份不同,发现发病高峰期集中于4~6月份,与季节分布一致;按照年龄分布,疑似麻疹病毒感染患儿集中于1~3岁,7~14岁年龄较少,但阳性检出率最高的年龄段集中在0~1岁,高达60.0%,根据年龄的增长MV阳性检出率逐渐降低;按照民族分布,汉族所占人数最多,阳性检出率为49.3%,少数民族阳性检出率低,为28.8%。结论患儿麻疹病毒感染在临床上应注重婴幼儿麻疹病毒感染的预防,继续做好适龄儿童的基础免疫工作,通过合理预防接种来有效预防麻疹暴发流行。     

不同性别、年龄小儿急性腹泻的常见病原微生物检验结果分析

目的分析不同性别、年龄小儿急性腹泻的常见病原微生物检验结果。方法选取2019年1月~2021年1月于我院就诊的100例急性腹泻患儿为研究对象,所有患儿均进行病原微生物检验,包括细菌分离培养及鉴定、ELISA法轮状病毒检测,分析所有患儿病原菌分布情况,比较不同年龄、性别患儿病原菌检出率。结果100例患儿标本中共检出病原微生物40株(40.0%),其中轮状病毒8株(8.0%)、志贺菌4株(4.0%)、大肠埃希菌25株(25.0%),沙门菌3株(3.0%);1~2岁患儿常见病原微生物总检出率显著高于0.4~1岁患儿,差异有统计学意义(P<0.05);40株病原菌感染患儿中,女患儿19例(47.5%),男患儿21例(52.5%),不同性别患儿常见病原微生物检出率比较,差异无统计学意义(P>0.05)。结论小儿急性腹泻中不同年龄患儿病原微生物检出情况存在一定差异,但病原微生物检出情况与患儿性别无关,小儿急性腹泻大肠埃希菌为小儿急性腹泻的主要病原微生物。因此,治疗时应注意患儿年龄差异,并分析病原微生物分布规律和感染类型,以对症治疗,提高治疗效果。     

沧州地区5岁以下小儿腹泻4种病毒性病原学研究

目的研究沧州地区5岁以下儿童腹泻的4种病毒性病原学。方法选取2013年1月-2016年1月沧州市中心医院确诊为腹泻病的5岁以下患儿450例为研究对象,轮状病毒(RV)抗原检测基于胶体金免疫分析试验的基础上进行酶联免疫吸附试验,人星状病毒(HAst V)和人杯状病毒(Hu CV)抗原均采用RT-PCR法进行检测,肠道腺病毒(EAd V)抗原采用常规PCR法检测。比较不同年龄患儿的RV感染分布情况、4项病毒检出率、4项病毒在季节和性别方面的发生率。结果 450例患儿中225例患儿RV抗原检测呈阳性,阳性率为50.00%;其中2个月的幼儿阳性检出率最高,60个月的幼儿阳性检出率最低。Hu CV患儿89例,检出率为19.78%;HAst V患儿81例,检出率为18.00%,EAd V患儿55例,检出率为12.22%。RV多发于春季,HAst V多发于夏秋季节,Hu CV和EAd V均多发于秋季。男性患儿各项病毒的检出率均要高于女性患儿,差异具有统计学意义(P0.05)。结论沧州地区5岁以下儿腹泻中RV病毒抗原检出率最高,且病发季节集中在春季,男性患儿病发多于女性患儿,临床早期病毒检测过程中利用胶体金免疫分析检测病原,并结合酶联免疫吸附试验、PCR、RT-PCR等方法进行检测,可在患儿腹泻早期查明病毒性感染病原学因素,从而为临床治疗提供依据。     

柳江县婴幼儿腹泻轮普煤状病毒感染情况分析

目的了解我县5岁以下人群轮状病毒性腹泻的流行情况和发病率,为考核轮状病毒疫苗免疫保护效果提供基本资料。方法以我县辖区内所有医疗卫生机构作为腹泻病例监测点,回顾性分析2009年12月-2010年4月间监测范围内98例5岁以下儿童腹泻发病情况,采用ELISA双抗体夹心法对患儿粪便标本进行轮状病毒检测,并建立调查报告,制定针对性干预措施。结果本组98例5岁以下儿童腹泻患儿中,共37例患儿大便检测出RV,RV检出率37.8%;3-4月份为婴幼儿腹泻轮状病毒感染高峰期;不同性别间的RV检出率无显著性差异(P>0.05);0-5岁中各年龄组患儿的大便均检测出RV,其中以6-24个月年龄组分布较多(21.5%),0-6个月组次之(9.2%),2-5岁组最低(7.1%)。37例RV感染患儿中,以黄色水样便和稀汁便最为多见共28例(75.7%)。结论轮状病毒是引起冬春季节5岁以下儿童腹泻的主要致病因子,3-4月份感染几率率最高,以6个月-2岁年龄患儿显著。进行准确的婴幼儿腹泻轮状病毒检测,可为临床医生提供可靠的诊疗依据。     

疫苗接种前后腹泻患儿轮状病毒检测结果

目的通过对常山县引入轮状病毒(RV)疫苗前后RV抗原检测结果进行分析,了解A群RV感染情况的变迁,为临床诊疗提供依据。方法采用免疫层析双抗体夹心法检测常山县2011—2014年门诊及住院的6月龄~3岁腹泻患儿的RV抗原,分析4年间RV抗原检出率的变化。结果 2011—2014年本地门诊及住院的6月龄~3岁腹泻患儿的RV抗原检出率呈下降趋势(P0.01)。对535例患儿病前RV疫苗免疫史的回顾调查结果显示,389例疫苗接种儿童的RV阳性率为2.31%,明显低于未接种RV疫苗的11.64%(P0.01)。结论常山县门诊及住院的6月龄~3岁患儿RV感染呈下降趋势,但2014年仍有5.00%阳性率,应继续加强疫苗接种,对腹泻患儿进行常规RV抗原检测。     

宁波市鄞州区感染性腹泻细菌病原学监测与分析

目的了解鄞州区感染性腹泻流行病原菌谱与流行特征,积累感染性腹泻疾病的本底资料,为制定防控措施提供科学依据。方法采集感染性腹泻病例的粪便标本,进行病原菌分离、鉴定,分析其流行病学特征。结果从499份标本中检出10种病原菌共51株,检出率为10.22%,其中副溶血性弧菌检出最多(54.90%,28/51),其次是沙门菌(9.80%,5/51)、溶藻弧菌(7.84%,4/51)、变形杆菌(7.84%,4/51)。6月-9月是病原菌检出高峰,副溶血性弧菌在20岁~39岁组和40岁~59岁组中分布较多,检出率分别为9.49%和11.57%。检出条件致病菌16株,占31.37%。结论鄞州区感染性腹泻病原菌呈夏季、秋季高发,青壮年为主,副溶血性弧菌是主要流行株的特征;病后即就诊能提高病原菌的检出率;条件性致病菌检出概率较高,应引起人们的关注;加强海产品检测和重点人群的饮食安全宣传教育能减少疾病的发生。     

Do regional variations in prevalence of cryptosporidiosis occur? The central Ohio experience.

We screened 2,780 consecutive stool specimens submitted for routine ova and parasite examination to assess the prevalence of cryptosporidiosis in a pediatric patient population in central Ohio. The stools were prepared by formalin-ethyl acetate concentration followed by cold Kinyoun acid-fast stain of the sediment. In addition, 912 consecutive intestinal biopsies were monitored for the presence of the parasite. Cryptosporidium oocysts were found in only 0.3 per cent of stool specimens (seven specimens from three patients) and in none of the intestinal biopsies. Due to this low prevalence of cryptosporidiosis, we conclude that routine screening of stool specimens for Cryptosporidium sp. is unnecessary in our patient population. Screening should be targeted to immune compromised patients and patients with persistent diarrhea and no apparent etiology. Our study also supports the concept that there are geographic variations in the prevalence of cryptosporidiosis.     

Cryptosporidiosis in Great Yarmouth--the investigation of an outbreak

A community outbreak of 36 cases of Cryptosporidium infection which occurred during Spring 1986 in Great Yarmouth and Waveney is described. A period prevalence study suggested that there was a more widespread outbreak of diarrhoeal illness in the locality although only 3/68 stool samples obtained at a median time interval of 38 days from the onset of symptoms contained Cryptosporidium oocysts. The distribution of cases of cryptosporidiosis in time and place suggested person to person spread rather than a common vehicle. A retrospective matched case-control study provided no evidence of water borne spread.     

The epidemiology of cryptosporidiosis and other intestinal parasitoses in children in southern Guinea-Bissau

In order to determine the prevalence of Cryptosporidium and other intestinal parasites, a household sample survey of children under 5 years old was carried out during the late dry season in 8 rural villages in southern Guinea-Bissau, West Africa. Cryptosporidium oocysts were found in 10 of 270 stool samples (3.7%), using a safranin-methylene blue staining method. Of these 10 children (age range 5-16 months), all non-Muslims, 6 had diarrhoea, giving a prevalence of 12.5% in 48 children with diarrhoea, compared with 1.8% in children without diarrhoea (P less than 0.001). The ethnic group with the highest prevalence (9.2%) also kept most domestic animals, and was the only group to keep cattle. Giardia lamblia was found in 16 children, and the overall prevalences of other enteric parasites were: hookworm, 21.7%; Strongyloides stercoralis, 7.4%; Ascaris lumbricoides, 6.9%; Trichuris trichiura, 4.4%; Entamoeba histolytica, 1.5%; and Taenia sp., 0.5%. The prevalence of cryptosporidiosis was highest in the age group 7-12 months, while for the other parasites it was highest in the oldest children. The prevalence of hookworm was highest (c. 50%) in the southernmost villages. No significant relationship was found between hookworm infection and anaemia.     

An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark

Cryptosporidium has become increasingly recognized as a pathogen responsible for outbreaks of diarrhoeal illness in both immunocompetent and immunocompromised persons. In August 2001, an Illinois hospital reported a cryptosporidiosis cluster potentially linked to a local waterpark. There were 358 case-patients identified. We conducted community-based and waterpark-based case-control studies to examine potential sources of the outbreak. We collected stool specimens from ill persons and pool water samples for microscopy and molecular analysis. Laboratory-confirmed case-patients (n=77) were more likely to have attended the waterpark [odds ratio (OR) 16.0, 95% confidence interval (CI) 3.8-66.8], had pool water in the mouth (OR 6.0, 95% CI 1.3-26.8), and swallowed pool water (OR 4.5, 95% CI 1.5-13.3) than age-matched controls. Cryptosporidium was found in stool specimens and pool water samples. The chlorine resistance of oocysts, frequent swimming exposures, high bather densities, heavy usage by diaper-aged children, and increased recognition and reporting of outbreaks are likely to have contributed to the increasing trend in number of swimming pool-associated outbreaks of cryptosporidiosis. Recommendations for disease prevention include alteration of pool design to separate toddler pool filtration systems from other pools. Implementation of education programmes could reduce the risk of faecal contamination and disease transmission.     

Laboratory ascertainment of Cryptosporidium and local authority policies for investigating sporadic cases of cryptosporidiosis in two regions of the United Kingdom

To discover laboratory ascertainment and reporting practice for cases of cryptosporidiosis in two health authority regions, we surveyed laboratories serving Wales and the North West of England for faecal screening policies and methods for detection of Cryptosporidium. Forty-eight of the 49 laboratories responded, of which 39 (81%) screen all stool specimens from symptomatic individuals for Cryptosporidium and 9 (19%) screen selected specimens. Although laboratory screening is more complete than has been reported in other regions, we identified discrepancies where patient age was used as a selection criterion, and we make suggestions to amend this. Forty-two (88%) responding laboratories report confirmed cases to the regional Communicable Disease Surveillance Centre (CDSC) and 45 (94%) report to the local authority environmental health department. We also surveyed local authorities in both regions for policy and practice concerning the investigation of reported cases of cryptosporidiosis in the same regions. All 59 local authorities responded, of which 57 (97%) investigate cases by completion of an exposure questionnaire as well as providing advice on the prevention of spread of infection. Variation in case ascertainment may influence perception of incidence, clusters and outbreaks of cases of cryptosporidiosis.     

An outbreak of cryptosporidiosis in a day-care center in Georgia

Diarrhea among the 11 million children attending day-care centers in the United States is common, but infection control of enteric pathogens in the day-care center setting remains a challenge. In August 1989, an outbreak of cryptosporidiosis was investigated at a day-care center in Georgia. A total of 49% (39/79) of children and 13% (3/23) of staff members who submitted stool specimens were found to be infected with Cryptosporidium. A total of 77% (30/39) of infected children had mild-to-moderate diarrhea (median duration, 5 days). Children were at highest risk if they were less than age 36 months, in diapers, and not toilet trained. Serial stool specimens were collected from 12 infected children. After diarrhea had ceased, oocyst shedding continued in all children for a mean duration of 16.5 days. It is concluded that the prevalence of asymptomatic infections and the duration of shedding after the end of symptoms may previously have been underestimated. Cohorting or exclusion from the day-care center of children who are asymptomatic shedders is not practical, and the management of cryptosporidiosis in day-care centers remains a major challenge.     

Cryptosporidiosis outbreak at a summer camp--North Carolina, 2009

In July 2009, local, regional, state, and federal public health officials investigated a cryptosporidiosis outbreak at a youth summer camp in North Carolina. The investigation identified 46 laboratory-confirmed and probable cryptosporidiosis cases at the camp. Analyses of data from a retrospective cohort study of staff members revealed that eating ham from a sandwich bar that included camp-grown raw produce and sharing a cabin with an ill person were significantly associated with illness. Cryptosporidium isolates from stool specimens of livestock and humans at the camp were of the identical Cryptosporidium parvum subtype, IIaA17G2R1, indicating that zoonotic transmission had occurred, and suggesting a link not implicated by traditional epidemiologic methods. This investigation underscores the importance of reducing the risk for Cryptosporidium transmission in camp settings and the value of Cryptosporidium subtyping as a tool to elucidate cryptosporidiosis epidemiology.     

Cryptosporidium as a co-pathogen in infantile diarrhea and pneumonia

The authors describe a case of cryptosporidiosis in a 10 month old immunocompetent infant, who suffered from prolonged diarrhoea and pneumonia. Cryptosporidium oocysts, Giardia lamblia were detected by using modified Kinyoun stain, and klebsiella was identified in the stool culture. According to the clinical presentation and the laboratory data the streptococcus infection is presumed as cause of the pneumonia, but the authors could not exclude the role of cryptosporidium in predisposing and/or causing the pneumonia.     

Outbreak of cryptosporidiosis associated with a firefighting response - Indiana and Michigan, June 2011

On June 20, 2011, the Indiana Department of Homeland Security notified the Indiana State Department of Health (ISDH) of an Indiana fire station that reported gastrointestinal illness among a substantial percentage of their workers, causing missed workdays and one hospitalization as a result of cryptosporidiosis. All ill firefighters had responded to a barn fire in Michigan, 15 miles from the Michigan-Indiana border on June 6; responding firefighters from Michigan also had become ill. ISDH immediately contacted the Michigan Department of Community Health (MDCH) concerning this outbreak. The investigation was led by MDCH in partnership with ISDH and the Michigan local health department (LHD). Among 34 firefighters who responded to the fire, 33 were interviewed, and 20 (61%) reported gastrointestinal illness ≤12 days after the fire. Cryptosporidium parvum was identified in human stool specimens, calf fecal samples, and a swimming pond. Based on these findings, the following public health recommendations were issued: 1) discontinue swimming in the pond, 2) practice thorough hygiene to reduce fecal contamination and fecal-oral exposures, and 3) decontaminate firefighting equipment properly. No additional primary or secondary cases associated with this exposure have been reported. The findings highlight a novel work-related disease exposure for firefighters and the need for public education regarding cryptosporidiosis prevention.