Longitudinal neutralizing antibody responses after SARS-CoV-2 infection: A convalescent cohort study in Taiwan

BackgroundUnderstanding the neutralizing antibody (NAb) titer against COVID-19 over time is important to provide information for vaccine implementation. The longitudinal NAb titer over one year after SARS-CoV-2 infection is still unclear. The purposes of this study are to evaluate the duration of the neutralizing NAb titers in COVID-19 convalescents and factors associated with the titer positive duration.MethodsA cohort study followed COVID-19 individuals diagnosed between 2020 and 2021 May 15th from the COVID-19 database from the Taiwan Centers for Disease Control. We analyzed NAb titers from convalescent SARS-CoV-2 individuals. We used generalized estimating equations (GEE) and a Cox regression model to summarize the factors associated with NAb titers against COVID-19 decaying in the vaccine-free population.ResultsA total of 203 convalescent subjects with 297 analytic samples were followed for a period of up to 588 days. Our study suggests that convalescent COVID-19 in individuals after more than a year and four months pertains to only 25% of positive titers. The GEE model indicates that longer follow-up duration was associated with a significantly lower NAb titer. The Cox regression model indicated the disease severity with advanced condition was associated with maintaining NAb titers (adjusted hazard ratio: 2.01, 95% CI: 1.11–3.63) and that smoking was also associated with higher risk of negative NAb titers (adjusted hazard ratio: 0.55, 95% CI: 0.33–0.92).ConclusionsNeutralizing antibody titers diminished after more than a year. The antibody titer response against SARS-CoV-2 in naturally convalescent individuals provides a reference for vaccinations.     

876例肾综合征出血热患者的流行病学和临床特征的回顾性分析

目的 研究肾综合征出血热（hemorrhagic fever with renal syndrome，HFRS）的流行特征、临床特点及危险因素，为HFRS的预防控制和临床诊断提供依据。方法 收集湖北省近5年HFRS临床诊断病例和实验室确诊病例的个案调查资料876例，采用回顾性分析方法，应用SPSS 17.0对数据进行统计分析。结果 患者平均年龄为（47.67±13.97）岁，以男性农民为主，症状以轻型、中型为主（80.26%）。临床表现则多见发热（96.69%）、乏力（92.58%）、蛋白尿（88.93%）、血小板减少（80.59%）、白细胞升高（63.70%）等。相关暴露因素中，主要有鼠或鼠排泄物接触史。结论 湖北省HFRS患者以轻型和中型为主，同时出现发热、血小板减少和蛋白尿可作为HFRS早期诊断的参考依据；应加强农村防鼠灭鼠工作，开展重点地区重点人群的健康教育工作，提高疫苗接种率。     

Mycobacterium chelonae bloodstream infection induced by osteomyelitis of toe: A case report

Mycobacterium chelonae is a rapidly growing mycobacterium that has the potential to cause refractory infections in humans. Mycobacteremia resulting from the organism is extremely rare, and its clinical features are yet to be uncovered. We herein present a case of M. chelonae bloodstream infection involving an immunocompromised older patient. A 79-year-old woman, on a long-term treatment with prednisolone plus tacrolimus for rheumatoid arthritis, visited our outpatient department complaining of deteriorating pain and swelling at her right 1st toe. Laboratory parameters showed elevated C-reactive protein and leukocytosis, and magnetic resonance imaging indicated osteomyelitis at the proximal phalanx of her right 1st toe. Considering the refractory course, the infected toe was immediately amputated. M. chelonae was isolated from bacterial cultures of the resected tissue and blood (BD BACTEC™ FX blood culture system, Becton Dickinson, Sparks, MD, USA), leading to a diagnosis of disseminated M. chelonae infection. We treated the patient with an antibiotic combination of clarithromycin, minocycline, and imipenem (2 weeks), which was converted to oral therapy of clarithromycin, doxycycline, and levofloxacin. This case highlighted the potential pathogenesis of M. chelonae to cause mycobacteremia in an immunocompromised patient.     

The annual risk of tuberculosis infection in newly hired researchers and healthcare workers using interferon-gamma release assay in Japan

The tuberculosis (TB) notification rate in Japan is gradually decreasing but has not yet achieved “pre-elimination,” defined by the World Health Organization. To effectively tackle, control, and eliminate TB, estimating and monitoring the annual risk of TB infection (ARI) using tuberculin skin testing (TST) to understand the dynamics of TB epidemiology are significantly important. However, studies estimating ARIs using TST are few considering that Bacillus Calmette-Guérin vaccination coverage is high in Japan. This was a single-center, cross-sectional study conducted between January 2011 and December 2018 in Tokyo area where interferon-gamma release assays (IGRAs) were performed in newly hired researchers of Keio University School of Medicine and healthcare workers of Keio University Hospital to determine TB infection. We estimated the prevalence of TB infection and ARI based on their IGRA results. Among the 3908 subjects, 83 (2.124%) had positive IGRA results. Multiple logistic regression analysis revealed that age was a significant risk factor for positive IGRA result (adjusted odds ratio, 1.046). The ARIs were 0.049%–0.156% between 1986 and 2004, midyears of TB infection, but have not significantly decreased over approximately two decades. To decrease the risk of TB infection, advanced strategies to control and eliminate TB in Tokyo area are significantly required.     

云南省2005-2012年91株甲型副伤寒沙门菌病原学特征分析

目的通过对分离自云南省不同地区、不同年份的甲型副伤寒沙门菌进行病原学分析研究,弄清云南省甲型副伤寒的流行特征,为查明云南省甲型副伤寒高发原因提供科学依据。方法采用K—B纸片扩散法对所有菌株进行药物敏感试验;采用脉冲场凝胶电泳（PFGE）对菌株进行分子分型研究。结果91株甲型副伤寒沙门菌药敏试验结果表明,大多数菌株对常用多种抗生素敏感,但有部分地区的菌株出现三重及多重耐药。所有菌株的PFGE结果显示,91株甲型副伤寒沙门菌Xba I酶切结果可分为两个大的聚类群,而且经Xba I和Spe I双酶切证实云南省不同地区、年份分离的菌株具有较高的同源性关系。结论云南省的甲型副伤寒沙门菌具有2种类型的优势菌株,并且具有较高的同源性关系,提示云南省不同地区、年份的甲型副伤寒的流行可能具有相似的传播途径,而菌株的药敏试验结果则能给临床治疗提供用药参考依据。     

云南省保山市2005—2015年伤寒副伤寒流行病学特征

目的 分析云南省保山市伤寒副伤寒流行特征,为伤寒副伤寒防控提供参考依据。方法 对保山市2005—2015年伤寒副伤寒疫情资料进行描述性分析。结果 保山市伤寒副伤寒年均发病率为12.11/10万,以伤寒为主;各年伤寒/副伤寒、伤寒、副伤寒发病率差异有统计学意义（χ²_伤寒=314.907,P<0.05;χ²_副伤寒=249.316,P<0.05;χ²_{伤寒/副伤寒}=249.316,P<0.05）,2014年以后伤寒/副伤寒、伤寒、副伤寒发病率大幅下降,各发病率均以2015年最低;各月均有病例报告,7—9月为发病高峰;五县区伤寒、副伤寒发病率由高到低依次为施甸县、龙陵县、隆阳区、腾冲县、昌宁县（χ²_伤寒=1 375.149, P<0.05;χ²_副伤寒=431.417,P<0.05;χ²_{伤寒/副伤寒}=249.316,P<0.05）;发病居前三位的职业为农民、学生和散居儿童,分别占总发病的53.95%、21.69%、12.60%;男∶女=1∶1.05;5~10岁组伤寒/副伤寒发病率最高。结论 2014年后保山市伤寒副伤寒发病率大幅降低但仍高于全国平均水平,应对农民、学生、散居儿童以及高发县采取有针对性的干预措施。     

Emergence of truncated PB1-F2 protein of H3N2 influenza virus during its epidemic period in Jiangsu Province, China

Background PB1-F2 protein has been proven to increase the pathogenicity of influenza A virus （IAV） strains in primary infection and in secondary bacterial infection. It can also regulate the activity of viral polymerase. However, it was shown in another retrospective study that a portion of IAVs do not express full-length PB1-F2 protein during virus development; different kinds of stop codons cause exits in the open reading frames and form PB1-F2 gene products with the corresponding genotypes. Truncated PB1-F2 in human H3N2 IAVs has long been detected in North America but its evolution in China is still unclear. Methods Influenza-like illnesses （ILls） from the whole of Jiangsu Province were collected and inspected to determine the type and subtype of the viruses. A portion of isolates collected in the epidemic period were selected as samples for later whole-genome sequencing, and the exact sequences were determined and analyzed. Results H3N2 influenza virus was one of the epidemical strains which had been prevalent during 2009-2010, in Jiangsu. Five H3N2 isolates with truncated PB1-F2 protein （25aa） were detected in influenza samples from Nanjing and Xuzhou, while seven similar H3N2 isolates were also reported in Niigata, Japan. Conclusion This emergence indicates the possibility that there has been transmission of the H3N2 virus between the two countries.     

综合性医院参与艾滋病临床综合医疗服务的研究

目的：探讨综合性医院参与艾滋病临床医疗服务的挑战与对策。方法收集四川省人民医院城东病区自开诊以来参与艾滋病临床治疗以及职业暴露情况的资料,结合相关领域政策法规,使用META-LAB高性能计算平台（ HCP ）对数据进行分析。结果2009年11月至2012年12月合计报告感染者42例（门诊报告4例、住院报告38例）,除1例因需抗逆转录病毒治疗（ ART）治疗转入定点医院外,其余均在本院接受治疗,其中手术治疗6例。各年份合计职业暴露共计49例次,总体职业暴露发生率为0.05％,HIV相关职业暴露4例次。所有HIV相关职业暴露者后续HIV抗体检测均为阴性。结论随着艾滋病疫情的蔓延,综合性医院参与艾滋病防治工作已成必然。在管理制度、安全意识培训等方面进行调整和适当投入,职业暴露发生率可以控制在很低水平,医务人员因为医疗操作而感染HIV的风险可以得到有效控制。综合性大医院完全可以承担艾滋病感染者的普通医疗服务。     

海南省手足口病重症病例危险因素的1:1匹配病例对照研究

目的 探讨手足口病重症病例发病的危险因素,为重症病例的防控提供科学依据。方法 按手足口病重症病例比例将海南省各县分为"高、中、低"三层,每层随机选取2个县,共对6个县的125例手足口病重症病例和125例普通病例进行现场调查,采用1:1配对的病例对照方法进行危险因素分析。结果 单因素条件Logistic回归分析发现初诊在村卫生室或私人诊所、非母乳喂养、肠道病毒71（enteroviruses 71,EV71）感染、就诊前最高体温高于39℃、发病到确诊时间≥ 2 d等5个因素在两组病例间分布存在差异。多因素条件Logistic回归发现EV71感染,初诊在村卫生室或私人诊所,非母乳喂养及发病到确诊时间≥ 2 d为重症病例发病的危险因素。结论 加强病原学监测,根据EV71比例变化及时发布预警;提倡母乳喂养,禁止乡村医生、个体诊所接诊5岁以下发热儿童;加强培训,提高各级医疗机构手足口病诊断水平,有助于降低手足口病重症的发生危险。     

江苏省2004～2011年感染性腹泻病流行特征分析

目的:分析江苏省感染性腹泻病流行特征,为综合防控措施的科学制订和综合监测工作的有效开展提供科学依据? 方法:对2004~2011年江苏省感染性腹泻病的发病情况和近5年各类感染性腹泻病的病原学监测结果进行分析,对全省所有县及县以上医疗机构在感染性腹泻病实验室检测方面的相关工作开展情况进行调查?结果:2004~2010年全省感染性腹泻病发病率呈现逐年下降趋势,2011年发病率有所反弹,年平均发病率43.79/10万;2004年以来其他感染性腹泻病在感染性腹泻病中所占的构成比增加趋势明显;感染性腹泻病总体呈较为典型的夏季高峰,但伤寒 + 副伤寒的季节分布近8年中有6年在8?9?10月呈现 “V”字型分布,有一定的特殊性和规律性;各类感染性腹泻病的职业分布集中在农民?散居儿童?学生和工人4类人群;发病以男性为主,性别构成比逐年略有增加;随着年龄段上升发病率逐渐下降;报告发病率和实验室检测工作开展率均为苏南高于苏中,苏中高于苏北?病原学监测结果显示,近年来,我省霍乱和痢疾的菌群和菌型分布有所变化,伤寒 + 副伤寒菌群和菌型分布较为稳定?结论:江苏省感染性腹泻病近年来得到了较好的控制,总体和各分类病种发病特征有一定的规律性和趋势性,今后除继续做好此类传染病的监测和防控工作外,应进一步加强腹泻类传染病病原检测能力?提高实验室诊断率和病原学诊断结果的报告率?