Oral delivery of Hyperimmune bovine serum antibodies against CS6-expressing enterotoxigenic Escherichia coli as a prophylactic against diarrhea

ABSTRACT

Background

. Oral administration of bovine antibodies active against enterotoxigenic Escherichia coli (ETEC) have demonstrated safety and efficacy against diarrhea in human challenge trials. The efficacy of bovine serum immunoglobulins (BSIgG) against recombinant colonization factor CS6 or whole cell ETEC strain B7A was assessed against challenge with the CS6-expressing B7A.     

Validation of Rome II criteria for functional gastrointestinal disorders by factor analysis of symptoms in Asian patient sample

BACKGROUND: It has been unclear as to whether the Rome II criteria could be applied to patients in the Asia region with functional gastrointestinal (GI) diseases. The aim of the present study was to determine if symptoms of Asian patients with functional gastrointestinal disorders formed groups which corresponded to the Rome II diagnostic criteria. METHODS: A modified English version of Talley's bowel disease questionnaire was developed in collaboration with various research teams in accordance with the Rome II criteria. This instrument was translated into the local languages of the following nine Asian regions: China, Hong Kong, Indonesia, Korea, Malaysia, Singapore, Taiwan, Thailand and Vietnam. From September to December 2001, newly enrolled outpatients attending 14 GI or medical clinics in these regions were invited to complete the questionnaire. From these respondents, patients with functional gastrointestinal disorders fulfilling the '12 weeks out of 12 months' criteria were separated for further analysis. Principal component factor analysis with varimax rotation was used to identify symptom clusters or factors. These factors were compared with the existing classification of functional GI diseases derived from the Rome II criteria. RESULTS: Factor analysis of symptoms from 1012 functional GI patients supported the Rome II classification of the following groups of functional GI disorders: diarrhea-predominant irritable bowel syndrome, functional constipation, functional dyspepsia, functional abdominal pain syndrome, functional heartburn, and functional vomiting. Functional diarrhea was combined with functional anorectal disorders, and globus merged with functional dysphagia into one factor. Some of the functional dyspepsia, abdominal bloating and belching symptoms were loaded into one factor. CONCLUSIONS: Factor analysis of symptoms from a sample of Asian patients with functional GI disorders partially supported the use of the Rome II classification.     

Clostridium difficile toxoid vaccine in recurrent C. difficile-associated diarrhea

BACKGROUND & AIMS: Recurrent C difficile -associated diarrhea (CDAD) is associated with a lack of protective immunity to C difficile toxins. A parenteral C difficile vaccine containing toxoid A and toxoid B was reported previously to be safe and immunogenic in healthy volunteers. Our aim was to examine whether the vaccine is also well tolerated and immunogenic in patients with recurrent CDAD. METHODS: Subjects received 4, 50-microg intramuscular inoculations of the C difficile vaccine over an 8-week period. Serum antitoxin antibodies were measured by ELISA, and toxin neutralizing activity was evaluated using the tissue culture cytotoxin assay. RESULTS: Three patients with multiple episodes of recurrent CDAD were vaccinated. Two of the 3 showed an increase in serum IgG antitoxin A antibodies (3-fold and 4-fold increases, respectively) and in serum IgG antitoxin B antibodies (52-fold and 20-fold, respectively). Both also developed cytotoxin neutralizing activity against toxin A and toxin B. Prior to vaccination, the subjects had required nearly continuous treatment with oral vancomycin for 7, 9, and 22 months, respectively, to treat recurrent episodes of CDAD. After vaccination, all 3 subjects discontinued treatment with oral vancomycin without any further recurrence. CONCLUSIONS: A C difficile toxoid vaccine induced immune responses to toxins A and B in patients with CDAD and was associated with resolution of recurrent diarrhea. The results of this study support the feasibility of active vaccination against C difficile and its toxins in high-risk individuals but must be validated in larger, randomized, controlled trials.     

人芽囊原虫在腹泻患者中的感染状况及繁殖方式

目的　观察人芽囊原虫在腹泻患者中的感染状况及繁殖方式 ,为进一步研究其生理生化特性及致病机理奠定基础。　方法　调查腹泻患者临床表现 ;用生理盐水涂片、碘液染色和铁苏木素染色法在光镜下观察其在粪便标本和培养物及动物模型肠内容物中形态、结构及繁殖方式。　结果　健康人群和腹泻人群粪便标本中人芽囊原虫检出率分别为 0 .94% (2 2 13 )和 2 4.73 % (4 6 186) ;人芽囊原虫与其它肠道寄生原虫有合并感染 ;有二分裂、内二芽生殖和裂体增殖 3种繁殖方式。　结论　人芽囊原虫在腹泻患者中有较高的感染率 ;易与结肠内阿米巴和其他非致病阿米巴合并感染 ;以3种无性生殖方式繁殖。     

感染性腹泻患者病原菌流行趋势及耐药性分析

目的了解感染性腹泻患者常见病原菌的流行趋势及耐药性,为临床治疗提供科学依据。方法对2012年4月1日-2017年10月31日本院肠道门诊12 156例感染性腹泻患者粪便标本进行增菌及分离培养,用Vitek 2 Compact全自动微生物鉴定/药敏分析系统和基质辅助激光解吸飞行时间质谱仪(MALDI-TOF MS)进行菌种鉴定,凝集试验进行血清分型,K-B纸片扩散法测定6种抗菌药物敏感性。结果 12 156份标本共培养出病原菌1 218株,致病菌总检出率为10.02%,其中弧菌属7.62%(926/12 156)、气单胞菌属0.79%(96/12 156)、沙门菌属1.46%(178/12 156)、志贺菌属0.15%(18/12 156)。2012-2017年致病菌年检出率分别为9.2%、11.9%、13.4%、7.0%、11.3%和7.2%。志贺菌属检出率维持较低水平,但其对氨苄西林、复方磺胺甲噁唑存在较高耐药现象。其余病原菌除对氨苄西林耐药率较高外,对其余5种抗菌药物均保持较高的敏感性。结论本院感染性腹泻患者的病原菌主要为弧菌属,耐药性最高的为志贺菌属,整体感染呈散发态势,应加强对感染性腹泻患者病原菌及耐药性的检测。     

肇庆市其它感染性腹泻监测数据预警效果分析

目的建立肇庆市其它感染性腹泻监测预警体系,进行早期预警监测。方法利用2010-2012年肇庆市其它感染性腹泻监测数据,使用控制图法、历史限值法和指数加权移动平均法,对2013年其它感染性腹泻监测数据进行拟合,分析预警的效果。结果 2013年其它感染性腹泻疫情控制图法显示有两个流行时期,分别为第2~5周、第44~52周;历史限值法显示有两个时期高于历史同期水平,分别为第4~16周、第50~52周;指数加权移动平均法显示第3~4周以及第43~52周疫情有明显增加。结论综合运用控制图法、历史限值法和指数加权移动平均法三种预警方法能够比较准确、直观、可靠地对肇庆市其它感染性腹泻疫情流行情况进行早期预警。     

藿香正气水联合腹部理疗治疗小儿腹泻的临床效果观察

目的:探究藿香正气水联合腹部理疗治疗小儿腹泻的临床效果。方法:选取我院儿科收治的腹泻患儿60例,根据随机数字表法分为对照组和观察组各30例。对照组予以双歧杆菌三联活菌胶囊和布拉氏酵母菌胶囊口服治疗;观察组在对照组的基础予藿香正气水口服,同时采用旋磁按摩仪按摩患儿腹部及电磁波治疗仪照射患儿腹部。治疗结束后对比分析两组临床疗效及症状改善情况。结果:治疗后与对照组相比,观察组总有效率较高,腹痛消失时间、呕吐消失时间、退热时间以及大便常规恢复正常时间较短(P0.05)。结论:藿香正气水联合腹部理疗治疗小儿腹泻临床效果显著。     

诺如病毒感染性腹泻临床特点分析

目的分析诺如病毒感染性腹泻的临床特点。方法收集我院肠道门诊2007年10月-2008年1月的腹泻患者大便标本,分析临床资料,采用RT—PCR方法检测诺如病毒,并对检测结果进行统计分析。结果检测到诺如病毒阳性者115例,阳性率为45．82％。阳性病例中伴有呕吐者较阴性者多,且便常规红、白细胞数基本都在正常范围内,与阴性病例比较差异具有统计学意义（P〈0．05）。结论诺如病毒感染性腹泻在肠道门诊患者中是常见病,发病率较高。单凭临床症状不易与其他腹泻相鉴别,确诊有赖于病原学诊断。     

徐州地区感染性腹泻病人中致病性弧菌的分布研究

目的了解徐州地区感染性腹泻中致病性弧菌的分布情况,掌握其流行规律,为致病性弧菌引起的感染性腹泻提供科学的控制和防治依据。方法用常规分离培养方法检测感染性腹泻粪便或肛拭子标本2674例。结果共检出致病性弧菌10个种类,518株,总检出率为19.37%。结论致病性弧菌是引起本地区感染性腹泻的主要病原菌之一,种类分布繁多。应加强对致病性弧菌的动态监测。     

对诺如病毒感染性腹泻的新认识

诺如病毒属中的诺沃克病毒（GI．1）是最早被确认可引起人类病毒性腹泻和胃肠炎的病原。但由于缺乏敏感和常规的诊断方法,大多数临床医生对其重要性认识不足。随着分子生物学的进展及新型诊断技术的应用,诺如病毒目前已被欧美公认为导致成人病毒性胃肠炎的首要病原,也是儿童病毒性胃肠炎的第二位病原。本文对诺如病毒性胃肠炎的最新理念作一综述。