山东地区肾综合征出血热血清流行病学研究

目的查明山东地区肾综合征出血热(HFRS)的临床和流行特征、疫源地血清型别以及病人血清型与宿主动物血清型的关系,探讨疫源地血清型别的演变。方法采用IFA法检测抗原与抗体,分型分别采用IFA、HI和RPHI等技术,同时作病毒分离。结果HFRS患者汉城型(SEO)占91.48%,汉坦型(HTN)占7.12%,未定型占1.31%,以SEO感染占优势。近年疫区的扩大与患者剧增主要由SEO病毒感染所致。HFRSV抗原型别和血清型均宿主种类相一致,即为家鼠HFRS抗原型别和血清型均为SEO,野鼠为HTN。并与疫区患者血清型相一致。两型患者发病高峰不同,临床特征基本相似,临床分型均有轻型和重型。分离毒株抗原型和毒力有差别,检出含有HTN病毒抗原成分的SEO病毒株。结论山东地区HFRS是SEO为主的混合型疫区,同时是否存在新的病毒感染者还需进一步研究。近年疫区的扩大与患者剧增主要由SEO病毒感染所致。     

某区部队病毒性肝炎发病率与血清学分型的回顾性研究

目的:了解部队肝炎疫情和血清型变化趋势,指导部队做好防治工作.方法:分别采用收集部队历年肝炎疫情和流行病学资料,同时抽查部分血清标本,用ELISA检测甲型、丙型、丁型和戊型等肝炎感染指标,RIA检测乙型肝炎感染指标进行综合分析.结果:调查结果表明战区历年肝炎发病以散发为主,偶见局灶性流行. 在1980年以前发病率波动在2‰左右,1959年发病率为高(3.54‰). 1981年以后稳步下降,1995年降至0.11‰,1996～2005年波动在1‰左右,特别是甲型下降明显. 各型肝炎均有发生,其中以乙型为主;战士发病比重高占50%以上.结论:在部队病毒性肝炎防治工作中,应以乙型肝炎为重点,同时加强甲型肝炎的预防措施.     

流感嗜血杆菌患儿分离株的血清分型和耐药模式研究

目的　了解流感嗜血杆菌患儿分离株的血清分型和体外耐药模式。方法　对本院2 0 0 1年 8月～ 2 0 0 2年 7月经apiNH卡鉴定的 2 4 7株流感嗜血杆菌 ,用玻片凝集法进行血清分型 ,用Kirby Bauer法检测其对 13种抗生素的敏感性 ,并用E test法检测氨苄西林的最低抑菌浓度。用头孢硝噻酚法检测 β内酰胺酶。 结果　不可分型流感嗜血杆菌 15 3株 ,占细菌总数 6 1 9% ,可分型菌株94株 ,占 38 1% ;可分型株在男女患儿中的分离率分别为 4 3 2 % (70 / 16 2 )和 2 8 2 % (2 4 / 85 ) ,差异有显著性 (χ2 =3 95 ,P <0 0 5 )。可分型菌株中d型构成比达 90 4 % ,b型仅 1 1%。 4 1株菌株(16 6 % )产生 β内酰胺酶。 2 33株菌株成功完成药敏试验 ,结果显示 :85 4 %的菌株对氨苄西林敏感 ,对头孢克洛、头孢噻肟、头孢曲松、亚胺培南、利福平、克拉霉素和氯霉素的敏感率分别高达98 7%、99 6 %、99 6 %、99 6 %、98 7%、91 0 %和 90 6 %。所有的菌株均对氨苄西林 /舒巴坦、阿莫西林 /克拉维酸和氧氟沙星敏感。菌株对甲氧苄啶 磺胺甲基异恶唑的耐药率最高 ,达 4 5 9%。可分型株对氨苄西林和甲氧苄啶 磺胺甲基异恶唑的耐药率显著高于不可分型株。β内酰胺酶阳性菌多重耐药率显著高于阴性菌 (χc2 =14 6 8,P <0 0 0 1     

Comparison of serotyping, ribotyping and pulsed-field gel electrophoresis for distinguishing group A Streptococcus strains isolated in Albania

Conventional serotyping for T antigens, rRNA gene restriction fragment length polymorphism analysis (ribotyping) and pulsed-field gel electrophoresis were compared for distinguishing among group A streptococci isolated in Albania between 1980–1982 and in 1995. A total of twelve serotypes were identified among seventy GAS strains. Ribotyping revealed eight and eleven distinct patterns after digestion with HindIII and PvuII, respectively. Twenty-three strains of serotype T12 were subdivided in 10 ribotypes and 11 strains of T2 serotype were differentiated in 5 ribotypes. By comparison, PFGE generated 37 patterns after SmaI digestion. The index of discrimination, using the Hunter–Gaston formula, was applied to assess the value of these methods for interpretation of the epidemiological data. For serotyping the value of index was 0.85. The ribotyping system revealed an ID of 0.83 when the combination HindIII and PvuII was used. This index reached 0.97 for PFGE. The methods used were useful to subtype the isolates of GAS.     

感染性腹泻中副溶血性弧菌的监测与研究

目的:了解余姚市感染性腹泻中副溶血性弧菌的感染状况及其研究。方法:采集感染性腹泻病人的大便或肛拭标本,依据GB/T4789.7进行增菌、分离、生化鉴定、血清分型,最后进行药敏试验和PCR毒力基因检测。结果:2007~2008年共检验标本513份,检出副溶血性弧菌43株,检出率为8.38%。药敏试验:43株副溶血性弧菌对阿莫西林棒酸、青霉素、氨苄西林、环丙沙星、头孢唑林、头孢哌酮、庆大霉素7种抗生素的耐药率分别为58.1%、55.8%、、44.2%、7.0%、4.7%、4.7%、4.7%,对另外13种抗生素均敏感。血清分型:43株副溶血性弧菌分布于O1、O2、O3、O4、O6、O11共6个O抗原群;其中以03群为主,占67.4%。毒力基因:有40株副溶血性弧菌检出含有tdh基因,检出率高达93.02%,均未检出trh基因。结论:检出的副溶血性弧菌以03群为主,占67.4%;对阿莫西林棒酸、青霉素耐药性最强,分别为58.1%、55.8%;93.02%的菌珠含有tdh基因,所有菌株均不含trh基因。     

慢性牙周炎患者抗伴放线放线杆菌IgG滴度改变的临床意义

目的：明确慢性牙周炎(chronic periodontitis, CP)患者血清抗伴放线放线杆菌(Aggregatibacter actinomycetemcomitans, Aa)血清c型的抗体反应并探讨其与牙周临床指标的关系。方法: 采集30例CP患者和45例牙周健康者的空腹静脉血, 同时收集CP患者的龈下菌斑和非刺激性全唾液用于Aa的检测(PCR方法), 应用酶联免疫吸附方法（ELISA）测定血清中抗Aa血清c型IgG抗体滴度。结果: CP组和健康对照组血清抗Aa血清c型抗体检出率均为100%。CP组IgG抗体滴度高于健康对照组,差异有统计学意义［(10.9 ± 1.9） vs （9.1 ± 1.8）, P=0.000］; 同时CP组抗体滴度升高率也高于健康对照组, 差异有统计学意义(23.3% vs 0%, P=0.003)。龈下菌斑或唾液Aa检出阳性的7例慢性牙周炎患者血清IgG抗体滴度(12.6 ± 1.6)高于Aa阴性患者(10.4 ± 1.7), 差异有统计学意义(P=0.005)。 CP患者血清抗Aa IgG抗体滴度与全口平均探诊深度呈正相关(r=0.344, P=0.068)。结论: 血清c型为CP患者定植的Aa的重要血清型;CP患者血清抗Aa抗体并非简单的保护作用。     

Bacteremic pneumococcal pneumonia: serotype distribution,antimicrobial susceptibility,severity scores,risk factors,and mortality in a single center in Chile

AimsBacteremic pneumococcal pneumonia (BPP) is a severe condition. To evaluate seasonal distribution, mortality, serotype frequencies, antimicrobial susceptibility, and different severity scores among patients with BPP.Patients and methodsPatients were identified by laboratory data and restricted to adulthood. Standard methods were used for serotyping and antimicrobial susceptibility. Risk factors were analyzed by univariate and multivariate methods. Severity scores (APACHE II, CURB-65 and CAP PIRO) were compared using ROC curves.ResultsSixty events of community-acquired BPP occurred between 2005 and 2010. A seasonal pattern was detected. Mean age was 72.1 years old (81.4% ≥60 years). All had a predisposing factor. Previous influenza (3.3%) or pneumococcal immunization (1.7%) was infrequent. Admission to critical units was required by 51.7%. Twenty-two serotypes were identified among 59 strains. Only one strain had intermediate resistance to penicillin (1.7%). In-hospital mortality reached 33.3%. Multivariate analysis identified a CAP PIRO score > 3 (OR 29.7; IC95 4.7–187), age ≥65 years (OR 42.1; IC95 2.2–796), and a platelet count < 100,000/μL (OR 10.9; IC95 1.2–96) as significant independent factors associated with death. ROC curve analysis did not reveal statistical differences between the three severity scores to predict death (AUC 0.77–0.90). The prognostic yield for all of them was limited (Positive Likelihood Ratio: 1.5–3.8).ConclusionsBPP had a high case-fatality rate in this group of adult patients with no association to resistant isolates, and a low immunization record. Three independent factors were related to death and the prognostic yield of different severity scores was low.     

甘肃省2005年-2011年志贺菌菌型变迁及耐药性监测分析

目的:为了解志贺菌属腹泻在甘肃省的流行、变迁及耐药状况。方法:于2005年-2011年对兰州市、武威市细菌性痢疾监测点分离菌株和2起幼儿园食物中毒分离的宋内氏志贺菌株进行了血清型分型及菌株耐药性分析。结果:7年共采样4546份,分离到志贺菌773株,阳性率为17.00%。血清型以福氏志贺菌(B群)居优势514株,占66.49%,其次为宋内氏志贺菌(D群)256株,占33.12%。分离菌株对10种抗生素耐药率增高,为多重耐药,耐药种类达10种。结论:甘肃省细菌性痢疾菌群仍然是腹泻的首要病原,不同年份血清型、菌株的耐药率有所差异。     

从蛇体内分离72株沙门氏菌的菌型鉴定

从南昌市农贸市场采集的金环蛇、银环蛇、眼镜蛇和大王蛇的肠内容物标本124份,分离到沙门氏菌72株,分属于Ⅰ、Ⅱ、Ⅲb和Ⅳ四个亚种,16个O群的27个血清型。即亚种Ⅰ7个血清型;亚种Ⅱ3个血清型;亚种Ⅲb15个血清型;亚种Ⅳ2个血清型。有4个血清型为1983年沙门氏菌抗原表和1984、1985和1986年增补表中所未列的,为新型,有8个血清型是国内首次报告。有5个生化变体是过去未报告过的。本文的结果表明,在蛇体内不仅存在许多罕见的沙门氏菌血清型,而且还存在许多亚属Ⅰ的常见血清型,它是人类沙门氏菌感染的一个不可忽视的传染源。