丽水市十三项呼吸道病原体感染情况及特点分析北大核心CSCD

目的了解丽水市呼吸道病原体感染情况及流行病学特征,为呼吸道传染病诊疗与防控提供科学依据。方法回顾性分析2020年3月至2021年12月丽水市人民医院收治的4035例呼吸道感染患者13项呼吸道病原体PCR毛细电泳核酸检测结果,并分析病原体感染分布特征。结果呼吸道病原体感染患者阳性检出率为32.24%(1301/4035),检出率前5位分别是HRV(16.60%)、HRSV(7.09%)、HPIV(2.87%)、HMPV(2.21%)、HADV(1.96%)。混合感染阳性占比为7.61%(99/1301),Boca病毒(76.0%)与Ch(46.15%)易与其它病原体形成混合感染。不同性别呼吸道病原体感染率差异无统计学意义(P>0.05)。虽然不同季节呼吸道病原体整体感染率差异无统计学意义(P>0.05),但HRV好发于春秋两季,而HPIV在春秋两季感染率较低,春季HRSV感染率较低,HADV在夏秋两季感染率较低,HMPV在冬季较为流行。未成年人呼吸道病原体感染率较高,HRSV、HRV、HPIV、HADV和Boca主要发生于未成年人组,InfB和HMPV在未成年和青年人群感染率都较高。结论未成年人群是呼吸道病原体易感人群,应加强未成年人呼吸道传染病防控。     

从五运六气角度探析己亥年冬瘟

2019年为己亥之年,土运不足,厥阴风木司天,少阳相火在泉。下半年相火淫胜,火气流行,克金、刑水。风木盛则克制土运,土运本不足,致虚者更虚,强者更强,此谓之不相得,不相得则病;且气克运,古称之为天刑,天刑之年多灾害。2019年,冬季主气太阳寒水之上少阳相火客临,致冬不藏反长,天不寒反暖。地气封藏不固,水中阳气不藏,本应该被抑制或杀灭的微生物却因火热而未灭,并得少阳火毒助长而毒性更猛,化生为火疫。2020年为庚子年,主行金运,金克木,可平复2019年偏盛之木运,故瘟毒会被2020年之金运削弱或肃杀。针对此次瘟疫,未病之人预防要点为:虚邪贼风,避之有时;精神内守,病安从来;正气存内,邪不可干;饮食宜忌,尤为重要;避秽化浊,芳香化湿。已病之人的治疗,依据此次瘟疫"少阳火毒夹湿"病机,以咸补之,以甘泻之,以咸耎之,岁谷宜丹,间谷宜豆。此次瘟毒的性质虽为湿热火毒,但患者体质却有寒热虚实之别,感染后症状、病情和预后亦不同,故中医临证时应遵循辨证论治,三因治宜的原则;若体质素有湿热,邪从本气而化,可遵循运气病机施治;若体质本热,湿去而化为火毒,则应以制火为主;若体质本寒,热去而化寒湿,则应温化寒湿,芳香化浊;若体质素虚,出现危重证候,则应在祛邪时,重视固护元气。     

Laboratory Biosafety: Laboratory response checklist for infectious disease outbreaks—preparedness and response considerations for emerging threats

The purpose of the Laboratory Response Checklist for Infectious Disease Outbreaks (the Checklist) is to provide public health laboratories and laboratory networks operating at multiple jurisdictional levels with a useful, adaptable tool to help rapidly identify important outbreak response considerations, particularly when investigating a previously unknown infectious disease threat. The Checklist was developed by the National Microbiology Laboratory of Canada in collaboration with provincial/territorial, national and international laboratory experts, including the Canadian Public Health Laboratory Network, and the Global Health Security Action Group Laboratory Network. While the Checklist was initially designed to reflect lessons learned through National Microbiology Laboratory participation in extended national and international outbreak responses (e.g. Zika virus epidemic [2015–2016], Ebola virus epidemic, West Africa [2014–2016]), the importance of optimizing laboratory response coordination has only been underscored by the ongoing challenges presented by the coronavirus disease 2019 (COVID-19) pandemic response requirements. The Checklist identifies five highly interdependent laboratory response themes, each of which encompasses multiple considerations that may be critical to a coordinated, strategic outbreak response. As such, the comprehensive review of Checklist considerations by responding laboratory organizations may provide a valuable opportunity to quickly detect key response considerations and interdependencies, and mitigate risks with the potential to impact public health action.     

Biological risk among hospital housekeepers

Although not directly responsible for patient care, hospital housekeepers are still susceptible to accidents with biological material. The objectives of this study were to establish profile and frequency of accidents among hospital housekeepers, describe behaviors pre- and postaccident, and risk factors. This was a cross-sectional study with hospital housekeepers in Goiania, Brazil. Data were obtained from interviews and vaccination records. The observations were as follows: (1) participating workers: 94.3%; (2) incomplete hepatitis B vaccination: 1 in 3; and (3) accident rate: 26.5%, mostly percutaneous with hypodermic needles, and involved blood from an unknown source; roughly half occurred during waste management. Upon review, length of service less than 5 years, completed hepatitis B vaccination, and had been tested for anti-HBs (hepatitis B surface antigen) influenced frequency of accidents. These findings suggest that improper disposal of waste appears to enhance the risk to hospital housekeepers. All hospital workers should receive continued training with regard to waste management.     

Genome-wide bioinformatics analysis of FMN,SAM-I,glmS, TPP,lysine, purine,cobalamin, and SAH riboswitches for their applications as allosteric antibacterial drug targets in human pathogenic bacteria

Objectives: A constantly growing number of antibiotic-resistant strains of human pathogenic bacteria is an acute problem. Prolonged illnesses and increasing mortality worldwide mean that there is an urgent need to develop novel antibacterial drugs based on new targets and mechanisms of action. We present in silico analyses of bacterial riboswitches that may be suitable as antibacterial drug targets.

Methods: Most bacterial riboswitches are allosteric cis-acting gene control elements located in the 5?-untranslated region of messenger RNAs. Riboswitches sense specific metabolites and regulate the synthesis of some essential cellular metabolites in many pathogenic bacteria but are not found in humans. We present a complete and comprehensive genome-wide bioinformatics analyses of the suitability of eight riboswitches as antibacterial drug targets in various pathogenic bacteria.

Results: Based on our in silico analyses, we classify the riboswitches in four different groups based on their suitability to be used as antibacterial drug targets. We have estimated that FMN, SAM-I, glmS, TPP, and Lysine riboswitches are promising targets for antibacterial drug discovery.

Conclusion: This research enables us to focus antibacterial drug discovery research only on those riboswitches whose inhibition will result in suppression of the growth of certain pathogenic bacteria.     

Emerging tick-borne pathogens in the Nordic countries: A clinical and laboratory follow-up study of high-risk tick-bitten individuals

Despite the presence of several microorganisms, other than Borrelia burgdorferi sensu lato (Bbsl) and TBE virus, in Ixodes ricinus ticks from the Nordic countries, data is lacking on their pathogenic potential in humans. In this study, we wanted to investigate the aetiology and clinical manifestations of tick-transmitted infections in individuals seeking medical care following a tick-bite.The sampling frame was participants of a large-scale, prospective, multi-centre, follow-up study of tick-bitten volunteers recruited in Sweden, Finland and Norway in the years 2007–2015. Participants who sought medical care during the three-month follow-up period and from whom blood samples were collected during this healthcare visit (n = 92) were tested, using PCR, for exposure to spotted fever group (SFG) Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Moreover, 86 of these individuals had two serum samples, collected three months apart, tested serologically for six tick-borne microorganisms. The selected organisms – Bbsl, SFG rickettsiae, Anaplasma phagocytophilum, TBE virus, Babesia microti and Bartonella henselae – have all been detected in field-collected ticks from the Nordic countries. Medical records were reviewed and questionnaires were completed to determine clinical manifestations.We found Lyme borreliosis to be the most common tick-transmitted infection as seen in 46 (54%) of the 86 participants with available medical records. Among the 86 participants with paired sera, serological or molecular evidence of recent exposure to other microorganisms than Bbsl could be demonstrated in eight (9%). Five participants (6%) exhibited serological evidence of recent concomitant exposure to more than one tick-borne microorganism. Clinical presentations were mild with one exception (TBE).In conclusion, our data suggest a low risk of infection with tick-borne microorganisms, other than Bbsl, in immunocompetent tick-bitten persons from the examined regions, a low occurrence of co-infection and mostly mild or no overt clinical signs of infection in immunocompetent persons exposed to the studied agents.     

温病学理论指导下的新型冠状病毒肺炎诊治刍议

基于温病学理论,探讨新型冠状病毒肺炎的中医病因病机与诊治思路。温病学说源于明清之前的历代中医理论积累,经过长期的温热病防治实践而形成,其对于外感热病(包括烈性传染病)的病因病机、证治方药有着较为系统的论述,近年来在我国的新发传染病防治中发挥出积极的作用。温瘟相通,瘟疫病因多为热毒疫邪,表现为热证阳证,可按温病学中的卫气营血或三焦辨证分期论治,或治以吴又可、庞安时等的经方验方,这些因、机、证、治理论可试用于新型冠状病毒肺炎的中医诊疗。且肺与大肠相表里,胃肠道也是新型冠状病毒侵袭或繁殖的部位,采用中医清热通下之法,使邪从肠道而出,可能是减轻体内病毒感染与肺脏炎症的一种途径。     

Epidemiology of tick‐borne pathogens in the semi‐arid and the arid agro‐ecological zones of Punjab province,Pakistan

Tick‐borne diseases (TBDs) have a large impact on animal health and the livelihood of livestock owners, particularly in developing countries. Although climatic and ecological conditions in Pakistan may favour the transmission of tick‐borne pathogens (TBPs), only a few systematic studies have been carried out on TBPs and the diseases that they cause in this country. To improve our understanding of the distribution of TBPs, 3,807 ticks were collected from ruminants (n = 369) on 108 livestock farms (semi‐arid zone = 36, arid zone = 72) in Punjab Province. After morphological identification ticks were pooled into 405 pools (Hyalomma anatolicum = 300, Rhipicephalus microplus = 89, Hyalomma dromedarii = 9, Rhipicephalus turanicus = 7) based on their species, locality of collection, and the host. DNA from each pool was screened by a Reverse Line Blot (RLB) hybridization assay for the presence of Anaplasma, Ehrlichia, Rickettsia, Babesia, and Theileria species. DNA from at least one TBP was found in 142 (35.1%) pools. Among the positive pools, 91 (64.1%) had a mixed infection with two or more TBPs, whereas 51 (35.9%) pools were infected with a single TBP. The detected pathogens not only included species that were known to be endemic in Pakistan, such as Theileria annulata (6.7%), Theileria orientalis (3.5%), Anaplasma marginale (5.7%), Anaplasma centrale (2.7%), Anaplasma ovis (1.5%), Babesia bigemina (0.7%), and Babesia bovis (0.2%), but also several TBPs that had not been reported to occur in Pakistan before. This included Ehrlichia minasensis (3.2%), an Anaplasma platys‐like organism (1.2%), Babesia occultans (0.2%), and Rickettsia massiliae (0.2%), as well as two previously uncharacterized species: Ehrlichia sp. Multan (18.0%) and Anaplasma sp. (BL099‐6) (2.22%). The pathogenicity of these novel species remains to be examined. This study shows that a much broader spectrum of TBPs is present in Pakistan than previously thought, including several zoonotic pathogens.