上海市浦东新区腹泻患者气单胞菌流行特征及毒力基因研究

目的 了解上海市浦东新区腹泻患者气单胞菌流行特征及毒力基因特征。方法 2012年1－12月,在上海市浦东新区12家腹泻监测点医院对符合病例定义的病例采集粪便,进行13种腹泻病原体检测,对分离到的气单胞菌株进行5种与腹泻相关的毒力基因(ast、aerA、act、alt、hlyA)检测。结果 2 533例腹泻患者中,101例感染气单胞菌,阳性率为4.0%,分离到嗜水气单胞菌17株(18.8%),维隆气单胞菌温和变种44株(52.5%),豚鼠气单胞菌12株(29.7%)。44例患者为气单胞菌与其他病原体混合感染。夏季为高发季节,≥20岁人群高发。71例(70.3%)患者临床症状为水样便,20例(19.8%)患者出现呕吐症状,11例(10.9%)有发热症状。95.0%的气单胞菌携带毒力基因,hlyA基因阳性率为5.9%,aerA基因阳性率为6.9%,act基因阳性率为67.3%,alt基因阳性率为42.6%,ast基因阳性率为13.9%。结论 浦东新区腹泻患者中气单胞菌感染阳性率较高,并存在较高比例的混合感染。绝大多数气单胞菌都携带毒力基因,且分布存在差异性。     

Application of toxicokinetics to improve chemical risk assessment: Implications for the use of animals

While toxicokinetics has become an integral part of pharmaceutical safety assessment over the last two decades, its use in the chemical industry is relatively new. However, it is recognised as a potentially important tool in human health risk assessment and recent initiatives have advocated greater application of toxicokinetics as part of an improved assessment strategy for crop protection chemicals that could offer greater efficiency, use fewer animals and provide better data for risk assessment purposes. To explore the potential scientific and animal welfare benefits of increased use of toxicokinetic data across the chemical industry, an international workshop was held in 2008. Experts from a wide range of chemical industry sectors, including industrial chemicals, agrochemicals and consumer products, participated in the meeting as well as representatives from relevant regulatory authorities. Pharmaceutical industry experts were also invited, in order to share experiences from the extensive use of toxicokinetics in drug development. Given that increased generation of toxicokinetic data could potentially result in an increased number of animals undergoing testing, technologies and strategies to reduce and refine animal use for this purpose were also considered. This paper outlines and expands upon the key themes that emerged from the workshop.     

上海市浦东新区2013－2017年感染性腹泻病原流行特征分析

目的 了解2013-2017年上海市浦东新区感染性腹泻病原流行特征,为制定监测方案和开展感染性腹泻防治工作提供科学依据。方法 2013年1月至2017年12月,根据地理位置、覆盖人群和就诊量,在本区3所三级医院、9所二级医院和2所社区卫生服务中心开展腹泻病原主动监测,填写门诊病例个案调查表,采集粪便样品进行5类病毒和8类细菌的病原学检测。结果 共纳入感染性腹泻病例9 301例,病原阳性率为55.7%（5 179）。单一病毒、单一细菌和混合感染的阳性率分别为26.7%（2 481）、17.0%（1 579）和12.0%（1 119）。单一病毒阳性病例中,诺如病毒阳性率最高（15.4%,1 428/9 301）,其次为轮状病毒（7.2%,667/9 301）;单一细菌阳性病例中,致泻性大肠埃希菌阳性率最高（6.7%,619/9 301）,其次为非伤寒沙门菌（3.3%,305/9 301）;混合感染病例中,病毒-细菌阳性率最高（4.9%,459/9 301）。诺如病毒（17.0%,838/4 938）和致泻性大肠埃希菌（7.2%,354/4 938）阳性率在20~59岁年龄组最高,轮状病毒（9.4%,178/1 896）和非伤寒沙门菌（4.9%,93/1 896）阳性率在0~4岁年龄组最高。诺如病毒年度流行呈现春季和秋季2个高峰,轮状病毒呈现冬季高峰,致泻性大肠埃希菌呈现夏季高峰,非伤寒沙门菌呈现夏季小高峰。结论 2013-2017年上海市浦东新区感染性腹泻病原阳性率高,诺如病毒、轮状病毒和致泻性大肠埃希菌是本地区优势病原体,病原在不同年龄组分布存在差异,优势病原季节性流行特征明显。