埃立克体宿主和媒介的研究进展

埃立克体是近年来新发现的能感染人类的一类病原体,其宿主动物广泛,传播媒介多样。由于其所致疾病复杂多样,而且有较高的病死率,国外已就其媒介和宿主进行了广泛的研究,我国也已有埃立克体感染的报道。因此,今后我国有必要对埃立克体宿主和媒介做进一步的研究,制定媒介控制方案,为埃立克体感染的防制打好基础。     

巴尔通体对19种抗生素体外敏感性分析

目的 检测巴尔通体菌株对10类19种抗生素最低抑菌浓度（MICs）,分析药物敏感性及耐药性,为指导临床用药和耐药监测提供实验和数据参考。方法 采用E试验法,检测巴尔通体属11种、35株菌株对强力霉素、阿奇霉素、利福平等19种抗生素的MICs。将培养的巴尔通体菌制成McFarland（MCF）2.0浊度的菌悬液,均匀涂布于含5%去纤维羊血的胰酶大豆琼脂培养基上,置5% CO2的37℃培养箱培养。培养5~7 d后判读MICs。结果 35株巴尔通体菌在体外对强力霉素、阿奇霉素、红霉素、克拉仙霉素等13种抗生素敏感,MICs 0.016 mg/L;34株对利福平敏感,MICs 0.002 mg/L;对克林霉素、丁胺卡那霉素、万古霉素、多粘菌素和磺胺类5种抗生素不敏感,MICs较高。结论 绝大多数巴尔通体菌对强力霉素等14种抗生素敏感,但也对克林霉素等5种抗生素不敏感,在对巴尔通体病进行治疗时要注意选择敏感药物。     

4种病原菌特异基因片段阳性蜱的16S rRNA基因克隆文库分析

Objective To develop the method of 16S rRNA gene clone library for tick bacterial flora analysis, and to analyze the detection effective of pathogens in tick and capacity of bacterial flora diversity. Methods Primers were designed according to the specific gene of Borrelia burgdorferi, Bartonella henselae, Anaplasma phagocytophilum, Ehrlichia chaffeensis and templates were choosen by positive PCR result to amplify the DNA extracted from the ticks. One set of primers targeting 16S rRNA gene conserved region were chosen to amplify certain fragments, DNA extraction, PCR reaction, cloning and sequencing. Nucleotide sequences were compared with GenBank database. Calculated Coverage values of clone library and Shannon-Wiener diversity index. Results Sixteen defined genus-or species-bacteria were detected in 103 valid sequences. Eight species were edge type (Clone No. > 5). Three kinds of pathogens were identified (Borrelia burgdorferi, Bartonella henselae and Rickettsia sp). Three kinds of pathogens were not edge type(Clone No. < 5). Coverage value was 96.11%, and Shannon-Wiener index was 2.40. Analysis results of cloning sequence showed that tick-parasitic bacteria mainly were α and γ deformation mycetes which accounted for 56.25% (9/16). Conclusions The 16S rRNA gene sequences technology could make relative quantitative of bacterial flora, and detect many kinds of pathogens in tick. It's a good method for detection of pathogens and bacterial flora analysis.     

4种病原菌特异基因片段阳性蜱的16S rRNA基因克隆文库分析

Objective To develop the method of 16S rRNA gene clone library for tick bacterial flora analysis, and to analyze the detection effective of pathogens in tick and capacity of bacterial flora diversity. Methods Primers were designed according to the specific gene of Borrelia burgdorferi, Bartonella henselae, Anaplasma phagocytophilum, Ehrlichia chaffeensis and templates were choosen by positive PCR result to amplify the DNA extracted from the ticks. One set of primers targeting 16S rRNA gene conserved region were chosen to amplify certain fragments, DNA extraction, PCR reaction, cloning and sequencing. Nucleotide sequences were compared with GenBank database. Calculated Coverage values of clone library and Shannon-Wiener diversity index. Results Sixteen defined genus-or species-bacteria were detected in 103 valid sequences. Eight species were edge type (Clone No. > 5). Three kinds of pathogens were identified (Borrelia burgdorferi, Bartonella henselae and Rickettsia sp). Three kinds of pathogens were not edge type(Clone No. < 5). Coverage value was 96.11%, and Shannon-Wiener index was 2.40. Analysis results of cloning sequence showed that tick-parasitic bacteria mainly were α and γ deformation mycetes which accounted for 56.25% (9/16). Conclusions The 16S rRNA gene sequences technology could make relative quantitative of bacterial flora, and detect many kinds of pathogens in tick. It's a good method for detection of pathogens and bacterial flora analysis.     

2004－2016年浙江省登革热疫情时空聚集性分析

目的 探测2004 — 2016年浙江省登革热疫情的时空聚集性分布,为制定登革热的防控策略提供参考依据。 方法 以2004 — 2016年浙江省登革热病例为研究对象,运用SaTScan软件进行时空扫描统计分析,使用ArcGIS软件对登革热总疫情和散发疫情的地区分布及时空扫描统计分析结果进行可视化展示。 结果 时空扫描统计分析结果显示,2004 — 2016年浙江省登革热总体疫情共有2个聚集区（ P＜0.05）,分别为义乌市（2009–08 –01至2009 –09–30）和慈溪市（2004 –09–01至2004–10 –31）;散发疫情共有1个一类聚集区和2个二类聚集区（P＜0.05）,分别为义乌市和浦江县（2012–08–01至2016–12–31）、杭州市市区（2013 –07–01至2016–11–30）和宁波市市区（2013 –07–01至2016–10–31）。 结论 义乌市、杭州市市区和宁波市市区是登革热输入的高危地区,输入风险在不断增加,浙江省应制定有效的登革热预防控制策略。      

肺泡蛋白沉积症一例

肺泡蛋白沉积症（pulmonaryalveolarproteinosis，PAP）是一种以肺泡大量过碘酸雪夫（periodicacid—Schiff，PAS）染色阳性的蛋白类物质沉积为特征的肺部疾病。Rosen等在1958年首先报道，至今国际上累计报道有400余例，成人患者居多，很少发生在婴幼儿，有人认为发病越早，病情越重。1岁以下婴儿发病，死亡率〉80％，出生时发病婴儿，100％死亡。为了加强对婴儿肺泡蛋白沉积症的认识，特报道我院所见1例，并对其发病特征、诊断和治疗进行讨论。     

重症监护病房肺部真菌感染40例

目的探讨重症监护病房(ICU)儿童肺部真菌感染危险因素及防治对策。方法回顾性分析武汉市儿童医院ICU2003年1月～2007年1月40例肺部真菌感染患儿抗生素、激素和侵入性操作使用情况及其防治与转归。结果40例患儿均有长期使用广谱抗生素和糖皮质激素史,75%患儿接受过侵入性操作或治疗,平均住院时间长(37.8d)。其临床症状及体征不典型,影像学检查无特异性。病原以白色念珠菌居首,占80%,曲霉菌属次之。治愈35例(87.5%),死亡5例(12.5%)。结论长期使用广谱抗生素及糖皮质激素是儿童肺部真菌感染主要危险因素。合理应用抗生素和糖皮质激素,减少不必要侵入性操作,加强微生态免疫营养支持,及时用高效抗真菌药物,有助于降低肺部真菌感染的发生。     

2015年浙江省人间布鲁氏菌病监测结果分析

目的 了解浙江省人间布鲁氏菌病（布病）发病状况及流行规律,为制定防治策略提供依据。方法 疫情资料来自国家疾病监测信息报告管理系统的疫情报告,采用描述流行病学和统计学方法分析数据;布病重点职业人群血清学检测采用虎红平板凝集试验和试管凝集试验。结果 2015年浙江省共报告布鲁氏菌病病例98例,发病率为0.18/10万,发病年龄主要集中在30～65岁年龄组,男女性发病数比例为2.63:1;2015年全省检测重点人群6 815人,阳性160例,阳性者中新发患者84例,感染者35例,41例既往患者和感染者。发病到确诊平均间隔时间30 d。结论 浙江省布病疫情呈稳定趋势,应加强医务人员培训和健康教育等工作以有效控制疫情,防止发生慢性化患者。     

一犬伤多人事件的案例调查

<正>浙江省是狂犬病的老疫区,每年都有数十例狂犬病病例发生并死亡,其中部分病例是一犬伤多人事件中的暴露者。为了解浙江省一犬伤多人事件的危险性和危害程度,制订有效遏制狂犬病的防控对策,我们对2011年浙江省报告的9起一犬伤多人