2007-2009年鲍氏不动杆菌的耐药性分析

目的了解鲍氏不动杆菌耐药性的变迁,为临床合理用药提供依据。方法回顾性分析2007-2009年临床分离的1318株鲍氏不动杆菌药物敏感结果,细菌鉴定和药物敏感试验采用法国生物梅里埃公司VITEK-2全自动微生物分析仪。结果鲍氏不动杆菌主要来自ICU,占24.7%,其次为呼吸内科,占19.3%;标本来源主要为痰,占43.2%,其次为尿液,占13.8%;鲍氏不动杆菌对多种常见抗菌药物耐药率较高,除阿米卡星和妥布霉素耐药率近年来有下降趋势外,多种抗菌药物耐药率呈上升趋势;对其敏感性较好的抗菌药物有哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南、美罗培南和阿米卡星。结论鲍氏不动杆菌多药耐药现象严重,临床应根据药敏结果合理用药,注意消毒与隔离,控制耐药株的流行。     

Genetic and biological variability in human nutrient requirements.

Multiple factors, associated with the host and environment, as well as the chemical form of the nutrient, its availability, chemical and metabolic interactions among nutrients, result in a variability in nutrient requirements that is probably well beyond that observed in controlled laboratory studies of small groups of "normal" healthy subjects. Although many factors are recognized as contributing to the variation in human nutrient requirements, current knowledge is largely of qualitative significance: Garn (40) state that this level of knowledge and investigation "has a long past but no foreseeable future." It is sad commentary that neither do we know adequately the quantitative extent of biological variation in requirements among individuals for any of the essential nutrients nor the quantitative importance of most of the factors which affect requirements in population groups. We believe that the potential contributions of nutrition toward solving problems of human disease and for maintaining health in populations depend as much on a better definition of the quantitative aspects of human nutrient requirements as on improved understanding of the utilization, function and metabolism of nutrients at the cellular, organ, and whole body level.     

2007年～2009年滨城区碘盐检测结果分析

目的:了解滨城区居民碘盐食用情况,及时发现问题并采取相应干预措施,保证居民食碘盐的策略得到有效落实。方法:根据《全国碘盐监测方案》对居民户的食用碘盐进行随机抽查和结果判定。结果:2008~2009年,全区碘盐覆盖率、碘盐合格率和合格碘盐食用率均高于95%,2007年合格碘盐食用率低于90%。结论:2008~2009年,全区碘盐覆盖率、碘盐合格率和合格碘盐食用率均达到国家标准。     

Prevalence and phylogenetic analysis of rotavirus genotypes in Thailand between 2007 and 2009

Rotaviruses are the most common cause of severe diarrhea among infants and young children worldwide, especially in developing countries. In Thailand, rotavirus has presented a major public health problem causing severe diarrhea in infants and young children. It was responsible for about one-third of diarrheal diseases in hospitalized patients. In this study, we have analyzed the distribution and performed molecular characterization of rotaviruses circulating in infants and young children with diarrhea admitted to the city and rural hospitals in Thailand between July 2007 and May 2009. Group A human rotavirus was detected in 158 (28.4%) of 557 fecal specimens by RT-PCR. The peak incidence of infection was found in the winter months between December and March. The G1P[8] strain was identified as the most prevalent (49.4%) followed by G9P[8] (22.2%), G2P[4] (20.2%) and G3P[8] (0.6%). The uncommon strains G12P[8], G12P[6] and G3P[9] were also detected. Phylogenetic analysis of selected G and P genotypes isolated in this study was performed to compare with the reference strains from different countries. Emergence of G12 in the northern part of Thailand was observed and phylogenetic analysis demonstrated close relation between Thai isolates and strains from India. The present study reveals the recurring changing genotypes of rotavirus circulating in Thailand. The genetic association between isolates from Thailand and other countries ought to be considered with regard to local and global dissemination of rotavirus as it is crucial for prevention especially, with respect to vaccine implementation.     

2007～2009年桂林市受检样品微生物污染状况分析

目的了解桂林市受检样品的微生物污染状况,为今后食品安全及饮水安全提供科学依据。方法将现场抽检或被检单位送检的各类微生物检测结果汇总,并进行统计分析。结果2007~2009年桂林市受检各类样品(不含餐饮具)6 253份,平均合格率为83.51%。食品及食品用产品、水质、公共场所平均合格率分别为81.87%、86.19%、79.57%。水质样品大肠菌群平均合格率为88.08%,餐饮具微生物检测平均合格率为89.02%。结论桂林市各种健康相关产品受到微生物污染比较严重,应加强卫生监督监测工作,并采取有针对性的预防与控制措施,提高卫生质量,确保人民群众的健康和安全。     

Financial costs of deworming children in all primary schools in Cambodia

In 2002, Cambodia's Ministry of Health launched a deworming programme to deliver an anthelmintic drug (mebendazole 500 mg) and health education to 75% of its school children twice a year. Cambodia's school population is approximately 2.8 million. The deworming programme was organized into two phases: the first phase (December 2002-March 2003) targeted more than one million school children from 11 provinces; and the second phase (July 2003-January 2004) targeted the entire school population. The cost to treat each child was 12 cents (0.11 USD) during the first phase, 6 cents during the second phase, and 3 cents for re-treatment in areas where the campaign was conducted for the second time. The Cambodian experience demonstrates that, with political commitment, high coverage for deworming is achievable even in a country with minimal resources. Cambodia's deworming programme represents a successful model for other developing countries.     

Intra- and interindividual variability of glucose tolerance in an elderly population

The intra- and interindividual variability of the oral glucose tolerance test (OGTT) and other risk factors was investigated in 237 subjects, aged 64-87, examined annually in the period 1971-1975. Coefficients of intraindividual variation (CVa) were calculated from individual regressions on time. The lowest CVa was found for the summary index including fasting glucose (area under the curve, AUC): 10.0 +/- 4.9%. For fasting and 30, 60, and 120 min glucose the values ranged from 12 to 18%. The CVa's were not associated with age, gender, drug use, and disease prevalence, and may also be applied to other populations. The reliability coefficient depended on the prevalence of diabetes in the population and was higher than observed in younger populations. The highest reliability coefficient was observed for AUC: 0.81. For the combined information of OGTT, reflected by AUC or by classification according to WHO criteria, the variability was comparable to that of other cardiovascular risk factors such as serum total cholesterol.     

2007-2009年ICU铜绿假单胞菌的耐药性变迁

目的 了解铜绿假单胞菌(PAE)在ICU医院感染的分布,以及对多种抗菌药物耐药率的变迁,为临床应用抗菌药物提供依据.方法 用K-B纸片扩散法对2007-2009年外科重症监护病房PAE进行药敏试验,分析其耐药性变化.结果 外科PAE主要来源于痰液、分泌物、尿液;同时,对所监测的13种抗菌药物均有较高程度的耐药,特别是头孢曲松、甲氧苄啶、头孢吡肟和左氧氟沙星耐药率有上升的趋势.结论 医院外科重症监护病房PAE感染主要在呼吸道、泌尿系统以及创面感染,其中呼吸道感染最为严重;PAE耐药性逐渐加剧,因此对它进行规范连续的耐药监测,及时发现耐药菌株,对临床调整治疗方案,预防医院感染的发生是十分重要.     

Genetic diversity of human rhinoviruses in Cambodia during a three-year period reveals novel genetic types

Acute respiratory viral infections are a major cause of morbidity during early childhood in developing countries. Human rhinoviruses are the most frequent cause of upper respiratory tract infections in humans, which can range in severity from asymptomatic to clinically severe disease. In this study we collected 4170 nasopharyngeal swabs from patients hospitalised with influenza-like illness in two Cambodian provincial hospitals between 2007 and 2010. Samples were screened for 18 respiratory viruses using 5 multiplex PCRs. A total of 11.2% of samples tested positive for human rhinoviruses (HRV). VP4/2 and VP1 regions were amplified and sequenced to study the distribution of rhinoviruses genotypes and species in Cambodia during this three-year period. Five novel genotypes, 2 species A, 2 species B and 1 species C were identified based on VP1 sequences. Co-infections with other viruses were demonstrated.     

Longitudinal variability of time-location/activity patterns of population at different ages: a longitudinal study in California

Background

Synoptic circulation patterns (large-scale tropospheric motion systems) affect air pollution and, potentially, air-pollution-morbidity associations. We evaluated the effect of synoptic circulation patterns (air masses) on the association between ozone and hospital admissions for asthma and myocardial infarction (MI) among adults in North Carolina.

Methods

Daily surface meteorology data (including precipitation, wind speed, and dew point) for five selected cities in North Carolina were obtained from the U.S. EPA Air Quality System (AQS), which were in turn based on data from the National Climatic Data Center of the National Oceanic and Atmospheric Administration. We used the Spatial Synoptic Classification system to classify each day of the 9-year period from 1996 through 2004 into one of seven different air mass types: dry polar, dry moderate, dry tropical, moist polar, moist moderate, moist tropical, or transitional. Daily 24-hour maximum 1-hour ambient concentrations of ozone were obtained from the AQS. Asthma and MI hospital admissions data for the 9-year period were obtained from the North Carolina Department of Health and Human Services. Generalized linear models were used to assess the association of the hospitalizations with ozone concentrations and specific air mass types, using pollutant lags of 0 to 5 days. We examined the effect across cities on days with the same air mass type. In all models we adjusted for dew point and day-of-the-week effects related to hospital admissions.

Results

Ozone was associated with asthma under dry tropical (1- to 5-day lags), transitional (3- and 4-day lags), and extreme moist tropical (0-day lag) air masses. Ozone was associated with MI only under the extreme moist tropical (5-day lag) air masses.

Conclusions

Elevated ozone levels are associated with dry tropical, dry moderate, and moist tropical air masses, with the highest ozone levels being associated with the dry tropical air mass. Certain synoptic circulation patterns/air masses in conjunction with ambient ozone levels were associated with increased asthma and MI hospitalizations.     

Genetic variability of human respiratory syncytial virus in Pune,Western India

Human respiratory syncytial virus (RSV) is one of the most important respiratory viruses causing acute respiratory tract infections amongst children. Based on genotyping of the attachment glycoprotein (G) gene, it is divided into two groups, RSV-A and RSV-B. Infection with one group does not confer immunity against the other and children infected with one antigenic group are more likely to be reinfected with the heterologous group. We tested 854 samples of patients with influenza like illness (ILI)/severe respiratory illness (SARI) during the period 2009–2012 for RSV using a conventional multiplex RT-PCR and found 159 (18.61%) samples to be positive for RSV of which 130 (15.22%) were positive for RSV-B and 29 (3.39%) for RSV-A suggesting that RSV-B was the predominant group circulating in Western India during the study period. Seasonal RSV outbreaks were observed in the monsoon and winter months. RSV was more prevalent amongst children in the 0–24 month age group (21.53%) in comparison to children in the 24–60 month age group (13.01%). Phylogenetic analysis using the G gene of 27 representative RSV-A positive samples revealed that all sequences belonged to the NA1 genotype. Of these, 5 sequences exhibited the novel 72 nucleotide duplication in the C-terminal of the G gene first reported from Ontario, Canada and clustered in the newly designated ON1 genotype. Also, 32 of the 33 RSV-B sequences exhibited the 60 nucleotide duplication associated with genotype BA and phylogenetic analysis showed that these sequences belonged to the genotype BA9 and BA12. We also found one RSV-B sequence belonging to genotype GB2, which has not been previously reported in India.     

Cardiovascular risk factors predicting all causes of death in an occupational population sample

A group of 768 men aged 40-59 at entry examination and belonging to an occupational sample of railroad employees in Rome have been examined for the measurement of some risk factors and followed-up for 20 years. In all 676 men, free from life-threatening diseases and with all measurements available, produced 166 fatal events in 20 years. Out of the 27 different personal characteristics considered only six contributed significantly to the multivariate prediction of all causes of death in the Cox proportional hazards computed by the forward stepwise technique. The factors predicting all causes of death were age, cigarette smoking, diabetes, blood pressure, mother's vital status and being on a diet prescribed by a doctor. The relative risk of those located in the upper decile of the estimated risk as compared to the bottom decile was 8.2. The results do not differ much from those obtained in a demographic sample studied in the same way.     

Exposure to environmental tobacco smoke in the nonsmoking population of Cambodia

OBJECTIVE: To estimate the extent of environmental tobacco smoke (ETS) exposure among nonsmokers in the adult population of Cambodia. METHODS: A cross-sectional survey was conducted on a nationally representative sample of 13,988 Cambodian adults in 2005. Information on smoking and exposure to ETS was obtained by trained interviewers using a standard questionnaire. RESULTS: Overall, 37.4% of the 10,263 nonsmoking responders, or an estimated 1,629,700 nonsmoking Cambodians, were exposed to ETS. One third of pregnant women (31.4%) were exposed to ETS at home. In both unadjusted and adjusted models, men were less likely to be exposed to ETS at home (OR=0.34; 95% CI=0.29-0.41) and more likely to be exposed to ETS at work and in public places (OR=3.08; 95% CI=2.14-4.43 and OR=2.17; 95% CI=1.82-2.59, respectively). Education was inversely related to ETS exposure at home (OR=0.51; 95% CI=0.27-0.96 for 10 years of education vs 5 years or less). Legislators, senior officials, and managers were less likely to be exposed to ETS at home than professionals (OR=0.13; 95% CI=0.04-0.46), but more likely to be exposed at work or in public places. Rural residence was associated with higher ETS exposure in the home (OR=2.52; 95% CI=1.71-3.71) and lower ETS exposure at work (OR=0.42; 95% CI=0.24-0.76) compared to urban residence. CONCLUSIONS: The high prevalence of ETS exposure among adult Cambodians indicates an urgent need for specific measures such as public awareness campaigns, policies, and regulations to protect nonsmokers in Cambodia.     

湖州市某小学一起人偏肺病毒呼吸道感染暴发疫情调查

  目的  了解湖州市某小学一起人偏肺病毒(human metapneumovirus,hMPV)引起呼吸道感染暴发疫情的流行病学特征,为今后预防控制hMPV引起的上呼吸道感染学校暴发疫情提供科学参考。  方法  根据《流感样病例暴发疫情处置指南》(2018年版)等开展调查。采集现症病例咽拭子开展新冠病毒核酸检测,如为阴性再开展流感病毒等其他常见的14种上呼吸道病毒检测。  结果  共发现53例hMPV感染病例,首发病例为2020年12月15日; 病例集中在12月21—26日; 末例病例为12月29日。历时15 h疫情结束。病例均为一年级学生,发病班级罹患率为44.92%(53/118),其中101班的罹患率为23.08%(9/39),102班为53.85%(21/39),103班57.50%(23/40),差异有统计学意义(χ2=10.07,P < 0.05)。病例年龄在6~7岁。发病班级男生罹患率为48.00%(24/50),女生为42.65% (29/68),差异无统计学意义(χ2=0.33,P>0.05)。所有病例临床症状均较轻,以咳嗽、咽痛、流鼻涕为主,仅少部分出现发热。采集20例现症病例咽拭子标本,13例hMPV核酸阳性。  结论   hMPV引起的症状相比流感较轻,不容易引起学校和家长的重视。学校应开展相关防治知识宣传,做好晨午检,杜绝带病上课。