上海市集中式中央空调冷却塔水嗜肺军团菌污染状况分析

目的了解上海市宾馆、大型商场、超市及写字楼中央空调系统嗜肺军团菌的污染状况。方法采集上海市100家公共场所集中式中央空调冷却塔水100份,经酸处理,以GVPC、BCYE、血平板进行菌落筛选,并应用生化反应鉴定,最后进行血清学分型。结果100份冷却塔水检出嗜肺军团菌的样本数为75份,检出率达75％（75／100）,其中宾馆、大型商场、超市、写字楼阳性率分别为80．6％、72．7％、72．7％、70％。75份检出水样中分离到76株军团菌,血清型别呈多样化,但以LPl为主,同一份水样同时检出2个型别的占总检出水样的1．3％（1／75）。结论上海市公共场所中央空调冷却水中嗜肺军团菌污染严重,血清型别呈多样化,对人群健康构成潜在威胁,需要引起重视,以防军团菌病的暴发流行。     

甲氧西林耐药的金黄色葡萄球菌耐药性及分子流行病学调查

目的了解甲氧西林耐药的金黄色葡萄球菌(MRSA)的耐药性及分子流行病学特点。方法采用纸片扩散法及琼脂稀释法检测2002年从北京协和医院住院患者分离的165株MRSA的耐药性；采用脉冲场凝胶电泳(PFGE)技术对其中重症监护病房(ICU)和呼吸重症监护病房(RCU)分离的65株MRSA作同源性分析。结果165株MRSA对万古霉素和替考拉宁的敏感率为100％，对庆大霉素的耐药率为100％；对左氧氟沙星、四环素、红霉素耐药率分别为98．2％、96．3％、93．9％。对甲氧苄啶，磺胺甲噁唑和氯霉素敏感率分别为95．8％及98．8％；ICU和RCU病房分离MRSA的PFGE图谱有5种类型(A—E型)，以A型为主(56株)，A型又包括A1亚型(55株)和A2亚型(1株)。结论医院获得性MRSA是多重耐药菌，在ICU和RCU病房发生了基因型为A1亚型的MRSA菌株暴发流行。     

2016～2017年泌尿系感染病原菌特征分析

目的 了解2016～2017年泌尿系感染病原菌、性别、年龄、科室分布特点,为临床泌尿系感染疾病诊断与医院感染控制提供可靠依据.方法 收集医院2016年1月至2017年12月分离的泌尿系感染病原菌1369株,细菌培养和药敏试验按《全国临床检验操作规程》(第四版)进行,采用VITEK-2 compact全自动药敏鉴定分析仪对菌株进行鉴定及药敏试验,药敏折点判断采用美国临床实验室标准化委员会(CLSI)2017版标准.采用WHONET 5.6软件和卡方检验进行数据处理和分析.结果 1369株病原菌中,分别检出革兰阴性菌778株(56.83％),革兰阳性菌303株(22.13％),真菌288株(21.04％),主要以革兰阴性菌为主.革兰阴性菌分离率前两位的病原菌分别为大肠埃希菌(28.85％)、肺炎克雷伯菌(11.91％).革兰阳性菌分离率前两位分别为屎肠球菌(11.91％)、粪肠球菌(4.53％).真菌分离率最高为白色假丝酵母菌(8.25％).男女性别占分别为男性为62.24％、女性37.76％.泌尿系感染人群占比前三位的为81 ～ 90岁(43.54％)、71 ～80岁(21.18％)、61～ 70岁(12.56％).泌尿系感染病原菌在全院各病区均有分布,病区分离率前3位分别为占ICU病区(26.52％),神经与精神病区(17.02％),急诊病区(10.52％),其中以ICU病区最多.结论 医院泌尿系感染病原菌以革兰阴性菌为主,大肠埃希菌为主要致病菌.男性患者较女性患者更容易导致泌尿系感染.泌尿系感染人群以60岁以上人群比例最多,其中81-90年龄段占比较高.ICU病区患者泌尿系感染几率最高.及时监测尿液标本临床分离株的分布情况和特征,能够帮助临床医生诊断尿路感染.     

江苏省苏州及南京地区2010年婴幼儿腹泻中诺如病毒分子流行病学研究

目的 了解江苏地区婴幼儿腹泻患者中诺如病毒的感染情况,明确该地区诺如病毒的主要基因型别和流行病学特征.方法 收集2010年江苏省苏州市婴幼儿医院及南京市婴幼儿医院疑似病毒性腹泻粪便标本498例,采用荧光定量PCR方法检测粪便中诺如病毒RNA及其基因组别,并对部分阳性标本测序以明确基因型.结果 498份粪便标本中,GⅠ组诺如病毒阳性标本为2例,阳性率为0.4％,GⅡ组诺如病毒为190例,阳性率为38％,对本地区部分诺如病毒阳性标本进行测序,2份GⅠ标本中,一株为GⅠ1型,另一株为GⅠ3型;测序的23份GⅡ标本中21株为GⅡ4型,2株为GⅡ3型.结论 诺如病毒是本省婴幼儿病毒性腹泻的重要病原体,以诺如病毒GⅡ4型为主,同时也存在其他型别的感染流行.     

南京地区婴幼儿杯状病毒感染的分子流行病学研究

目的 了解南京地区婴幼儿杯状病毒腹泻的感染状况、临床表现以及分子流行病学特征.方法 采集2010年7月至2011年6月南京医科大学附属南京儿童医院5岁以下腹泻患儿粪便标本及儿童保健中心健康婴幼儿粪便标本各428份.采用反转录-聚合酶链反应( RT-PCR)检测杯状病毒,测序确定其基因型别.结果 428份腹泻样本中有63份为杯状病毒阳性,检出率为14.72％.其中诺如病毒GⅡ型58例,未检出诺如病毒GⅠ型,札如病毒5例,以诺如病毒GⅡ-4 2006b型为主要流行株.428份健康对照组标本杯状病毒检出19例,诺如病毒6例,札如病毒11例,2例为诺如病毒GⅡ型和札如病毒混合感染.结论 南京地区婴幼儿中存在不同基因型杯状病毒感染,流行毒株以GⅡ.2006b为主.     

耐甲氧西林金黄色葡萄球菌的脉冲场凝胶电泳分型研究

目的　探讨耐甲氧西林金黄色葡萄球菌 (MRSA)的分子流行病学特点。方法　采用脉冲场凝胶电泳 (PFGE)技术对我院在 2 0 0 1年 6月～ 2 0 0 2年 4月临床分离的 5 0株MRSA作同源性分析。结果　 5 0株MRSA的PFGE图谱分为 6个组 (A～F型 )。以A型 (2 7株 )、B型 (10株 )、C型 (10株 )流行为主。 5 0株MRSA中共有 17株和重症监护室 (ICU)相关 ,占 34%。流行菌株在各病房之间传播。结论　ICU是MRSA的高发区域和疫源地 ,神经外科、肝胆胰外科和干部病房中MRSA的分离率也较高。在同一病人不同时间不同部位所采集的菌株同源性不尽相同     

重症监护病房多重耐药菌感染分析及控制措施

目的 了解重症监护病房(ICU)多重耐药菌感染分布特点,为临床治疗和ICU预防控制多重耐药菌感染提供科学的依据.方法 使用商品诊断试剂做细菌鉴定及药物敏感试验,药物敏感试验为微量肉汤稀释法;耐药性数据用LIS系统统计.结果 共分离216株多重耐药菌中,178株分离自痰标本,占82.73％,其次是尿标本占15.27％,其中G-杆菌190株,占87.96％,G+杆菌仅26株,占12.04％.排在前三位的分别为大肠埃希菌(36.11％)、肺炎克雷伯菌(21.76％)、铜绿假单胞菌(18.06％).结论 分离的多重耐药菌主要来自痰标本,以革兰阴性杆菌分离率高,临床应合理使用抗生素,加强院内感染预防及控制措施,降低多重耐药菌院内感染发生率.     

分型引物RT-PCR法在杯状病毒分子流行病学研究中的应用

目的：应用分型引物RT-PCR法确定五个地区病毒性腹泻粪便标本中杯状病毒流行型别及感染情况。方法：对五个地区收集的〈5岁病毒性腹泻粪便标本应用针对病毒壳体区域设计的四对引物（GⅠ—SKF／GⅠ-SKR、COG2F／G2-SKR、SLV5317／SLV5749、PreCAP1／82b）进行反转录-聚合酶链反应（RT-PCR）扩增诺如病毒GⅠ和GⅡ组、扎如、星状病毒（Astrovirus）,扩增产物通过1．5％琼脂糖凝胶电泳鉴定。选取部分阳性标本测序研究型别流行特点。结果：本实验从663例标本中共检出单独感染诺如病毒、扎如病毒和星状病毒阳性标本数分别为84、4、11株,同时还发现3株混合感染标本。选取24株诺如病毒阳性标本测序分析发现19株为GⅡ／4型,2株为GⅡ／3型,1株为GⅡ／1型,1株为GⅡ／13型,1株为GⅡ／15型,4株扎如病毒中2株为SGⅠ／1型,1株为SGⅡ／3型,1株为SGⅡ／1型。结论：研究表明杯状病毒是我国婴幼儿腹泻重要病原体,诺如病毒流行株为GⅡ／4型毒株,同时存在其它型别的散在流行;福建、兰州检测到不同型别扎如病毒证明我国存在多种型别的扎如病毒感染。     

水环境分离细菌及临床分离弗劳地柠檬酸杆菌中喹诺酮耐药基因qnr及aac(6')-Ⅰ b-cr的检测

目的 调查水环境分离细菌及临床分离弗劳地柠檬酸杆菌中喹诺酮耐药基因qnr和aac(6')-Ⅰ b-cr的流行情况及qnr基因型分布.方法 从杭州10个不同的水域中分离细菌,从4个城市的多家医院收集弗劳地柠檬酸杆菌临床菌株.琼脂稀释法测定环丙沙星、左氧氟沙星和萘啶酸对细菌的最低抑菌浓度(MIC).PCR方法检测细菌中qnrA、qnrB、qnrS及aac(6')-Ⅰ b-cr基因.对PCR产物进行测序及序列分析,确定各基因型别.结果 从水环境分离到78株革兰阴性杆菌(包括33株肠杆菌科细菌、21株气单胞菌属、10株不动杆菌属、10株假单胞菌属、2株产碱杆菌属和2株邻单胞菌属细菌).10株弗劳地柠檬酸杆菌中有8株qnrB基因阳性;9株大肠埃希菌中qnrS1和aac(6')-Ⅰb-cr基因阳性各1株;1株斑点气单胞菌(Aeromonas punctata)qnrS2阳性.临床分离的103株弗劳地柠檬酸杆菌中,qnr基因检出75株(72.8%),其中qnrA1有3株(2.9%),qnrB有65株(63.1%),qnrS2有1株(1.0%),qnrA1合并qnrB阳性5株(4.8%),qnrS1合并qnrB阳性1株;aa47(6')一Ⅰ b检出33株(32.0%),其中12株(11.6%)存在-cr变异体.qnrB的基因型以qnrB9、qnrB8和qnrB6为主.结论 首次在欧洲以外地区分离到携带qnrS2基因的气单胞菌属细菌.水环境及临床分离的弗劳地柠檬酸杆菌中qnrB基因的携带率非常高,后者同时有较高的aac(6')-Ⅰ b-cr携带率.弗劳地柠檬酸杆菌中qnrB基因的亚型以qnrB9、qnrB8和qnrB6最为常见.     

贵阳地区GⅡ.4型诺如病毒变异株的初步研究

目的 了解贵阳地区GⅡ.4型诺如病毒变异株的组成及其点突变.方法 监测2010年6-11月于贵阳地区哨点医院就诊的急性胃肠炎病例,收集粪便标本,采用荧光定量逆转录-聚合酶链反应(real-time RT-PCR)初步鉴定,随机选取部分GⅡ型诺如病毒阳性标本,采用一步法RT-PCR对其VP1基因区克隆及测序,基因序列与国内外流行的GⅡ.4型诺如病毒进行系统进化及氨基酸位点的突变分析.结果 检测标本426份,有267份(62.68％)GⅡ型诺如病毒阳性,测序获得了9份GⅡ.4型诺如病毒VP1基因组序列,贵州省2010年流行的GⅡ.4型诺如病毒包括2个变异株(GⅡ.42008a和GⅡ.4 2008b新型变异株),亚型组闻的VP1基因的同源性为95.90％ ～ 96.72％,亚型组内同源性为99.45％ ～ 100％,有2个氨基酸位点易发生突变.结论 贵阳地区2010年夏秋季急性胃肠炎以诺如病毒GⅡ型为主,并且变异株具有多样性.     

Nosocomial Outbreak of Carbapenem-Resistant Acinetobacter baumannii in Intensive Care Units and Successful Outbreak Control Program

Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe an outbreak of carbapenem-resistant A. baumannii (CRAB) in the ICUs of a Korean university hospital, along with a successful outbreak control program. From October 2007 through July 2008, CRAB was isolated from 57 ICU patients. Nineteen patients were diagnosed as being truly infected with CRAB, four of whom were presumed to have died due to CRAB infection, producing a case-fatality rate of 21.1%. In surveillance of the environment and the healthcare workers (HCWs), CRAB was isolated from 24 (17.9%) of 135 environmental samples and seven (10.9%) of 65 HCWs. The pulsed field gel electrophoresis patterns showed that the isolates from patients, HCWs, and the environment were genetically related. Control of the outbreak was achieved by enforcing contact precautions, reducing environmental contamination through massive cleaning, and use of a closed-suctioning system. By August 2008 there were no new cases of CRAB in the ICUs. This study shows that the extensive spread of CRAB can happen through HCWs and the environmental contamination, and that proper strategies including strict contact precautions, massive environmental decontamination, and a closed-suctioning system can be effective for controlling CRAB outbreaks.     

Molecular epidemiology of Enterobacter aerogenes acquisition: one-year prospective study in two intensive care units.

To evaluate the respective contributions of patient-to-patient transmission and endogenous acquisition of Enterobacter aerogenes isolates, we conducted a prospective epidemiologic study in two intensive care units (ICUs) between May 1994 and April 1995. We collected a total of 185 E. aerogenes isolates: 130 from 51 patients in a surgical ICU (SICU), 45 from 26 patients in a medical ICU (MICU), and 10 from the environments in these two ICUs. All isolates were typed by random amplification of polymorphic DNA and enterobacterial repetitive intergenic consensus PCR. Among the 175 clinical isolate, we observed 40 different profiles by random amplification of polymorphic DNA and 36 different profiles by enterobacterial repetitive intergenic consensus PCR. We identified a ubiquitous and prevalent clone, corresponding to 58% of SICU and 41% of MICU clinical isolates. Three epidemiologically related strains were specific to each ICU and represented 17% of SICU and 24% of MICU clinical isolates; unique type strains represented 17 and 29% of SICU and MICU clinical isolates, respectively, and E. aerogenes strains which were spread to a limited degree and which were isolated less than five times during the 1-year study period represented 8 and 6% of SICU and MICU clinical isolates, respectively. Our results show that E. aerogenes is acquired in the ICU in three different ways: patient-to-patient spread of a prevalent or an epidemiologically related strain, acquisition de novo of a strain from patients' own flora, and acquisition of a nonendemic strain followed by occasional patient-to-patient transmission. The findings point out the importance of patient-to-patient transmission in E. aerogenes acquisition and suggest that changes in E. aerogenes ecology in the hospital have taken place during the past decade.     

Epidemic multidrug-resistant Acinetobacter baumannii related to European clonal types I and II in Rome (Italy)

The molecular epidemiology and the genetic basis of antibiotic resistance in 88 multidrug-resistant (MDR) Acinetobacter baumannii strains isolated during 18 months from infected patients in seven intensive care units (ICUs) in Rome were investigated. Random amplified polymorphic DNA and macrorestriction analysis identified two predominant clonal types, genetically related to the European epidemic clones I (type 2) and II (type 1), accounting for 98.9% of A. baumannii ICU isolates. Type 1 was isolated from all ICUs under survey. Class 1 integrons of 2.2 and 2.5 kb were detected in type 1 and type 2 isolates, respectively. The integron structures were similar to those previously determined for epidemic A. baumannii strains from various European countries, and suggestive of integron rearrangement/exchange among isolates related to the European epidemic clones I and II. Carbapenem resistance was associated with the presence of the bla _OXA-58 gene in type 1 isolates. The results indicate that the A. baumannii type 1 clone has a high potential of spreading among hospitals.     

Elucidating the Origins of Nosocomial Infections with Candida albicans by DNA Fingerprinting with the Complex Probe Ca3

Computer-assisted DNA fingerprinting with the complex probe Ca3 has been used to analyze the relatedness of isolates collected from individuals with nosocomial bloodstream infections (BSIs) and hospital care workers (HCWs) in the surgical and neonatal intensive care units (ICUs) of four hospitals. The results demonstrate that for the majority of patients (90%), isolates collected from commensal sites before and after collection of a BSI isolate were highly similar or identical to the BSI isolate. In addition, the average similarity coefficient for BSI isolates was similar to that for unrelated control isolates. However, the cluster characteristics of BSI isolates in dendrograms generated for each hospital compared to those of unrelated control isolates in a dendrogram demonstrated a higher degree of clustering of the former. In addition, a higher degree of clustering was observed in mixed dendrograms for HCV isolates and BSI isolates for each of the four test hospitals. In most cases, HCW isolates from an ICU were collected after the related BSI isolate, but in a few cases, the reverse was true. Although the results demonstrate that single, dominant endemic strains are not responsible for nosocomial BSIs in neonatal ICUs and surgical ICUs, they suggest that multiple endemic strains may be responsible for a significant number of cases. The results also suggest that cross-contamination occurs between patients and HCWs and between HCWs in the same ICU and in different ICUs. The temporal sequence of isolation also suggests that in the majority of cases HCWs are contaminated by isolates from colonized patients, but in a significant minority, the reverse is true. The results of this study provide the framework for a strategy for more definitive testing of the origins of Candida albicans strains responsible for nosocomial infections.     

Molecular epidemiologic analysis of methicillin-resistant Staphylococcus aureus isolates from bacteremia and nasal colonization at 10 intensive care units: multicenter prospective study in Korea

We investigated molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) isolated at 10 intensive care units (ICUs) in Korea. MRSA isolates from bacteremia and nasal colonization were collected prospectively from October 2008 through May 2009 at 10 University-affiliated hospital ICUs. A total of 83 and 175 MRSA strains were isolated from bacteremia and nasal colonization, respectively. Acquired group accounted for 69.9% (n = 58) of bacteremia and 73.1% (n = 128) of nasal colonization. Pulsed-field gel electrophoresis (PFGE) type B (SCCmec type II/ST5) was dominant in the acquired group followed by PFGE type D (SCCmec type IVA/ST72; a community genotype). Seven of 58 (12.1%) acquired bacteremia and 15 of 128 (11.8%) acquired nasal colonizations had SCCmec type IVA/ST72 genotype, which indicated that the community genotype had already emerged as a cause of ICU acquired MRSA infection or colonization. Antibiotic resistance rates to ciprofloxacin, tetracycline, clindamycin and trimethoprim/ sulfamethoxazole were 84.4%, 67.1%, 78.1%, and 12.0%, respectively. Susceptibility to ciprofloxacin best predicted a community genotype (sensitivity 96.5%; specificity 96.9%; odds ratio 861; 95% confidence interval 169-4,390, P < 0.001) and the positive predictive value was 90.2%. Among 23 nasal re-colonized strains, 7 MRSA strains (30.4%) were different from the originally colonized strains on the basis of PFGE types.     

Serotype distribution and antimicrobial susceptibility of group A streptococci (Streptococcus pyogenes) isolated in Taiwan

T-protein serotypes and antimicrobial susceptibility of a total of 139 group A streptococci (GAS) strains isolated in Taiwan area in 1993 and during the outbreak of scarlet fever in 1994 were analyzed. All strains were T-typable, and T12 (42.46%) and T4 (38.85%) were the dominant T types. According to the results of analysis of antimicrobial susceptibility, all GAS strains were divided into 9 resistotypes, A (all susceptible), B (resistant to tetracycline), C (resistant to erythromycin and tetracycline), D (resistant to chloramphenicol and tetracycline), E (resistant to chloramphenicol and clindamycin), F (resistant to chloramphenicol, clindamycin and tetracycline), G (resistant to clindamycin, erythromycin and tetracycline), H (resistant to chloramphenicol, clindamycin, erythromycin and tetracycline), and I (resistant to chloramphenicol, clindamycin, erythromycin, tetracycline and vancomycin). Type B (37.42%) was the dominant type. Type A (25.91%), and type H (26.63%) also appered with high incidence. Most of strains isolated from Mid-Taiwan were type H. Only one strain, that was isolated in I-lan, was resistant to vancomycin, in addition to resistant to chloramphenicol, clindamycin, erythromycin, and tetracycline. All strains were susceptible to penicillin G, ampicillin, and ceftriaxone. Some strains were resistant to chloramphenicol (32.38%), clindamycin (30.22%), erythromycin (31.66%), tetracycline (73.39%), and vancomycin (0.70%). During the outbreak of scarlet fever in 1994, the dominant T types of strains isolated in North-Taiwan and Mid-Taiwan were T4 and T12, respectively, and the major resistotypes of those strains were B and H types, respectively. These clues suggested that the outbreaks occurring in North-Taiwan and Mid-Taiwan may have no epidemiological linkage between each other.     

无锡地区流感病毒病原学监测及H3亚型血凝素基因变异研究

目的 监测无锡地区2005年至2008年季节性流感型与亚型分布并了解2008年部分A/H3N2分离株血凝素(8A)基因变异状况.方法 无锡地区医院门诊流感样患者及集体单位聚集性流感样暴发患者采集鼻咽拭标本,接种MDCK细胞,采用标准抗血清鉴定阳性分离株型与亚型,并对2008年部分H3亚型流感病毒进行HA全基因测序,分析HA基因变异状况.结果 2005年至2008年9月,在无锡地区流感样患者中共分离到435株流感病毒,其中164株为A/H1N1亚型,80株为MH3N2亚型,B型191株.型与亚型有明显季节性分布强弱特征.H3亚型HA序列分析,无锡地区9株分离株与上海地区同期分离株接近,有很多序列相互穿插归属于进化树的同一分支,与WHO 2008-2009年疫苗推荐株相近.结论 近年无锡地区散发和局部暴发流感病毒感染仍主要为A/H1N1、A/H3N2和B型,A/H3N2 HA基因与上海地区同期分离株接近,与WHO 2008-2009年疫苗推荐株相近.     

无锡地区流感病毒病原学监测及H3亚型血凝素基因变异研究

目的 监测无锡地区2005年至2008年季节性流感型与亚型分布并了解2008年部分A/H3N2分离株血凝素(8A)基因变异状况.方法 无锡地区医院门诊流感样患者及集体单位聚集性流感样暴发患者采集鼻咽拭标本,接种MDCK细胞,采用标准抗血清鉴定阳性分离株型与亚型,并对2008年部分H3亚型流感病毒进行HA全基因测序,分析HA基因变异状况.结果 2005年至2008年9月,在无锡地区流感样患者中共分离到435株流感病毒,其中164株为A/H1N1亚型,80株为MH3N2亚型,B型191株.型与亚型有明显季节性分布强弱特征.H3亚型HA序列分析,无锡地区9株分离株与上海地区同期分离株接近,有很多序列相互穿插归属于进化树的同一分支,与WHO 2008-2009年疫苗推荐株相近.结论 近年无锡地区散发和局部暴发流感病毒感染仍主要为A/H1N1、A/H3N2和B型,A/H3N2 HA基因与上海地区同期分离株接近,与WHO 2008-2009年疫苗推荐株相近.     

无锡地区流感病毒病原学监测及H3亚型血凝素基因变异研究

目的 监测无锡地区2005年至2008年季节性流感型与亚型分布并了解2008年部分A/H3N2分离株血凝素(8A)基因变异状况.方法 无锡地区医院门诊流感样患者及集体单位聚集性流感样暴发患者采集鼻咽拭标本,接种MDCK细胞,采用标准抗血清鉴定阳性分离株型与亚型,并对2008年部分H3亚型流感病毒进行HA全基因测序,分析HA基因变异状况.结果 2005年至2008年9月,在无锡地区流感样患者中共分离到435株流感病毒,其中164株为A/H1N1亚型,80株为MH3N2亚型,B型191株.型与亚型有明显季节性分布强弱特征.H3亚型HA序列分析,无锡地区9株分离株与上海地区同期分离株接近,有很多序列相互穿插归属于进化树的同一分支,与WHO 2008-2009年疫苗推荐株相近.结论 近年无锡地区散发和局部暴发流感病毒感染仍主要为A/H1N1、A/H3N2和B型,A/H3N2 HA基因与上海地区同期分离株接近,与WHO 2008-2009年疫苗推荐株相近.     

无锡地区流感病毒病原学监测及H3亚型血凝素基因变异研究

目的 监测无锡地区2005年至2008年季节性流感型与亚型分布并了解2008年部分A/H3N2分离株血凝素(8A)基因变异状况.方法 无锡地区医院门诊流感样患者及集体单位聚集性流感样暴发患者采集鼻咽拭标本,接种MDCK细胞,采用标准抗血清鉴定阳性分离株型与亚型,并对2008年部分H3亚型流感病毒进行HA全基因测序,分析HA基因变异状况.结果 2005年至2008年9月,在无锡地区流感样患者中共分离到435株流感病毒,其中164株为A/H1N1亚型,80株为MH3N2亚型,B型191株.型与亚型有明显季节性分布强弱特征.H3亚型HA序列分析,无锡地区9株分离株与上海地区同期分离株接近,有很多序列相互穿插归属于进化树的同一分支,与WHO 2008-2009年疫苗推荐株相近.结论 近年无锡地区散发和局部暴发流感病毒感染仍主要为A/H1N1、A/H3N2和B型,A/H3N2 HA基因与上海地区同期分离株接近,与WHO 2008-2009年疫苗推荐株相近.