广州地区淋球菌血清学和营养分型研究

目的 确定广州地区淋球菌血清型和营养型流行特点。方法 采用乳胶凝集法对１３１株淋球菌进行血清学分型和Ｌａ Ｓｃｏｌｅａ法分析１０８株淋球菌培养型。结果 血清学分型以ＷⅡ／ＷⅢ为主，占８７．８％（１１５／１３１），ＷＩ型仅为９．９％（１３／１３）；营养型则以Ｐｒｏｔｏ、Ｐｒｏ＾－和ＩＬｅ＾－３种营养型为主，分别占４２．６％、２１．３％和１２．０％；另外ＷＩ仅见于Ｐｒｏｔｏ和Ｐｒｏ＾－营养型，ＷⅡ／Ｗ     

多形红斑与HLA相关性研究

目的 研究多形红斑与ＨＬＡ相关性。方法 采用血清学技术和聚合酶链式反应－序列特异性引物技术，检测多形红斑患者ＨＬＡＩ类抗原和ＨＬＡⅡ类基因。结果 在３０例多形红斑患者中，ＨＬＡ－Ａ３０＋３１、Ｂ１３抗原频率较对照组明显增高（Ａ３０＋３１：Ｐｃ〈０．０１，ＲＲ＝６．６４；Ｂ１３：Ｐｃ〈１０＾－３，ＲＲ＝７．８８）。ＨＬＡ－ＤＱＢＩ＊０４基因频率在多形红斑患者较正常人对照组明显增高（ＤＱＢＩ＊０４：Ｐ     

光线性角化病皮损细胞Bcl—2基因表达产物的定量分析

Ｂｃｌ－２蛋白是Ｂｃｌ－２基因的表达产物，可抑制细胞凋亡，在某些恶性肿瘤细胞出现过度表达。为探讨Ｂｃｌ－２蛋白与光线性角化病（ＡＫ）的关系，作者用流式细胞免疫荧光技术，检测了２７例ＡＫ。结果显示：２７例ＡＫ及正常对照的Ｂｃｌ－２蛋白相对含量ＦＩ（ＦｌｕｏｒｅｓｃｅｎｃｅＩｎｄｅｘ）分别为１．１５０±０．１８８和０．９９６±０．０６５（Ｘ－±Ｓ），０．０５＜Ｐ＜０．０１。但其中８例不典型增生严重ＡＫ的ＦＩ为１．３３５±０．０１７６（Ｘ－±Ｓ），与正常对照相比Ｐ＜０．０２。提示该病的Ｂｃｌ－２蛋白有增高的倾向。     

麻风病人血清中酚糖脂抗体与梅毒抗体的关系分析

对２２３例麻风病人血清同时进行（ＮＴ－Ｐ－ＢＳＡ）－ＥＬＩＳＡ和ＵＳＲ试验，ＵＳＲ阳性者作ＴＰＨＡ试验。在麻风病人中ＵＳＲ阳性５９例（２６．５％，ＭＢ３３．５％，ＰＢ３．８％），ＴＰＨＡ阳性仅１例（０．４％）。ＵＳＲ生物学假阳性多发生在ＮＴ－Ｐ－ＢＳＡ抗体阳性（８４．７％）的ＭＢ病人（９６．６％），但ＵＳＲ的阳性强度与ＮＴ－Ｐ－ＢＳＡ抗体水平无关。在麻风病高流行区进行性病调查时应考虑梅毒非特异性试验假阳性因素，必要时结合特异性试验和临床表现作出诊断。     

用MDT后麻风病人及其接触者血中的抗PGI IgM抗体检测

推广应用ＭＤＴ后用ＮＴ－Ｏ－ＢＳＡ－ＥＬＩＳＡ检测了１７１５名麻风接触者和６例新病人血中的抗ＰＧＩ－ＩｇＭ抗体。１７１５例接触者中的抗体阳性率分别为：开始ＭＤＴ前３３．４％，用ＭＤＴ２－２４个月３２．８２％，用ＭＤＴ后４８个月２１．８４％（Ｐ＜０．００１）；６例新病人在推广ＭＤＴ５年时ＯＤ下降７２．７４％；连续观察２４３例抗体阳性的接触者，２－５年共发病７例（ＢＴ１例，ＢＬ４例，ＬＬ２例）。结果说     

麻风反应及其有关因素的分析

４２６例ＢＴ￣ＢＬ麻风中，４１例发生Ｉ型反应（９．６％）；２１８例ＢＢ￣ＬＬ型病人中２９例发生Ⅱ型反应（１３．３％）。对反应的危险因素的分析显示，ＢＩ在０．１￣３．０，用ＭＤＴ１￣６个月时及ＢＴ和ＢＢ型是Ｉ型反应的危险因素。青春期发病、ＢＩ在３．１￣５．０、用ＭＤＴ４￣６个月及ＢＬ和ＬＬ型是Ⅱ型反应的危险因素。     

McAb－BA－ELISA检测人血清青霉素特异性IgE

利用单克隆抗体及生物素亲和素系统，建立ＭｃＡｂ－ＢＡ－ＥＬＩＳＡ检测人血清青霉素特异性ＩｇＥ。２７例青霉素Ｉ型变态反应患者中，６例青霉素特异性ＩｇＥ（２２．２％）阳性；而１００例非青霉素过敏者均阴性，且随机使用青霉素无反应。结果尚表明青霉素特异性ＩｇＧ并未明显影响青霉素特异性ＩｇＥ的检测（Ｐ＞０．０５）。     

McAb－BA－ELISA检测人血清青霉素特异性IgE

利用单克隆抗体及生物素亲和素系统，建立ＭｃＡｂ－ＢＡ－ＥＬＩＳＡ检测人血清青霉素特异性ＩｇＥ。２７例青霉素Ｉ型变态反应患者中，６例青霉素特异性ＩｇＥ（２２．２％）阳性；而１００例非青霉素过敏者均阴性，且随机使用青霉素无反应。结果尚表明青霉素特异性ＩｇＧ并未明显影响青霉素特异性ＩｇＥ的检测（Ｐ＞０．０５）。     

北方汉族白癜风患者HLA－Ⅰ类抗原相关性研究

目的 探讨中国北方汉族人群中白癜风与ＨＬＡ－Ⅰ类抗原的相关性。方法 白癜风患者９５例，采用ＨＬＡ血清学分型技术检测ＨＬＡ－Ａ、Ｂ位点的抗原特异性，并与１００例正常人进行比较。结果 ①白癜风患者ＨＬＡ－Ａ２、Ａ１０、Ａ３０＋３１、Ｂ１３、Ｂ１５抗原频率显著增高（Ｐｃ〈０．０１）；ＨＬＡ－Ａ２８、Ｂ４６抗原频率显著降低（Ｐｃ〈０．０１）。②有明确家族史的白癜风患者ＨＬＡ－Ａ１０、Ｂ１３、Ｂ１５抗原频率     

性病门诊患者人类免疫缺陷病毒和单纯疱疹病毒感染的血清学检测

为了解我同性病患者中人类免疫缺陷病毒（ＨＩＶ）和单纯疱疾病毒（ＨＳＶ）感染的流行情况，我们选择了我所性病门诊的病人进行了淋球菌分离培养以及ＨＩＶ和ＨＳＶ感染的血清学检测。结果表明，８８份临床标本淋球菌分离培养阳性率为２８．４％。ＨＳＶ－１和ＨＳＶ－２抗体检出率分别为５９．１％和２５．０％。统计分析结果表明，淋球菌感染和ＨＳＶ－２抗体阳性之间有一定的相关性（Ｐ＜０．０１）。８８份血清标本ＨＩＶ抗体检出率为０．     

A serovar analysis of heterosexual gonorrhoea in Edinburgh 1986-90.

OBJECTIVE--To analyse the frequency of different gonococcal serovars within Edinburgh, Scotland and to describe changes that occurred in the frequency of such serovars over time. METHODS--All heterosexual patients with a diagnosis of gonorrhoea confirmed on culture between January 1986 and December 1990 had their gonococcal strain serotyped. Temporal changes in the prevalence of gonorrhoea and the serovar of the isolates were analysed. RESULTS--Isolates of Neisseria gonorrhoeae from 1356 episodes of gonorrhoea were serotyped. Three serovars, Bajk (IB-3/IB-6), Bacejk (IB-1/IB-2) and Aedgkih (IA-1/IA-2), dominated, occurring in two-thirds of all infections. Over the study period Bajk (IB-3/IB-6) and Aedgkih (IA-1/IA-2) isolates declined in frequency in parallel with an overall fall in the prevalence of gonorrhoea but Bacejk (IB-1/IB-2) persisted at a lower but fairly constant level. Despite a fall in the number of gonococcal infections the variety of new serovars being isolated fluctuated. CONCLUSIONS--The ability of some serovars to persist while others decline in incidence may be partially related to antibiotic sensitivities but other factors such as an ability to evade the immune response and transfer of serovars from one population group to another may also be important.     

Characterisation of penicillinase producing gonococci isolated in Munich, 1981-6.

Twenty three penicillinase producing strains of Neisseria gonorrhoeae (PPNG) isolated in Munich from 1981 to 1986 were characterised in terms of their plasmid content, auxotypes, protein I serovars, and sensitivity to antibiotics. Sixteen strains (70%) harboured a 4.4 megadalton plasmid, with 13 of these strains also containing a 24.4 megadalton plasmid. Seven strains (30%) contained a 3.2 megadalton plasmid, with only one of them containing a 24.4 megadalton plasmid. Thirteen strains (57%) were prototrophic, eight (35%) required proline, one required arginine, and one required proline and arginine for growth. Serovar analysis showed that 16 strains (70%) belonged to the protein IB serogroup and comprised four serovars (IB-1, IB-5, IB-7, and IB-8). The seven strains belonging to the IA serogroup also comprised four serovars (IA-2, IA-4, IA-6, and IA-10). Although 18 different categories of plasmid, auxotype, and serovar were found in the 23 PPNG strains, there was a similarity between the auxotypes in terms of the range of serovars they comprised. Measurement of minimum inhibitory concentrations (MICs) of antibiotics for the strains showed that they were all susceptible in vitro to spectinomycin (MIC less than or equal to 32 mg/l), enoxacin (MIC less than or equal to 0.25 mg/l), cefotaxime, ciprofloxacin, and ceftriaxone (MICs less than or equal to 0.064 mg/l), whereas about half showed some resistance to tetracycline or cefotiam, or both.     

Associations between serotype and susceptibility to antibiotics of Neisseria gonorrhoeae.

A serological classification scheme for Neisseria gonorrhoeae was used to investigate the epidemiological associations between gonococcal serotype and other bacterial and host characters. Six hundred and fifty clinical isolates of non-penicillinase producing N gonorrhoeae from the Praed Street Clinic, St Mary's Hospital, were included in this study. The strains collected represented 41 serovars, although 485 (75%) of the 650 strains belonged to five serovars. Strains of serovar IA-1/2 were commonly isolated from the cervix and tended to be sensitive to penicillin and moderately resistant to erythromycin. Strains of serovar IB-1 showed bimodal patterns of susceptibility to both penicillin and erythromycin and were obtained equally from all anatomical sites. Strains of serovar IB-2 were isolated more often from the rectum and were associated with homosexually acquired infections, whereas those of serovar IB-3 were sensitive to erythromycin and were rarely isolated from the rectum. Strains of IB-5/7 were more resistant to penicillin and erythromycin than strains of other serovars. The serological classification of N gonorrhoeae is thus a powerful tool that may be used to study biological characteristics of the gonococcus, such as susceptibility to antimicrobials and site tropism.     

High percentages of resistance to tetracycline and penicillin and reduced susceptibility to azithromycin characterize the majority of strain types of Neisseria gonorrhoeae isolates in Cuba, 1995-1998

BACKGROUND: In many regions the susceptibility of Neisseria gonorrhoeae isolates to antimicrobial agents is rarely tested. The Gonococcal Antimicrobial Surveillance Program (GASP) in Cuba was established as part of a larger regional GASP program to facilitate the collection and reporting of antimicrobial susceptibility data for N gonorrhoeae isolates. GOAL: The goal was to retrospectively determine the antimicrobial susceptibility and molecular epidemiology of 91 isolates of N gonorrhoeae isolated from 11 centers in Cuba. STUDY DESIGN: Isolates of N gonorrhoeae were collected and presumptively identified from 11 Cuban provincial health centers. They were then forwarded to the National Laboratory of Pathogenic Neisseria Havana for confirmatory identification and were subsequently analyzed at the Center for GASP in Ottawa. Isolates were tested for susceptibility to penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin, and azithromycin by the agar dilution method. To establish baseline data for molecular epidemiologic profiles, the auxotype (A), serovar (S), plasmid content (P), and TetM type of the isolates were determined. Certain A/S/P classes were further analyzed by pulsed field gel electrophoresis (PFGE). RESULTS: High percentages of the 91 N gonorrhoeae isolates were resistant to penicillin (68%) and tetracycline (83.5%), with 56% being penicillinase-producing (PPNG) and 64% carrying plasmid-mediated tetracycline resistance (TRNG; 50% were PP/TRNG). An additional 14% of the isolates carried chromosomal resistance (CMRNG) to either tetracycline or penicillin or both antibiotics. All isolates were susceptible to spectinomycin, ceftriaxone, and ciprofloxacin. However, nine isolates were resistant to azithromycin (MIC, > or = 1.0 microgram/ml), and 43 other isolates displayed reduced susceptibility to this antibiotic (MIC, 0.25-0.5 microgram/ml). Although a total of 21 different A/S classes were identified, most of the isolates (61) belonged to three A/S classes: NR/IA-6 (35 isolates), NR/IB-1 (15 isolates), and P/IA-6 (11 isolates). Thirty-two of 45 PP/TRNG were A/S class NR/IA-6, and nine of the P/IA-6 isolates were TRNG. By contrast, most of A/S class NR/IB-1 (8) were CMRNG. PFGE analysis following digestion with NheI or SpeI further clustered the isolates into separate groups. CONCLUSIONS: This study demonstrates high percentages of N gonorrhoeae isolates with penicillin and tetracycline resistance in Cuba. As has been noted in other studies in the Caribbean region and Latin America, resistance and reduced susceptibility to azithromycin are developing as emerging problems. Since penicillin and tetracycline continue to be widely used for the treatment of gonococcal infections in Cuba, this study indicates the importance of antimicrobial susceptibility surveillance so that effective antibiotics may be recommended for treatment of gonococcal infections.     

男性泌尿生殖道感染非淋病奈瑟菌的毒力相关基因检测

目的检测男性泌尿生殖道分离的非淋病奈瑟菌毒力相关基因,探讨非淋病奈瑟菌的致病机理。方法采用PCR扩增和核苷酸序列分析技术,检测从男性泌尿生殖道感染患者生殖道分离的6个菌种12株非淋病奈瑟菌的毒力相关基因orf1,nspA,PIA,PIB,opa,iga,pilE。结果 12个分离菌株中8株(检出率66.67%)检出毒力相关基因,其中orf1的阳性率为25.00%(3/12),opa为25.00%(3/12),PIB为16.67%(2/12),nspA为8.33%(1/12),各菌株均未检出PIA,pilE与iga。结论感染男性泌尿生殖道的部分非淋病奈瑟菌具有淋病奈瑟菌的毒力相关基因。但这些毒力相关基因并不是非淋病奈瑟菌引起男性生殖道感染的唯一致病因素,非淋病奈瑟菌的男性生殖道致病性可能与其黏膜寄生性等生物学特性有关。     

Auxotypes, serovars, and trends of antimicrobial resistance of Neisseria gonorrhoeae in Kigali, Rwanda (1985-93)

OBJECTIVE: To investigate the in vitro antimicrobial susceptibility and the auxotype/serovar distribution of Neisseria gonorrhoeae in Kigali, Rwanda, during 1985-93. METHODS: As part of a monitoring programme the in vitro susceptibility of 1604 isolates of N gonorrhoeae was determined by agar dilution. Auxo- and serotyping was performed on 1350 and 1313 isolates respectively. RESULTS: The prevalence of penicillinase producing N gonorrhoeae (PPNG) remained stable at a rate of 39% during 1985-91 and increased to 61% in 1992-3. Chromosomal resistance to penicillin was common among non-PPNG and resistance to thiamphenicol and tetracycline was common among both PPNG and non-PPNG. High level, plasmid mediated resistance to tetracycline (TRNG) was observed for the first time at the end of 1989 and increased from 2% of the isolates in 1990 to 50% by 1993. A trend for increasing resistance to norfloxacin and ofloxacin was observed during 1985-90 but disappeared in 1991-93. Five isolates with high level resistance to norfloxacin (MIC 2 mg/l) were observed in 1990. Resistance to trimethoprim-sulphamethoxazole (TMP-SMZ) emerged at the end of 1990 and was observed among 10% of the isolates during 1991-3. All strains remained susceptible to ofloxacin, ciprofloxacin, spectinomycin, and ceftriaxone. Overall, 75% of the isolates were prototrophic or required proline for their growth and 62% belonged to serovars IA-6 and IB-1. The prevalence of serovar IB-4 increased strongly during the last 3 years of the study. CONCLUSION: Resistance to penicillin, thiamphenicol, and tetracycline was common in N gonorrhoeae during 1985-1993. The rapid spread of TRNG after 1989 and the steep increase of PPNG during 1992-3 were the most striking facts of the study period. The auxotype and serovar distribution was comparable with findings from other African countries.




     

Pulsed-field gel electrophoresis as an epidemiologic tool for Neisseria gonorrhoeae: identification of clusters within serovars.

BACKGROUND: The increasing incidence of gonorrhea in Sweden in 1998 was due to mostly domestic cases. Among these, two core groups were identified: homosexual men with serovar IB-2 and young heterosexuals with serovar IB-3. GOALS: To explore the genetic homogeneity/heterogeneity within the predominant serovars, IB-2 and IB-3, of Neisseria gonorrhoeae in Sweden by pulsed-field gel electrophoresis (PFGE) and to compare these results to epidemiologic information, as well as examine the genetic diversity within and between the 25 other represented serovars of N gonorrhoeae. STUDY DESIGN: By PFGE, 237 N gonorrhoeae isolates were examined, and the results were compared with epidemiologic data for the IB-2 and IB-3 isolates. RESULTS: In 79% of the domestic IB-2 cases involving homosexuals and 66% of the domestic IB-3 cases involving young heterosexuals, the isolates were genetically indistinguishable by PFGE. A high genetic diversity was identified within and between the 27 included serovars. CONCLUSIONS: Examination by means of PFGE indicated that one N gonorrhoeae clone each of the serovars IB-2 and IB-3 created the majority of the two core groups of domestic cases.     

Epidemiology of penicillin resistant Neisseria gonorrhoeae.

OBJECTIVE--To study the epidemiology of Neisseria gonorrhoeae that exhibit both chromosomal and plasmid-mediated resistance to penicillin. MATERIALS AND METHODS--A total of 1589 strains of N gonorrhoeae isolated from patients attending St Mary's Hospital, London were tested for both their susceptibility to penicillin and for their auxotype and serotype. RESULTS--Of the 940 non-penicillinase producing N gonorrhoeae, 840 were considered penicillin sensitive (MIC less than or equal to 0.5 mg/l) and 100 were chromosomally-mediated resistant N gonorrhoeae (CMRNG), (MIC greater than or equal to 1.0 mg/l). Of the 649 penicillinase producing N gonorrhoeae (PPNG), 429 carried the 4.4 megadalton (MDa) penicillinase encoding plasmid and 220 carried the 3.2 MDa plasmid. CMRNG were predominantly serogroup IB (90%). PPNG with 3.2 MDa plasmid were the only group more often serogroup IA (58%) than IB (42%). Serovar IA-1/2 and requirement for arginine, hypoxanthine and uracil (AHU) were associated with increased susceptibility to penicillin whereas serovar IB-5/7 was associated with decreased susceptibility in nonPPNG. There was a significant difference in the distribution of the IA and IB serovars between PPNG carrying either the 4.4 MDa or 3.2 MDa plasmid. AHU and PAOU requiring strains were not found among PPNG and were uncommon among CMRNG. CONCLUSION--Some clear associations have been found but the pattern among PPNG appears more complex and in most instances could be related to clusters of a single strain over a short time span.     

Antibiotic susceptibilities, serotypes and auxotypes of Neisseria gonorrhoeae isolated in New Zealand.

OBJECTIVE--The aim of the study was to determine the distribution of auxotypes and serotypes and the prevalence of antibiotic resistance among New Zealand isolates of Neisseria gonorrhoeae. MATERIALS AND METHODS--A total of 486 gonococci isolated in 1988 were auxotyped, serotyped, and tested for susceptibilities to ten antibiotics. RESULTS--The gonococci were susceptible to all the antibiotics tested except penicillin and tetracycline. Eleven (2.2%) produced beta-lactamase, one (0.2%) showed chromosomal penicillin resistance, and 18 (3.7%) were resistant to a low-level of tetracycline. Most of the gonococci belonged to six auxotypes. The three predominant auxotypes were arginine-requiring (Arg-), non-requiring (NR), and arginine, hypoxanthine, uracil-requiring (AHU-). The majority of the isolates belonged to serogroup IB and to six serovars. The most prevalent serovars were IB-3 and IB-1. There was an association between penicillin susceptibility and auxotype or serovar among non-penicillinase producing N. gonorrhoeae (PPNG) isolates. CONCLUSIONS--Antibiotic resistance, including penicillin resistance, remains uncommon among gonococci in New Zealand. Baselines have been established for future epidemiological studies using both auxotyping and serotyping.     

淋病奈瑟菌膜蛋白抗原表位的研究

目的利用人工合成多肽制备针对淋球菌外膜蛋白PIB抗原表位的特异性多克隆抗体,以期用于淋球菌的检测,为进一步建立新型淋病快速诊断方法提供研究基础。方法根据PIB抗原表位的氨基酸序列合成一段多肽(LD1),并将其与钥孔血蓝蛋白(KLH)偶联构成完全抗原LD1-KLH,免疫动物,收集抗血清,用ELISA和Western blot检测其特异性。结果ELISA检测表明,LD1-KLH具有免疫原性,免疫动物能刺激机体产生较强的体液免疫反应,兔血清抗体和豚鼠血清抗体效价最高分别达到1:3200和1:25600;抗血清能与淋球菌临床株特异性结合,与葡萄球菌、链球菌、大肠杆菌和真菌等其他微生物之间没有交叉反应;Westernblot结果显示,抗血清能识别淋球菌裂解物,产生特异性条带,相对分子质量(Mr)为37300。结论人工合成多肽具有免疫原性,能诱导机体产生识别淋球菌抗原表位的特异性抗体。