TORCH感染孕妇的宫内垂直传播率和子宫蜕膜感染率的检测

目的 测定TORCH感染孕妇的宫内垂直传播率和子宫蜕膜感染率.方法 在有不良妊娠结局的孕妇中取IgM阳性患者作为研究对象,用定性PCR方法检测绒毛和蜕膜中TOX(弓形虫)-DNA,CMV(巨细胞病毒)-DNA,HSV-2(单纯疱疹病毒2型)-DNA的阳性率;用荧光定量PCR方法检测绒毛和蜕膜中RV(风疹)-RNA的阳性率.结果 132例有不良妊娠结局孕妇中血清TORCH IgM阳性例数分别为:TOX 25例,RV 15例,CMV 19例,HSV-2 16例.其绒毛PCR检测阳性例数分别为:TOX 11例,RV 3例,CMV 9例,HSV-25例;宫内垂直传播率为TOX 44.00%(11/25),RV 20.00%(3/15),CMV47.37%(9/19),HSV 31.25%(5/16).其蜕膜PCR检测阳性例数分别为:TOX 8例,RV 2例,CMV 8例,HSV-2 3例;蜕膜感染率为TOX 32.00%(8/25),RV 13.33%(2/15),CMV 42.11%(8/19),HSV 18.75%(3/16).绒毛检测组和蜕膜检测组构成比相比较,两组构成比相同(P＞0.05).结论 ①孕期母体TORCH感染具有很高的宫内垂直传播率,其中以CMV为最高;②孕期母体TORCH感染其蜕膜的感染率也很高.母体蜕膜的TORCH感染是胎儿宫内感染的重要原因之一.     

Fungal infection of the lung

The close link between cholesterol levels and atherosclerosis appears indisputable. Yet, much about the specifics (eg, the significance of various apolipoproteins) remains to be discovered. Nevertheless, enough is now known to support a therapeutic approach aimed at lowering the low-density lipoprotein cholesterol level while simultaneously raising the high-density lipoprotein cholesterol level. In this article, Dr Tzagournis summarizes the supportive evidence and explains effective therapeutic measures.     

Cryptococcal infection of the nervous system

Eighteen patients with cryptococcal infection of the central nervous system seen during a 10-year period were reviewed. Eleven patients (61 per cent) were immunocompromised due to underlying disease and seven of these were on steroids, cyclophosphamide or both. Two-thirds of patients presented with the triad of fever, headache and neck rigidity suggesting meningitis; seizures and mental confusion were uncommon. A high index of suspicion was essential for diagnosis particularly in immunocompromised subjects, and the diagnosis was established by positive Indian-ink preparation, culture or raised antigen titre in the cerebrospinal fluid. CT scan was helpful for diagnosis and progress monitoring. Amphotericin B and 5-fluorocytosine were the mainstay of treatment, and imidazole derivatives and garlic may be helpful adjuncts. Mortality was 39 per cent, but full recovery was the usual outcome in those who survived. The prognosis was worse with immunocompromised patients, and of those who died, comma and/or convulsion on admission and marked cerebral oedema and hydrocephalus on CT were notable features.     

Reducing the risk of healthcare-acquired infection

Many patients experience increased hospital stays, poor health outcomes, or die each year, as a result of healthcare-acquired infections. Evonne Curran discusses the most common types of infection and suggests how nurses can minimise the risks of infection in clinical settings.     

Cryptococcal infection of the temporal bone

Cryptococcus neoformans is a yeast-like organism which, after inhalation, may cause pulmonary disease or a systemic fungemia associated with numerous extrapulmonary sites of infection, but most notably affecting the central nervous system. Despite this frequent involvement of the leptomeninges, only three cases of infection of the temporal bones have been previously described. We describe an additional case with comments on the possible significance of infection of this site.     

Prevalence of congenital cytomegalovirus infection according to the type of maternal infection in Japan

IntroductionVariable rates of cytomegalovirus (CMV) seropositivity in mothers from different individual's background may translate to distinct epidemiological patterns of congenital CMV infection.MethodsThe prospective cohort study was conducted in Japan to evaluate the prevalence of vertical transmission rate according to the type of maternal infection. Post hoc power as a follow-up analysis was evaluated to compare the statistical power with other studies from France, Finland and Brazil. One thousand one hundred sixty-three pregnant women were measured IgG, IgM and IgG avidity index. The urine samples of neonates of these women were evaluated using polymerase chain reaction to diagnose the vertical transmission.ResultsThe prevalence of congenital CMV infection in the study population was 0.4%. The proportions of patients with primary and nonprimary infections were 60% and 40%, respectively, with a maternal seroprevalence of 82.5%. The rate of vertical transmission among the seronegative pregnant women before pregnancy was statistically higher than that among the seropositive pregnant women before pregnancy (p < 0.05), with a study power of 52.7%. The same difference was observed in France and Finland for maternal seroprevalence of 61% and 72% and statistical power of 56.9% and 66.7%, respectively.ConclusionThe maternal seroprevalence of the present study conducted in Japan was much higher than that of studies in France and Finland. Nevertheless, seronegative pregnant women had a higher risk of vertical transmission before pregnancy.     

医院感染管理委员分片管理在门诊医院感染质量管理中的应用

目的探讨医院感染管理委员分片管理在门诊医院感染质量管理的应用和效果。方法成立医院感染管理委员会,并对各委员进行分片、培训、制订分片包干区委员职责,医院感染管理委员每月对包干科室进行感染措施落实检查并反馈,提出整改意见和措施,并予以整改。结果医院感染管理委员分片管理后门诊部各科室的医院感染管理质量提高,门诊部各项医院感染质量指标明显改善(P0.01)。结论医院感染管理委员分片管理方法有利于提高门诊部医院感染管理质量。     

预防青少年艾滋病感染是防治艾滋病传播的重要环节

获得性免疫缺陷综合征(AIDS),又称为艾滋病,它是由人类免疫缺陷病毒(HIV)所引起的.艾滋病有3种传播途径:性接触、母婴垂直传播及血液传播.自1981年第1例AIDS在美国发现后,AIDS就已经发展成为世界性的流行病.     

HCV infection in the elderly

AIM: To investigate prevalence, clinical picture and course of hepatitis C virus (HCV) infection in elderly patients. MATERIAL AND METHODS: A total of 1045 patients aged 60- 74 years with chronic diseases of the liver (CDL) were examined for hepatitis. RESULTS: HCV monoinfection was detected in 210 (20.1%) patients. Alcohol-viral etiology of HCV was revealed in 22% cases. HCV RNA was identified in 117 (76%) out of 154 elderly patients. All the HCV infected patients had 1b genotype, high viremia. Pain and asthenic syndromes were main clinical manifestations of HCV infection. Most often the activity of HCV infection in the elderly patients was low (88.6%), progression was slow (94.7%). The latter was registered in 22.8% patients. HCV infection in the elderly entails higher inflammation activity and incidence of HCV RNA. CONCLUSION: Complex examination of elderly patients for early detection of HCV, early diagnosis and treatment slows down progression of CDL, reduces the rate of development of severe complications and lethality.     

Acinetobacter infection in the ICU

Acinetobacter is a formidable challenge to managing critically ill patients. This pathogen's ability to rapidly develop antimicrobial resistance to all currently available antimicrobial agents is concerning because increasing data support attributable mortality to these bacteria when associated with hospitalized patients with comorbidities and severe illness. The role of dual therapy is currently unclear and might be associated with increased toxicities without proven synergy or ability to prevent the development of resistance. Infection control and antibiotic control measures might have the greatest impact on these bacteria. Continued efforts are needed to develop new antimicrobial agents against this pathogen and assess the ideal currently available agents.