碳青霉烯耐药大肠埃希菌的基因组学特点分析

目的 分析碳青霉烯耐药大肠埃希菌（ＣＲＥＣ）的基因组流行病学特征，调查共携带 ｂｌａＮＤＭ和 ｂｌａＫＰＣ的大肠埃希菌在南京 鼓楼医院的流行情况，并分析该类细菌的播散特点。 方法 对 ２０１５ 年从南京 ６ 家医院收集的 １１ 株 ＣＲＥＣ 菌株，进行全基因 组测序组装后，分析耐药基因、毒力因子、多位点序列分型（ＭＬＳＴ）、血清型和 ＦｉｍＨ 型的分布并构建系统发育树。 对于从南京 鼓楼医院 ２０１３—２０１７ 年收集的 ＣＲＥＣ 菌，使用 ＰＣＲ 和 ＤＮＡ 测序法筛选共携带 ｂｌａＮＤＭ和 ｂｌａＫＰＣ的菌株，脉冲场凝胶电泳技术 （ＰＦＧＥ）进行遗传相关性分析；接合试验分析基因的可转移性。 结果 所有的 ＣＲＥＣ 都携带了至少 １ 种碳青霉烯酶编码基因， 其中，９ 株 ＣＲＥＣ 细菌携带 ｂｌａＮＤＭ?５，３ 株携带 ｂｌａＫＰＣ?２，２ 株携带 ｂｌａＮＤＭ?１，３ 株同时携带 ｂｌａＮＤＭ?５和 ｂｌａＫＰＣ?２。 ＭＬＳＴ 分析发现 ７ 种不 同的序列分型（ＳＴ），２ 株细菌为 ＳＴ４１０，其余的 ６ 种 ＳＴ 型依次为 ＳＴ３４８９、ＳＴ１５６、ＳＴ６８３、ＳＴ２９７、ＳＴ１６７ 和 ＳＴ３６１；其次，１１ 株细菌 中鉴定出 ６ 种不同的血清型和 ８ 种 Ｆｉｍ 型；１１ 株细菌的质粒图谱虽然呈多样性，但每株细菌都含有质粒复制子 ＩｎｃＸ３。 系统 发育分析表明，１１ 个 ＣＲＥＣ 分离株之间有很大的遗传多样性；ＰＦＧＥ 显示 ６ 株共携带 ｂｌａＮＤＭ和 ｂｌａＫＰＣ的分离株之间也存在较大 的遗传多样性。 接合试验表明 ｂｌａＮＤＭ可转移，但与 ｂｌａＫＰＣ基因不在同一质粒。 结论 ｂｌａＮＤＭ是 ＣＲＥＣ 中主要的碳青霉烯酶基 因，ｂｌａＮＤＭ?５是主要的 ｂｌａＮＤＭ基因，可能通过 ＩｎｃＸ３ 质粒水平传播。 ＭＬＳＴ、Ｆｉｍ 分型、血清分型和进化树发育表明 ＣＲＥＣ 呈遗传 多样性。     

两种血清型HFRS患者病程中及病后4种特异性抗体测定分析

为评价汉滩及汉城型肾综合征出血热患者免疫状况，用ＥＬＩＳＡ法检测了５４例病程中，４７例病后１－６年ＨＦＲＳ患者（汉滩２４例，汉城２３例）血清中特异性ＩｇＡ、ＩｇＥ、ＩｇＧ、ＩｇＭ抗体。在病后血清中检出率及抗体滴度几何均数（ＧＭＴ）依次为ＨＦＲＳ－ＩｇＧ、ＩｇＡ、ＩｇＥ、ＩｇＭ，各本间差异显著（Ｐ〈０．００５），其中ＨＦＲＳ－ＩｇＧ抗体水平在病后第４年仍达１：１００以上（ＧＭＴ值）；ＨＦＲＳ－ＩｇＡ     

暴发菌痢的RAPD分 析

为评价随机ＰＣＲ在Ｆ２ａ志贺氏菌痢暴发事件分析中的作用和地位，本文应用ＰＣＲ技术（ＲａｎｄｏｍａｍｐｌｉｆｉｅｄｐｏｌｙｍｏｒｐｈｉｃＤＮＡ，ＲＡＰＤ或ＡｒｂｉｔｒａｒｉｌｙｐｒｉｍｅｄＰＣＲ，ＡＰ－ＰＣＲ）分析技术，对１９９２年、１９９４年广州、江门两地Ｆ２ａ菌痢暴发期间分离的暴发株、散发株和密切接触者分离株进行了系统研究，现报告如下。材料与方法１菌株：广州分离株包括３０株暴发事件分离株（Ｇ９２×××）、２８株散发株（ＧＳ×××、ＧＢ×××、ＧＣ×××）分别由广州市卫生防疫站、广州市白云区卫…     

某新建医院2017-2020年耐碳青霉烯类肺炎克雷伯 菌分子流行病学特征分析

摘要：目的 为新建医院的医院感染控制提供参考依据。 方法 回顾性分析 ２０１７—２０２０ 年苏州科技城医院微生物室分离的 ７６３ 株肺炎克雷伯菌临床分布及药敏试验结果；应用脉冲场凝胶电泳（ＰＦＧＥ）技术分析耐碳青霉烯类肺炎克雷伯菌（ＣＲＫＰ）的 同源性，ＰＣＲ 技术检测其碳青霉烯酶基因；对产碳青霉烯酶的菌株进行质粒接合转移实验；对代表性菌株进行全基因组测序 分析。 结果 该院肺炎克雷伯菌主要分离自痰液（５０．９８％）、尿液（３０．８０％）、血液（１２．０６％）、分泌物（７．７３％）等；菌株主要来 源于神经外科、呼吸内科、重症监护病区、肿瘤内科等科室；菌株对四环素、哌拉西林耐药率达 ３０％，对喹诺酮类、阿莫西林／ 克 拉维酸、哌拉西林／ 他唑巴坦、庆大霉素耐药率均在 ２０％以下，对阿米卡星、碳青霉烯类耐药率在 １０％以下；ＰＦＧＥ 结果显示 ＣＲＫＰ 有 ３２ 个克隆型，Ａ２２、Ａ２６ 型为相对优势克隆型；ＰＣＲ 法检测出 ２２ 株 ｂｌａＫＰＣ阳性，６ 株 ｂｌａＮＤＭ阳性，２ 株 ｂｌａＩＭＰ 阳性，２ 株 ｂｌａＫＰＣ 、ｂｌａＮＤＭ双阳性；７ 株 ｂｌａＫＰＣ 、２ 株 ｂｌａＮＤＭ阳性菌株接合转移成功；代表菌株全基因组测序结果显示该株菌为 ＫＰＣ?２、ＳＴ１１ 型，未携带肺炎克雷伯菌常见的 ｒｍｐＡ、ｒｍｐＡ２ 等毒力基因，携带少见的 ｉｕｔＡ、ｉｒｏＮ 毒力基因及 ｐｉｌＷ 基因。 结论 该新建医院 ＣＲＫＰ 的检出率呈上升趋势，耐药基因型逐渐多样性，应予以高度关注。     

视网膜母细胞瘤的病理形态和免疫组化观察

目的 探讨视网膜母细胞瘤（ＲＢ）的病理形态特征及组织起源。方法 回顾我院及广州军区总医院确诊为ＲＢ的病例共２８例，并作ＮＳＥ、Ｓ－１００及ＧＦＡＰ免疫组织化学染色。结果 光镜下２８例ＲＢ中，未分化为主型１０例，高分化为主型１８例；ＮＥＳ、Ｓ－１００、ＧＦＡＰ在ＲＢ中的表达率分别为８３．３％，４４．４％，３８．９％。结论 ＲＢ光镜下大体上可分为高分化为主型和未分化为主型，菊形团、双极样细胞、坏死和钙     

抗心磷脂抗体与反复自然流产关系的探讨

应用间接ＥＬＩＳＡ法检测１０５例反复自然流产患者血清中的抗心磷脂抗体，同时对ＡＮＡ、扩ｄｓ－ＤＮＡ、抗－Ｓｍ，抗－ＲＮＰ、ＲＦ进行了测定。结果表明：ＲＳＡ组ＡＣＡ阳性率为２８．６％，明显高于其他自身抗体及对照组（Ｐ＜０．０１），ＡＣＡ与ＲＳＡ患者的孕龄及流产次数无相关性（Ｐ＞０．０５），三种类别Ｉｇ中，以ＩｇＧ、ＩｇＧ、ＩｇＭ型ＡＣＡ检出率较高，中等或高水平的阳性结果占３３．３％（１０／３０），其     

INTERNET的作用及使用方法(一)

ＩＮＴＥＲＮＥＴ的作用及使用方法（一）黄国志１ＩＮＴＥＲＮＥＴ的主要作用可归纳为网络信息服务（ＷＷＷ）、电子邮件（Ｅ－ＭＡＩＬ）、网上讨论（ＭＡＩＬＩＮＧＬＩＳＴＳ、ＮＥＷＳＧＲＯＵＰ、ＢＢＳ）、计算机系统远程登录（ＴＥＬＮＥＴ）、文件传输（ＦＴＰ）...     

心肺复苏的最新进展——第六届WOLF CREEK会议纪要

第六届ＷＯＬＦＣＲＥＥＫ会议于 2 0 0 1年 6月 4日至 7日在美国加利福尼亚州风光明媚的著名度假胜地ＰＡＬＭＳＰＲＩＮＧＳ附近的ＲＩＴＺＣＡＲＬＴＯＮ宾馆举行。ＷＯＬＦＣＲＥＥＫ会议由来已久。创办人ＪＡＭＥＳＥＬＡＭ和ＰＥＴＥＲＳＡＦＡＲ都是急诊医学界的元老。会议宗旨是通过激励相关的实验室和临床研究 ,推动心肺复苏的临床实践。因为心肺复苏标准制定的可靠性迫切需要广泛的实验研究来验证。因此 ,该会议又称为“心肺复苏研究者会议” ,是全球最高层次的心肺复苏研讨会。第一届ＷＯＬＦＣＲＥＥＫ会议于 1975年在ＪＡＭＥ…     

二维多普勒超声对缺血性心肌病左室重构变化的研究

目的对缺血性心肌病（ＩＣＭ）患者的左室重构（ＬＶＲ）病理生理变化进行分析研究。方法应用ＨＰ ７７０２０ＡＣ型彩色多普勒血流显像仪（探头频率３．５ＭＨｚ）分别对５６例ＩＣＭ患者和５０例正常对照组进行分析评价。结果显示ＩＣＭ组的各项指标与正常组比较有显著性差异（Ｐ＜０．０１～０．００１）。ＩＣＭ组的ＬＶＥＤｄ、ＥＤＶ、ＥＳＶ、ＥＳＳ、ＰＶＡ、ＬＡＴ、ＬＡＦ显著增大，ＥＦ、ＣＯ、ＬＶＳＣＩ、ＭＶＣＦ、ＰＶＥ、ＰＦＲ及ＰＶＡ／ＰＶＥ显著降低（Ｐ＜０．０１～０．００１）。结论认为ＩＣＭ病人ＬＶＲ的主要病因与心肌缺血引起的梗塞区膨展、左室扩张、容量负荷及室壁应力的增加有关，而ＥＳＶ、ＥＤＶ及ＥＦ可作为了解ＩＣＭ远期预后的最佳指标     

HFRS患者血清特异性抗体及特异性循环免疫复合物同步测…

为进一步研究ＨＦＲＳ免疫损伤机制，用ＥＬＩＳＡ法同步测定了１０８例不同临床型，不同病日，病期ＨＦＲＳ患者血清中特异性ＩｇＡ，ＩｇＧ，ＩｇＭ抗体以及ＨＦＲＳ病毒特异性ＩｇＡ，ＩｇＧＩｇＭ型循环免疫复合物（ＣＩＣ）的水平及检出率，发现ＨＦＲＳ－ＩｇＡ型抗体水平在轻型病例高于中，重型病例，其差异在病程早期（发热，低血压休克期，或是３～８病日）尤为突出，而ＩｇＡ型ＣＩＣ则未见到上述差异，ＨＦＲＳ－ＩｇＧ，     

First identification of methicillin-resistant Staphylococcus aureus MLST types ST5 and ST45 and SCCmec types IV and Vt by multiplex PCR during an outbreak in a respiratory care ward in central Taiwan

We used molecular typing methods to investigate an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infections in a respiratory care ward in Taiwan. From March to June 2006, the incidence of MRSA infection increased 3.75-fold. The overall carrier rates among the health care workers (HCWs) were 31.3% (total S. aureus), 16.4% (MRSA), and 14.9% (methicillin-sensitive SA, MSSA). Pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), antibiograms derived from susceptibility testing of MRSA isolates, and multiplex polymerase chain reaction (PCR) provided strong epidemiologic and microbiologic evidence that the outbreak of MRSA infections at our hospital was linked to the same PFGE pulsotype A SCCmec type II, pvl-negative, MLST ST5 strain of MRSA isolated from seven HCWs and five patients. The outbreak was controlled by application of topical fucidin ointment to the anterior nares in all colonized HCWs. Multiplex PCR combined with PFGE and MLST is a feasible method for outbreak investigations in routine clinical laboratories.     

肝移植病房MRSA分子流行病学研究

目的研究我院肝移植病房MRSA同源性分布情况。方法收集我院2005年3月-2006年11月肝移植病人中分离金葡菌共57株，用头孢西丁纸片法进行MRSA表型检测，筛选MRSA，并用脉冲场凝胶电泳（PFGE）对MRSA菌株进行同源性检测。结果57株金葡菌中，46株为MRSA。MRSA经PFGE分为8个型（A～H型）。以A型（27株）、B型（10株）为主。在2005年3月-2006年11月发生了A1亚型的暴发流行。结论MRSA在肝移植病人间流行情况十分严重．及时检测MRSA并进行流行病学研究将有利于控制耐药菌的播散。     

Infection control for a methicillin-resistant Staphylococcus aureus outbreak in an advanced emergency medical service center, as monitored by molecular analysis

A methicillin-resistant Staphylococcus aureus (MRSA) outbreak occurred in an advanced emergency medical service center between 2010 and 2011. Our objective was to evaluate the status of the MRSA outbreak, as monitored by molecular analysis. Twenty-eight MRSA strains were isolated from blood samples from 11 patients, from other specimens (pharynx, nasal cavity, etc.) from 12 patients, from two environmental samples, and from the skin, middle nasal meatus, and urine of one patient each from other wards. Pulsed-field gel electrophoresis (PFGE) was performed to evaluate horizontal transmission. Molecular typing by PFGE showed that the 28 MRSA strains presented 7 patterns in total, and that 11 of the MRSA strains had the same PGFE pattern. Unselective use of intranasal mupirocin ointment, MRSA monitoring for new inpatients, and prevention of direct or indirect contact infection were performed. However, the number of inpatients with MRSA did not quickly decrease, and additional molecular typing by PFGE showed that 10 of 19 MRSA strains found (5 of 6 from blood, 5 of 13 from other specimens) were the same as those found previously. Lectures and ward rounds were performed repeatedly, and staff participation in ward rounds was suggested. Finally, the number of inpatients with MRSA significantly decreased more than 6 months after the intervention. Although the MRSA outbreak was thought to have ended, follow-up molecular typing by PFGE showed that horizontal transmission persisted. Our data suggest that various combinations of infection control measures are essential when dealing with an MRSA outbreak, and monitoring by molecular analysis using PFGE is useful to identify the status of the outbreak.     

多菌型副溶血性弧菌共感染引起集中事件调查分析

目的 分析一起副溶血性弧菌（VP）集中感染事件的菌株特征,明确该起感染事件的性质。方法 在2017年9月,广西某乡镇发生一起疑似食源性疾病暴发,现场采集13例患者肛拭子,分离到10株VP,利用O和K诊断血清对分离株进行玻片凝集实验分型,采用TaqMan水解探针荧光PCR检测分离株毒力相关tlh、tdh、trh和ORF8基因,并分别用Not Ⅰ和Sfi Ⅰ两种酶进行脉冲场凝胶电泳（PFGE）分型,导入Bionumerics 6.6软件进行聚类分析。结果 10株VP有5种血清型,6株为O3∶K6,其余4株血清型分别为O4∶K8、O1∶KUT、O2∶KUT和O10∶K19。所有菌株tlh基因均呈阳性,而trh基因呈阴性;6株O3∶K6血清型菌株和1株O4∶K8血清型菌株tdh基因均呈阳性;其余3株tdh基因呈阴性。经Bionumerics 6.6软件聚类分析,Not Ⅰ和Sfi Ⅰ酶切PFGE有8种型别,同为O3∶K6血清型的6株菌可分为4种型别。综合以上3个指标进行分析,该事件分离的10株菌中仅2株菌完全相同。结论 该起集中暴发事件由多种血清、不同PFGE型别的致病和非致病性VP多菌型共感染引起。     

Immediate control of a methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit

An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) colonization occurred from November 2001 in the neonatal intensive care unit (NICU) of our hospital. Since the establishment of our NICU in 1991, some MRSA has been detected in NICU patients. For MRSA infection preventive measures, utilization of the following items was implemented: mupirocin ointment, diluted povidone iodine, methylrosaniline chloride, and disposable rubber gloves. Patients in whom MRSA was detected received intranasal administration of the mupirocin ointment three times daily and were bathed in, or their entire body was wiped with diluted povidone iodine once daily for the first 3 days in each week. In addition, they received an intraoral application of methylrosaniline chloride daily. All therapy was done until MRSA strains were undetectable for 3 continuous weeks. Genotypes of 13 MRSA strains isolated from eight inpatients and one mother were analyzed by pulsed-field gel electrophoresis (PFGE). All PFGE patterns were identical, except for one, which had one distinct migrating fragment. These data suggested that this MRSA outbreak was caused by the same strain, which was derived from the mother of a low-birth-weight infant born on October 30, 2001. Gradually, the number of inpatients carrying MRSA decreased, until finally MRSA was no longer observed, in April 2002. Fortunately, we controlled the MRSA outbreak immediately, and none of the inpatients developed severe MRSA infection. We think that in our NICU, which is isolated from other hospital wards, it is important to prevent the entrance of MRSA-carrying mothers.     

肺炎克雷伯菌脉冲场凝胶电泳分型能力评价

目的 评价脉冲场凝胶电泳(pulsed field gel electrophoresis,PFGE)技术用于肺炎克雷伯菌(Klebsiella pneumoniae)的分型能力。 方法 选用220株肺炎克雷伯菌,对PFGE方法的分型力、可重复性、分辨力、流行病学一致性及其与多位点序列分型(MLST)的分型一致性进行评价。挑选全部220株菌株进行实验,评价PFGE的分型力;挑选18株菌株重复2次实验评价PFGE的可重复性;分别挑选3组无流行病关联的碳青霉烯耐药临床株、腹泻患者肠道分离株、食品分离株,使用Simpson差异指数(D)评价PFGE的分辨力;挑选同一次暴发期间分离的34株菌株,评价PFGE的流行病学一致性及其与MLST对暴发菌株分型结果的一致性;挑选64株不同来源的菌株,评价PFGE和MLST分型对流行病学不相关菌株的分型一致性。用BioNumerics软件对所有实验菌株的PFGE图谱进行分析。 结果 220株肺炎克雷伯菌中有216株通过PFGE能够获得有效的图谱,其分型力为98.18%(216/220);18株菌株重复2次实验的图谱完全一致;PFGE对无流行病关联的50株碳青霉烯耐药临床株、34株腹泻患者肠道分离株、48株食品分离株分型的D值分别为0.9910、0.9964、1.0000;针对34株暴发期间分离菌株,PFGE能够很好地甄别出暴发菌株,高度相关菌株和不相关菌株,并且分型结果与菌株分离病区、分离时间具有一致性;针对暴发菌株,PFGE能够将相同MLST型别的菌株聚成一簇;针对流行病学不相关菌株,PFGE不能将相同MLST型别的菌株分成相同或相似的带型或者聚成一簇。 结论 PFGE对肺炎克雷伯菌分型具有很好的分型力、可重复性和分辨力;针对暴发菌株,PFGE能够将相同MLST型别的菌株聚成一簇;针对流行病学不相关菌株,PFGE和MLST分型一致性差。     

Molecular epidemiology of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit

OBJECTIVES: To investigate the molecular epidemiology of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae in the neonatal intensive care unit of a university hospital in Italy. METHODS: Antibiotic susceptibility was evaluated by disc diffusion and Etest. ESBLs were identified by isoelectric focusing, PCR and DNA sequencing analysis. Genotyping was performed by PFGE analysis. Conjugation was performed by broth mating. RESULTS: Molecular typing of K. pneumoniae isolates identified three distinct PFGE patterns. Isolates of PFGE profile A were isolated during an epidemic in 1996, while isolates of PFGE profiles B and C were sequentially isolated from September 2002 to December 2004, when 233 colonizations and 19 infections by K. pneumoniae occurred. All K. pneumoniae strains of different PFGE types were identified as ESBL producers. DNA sequencing of amplified beta-lactamase genes identified a novel bla(TEM) ESBL (bla(TEM-136)) along with bla(SHV-1) in chromosomal and plasmid DNA from K. pneumoniae of PFGE type A, respectively, and bla(TEM-1) and bla(SHV-12) in plasmid DNA from K. pneumoniae of PFGE types B and C. Conjugation experiments demonstrated that resistance to third-generation cephalosporins, along with an approximately 80 kb plasmid containing bla(SHV-12) and bla(TEM-1), was transferred from K. pneumoniae epidemic strains of PFGE types B and C to a susceptible Escherichia coli host at a frequency of 4 x 10(-6) and 1 x 10(-6) cfu/recipient cell, respectively. CONCLUSIONS: The selection of ESBL-producing clones and the transfer of the bla(SHV-12) ESBL gene between different clones were responsible for the spread of K. pneumoniae in the neonatal intensive care unit.     

Molecular characterization of methicillin-resistant Staphylococcus aureus bloodstream isolates from Croatia

OBJECTIVES: The objectives of this study were (i) to investigate the genetic background of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates from Croatia and (ii) to monitor the prevalence of Panton-Valentine leucocidin (PVL) and toxic shock syndrome toxin-1 (TSST-1) among these isolates. METHODS: Eighty-two hospital-acquired MRSA bloodstream isolates, collected in 2001 and 2002 in Croatia, were characterized by PFGE, staphylococcal cassette chromosome mec (SCCmec) typing and multilocus sequence typing (MLST). The presence of genes encoding PVL and TSST-1 was investigated by real-time PCR. RESULTS: All strains were multiresistant and were distributed among 16 different similarity groups as determined by PFGE. Two of the groups, groups H and K, harboured the majority of the MRSA strains with 52 and 12%, respectively. The predominant SCCmec type found among the isolates was type I (89%). Eleven per cent of the strains harboured a modified SCCmec type III, which contained, in contrast to the regular type III, an additional dcs region. One strain harboured a novel SCCmec type, containing the ccrC gene in combination with the mecI gene, the dcs region, the locus between pI258 and Tn554 (locus E) and the locus between Tn554 and orfX (locus F). MLST showed the presence of ST111-MRSA-I and ST247-MRSA-I among Croatian MRSA isolates. All isolates were negative for both PVL and TSST-1. CONCLUSIONS: These results indicate the emergence of ST111-MRSA-I and ST247-MRSA-I in Croatia among MRSA bloodstream isolates. The virulence factors PVL and TSST-1 were not present among these isolates.     

Comparison of automated repetitive-sequence-based polymerase chain reaction and spa typing versus pulsed-field gel electrophoresis for molecular typing of methicillin-resistant Staphylococcus aureus

Automated repetitive polymerase chain reaction (PCR) (DiversiLab, bioMérieux, St. Laurent, Quebec, Canada) and single locus sequence typing of the Staphylococcus protein A (spa) gene with spa-type assignment by StaphType RIDOM software were compared to pulsed-field gel electrophoresis (PFGE) as the "gold standard" method for methicillin-resistant Staphylococcus aureus (MRSA) typing. Fifty-four MRSA isolates were typed by all methods: 10 of known PFGE CMRSA type and 44 clinical isolates. Correct assignment of CMRSA type or cluster occurred for 47 of 54 (87%) of the isolates when using a rep-PCR similarity index (SI) of ≥95%. Rep-PCR gave 7 discordant results [CMRSA1 (3), CMRSA2 (1), CMRSA4 (1), and CMRSA10 (2)], and some CMRSA clusters were not distinguished (CMRSA10/5/9, CMRSA 7/8, and CMRSA3/6). Several spa types occurred within a single PFGE or repetitive PCR types among the 19 different spa types found. spa type t037 was shared by CMRSA3 and CMRSA6 strains, and CMRSA9 and most CMRSA10 strains shared spa type t008. Time to results for PFGE, repetitive PCR, and spa typing was 3-4 days, 24 h, and 48 h, respectively. The annual costs of using spa or repetitive PCR were 2.4× and 1.9× higher, respectively, than PFGE but routine use of spa typing would lower annual labor costs by 0.10 full-time equivalents compared to PFGE. Repetitive PCR is a good method for rapid outbreak screening, but MRSA isolates that share the same repetitive PCR or PFGE patterns can be distinguished by spa typing.     

One predominant type of genetically closely related Shigella sonnei prevalent in four sequential outbreaks in school children

Seventy-six Shigella sonnei isolates from four sequential outbreaks in school children were analyzed to determine their relatedness. Outbreak strains exhibited two major antibiograms, 9 plasmid profiles, 10 enterobacterial repetitive intergenic consensus sequence (ERIC)-PCR patterns, and 17 pulsed-field gel electrophoresis (PFGE) patterns. Of typing methods, ERIC-PCR types generally coincided with the PFGE types within these outbreak strains. However, ERIC-PCR analysis could not discriminate an epidemiologically unrelated strain from some outbreak strains. Further computer-assisted analysis for similarity of the PFGE patterns revealed that the main culprits of these four sequential outbreaks were strains of pulsotype C (88.2% of total outbreak isolates). The results indicate that PFGE can provide more explicit relatedness of outbreak strains than the other typing methods examined. In conclusion, based on PFGE analysis, one predominant pulsotype of multiple genetically related strains of S. sonnei was prevalent in these four sequential outbreaks.