中医院患者下呼吸道感染卡他莫拉菌耐药性分析

目的了解中医院患者下呼吸道感染卡他莫拉菌的分布与耐药性,为该疾病提供有效的治疗措施。方法对2009年1月-2013年12月1 304例下呼吸道感染患者的痰标本进行检测,观察下呼吸道卡他莫拉菌感染的分布,并对检出的卡他莫拉菌进行药敏试验和β-内酰胺酶检测。结果从痰标本中培养出1 932株病原菌,卡他莫拉菌居第3位,共检出216株,占11.2%;均来自216例下呼吸道患者的痰培养标本,卡他莫拉菌在第一、四季度分离最高,分别占31.0%、33.8%;191株β-内酰胺酶检测结果阳性,产β-内酰胺酶率88.4%;卡他莫拉菌对头孢唑肟、头孢吡肟、左氧氟沙星、头孢呋辛、加替沙星和阿莫西林/舒巴坦的耐药率均<10.0%;对氨苄西林、头孢克洛与磺胺甲噁唑/甲氧苄啶的耐药率较高,分别为75.9%、62.0%和58.3%。结论卡他莫拉菌是下呼吸道感染患者的主要病原菌;第一季度和第四季度的是卡他莫拉菌感染的高发季节;在下呼吸道卡他莫拉菌抗感染治疗中应充分考虑其耐药性,合理应用抗菌药物。     

儿童卡他莫拉菌呼吸道感染的耐药性研究

目的探讨儿童呼吸道卡他莫拉菌的感染率与耐药性,为指导临床合理用药提供参考依据。方法选取2012年1月-2015年1月医院收治的1 240例呼吸道感染患儿,对其送检标本进行病原菌培养和药敏试验,采用K-B纸片法进行药敏试验,药敏结果按照美国临床实验室标准化研究所(CLSI)标准进行判定,采用SPSS20.0软件对数据进行统计分析。结果 1 240份标本共分离出138株卡他莫拉菌,检出率为11.13%,其中肺炎、哮喘并发感染、毛细支气管炎、支气管炎分别占66.67%、15.22%、10.14%和7.97%;卡他莫拉菌感染患儿性别比较差异无统计学意义,年龄分布和感染季节分布比较,差异有统计学意义(P0.05);卡他莫拉菌对阿莫西林/克拉维酸、环丙沙星、左氧氟沙星、克拉霉素、头孢哌酮/舒巴坦和亚胺培南敏感率均90.00%。结论儿童作为卡他莫拉菌感染的高危人群,尤其对于3岁以下和冬季患病儿童,应及时行药敏试验,合理选择抗菌药物治疗。     

儿科呼吸道标本病原菌分布情况及耐药性监测结果探讨

目的探讨儿科呼吸道标本病原菌分布情况及耐药性监测结果。方法收集2015年7月—2016年8月因呼吸道感染在儿科治疗的患儿呼吸道标本2 000份,对标本进行培养、抗菌药物敏感性与耐药性试验,并对结果进行统计分析。结果 2 000份标本中共分离出病原菌283株,主要为流感嗜血杆菌(58.3%)、肺炎链球菌(20.14%)及卡他莫拉菌(18.73%);药物敏感试验显示流感嗜血杆菌及卡他莫拉菌的β-内酰胺酶阳性率分别为41.8%和100.0%,青霉素耐药性检出率为3.8%。结论流感嗜血杆菌、肺炎链球菌及卡他莫拉菌是儿科呼吸道感染的主要病原菌,定期对病原菌分布情况进行统计分析,同时对耐药性进行监测分析,能够及时准确掌握病原菌耐药性变化情况,对儿童科学用药起到指导作用。     

苏州地区下呼吸道感染患儿卡他莫拉菌感染及耐药性分析

了解苏州地区下呼吸道感染儿童卡他莫拉菌的感染情况及耐药性.     

儿童呼吸道卡他莫拉菌分离株产β-内酰胺酶情况和耐药性以及菌株BRO酶基因特征

目的研究儿童呼吸道卡他莫拉菌分离株产β-内酰胺酶情况和耐药性以及菌株BRO酶基因特征。方法选择2016年2月-2019年1月因呼吸道感染就诊且从痰液标本中分离得到卡他莫拉菌的患儿,测定抗生素敏感性、产β-内酰胺酶情况、BRO酶基因表达情况。结果产酶菌株对氨苄西林、阿莫西林、头孢克洛、头孢呋辛、头孢吡肟、左氧氟沙星、克拉霉素产生耐药的发生率高于非产酶菌株,BRO-1基因阳性菌株对氨苄西林、阿莫西林、头孢克洛、头孢呋辛、头孢吡肟、左氧氟沙星、克拉霉素产生耐药的发生率高于BRO-2基因阳性菌株;产酶菌株和非产酶菌株、BRO-1基因阳性和BRO-2基因阳性菌株均对亚胺培南敏感,未发生耐药。结论儿童呼吸道卡他莫拉菌产β-内酰胺酶比例高,且BRO-1基因阳性菌株的耐药性强于BRO-2基因阳性菌株。     

儿童下呼吸道感染痰涂片与痰培养结果一致性研究

目的比较儿童下呼吸道感染痰涂片与痰培养结果,了解痰涂片的实验室诊断价值,同时对痰培养感染病原菌的分布及耐药性进行分析,以指导临床合理用药。方法收集2014年3—5月某院915份下呼吸道感染住院患儿的合格痰标本,涂片后进行革兰染色,同时对痰标本进行细菌培养、鉴定及药敏试验,将革兰染色镜检结果与培养结果进行比较。结果痰涂片与痰培养结果总体符合率为67.43%(617份),痰培养阳性率为65.90%(603份);分离病原菌730株,其中居前3位者分别是副流感嗜血杆菌(36.17%)、肺炎链球菌(24.38%)、卡他莫拉菌(13.29%)。产β-内酰胺酶率:副流感嗜血杆菌、流感嗜血杆菌、卡他莫拉菌分别为44.70%(118/264)、45.83%(11/24)、93.81%(91/97)。肺炎链球菌对大多数抗菌药物较敏感,对红霉素、四环素、复方磺胺甲口恶唑耐药率高,未发现对万古霉素、利奈唑胺、莫西沙星耐药的菌株。结论痰涂片具有一定的实验室诊断价值,痰培养同时应做涂片革兰染色,临床医生可根据常见病原菌的药敏结果合理用药,减少耐药菌的产生。     

引起呼吸道感染的卡他莫拉氏菌的检出及药敏试验

此文报告了2004年2月-2006年8月经临床确诊为呼吸道感染的患者共1827例,其中卡他莫拉氏菌235株,占12.8%。在235例卡他莫拉氏菌感染中,145例为COPD。对235株卡他莫拉氏菌进行药敏试验。结果表明其对青霉素、氨苄青霉素的耐药率达80%以上;对环丙沙星的耐药率达20.4%;对头孢曲松、头孢噻肟、优普同(头孢呱酮-舒巴坦钠)的耐药率分别为3.8%、5.1%及1.3%;对庆大霉素、丁胺卡钠的耐药率均为8.5%;235株卡他莫拉氏菌产β-内酰胺酶率为89.76%,应选用对β-内酰胺酶稳定的头胞菌素、氨基甙及喹诺酮类抗菌药物。     

哮喘急性发作住院患儿病原菌感染病原学分析

目的探讨呼吸道细菌感染病原学与儿童哮喘急性发作的相关性,以期更有效控制住院患儿呼吸道感染。方法对2005年1月-2010年1月宁波市妇女儿童医院住院治疗的哮喘急性发作患儿常规进行深部痰培养,并进行病原学分析。结果哮喘急性发作患儿375例,其中103例分离出≥1种病原菌,阳性率为27.5%;最常见的革兰阳性菌为肺炎链球菌17株,革兰阴性菌主要为流感嗜血菌23株、卡他莫拉菌15株、肺炎克雷伯菌14株;总检出率以低龄组为主,为32.8%;而流感嗜血菌、肺炎链球菌、卡他莫拉菌、肺炎克雷伯菌检出率以<3岁低龄组为主。结论流感嗜血菌、肺炎链球菌、肺炎克雷伯菌和卡他莫拉菌作为小儿呼吸道感染常见病原菌,其感染可能与诱发儿童哮喘急性发作密切相关。     

儿童呼吸道感染咽部细菌分布

目的　探讨儿童呼吸道感染细菌分布状况 ,建立某地区儿童呼吸道细菌感染谱。方法　选择具有呼吸道感染症状的 6岁以下儿童 ,按照《全国临床检验操作规程》的要求 ,取痰或咽拭子接种兔血平板和巧克力平板培养鉴定。结果　共分离 4 32株病原菌 ,分离率由高到低依次为卡他莫拉菌、克雷伯菌属、葡萄球菌属、肺炎链球菌、乙型溶血性链球菌、嗜血杆菌属、白色念珠菌、草绿色链球菌和肠杆菌。冬春季细菌培养阳性率高于夏秋季 (P <0 .0 5 )。结论　影响儿童呼吸道细菌感染的因素很多 ,各地分离细菌种类差异较大。     

卡他莫拉菌的致病性及耐药性的临床研究

目的 研究卡他莫拉菌的致病性及该菌在国内产β-内酰胺酶和超广谱β-内酰胺酶(ESBLs)的情况。方法 抗菌药物敏感试验为纸片扩散法，β-内酰胺酶为Nitrocefin，ESBLs确证试验为双纸片增效方法，均按NCCLS提出的标准实施。结果 从860例各类标本中分离出180株卡他莫拉菌，慢性阻塞性肺疾患26．2％，支气管肺炎27．5％，老年性上呼吸道感染25．8％，耳鼻喉疾患16．3％，皮肤科疾患17．5％，小儿上呼吸道感染17．3％，产β-内酰胺酶83．88％、超广谱β-内酰胺酶11．1％。结论 卡他莫拉菌为条件致病菌，可引起多种感染性疾病，其致病性和耐药性都呈上升趋势，尤其对产酶卡他莫拉菌应引起临床的高度重视。     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.