人群中非O1群霍乱弧菌检测及耐药性分析

[目的]了解宁波市食品及公共场所从业人员、腹泻病人等人群中非O1群霍乱弧菌携带、感染情况及其菌株的耐药性.[方法]用过筛法筛选、VBO诊断血清作血清分型,K-B法作药敏试验.[结果]从人群中筛检出非O1群霍乱弧菌236株,检出率1.3%（236/18 416）;能被VBO分型的有188株,总分型率79.7%（188/236）,分属25个血清型;检出株对头孢他啶、氯霉素和阿米卡星等抗生素敏感,对氨苄西林等青霉素耐药性较高,有15.3%（36/236）对弧菌抑制剂O/129纸片（10 μg、150μg.）有抗性,涉及11个血清型.[结论]筛检方法适用于非O1群霍乱弧菌检测VBO2为腹泻病人的优势血清型;常用抗生素大多具有良好的敏感性,病人分离株的耐药性高于从业人员,未发现多重耐药菌株;检出菌对弧菌抑制剂O/129的抗性增高,鉴定时应考虑到该因素.     

抗O/129弧菌抑制剂的非O1群霍乱弧菌特征

非O1群霍乱弧菌的鉴定常用生化、血清学等试验来确定，其中二氨基二异丙基喋啶磷酸盐(O1／129弧菌抑制剂)试验是鉴别非O1群霍乱弧菌等弧菌科细菌与其他细菌的特异性试验。常作为细菌命名的重要依据，在重要的微生物学检验专著上都认为弧菌属细菌对O／129弧菌抑制剂10，150μg敏感。本文对从业人员和腹泻病人中检出的非O1群霍乱弧菌抗O／129弧菌抑制剂菌株进行耐药性、毒力等检测，探讨其与致病力的相关性。现将鉴定结果报告如下。     

非O1群霍乱弧菌致病因子检测与分析

〔目的〕非O1群霍乱弧菌有多种致病因子引能起人群腹泻 ,为了解非O1群霍乱弧菌中致病性因子 ,对其进行检测与分析。〔方法〕用平板法和试管法测定溶血素 ;用小鼠测定非O1群霍乱弧菌菌株的急性毒性 ;用VTEC -RPLA法测定菌株的Vero毒素 ;用EIA法测定菌株的ST毒素 ;用PCR法测定菌株的CT毒素。〔结果〕非O1群霍乱弧菌平板法溶血素 2 2 6株阳性 ,阳性率为 94.4% ;试管法溶血素 2 2 0株阳性 ,阳性率为 88.9% ;未检出耐热性溶血素。产ST毒素的菌株186株 ,阳性率为 78.8%。 45株产VTl毒素 ,67株产VT2毒素 ,同时产VTl和VT2两种毒素的 3 5株。 3株非O1群霍乱弧菌检出CT毒素其因 ,产毒率为 1.3 %。〔结论〕检测发现非O1群霍乱弧菌对小鼠有较强的致病能力 ,说明其对人群的危害较大、毒性较强 ;检出CT毒素说明非O1群霍乱弧菌具有引起重症腹泻 (霍乱样腹泻 )的能力 ;检出溶血素、ST毒素、Vero毒素致病因子 ,说明非O1群霍乱弧菌的致病因子有多种。由于菌株发生CT毒素基因频度较低 ,目前不可能成为非O1群霍乱弧菌腹泻的主要的致病因素 ,而菌株发生溶血素、ST毒素、Vero毒素的频度较高 ,尤其是溶血素、ST毒素 ,有可能是非O1群霍乱弧菌的主要致病因子。     

滕州市185株弧菌及肠毒素检测分析

目的探讨滕州市弧菌种类、分布、构成特征和毒力因子。方法对就诊的急性腹泻病人采集腹泻便,按《卫生防疫细菌检验》提供的方法进行弧菌分离鉴定及肠毒素检测。结果1992～201i年共检测急性腹泻病人粪便4847份,检出各类弧菌185株,检出率为3．82％。其中以非O1群霍乱弧菌为主126株占68．i1％,其次是河弧菌16株占8．65％、梅契尼柯夫弧菌和弗尼斯弧菌各12株各占6．49％、溶藻弧菌9株占4．86％、副溶血弧菌8株占4．32％、霍乱弧菌2株占1．08％。结论在检出的弧菌中,以非O。群霍乱弧菌为主要菌群,另外还有霍乱弧菌、河弧菌、弗尼斯弧菌、溶藻弧菌、梅契尼柯夫弧菌和副溶血弧菌。非0。群霍乱弧菌能产生CT,与其致病性密切相关;NAG-ST是非0。群霍乱弧菌一种主要毒力因子。     

多重PCR检测霍乱弧菌的毒素相关基因

目的 探索建立一种快速、敏感地检测霍乱弧菌O1群、O139群、非O1／非O139群的毒素相关基因的方法。方法 针对霍乱弧菌霍乱肠毒素A亚单位基因(ctxA)、小带联结毒素基因(zot)、辅助霍乱肠毒素基因(oce)、霍乱弧菌毒素共调菌毛A基因(tcpA)、毒素表达调控蛋白基因(toxR)分别设计引物，建立多基因PCR方法；通过一次扩增反应之产物经琼脂糖凝胶电泳，可检测出菌株的毒素相关基因的携带情况。结果 阳性对照菌株：MO45(霍乱弧菌O139群)检出5种毒素相关基因，结果符合设计要求；其他不同来源的霍乱弧菌(O1群、O139群、非O1／非O139群)检出1—5种不等的毒素相关基因；根据毒素相关基因携带情况，可将菌株分为5个基因型，并可区分为产毒株和非产毒株；多重PCR敏感度可达10^2cfu／ml。结论 该方法快速、特异、敏感，具有较大的应用价值。     

平湖市市售水产品中致病性弧菌检测结果

目的了解平湖市市售水产品中副溶血性弧菌、创伤弧菌和霍乱弧菌的污染状况及其致病力,为预防食源性疾病并制定防控措施提供依据。方法采集2016—2017年平湖市海鲜批发市场、农贸市场及大型超市的海水产品和淡水产品,采用弧菌显色法进行副溶血性弧菌、创伤弧菌和霍乱弧菌定性检测,并进行毒力基因、血清型和药敏试验。结果 239份市售水产品中,副溶血性弧菌检出率为51.46%,创伤弧菌检出率为0.84%,O1群和O139群霍乱弧菌未检出。副溶血性弧菌血清型以O1、O2、O4和O5为主,分别占13.01%、26.02%、17.07%和17.07%,所有菌株均携带tlh基因,未携带tdh、trh基因,均为非毒力株,氨苄西林耐药率为69.57%;2株创伤弧菌均携带vvhA毒力基因,且对头孢西丁耐药。结论平湖市市售水产品中的致病性弧菌以副溶血性弧菌为主,均为非毒力株,不具有致病力。     

非O1群霍乱弧菌噬菌体-生物学分型

目的：了解用霍乱弧菌噬菌体和溶血性等4项生物学试验对非O1群霍乱弧菌进行噬菌体-生物学分型实际应用意义。方法：用VP1-VP55组弧菌噬菌体对非O1群霍乱弧菌进行噬菌体分型；用溶源性噬菌体敏感试验、溶源性测定、山梨醇发酵和溶血试验对非O1群霍乱弧菌进行生物学分型。结果：236株非O1群霍乱弧菌中能被5组O1群霍乱弧菌噬菌体分型的62株，总分型率为26．3％，其中腹泻病人52株，从业人员10株，分型率分别为22．0％和9．3％，分属于11个噬菌体型，腹泻病人以21、26噬菌体型居多，从业人员无优势型别，对5组O1群霍乱弧菌体均不敏感的174株；62株非O1群霍乱弧菌分属于e、f、k、l等4个生物型，23个噬菌体-生物型在8-31型之间，均属非流行株范畴；对第Ⅳ组噬菌体（10^9／ml）及其常规稀释噬菌体和溶原性噬菌体、溶源性表现为不裂解。结论：非O1群霍乱弧菌进行噬菌体分型，对预测非O1群霍乱弧菌流行具有一定的实用和指导性意义。现成的噬菌体分型方法对非O1群霍乱弧菌进行噬菌体分型存在一定的缺陷，应寻找更适宜于非O1群霍乱弧菌分型的噬菌体用于实际应用。     

2016年河南省淡水产品养殖环节4种常见致病性弧菌污染状况监测

目的 了解河南省淡水产品养殖环节4种常见致病性弧菌（霍乱弧菌、副溶血性弧菌、创伤弧菌和溶藻弧菌）的污染状况,为河南省食源性疾病的预防及溯源提供数据支持。方法 参照2016年国家食品安全风险监测-淡水动物性水产品养殖环节中常见弧菌专项监测工作手册进行样品的采集和检测。结果 从开封市和鹤壁市淡水产品养殖场中分别采集水产品、养殖水体和水底淤泥共计312份,开封市检出73株霍乱弧菌（46.79％）、13株副溶血性弧菌（8.33％）和17株溶藻弧菌（10.90％）,未检出创伤弧菌;鹤壁市检出8株霍乱弧菌（5.13％）,未检出副溶血性弧菌、溶藻弧菌和创伤弧菌。对13株副溶血性弧菌进行3种毒力基因（TLH、TRH和TDH）检测。13株副溶血性弧菌均具有不耐热溶血素基因（TLH）,有12株具有耐热相关直接溶血素基因（TRH）,均未携带耐热直接溶血素（TDH）。对81株霍乱弧菌进行血清分群,O1群霍乱弧菌3株（小川1株、稻叶1株和彦岛1株）,O139群霍乱弧菌5株,非O1/O139群霍乱弧菌73株。81株霍乱弧菌CTXA毒力基因阳性菌株7株,均为非O1/O139群霍乱弧菌。结论 河南省淡水养殖环节主要受霍乱弧菌、副溶血性弧菌和溶藻弧菌的污染,监测的2个地区污染情况存在差异,污染的优势弧菌是霍乱弧菌。     

鱼及环境中霍乱弧菌和溶藻弧菌污染状况和PFGE分型分析

目的了解开封地区鱼及相关水体中霍乱弧菌和溶藻弧菌的污染情况,并分析不同来源菌株的同源性关系。方法参照GB/T 4789.7—2013《食品安全国家标准食品微生物学检验副溶血性弧菌检验》,对所采集样本进行霍乱弧菌及溶藻弧菌的检测和霍乱弧菌的血清学分型,采用PFGE的方法对2种弧菌的代表菌株做分子分型。结果共检出霍乱弧菌72株,检出率为33.3%;检出溶藻弧菌101株,检出率为46.8%;从养殖场采集样本中霍乱弧菌为优势检出菌,而在销售和餐饮环节优势检出菌为溶藻弧菌;72株霍乱弧菌均为非O1/非O139群;16株霍乱弧菌代表菌株和20株溶藻弧菌代表菌株的PFGE分型相似度分别为53.6%~100.0%和60.1%~86.3%。结论开封地区鱼及环境中霍乱弧菌及溶藻弧菌污染较严重,菌株PFGE型别呈明显的多样性。     

2005年-2010年武汉市霍乱弧菌监测分析

目的:对2005年-2010年霍乱弧菌监测中分离的25株疑似菌株进行系统鉴定。方法:分离培养、血清学试验、系统生化鉴定(VITEK32)、PCR检测其分型及毒素基因、药敏试验。结果:25株菌鉴定为霍乱弧菌的有21株,与霍乱弧菌发生交叉凝集4株;病例监测主要为O139霍乱弧菌、外环境监测主要为O1群霍乱弧菌;病例监测菌株携带霍乱弧菌毒素基因(ctxAB)、其他菌株均不携带霍乱弧菌毒素基因(ctxAB)。药敏实验结果对诺氟沙星和环丙沙星敏感,对其他抗生素有不同程度的耐药。结论:武汉市霍乱弧菌在病例监测中主要为O139群霍乱弧菌产毒株、外环境监测中主要为O1群霍乱弧菌非产毒株,不同型别菌株存在不同程度耐药性。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

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.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

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.