Prevalence of active Helicobacter pylori infection among patients referred for endoscopy in Brunei Darussalam

INTRODUCTION: The prevalence of Helicobacter pylori (H. pylori) infection has been reported to vary between and even within countries. We retrospectively assessed the prevalence among patients referred for endoscopy in our local setting. METHODS: 4,700 patients, who had endoscopy and H. pylori testing for the first time over a five-year period, were reviewed. RESULTS: The mean age was 45.4 +/- 17.1 years (male 51.1 percent), with racial breakdown similar to the national breakdown. The main indications for endoscopy were dyspepsia (59.6 percent), anaemia (12.6 percent), gastrointestinal bleeding (9.4 percent) and gastro-oesophageal reflux (7.6 percent). The overall prevalence of H. pylori was 26.9 percent, highest in the 30-39 years (30.3 percent) age group. This was higher in males compared to females (30.3 percent versus 23.3 percent, p-value is less than 0.001). Among the racial groups, the expatriate (35.3 percent, p-values are less than 0.001) and the indigenous (31.3 percent, p-values are less than 0.001) groups had significantly higher prevalence rates compared to the Malays (25.9 percent) and the Chinese (23.2 percent). Patients with dyspepsia had the highest prevalence (29.8 percent) compared to the other indications. In patients with peptic ulcer disease, the prevalence rate was 46.9 percent. Over the five-year period, there was a decline in prevalence from 32.3 percent to 25.6 percent. This trend was seen in the Malays and the Chinese, but not the indigenous and the expatriate groups. CONCLUSION: Similar to reported data from the regions, prevalence of H. pylori infection varies, with the Malays and the Chinese having the lowest prevalence rate. The prevalence among those with peptic ulcer disease was lower than reported. There was also a decline in the overall prevalence.     

登革病毒和基孔肯雅病毒检测技术进展

登革病毒(Dengue virus,DENV)和基孔肯雅病毒(Chikungunya fever,CHIKV)都是虫媒病毒,具有相同的传播媒介、流行区域和季节分布。这两种病毒还会造成几乎相同的临床表现,特别是在感染的初始阶段,两者无任何可以鉴别的临床特征。而这两种病毒感染的治疗和临床管理策略是截然不同的,因此早期准确诊断是必要的。正确的诊断对于疾病监测、疫情控制、疫苗研究和药物开发非常重要。目前的检测技术,目标是检测病毒,病毒成分(抗原或核酸),或宿主的免疫产生的抗体。本文主要描述登革病毒和基孔肯雅病毒检测技术的概况,以及两者诊断技术上的研究进展。     

A fatal case of chikungunya virus infection with liver involvement

Recovery from chikungunya is previously considered universal and mortality due to the virus is rare and unusual. Findings from recent chikungunya outbreaks occurred in Reunion Island and India have since challenged the conventional view on the benign nature of the illness. Malaysia has experienced at least of 4 outbreaks of chikungunya since 1998. In the present on-going large outbreak due to chikungunya virus of Central/East African genotype, a previous healthy sixty six years gentleman without co-morbidity was noted to have severe systemic infection by the virus and involvement of his liver. He subsequently passed away due to cardiovascular collapse after 5 days of illness.     

丙型肝炎病毒的垂直传播研究

目的探讨丙型肝炎病毒(HCV)的垂直传播机制。方法选择6对抗-HCV与HCV RNA均阳性的母亲与胎儿,2对父亲抗-HCV与HCV RNA阳性、母亲阴性的胎儿为研究对象,检测父、母亲与子代HCV的感染标志,同时比较两代间所携HCV的基因型别与HCV C/E1区的序列同源性。结果6对母亲与胎儿HCV RNA阳性,基因型均一致,其中5对基因型别属Ⅱ型,1对属Ⅲ型。母亲与子代间所携HCV C/E1区的序列同源性极高,与其他母亲间、胎儿间的HCV同源性显著差异。2对父亲HCV RNA 阳性其胎儿未检测到HCV RNA。结论母亲与子代间存在出生前期的HCV的垂直传播。     

Relationship between placenta infection and intrauterine transmission of HBV

InChina,thetransmissionroutefrommothertoinfantisanimportantmodeofhepatitisBvirus(HBV)transmission.WiththeinjectionsofhepatitisBvaccineandhepatitisBimmunoglobulinamongnewborninfants,about90%ofinfantsborntoHBsAgcarriermothershavebeenpreventedfrominfection.However,therestillare5%--10%infantstobeinfectedbyHBVinutero,andwedefinitethemodeoftransmissionasHBVintrauterinetransmission[IJ.Theprecisemechanismsofintrauterinetransmissionarepoorlydefined,andthereisnoteffectivemeasurestocontrollingthem…     

尿路感染病原菌分布及耐药性分析

目的：探讨尿路感染的病原菌分布特点和细菌耐药现状,为临床合理使用抗菌药物提供参考。方法收集2012年6月-2013年9月我院尿路感染患者标本中分离的171株病原菌进行鉴定,同时对G-杆菌进行超广谱β内酰胺酶（ESBLs）检测,肠球菌属进行庆大霉素高水平耐药（HLGR）筛选。结果尿路感染病原菌分布占前三位的细菌为大肠埃希菌（33.92%）、肠球菌属（19.30%）、真菌（12.87%）,产ESBLs的大肠埃希菌检出率为65.52%,产ESBLs的肺炎克雷伯菌检出率为66.67%,HLGR肠球菌属检出率为51.52%。结论重视尿细菌培养和药敏试验,对院内感染的控制、抗菌药物的合理使用十分重要。     

Antigen detection in primary HIV infection

Serial blood samples were obtained from 21 homosexuals who had developed symptomatic primary infection with human immunodeficiency virus (HIV) after a median incubation time of 14 days. During the first two weeks after the onset of illness HIV antigen (p24) was detected in the blood by enzyme linked immunosorbent assay (ELISA). During the second and third weeks after the onset of illness p24 antibody was detected by Western blot assay and antigen concentrations rapidly decreased to undetectable values. Dissociation of antigen-antibody complexes showed complexed antigen during the phase of declining concentrations of free antigen. Neither free nor complexed antigen was detected in any serum samples for several months thereafter, which suggested that failure to detect HIV antigen reflected low or absent synthesis of viral protein rather than masking of antigen by antibodies. Reappearance of HIV antigen with a fall in p24 antibody concentration was observed in a few patients six months or more after the onset of disease. The combined use of antigen and antibody assays made it possible to obtain evidence of infection with HIV in all of the 95 serum samples tested, illustrating the usefulness of these assays for diagnosing infection with HIV in its early stages.     

小儿肺炎支原体感染的血清学检测

目的通过对308例呼吸道感染患儿血清肺炎支原体（mp）特异性抗体IgM及冷凝集试验（CAT）的检测，协助临床早期诊断mp感染及早治疗，缩短病程。方法对308例呼吸道感染患儿作血清冷凝集试验及用ELISA方法检测其肺炎支原体特异性抗体IgM。结果308例受检样品中抗mp—IgM阳性检测结果42例（占13．64％）。在42例临床诊断为mp的病例中，血清抗-mp—IgM和CAT均阳性18例；抗-mp—IgM阳性36例，CAT阳性23例。抗-mp—IgM的敏感性为85．7％，冷凝集试验的敏感性为54．8％，抗mp—IgM的敏感性较冷凝集试验高（P〈0.05）。结论临床上同时检测抗-mp—IgM和冷凝集试验可提高mp感染的早期诊断率。     

孕妇弓形虫感染与垂直传播的研究

目的 :探讨孕妇弓形虫感染对胎儿的影响。方法 :采用酶免三联诊断法对 35 6例母婴配对标本进行血清学检测。结果 :产妇弓形虫感染率平均为 19 1% ,各单项检测分别为循环抗原 (CAg) 15 2 %、IgM2 5 %、IgG3 4% ;新生儿弓形虫感染率平均为 17 7% ,其脐血各单项检测分别为CAg16 9%、IgM0 3%、IgG2 2 %。CAg垂直传播率为 35 2 % ( 19/5 4)。 4例畸胎儿中 1例脐血弓形虫CAg阳性。结论 :孕妇感染弓形虫可通过胎盘垂直感染胎儿 ,应引起围产医务工作者的高度重视 ,加强对弓形虫感染的早期诊断和及时治疗     

丙型肝炎病毒的垂直传播研究

目的 探讨丙型肝炎病毒(HCV)的垂直传播机制。方法 选择6对抗-HCV与HCVRNA均阳性的母亲与胎儿，2对父亲抗-HCV与HCVRNA阳性、母亲阴性的胎儿为研究对象，检测父、母亲与子代HCV的感染标志，同时比较两代问所携HCV的基因型别与HCVC／E1区的序列同源性。结果 6对母亲与胎儿HCVRNA阳性，基因型均一致，其中5对基因型别属Ⅱ型，1对属Ⅲ型。母亲与子代间所携HCVC／E1区的序列同源性极高，与其他母亲间、胎儿间的HCV同源性显著差异。2对父亲HCVRNA阳性其胎儿未检测到HCVRNA。结论 母亲与子代间存在出生前期的HCV的垂直传播。     

弓形虫感染母婴垂直传播的研究

目的探讨先天性弓形虫感染的传播途经及有关的危险因素。方法采用整群抽样的方法,对２８４例产妇及其新生儿,采集产妇（分娩前）静脉血３ｍｌ及其新生儿脐血３ｍｌ,用ＥＬＩＳＡ法一次性检测弓形虫循环抗原ＣＡｇ、弓形虫特异性ＩｇＧ和ＩｇＭ抗体。结果发现产妇阳性１５例,产妇总感染率为５．２８％;新生儿阳性５例,新生儿总感染率为１．７６％;同时对检出的５例新生儿弓形虫感染者进行交互配对分析,发现产妇弓形虫感染与其新生儿弓形虫感染间存在显著性的统计学联系（Ｐ＜０．０５）,其ＯＲ值为１３．６４,ＯＲ９５％的可信限为１．７５～１０６．３３。结论母婴垂直传播是新生儿先天性弓形虫感染的主要途径,对孕妇弓形虫感染的检测具有重要的优生学意义。     

Epidemiology of chikungunya in Malaysia: 2006-2009

This is a retrospective cross-sectional study based on the database of clusters of patients with clinical diagnosis of chikungunya (CHIK) that were referred to the National Public Health Laboratory for diagnostic investigations from January 2006 to December 2009. Of the 13,759 referred patients, a total of 6314 (45.9%) patients were laboratory confirmed to have CHIK and 7445 (54.1) patients were considered as clinical cases of CHIK by epidemiological link. Epidemic curves plotted using date of onset of illness for all referred clusters of cases showed that there were three unrelated outbreaks of CHIK in Malaysia from 2006 to 2009. There were two small outbreaks that occurred within the state of Perak in 2006. The cluster of cases in 2008 and 2009 were of related outbreak which started in Johor state and subsequently spread to various parts of Malaysia. The mean age of the patients was 37.0 years old and those patients in the laboratory confirmed group were significantly younger than those in the epidemiological linked group. The main presenting clinical features recorded in this study were fever, arthralgia, myalgia and rashes. Those patients in the laboratory confirmed group had a significant higher incidence of fever, arthralgia and rash than those in the epidemiological linked group.     

乙肝病毒宫内传播与胎盘感染的关系

目的：母亲乙肝病毒（ＨＢＶ）感染在宫内即可造成其胎儿感染，但其机理尚不清楚，作者试图了解胎盘细胞中ＨＢＶ的感染情况，宫内传播的危险因素和母胎传播的可能途径。     

厌氧菌检测技术在口腔颌面部感染治疗中的应用

目的：探讨口腔颌面部感染患者的厌氧菌病原菌分布及耐药情况,以指导临床治疗。方法：对北京大学口腔医学院口腔颌面外科收治的61例口腔颌面部感染患者的脓液标本进行需氧菌和厌氧菌培养,应用API 20A试剂盒对耐氧试验阴性菌株进行菌种鉴定,采用Etest方法检测菌株进行药敏试验,确定病原菌类型及厌氧菌耐药情况。收集61例患者的临床治疗及抗菌药物应用情况,记录临床治疗效果。结果：61例脓液标本均培养分离出细菌,其中单纯需氧菌感染6例（9.8%）,单纯厌氧菌感染7例（11.5%）,厌氧菌与需氧菌混合感染48例（78.7%）。厌氧菌感染总例数为55例（90.2%）,共分离出 81株厌氧菌。分离率最高的革兰阳性厌氧菌为消化链球菌属（Peptostreptococcus）、双歧杆菌属(Bifidobacterium)和疮疱丙酸杆菌(Pemphigus propionbacterium),上述3类革兰阳性厌氧菌均未出现对头孢西丁、阿莫西林/克拉维酸耐药菌株;分离率最高的革兰阴性厌氧菌为卟啉单胞菌属（Porphyromonas）和普雷沃菌属(Prevotella),上述两类革兰阴性厌氧菌均未出现对甲硝唑、头孢西丁、阿莫西林/克拉维酸耐药菌株。根据药敏试验结果指导临床治疗48例口腔颌面部感染患者,临床治愈率达到81.3%。结论：口腔颌面部感染多为需氧菌和厌氧菌混合性感染,其中厌氧菌占有较高比例,厌氧菌的培养及药敏试验结果对临床治疗具有良好的指导作用。