B群脑膜炎奈瑟氏菌多位点酶电泳型及其流行病学意义

为了阐明自70年代以来在我国11个省和2个直辖市内从流脑病人和带菌者中所分离的B群脑膜炎奈瑟氏菌(Nm)之间的流行病学关系,采用多位点酶电泳技术研究了57株病人菌株和45株带菌者菌株的多位点酶电泳型和克隆群。初步发现,上述菌株可分为69个电泳型(ET)和13个克隆群。其中I克隆群最为重要,因为从70年代以来,它代表了63.7%的所试的全部菌株,并且代表了77.2%的病人菌株,它在地理地区分布上也相当广泛。另外,还有一个明显的趋向,即是从1984年以后,越来越多的病人菌株集中于I克隆群,而且优势ET也出现在I克隆群的复合ET₁和ET₂₄中。当同病人菌株相比较时,上述带菌者菌株显示了更复杂的不同的基因型,只有40%的菌株属于上述I克隆群和优势ET。     

流行性感冒监测

1982至1990年6月,上海市共经历7次甲₃型和4次甲₁型中小程度的流感流行,分离到不同的病毒变种。甲₃型和甲₁型变种在本市交替流行间隔为1~2年左右。夏秋季和冬春期是本市流感活动高峰期。夏秋季流行的流感病毒亚型至冬春期常在我国北方和北半球一些国家引起流行。夏秋季流感疫情较平静,至冬春季流感病毒可出现进一步变异,引起较广泛流行。提供流感流行预测,为及时制备疫苗进行有效预防的依据。     

甲1型流感病毒的抗原漂移

本研究对1977~1983年期间分离的新甲₁型部分毒株之间。新甲₁型毒株和老甲₁型部分毒株之间,进行了抗原性状的分析,结果表明,1983年新甲,型出现了血凝素抗原性状明显漂移的新变种株,其神经氨酸酶抗原虽有变异,但仍与近几年来流行的优势株相近,对此类毒株扩大流行的可能性进行了推测。对新老甲₁型毒株间抗原分析的结果表明,流感病毒的抗原漂移无一定方向。在新甲₁型变种中,不断出现老甲₁型所没有的新抗原成分。这种趋向表明,甲₁型流感可能不会在短期内自行消失。     

A群脑膜炎奈瑟氏菌脂多糖抗原血清型在我国八省一市的分布

本文报道应用改进的HAI试验方法调查A群NM LPS抗原的血清型。此分型方法简单，可重复性亦好，并且可以测定各型LPS抗原的HAI滴度。以此方法检查我国八省一市所分离的96株A群NM，其中90株（93.7%）可以分成三个血清型（L₉、L₁₀和L₁₁），以L₁₀型最多见，占80株（83.3%），在我国流行分布较广。本试验初步分析，自1973年以后，我国流脑的流行主要与A群NM L₁₀型有关。     

我国沿海副溶血性弧菌血清型分布的实验调查

对135株来自我国沿海海产鱼贝类、海水、海泥及食物中毒患者的副溶血性弧菌,进行了血清学分型实验。结果表明:属于已知OK抗原型的106株(78.5%),分布于O1~12群的29个血清型。另有10株菌(7.4%)的血清型属于8个已知K抗原与其它O群组合的新菌型(神奈川现象阴性)。从群别看,以O₄群最多(38/30.4),O₁群次之(26/20.8);从型别看,以O₁K₃₂最多(18/14.4),O₅K₁₇次之(10/8.0)。O₁~O₅群菌株为108株80%)。仅具有O群抗原而未检出K抗原的有19株(14.1%)。不同样品的菌型分布未发现有特殊差异。     

8个城市1～4岁母乳喂养儿童体格生长百分位曲线研究

目的 制定城市母乳喂养儿童1～4岁年龄别体重、身长（身高）、头围和BMI百分位参考值及百分位曲线。方法 利用2008－2012年我国8个城市地区1 025名母乳喂养儿童1～4岁期间的体格生长纵向随访数据,采用MLwiN2.25软件构建年龄别体重、年龄别身长（身高）、年龄别头围和年龄别BMI多水平模型,同期引入家庭社会人口学特征、母亲围产期因素、父母生物学特征以及婴儿性别、年龄、泥糊状食物摄入、患病情况等相关因素。基于模型进行体格生长指标百分位参考值（P₃、P₁₅、P₅₀、P₈₅、P₉₇）预测以及百分位曲线的拟合。结果 制定出城市母乳喂养儿童1～4岁体格生长百分位参考值及相关百分位曲线。男、女童年龄别体重、身长（身高）、头围和BMI比较差异均有统计学意义（均P< 0.001）,且男童的体重、身长（身高）、头围和BMI比女童分别平均高0.56～0.76 kg、0.89～1.12 cm、0.64～0.91 cm、0.31～0.52 kg/m²。结论 本研究结果来源于纵向数据,能够为我国城市地区母乳喂养儿童体格发育评价提供更为科学的循证依据。     

北京地区婴幼儿病毒性肺炎血清抗体调查

本文对1978年冬~1988年春诊断为婴幼儿肺炎住院病人171份双份血清,采用血凝抑制试验及免疫酶联检测方法,进行腺病毒抗体检测。结果S₂≥S₁₄倍升高者56份,阳性率为32.75%,以3、7两型腺病毒为主;对6个冬春129份双份血清进行流感、副流感病毒抗体检测,结果S₂≥S₁₄倍升高者11例,阳性率为8.53%,以甲₁和甲₃型为主;行副流感病毒抗体检测结果,S₂≥S₁₄倍升高者27份,阳性率为20.93%,型别以副Ⅲ居多;对4个冬春60份双份血清行RSV抗体检测,结果阳性者14份,阳性率为23.30%。     

甘肃省流感季节性流行特征及病原变迁研究

目的 分析甘肃省流感季节性流行特征,为制定适宜的科学防控措施,优化流感疫苗预防接种指导意见提供依据。方法 收集2010年第1周至2016年第40周甘肃省分周流感病原学监测数据, χ²检验比较不同季节流感病毒核酸检测阳性率及病原型别构成,并用时间序列季节性分解方法分析流感病毒总阳性率及各型别阳性率的季节性流行特征。结果 共检测标本59 791份,流感病毒核酸阳性8 501份,阳性率14.22%,病毒型别以A（H1N1）pdm09型、A（H3N2）型和B型为主,占所有阳性标本的98.76%。不同季节流感病毒阳性率分别为春季15.12%、夏季0.98%、秋季4.02%、冬季24.26%。不同季节病毒型别构成,秋冬季以A（H3N2）型居多,春季以B型为主。甘肃省季节性流感呈典型的单峰型分布,流行高峰多出现在12月至次年1月,高峰起始时间以A（H3N2）型最早,其次是A（H1N1）pdm09型,B型最晚。结论 流感季节性流行高峰出现时间、持续时间与主要优势株的型别构成有关。甘肃省流感疫苗接种时间应为每年10月份,以便在流行期提供有效保护。     

2007-2021年我国诺如病毒急性胃肠炎暴发疫情流行特征及影响因素分析

目的 分析我国诺如病毒急性胃肠炎暴发疫情流行病学特征,探讨暴发疫情规模的影响因素,为及早控制暴发疫情提供科学依据。方法 对突发公共卫生事件管理信息系统2007年1月1日至2021年12月31日全国诺如病毒急性胃肠炎暴发疫情进行描述性流行病学分析,应用非条件logistic回归模型分析暴发疫情规模的影响因素。结果 2007-2021年共报告暴发诺如病毒急性胃肠炎疫情1 725起,报告疫情起数呈上升趋势。南方省份每年10月至次年3月为疫情高峰,北方省份疫情高峰为每年10-12月和次年3-6月。疫情报告地区从东南沿海省份逐步向中部、东北和西部省份扩散。疫情主要发生在学校和托幼机构（1 539起,89.22%）,其次为企事业单位（67起,3.88%）和社区家庭（55起,3.19%）。人与人接触为主要传播途径1 262起（73.16%）,GⅡ基因型为引起暴发疫情的主要病原型别（899起,81.58%）。首例病例发病至疫情报告时间间隔M（Q₁,Q₃）为3（2,6）d,疫情规模M（Q₁,Q₃）为38（28,62）例。近年来,疫情报告及时性提升,疫情规模随年份呈下降趋势,二者在不同发生场所之间差异均有统计学意义（P<0.001）。发生场所、传播途径、报告及时性和居住地类型是暴发疫情规模的影响因素（P<0.05）。结论 2007-2021年我国诺如病毒急性胃肠炎暴发疫情整体呈上升趋势,疫情波及地区范围不断扩大,但疫情发生规模整体呈下降趋势,疫情报告及时性提升,提高监测灵敏度和及早报告可有效控制疫情发生规模。     

人流感与猪流感关系的监测

作者于1982年4月和1983年5月在成都地区采集了336份人血清和607份猪血清。以Hsw₁N₁、H₁N₁、H₂N₂、H₃N₂和B流感病毒为抗原，用血抑试验检测其抗体，血抑阳性猪血清用单扩溶血试验复核结果表明，凡能感染人的流感病毒均能感染猪，猪血清和人血清中血抑抗体阳性率的增长呈平行关系。
此外，在22份猪血清中发现了B流感病毒的血抑抗体，阳性率为3.6%。经单扩溶血试验复核，其阳性率为72.7%。其中，4份猪血清与B病毒进行了中和试验，3份有中和B病毒的能力，猪血清中甲₂型血抑抗体阳性率为78.3%，几何平均滴度为42.5，经单扩溶血试验复核，其阳性率为48.7%。血清学方面的事实证明B型流感病毒能感染猪，甲₂型流感病毒近年来在猪群中曾广泛流行，並讨论了这些发现。     

我国A群脑膜炎奈瑟氏菌的克隆群体结构与流行病学意义

应用多位点酶电泳技术对从我国17个省市搜集的200株A群脑膜炎奈瑟氏菌(Nm)进行了克隆群体结构分(?)。结果表明,可将200株A群Nm分为23个电泳型(ET),7个克隆群,其中Ⅳ克隆群和Ⅴ克隆群为优势克隆群,两者的遗传距离为0.53。自60年代以来,每次流脑流行周期均以一种克隆群为主,如60年代和80年代主要由Ⅳ克隆群引起流行,分别占同时期菌株数的85.7％和82.4％;70年代的流行主要由Ⅴ克隆群引起,占该期间菌株数的88.4％。优势克隆群优势十分明显,流行时间长,地区分布广,而且不同周期A群Nm优势克隆群的变迁与其优势亚型的变化基本吻合。我国A群Nm的优势克隆群及优势亚型在流脑不同流行周期内皆显示了周期性变换的特征。     

A major methicillin-resistant Staphylococcus aureus clone predominates in Malaysian hospitals

This study was conducted to determine the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Malaysian hospitals. A total of 264 MRSA isolates from eight hospitals were subjected to typing by pulsed-field gel electrophoresis (PFGE) of SmaI restricted DNA. Antibiotic disk susceptibility testing was also carried out to determine their resistance patterns. Thirty-one PFGE pattern types were identified. Three major pattern types A, ZC and K were found with type A the predominant profile in c. 80% of strains and present in all hospitals. Unlike type A, other DNA pattern types were unique to the hospitals in which they were isolated. PFGE type A also consisted of strains that were multiply antibiotic resistant. The presence of a single predominant PFGE type in Malaysian hospitals is an important finding which suggests that inter-hospital spread of MRSA had occurred frequently and regularly.     

Clonal diversity of Streptococcus pyogenes within some M-types revealed by multilocus enzyme electrophoresis.

Twenty-two reference isolates and 30 local isolates of group A Streptococci were classified into 36 electrophoretic types (ET) on the basis of allozyme variation at 27 enzyme loci. Local isolates were characterized by a high frequency of M-non typable strains. M-type and ET were more closely associated in local isolates from an endemically-infected population; nevertheless, amongst the local isolates there were also strains of the same ET type with different M-types. A possible explanation is that genetic exchange between strains may introduce different M-types into strains of defined ET when these are exposed to strong selection in the presence of heavy loads of infection. In contrast to the reported clustering of strains associated with toxic shock-like syndrome into two closely related ET clones, we found no relationship of ET phenotype to acute poststreptococcal glomerulonephritis or rheumatic fever.     

Staphylococcal sepsis in a burns unit.

An outbreak of staphylococcal sepsis in a burns unit occurred between January 1976 and May 1978. Many patients and members of staff had boils, and a number of patients also developed septicaemia. Most of the boils in the early period of the trial and a large proportion of boils in patients during the later period yielded Staphylococcus aureus resistant to penicillin, tetracycline and erythromycin only (PTE), and were shown to be of phage type 95 in the early period while strains were phage typed. From blood cultures, most strains in the early period were of resistance pattern PTE and phage type 95, but in the later period other resistance patterns were predominant. Strains from burns were usually multiresistant (PTEKNML) and of the phage pattern 29/77, which had been endemic in the Unit, but during the early period of the outbreak there was an increased proportion of strains in burns with the resistance pattern PTE and of phage type 95. Staphylococcal sepsis has for many years been very infrequent in the burns unit. This outbreak seems to have been initiated by a strain of phage type 95 and resistance pattern PTE, but during the course of the outbreak the endemic strain of type 29/77 and some other staphylococci seem to have developed enhanced ability to cause clinical infections, conceivably by transduction from the epidemic strain of phage type 95.     

Use of plasmid profile typing for surveillance of Salmonella enteritidis phage type 4 from humans, poultry and eggs.

Plasmids were found in 1022 of 1089 (94%) of drug-sensitive strains of Salmonella enteritidis phage type 4 from humans (sporadic and outbreak cases), poultry (chickens) and eggs in England and Wales in the 5-year period 1988-92 and 25 plasmid profile patterns were identified. Strains characterized by a single plasmid of 38 MDa predominated (= plasmid profile type SE 38), comprising over 90% of isolates from humans, 70% from poultry and 92% from eggs. Eleven profile types were identified in strains from humans, 21 in strains from poultry and 3 in strains from eggs. Eight of the 11 patterns identified in human isolates were found in strains from poultry and 2 in strains from eggs. In contrast 15 patterns seen in poultry were not found in strains from humans. Four percent of strains from humans and 13% from poultry did not carry the 38 MDa plasmid but all strains from eggs were found to carry this plasmid. The second most common profile type in strains isolated between 1981 and 1988 was not identified in strains isolated from 1988-92. It is concluded that plasmid profile typing is a useful method for rapid differentiation within phage type 4 of S. enteritidis but that methods which can discriminate within the predominant profile type, SE 38, are now required.     

16SrRNA基因探针与ctx A基因探针用于霍乱弧菌分型

以地高辛为标记物,利用ＰＣＲ方法制备１６ＳｒＲＮＡａ基因探针与ｃｔｘＡ基因探针,经Ｓｏｕｔｈｅｒｎ杂交,对霍乱弧菌进行分型,对广东地区分离自病人的６０株埃尔托型（ＥＶＣ）、１０株Ｏ１３９群和２株标准株进行研究,经１６ＳｒＲＮＡ基因在探针共分为４个类型（Ａ、Ｂ、Ｃ和Ｄ）,ＥＶＣ和Ｏ１３９群均以Ｄ型为优势分为４个类型（Ａ、Ｂ、Ｃ和Ｄ）,ＥＶＣ和Ｏ１３９群均以Ｄ型我隆,经ｃｔｘＡ基因探针Ｓｏｕｔｈｅｒｍ     

The Tecumseh Study of Respiratory Illness. IX. Occurence of influenza in the community, 1966--1971.

The occurrence of types A and B influenza infections was determined by isolation and serology over six years among residents of Tecumseh, Michigan. By isolation, there was evidence of type A infection for a limited period during each year of the study; most rises in titer were detected during the periods of viral isolation, but some also occurred out of season. Outbreaks of type B infection were encountered three times during the six-year period and out of season infections were less frequently seen than with type A. Infection rates with type A were relatively flat over the age range, with high rates seen in infants and small children; in contrast, highest infection rates with type B were observed in the 5--14-year-olds. On examination of illness rates, it was found that some of the outbreaks wound have gone undetected if surveillance techniques for infection had not been in operation. Frequency of respiratory illness with activity restriction was taken as a guide to influenza virus activity during outbreaks; it was found that highest rates of such illnesses occurred among the 1--4-year-olds for type A outbreaks, and among the 5--9-year-olds during mixed or type B outbreaks.     

上海市1999～2003年流行性感冒流行特征分析

目的了解上海市流感流行特征，探讨流感病毒优势株的变化，为流感防制提供科学依据。方法选择流感监测点，采用流行病学、病原学和血清学方法进行调查。结果1999年流感样病例春秋两季高峰明显．2000年以来季节发病高峰减弱。流感病毒优势株为B型和H1N1型，分别占总病毒分离数的62．81％和32．23％．H3N2亚型活动弱，仅4．96％。1999年主要流行株为B型，2000年为H1N1亚型，2001年以来H1N1亚型和B型交替成为优势株。H1N1亚型病毒抗原性存在某些变异，B型病毒抗原性未发生变异。一般人群流感抗体水平保持较高水平，H3N2、H1N1和B型几何平均滴度(GMT)分别为70．00，67．33和87．67，但小年龄和老年龄组的抗体水平低于成年人。结论上海市近5年流感发病高峰减弱，以B型和H1N1亚型为优势株，其抗原性末发生明显的变异。与我国北方等省H3N2亚型为优势株不同。小年龄和老年人为易感人群。需加强H3N2亚型流感病毒监测，注意H3N2亚型病毒变异引起流行的可能性。     

2009－2015年深圳市不同来源样本中金黄色葡萄球菌毒力耐药特征及分子分型研究

目的 研究2009－2015年深圳市不同来源样本中金黄色葡萄球菌(Staphylococcus aureus,SA)携带毒力、耐药基因、耐药表型情况和分子型别研究。 方法 2009－2015年期间,86株SA分离自医院病人、医院环境涂抹样、食物中毒等样品。PCR方法检测毒力基因、耐药基因以及耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)的SCCmec基因型,进行蛋白A基因多态性(single locus DNA-sequencing of the repeat region of the Staphylococcus protein A gene,Spa)以及多位点序列分型(multilocus sequencing typing,MLST)研究。按照美国临床和实验室标准协会(Clinical and Laboratory Standards Institute,CLSI)方法,对抗菌药物进行药敏试验。 结果 检出21种毒力基因,55株(64.0%)携带mecA基因。SCCmec分型结果,Ⅲ型为优势型别(60.0%,33/55)。86株SA分为24种Spa型,MRSA菌株Spa优势型别为t030与t437,甲氧西林敏感金黄色葡萄球菌菌株(methicillin sensitive Staphylococcus aureus,MSSA)的优势型别为t091与t127。86株SA分为23种 MLST型,形成3个克隆复合体CC239(27.9%)、CCnew3(27.9%)与CC188(11.6%)。 结论 优势型别为ST239(Spa-t030)、STnew3(Spa-t437)具有多药耐药的特征,且携带多种毒力基因。MRSA流行株、非流行株与MSSA在携带毒力与耐药基因之间均存在差异。需要加强监测SA中的优势型别及MRSA菌株.关注其耐药的动态变化。