我国5岁以下儿童小肠结肠炎耶尔森菌感染临床特征及病原学分析

目的 了解我国5岁以下儿童小肠结肠炎耶尔森菌腹泻病例临床与病原学特征,分析其可能的感染来源,为小肠结肠炎耶尔森菌病的防控与诊断提供科学依据。 方法 收集2010—2020年间来自全国10个省市自治区哨点医院儿童腹泻标本、调查及回访问卷;对标本进行小肠结肠炎耶尔森菌的分离鉴定;菌株进行生物分型、血清型鉴定;毒力基因检测以及脉冲场凝胶电泳(pulsed field gel electrophoresis,PFGE)分型。 结果 2010—2020年共监测11 377例,分离到致病性小肠结肠炎耶尔森菌63株,包括61株O:3血清型、2株O:9血清型菌株,5岁以下腹泻儿童感染率0.55%(63/11 377)。不同性别儿童对致病性小肠结肠炎耶尔森菌的感染率差异无统计学意义,1～5岁感染率高于≤1岁病例(χ²=44.836,P＜0.05),感染患儿中1～5岁发热比例高于≤1岁(χ²=11.508 ,P<0.05),随访病例未发现后遗症。我国儿童感染O:3血清型致病性小肠结肠炎耶尔森菌的PFGE带型存在多样性,优势带型为K6GN11C30021、K6GN11C30012。 结论 我国5岁以下儿童感染致病性小肠结肠炎耶尔森菌的生物血清型以3/O:3为主,偶有4/O:3与2/O:9。根据患儿感染特点与高发季节推测食源为主要感染来源,需进一步调查研究。     

黄石市家畜家禽中小肠结肠炎耶尔森菌调查

[目的]了解黄石市常见家禽家畜中小肠结肠炎耶尔森菌的分布特性。[方法]采集常见家禽家畜粪便,共计1 590份,进行小肠结肠炎耶尔森菌检测和鉴定。[结果]1 590份样品中,检出小肠结肠炎耶尔森菌34株,阳性率为2.13%。分离到O:1、O:3、O:5、O:8、O:9等5种血清型的菌株。猪的检出率4.60%显著地高于其他家畜家禽(P﹤0.01)。1~3月和10~12月所分离的菌株,占全年菌株的55.88%,高于4~9月的44.12%。[结论]本地区家畜家禽中存在小肠结肠炎耶尔森菌的感染,以O:9型为主。应加强本地区牲畜监管,防止人感染耶氏菌。     

我国腹泻病患者和家畜家禽粪便标本中携带小肠结肠炎耶尔森氏菌HPI毒力岛的大肠杆菌的调查

目的　了解携带小肠结肠炎耶尔森氏菌HPI毒力岛的大肠杆菌在我国腹泻病患者粪便标本、动物粪便标本及部分食品标本中的存在情况和所致腹泻病的临床特征。方法　使用菌落原位杂交、DNA打点杂交和PCR扩增等方法。结果　在各地送检的从腹泻病患者粪便标本中分离到的、用常规方法不能鉴定的大肠杆菌中 ,均检出带有小肠结肠炎耶尔森氏菌HPI毒力岛的大肠杆菌菌株 ,检出率为 2 7.0 5 % (436 / 16 12 )。从市售食品标本中分离的大肠杆菌中 ,携带小肠结肠炎耶尔森氏菌HPI毒力岛的大肠杆菌的检出率为 10 .2 3% (9/ 88)。从家畜家禽粪便中分离的大肠杆菌中 ,携带小肠结肠炎耶尔森氏菌HPI毒力岛的大肠杆菌检出率为 5 .71% (16 / 2 80 )。携带小肠结肠炎耶尔森氏菌HPI毒力岛的大肠杆菌所致腹泻的典型临床表现为食欲不振、腹痛、寒战乏力、正常体温或低热、每日腹泻多在 6次以上、多为粘液便。结论　携带小肠结肠炎耶尔森氏菌HPI毒力岛的大肠杆菌在我国分布广泛 ,检出率高于其他几类致泻性大肠杆菌 ,对我国人民的健康是一个潜在的威胁     

小肠结肠炎耶尔森菌O∶9血清型特异性单克隆抗体筛选及其应用

目的利用杂交瘤技术筛选出能分泌小肠结肠炎耶尔森菌O∶9血清型特异性单克隆抗体的细胞株,用于该型菌株的鉴定。方法采用ELISA方法筛选克隆株,并用玻片凝集法进行单克隆抗体的特异性鉴定。结果筛选到3株能分泌小肠结肠炎耶尔森菌O∶9血清型特异性单克隆抗体的杂交瘤细胞株,分泌的抗体与经鉴定的18株小肠结肠炎耶尔森菌O∶9血清型菌株呈阳性反应,而与其他血清型小肠结肠炎耶尔森菌及常见肠道致病菌无交叉凝集反应;应用于小肠结肠炎耶尔森菌野生株分型鉴定时,能准确鉴定出其中的24株O∶9血清型菌株,与用日本进口分型血清鉴定、PCR毒力基因检测结果相同。结论筛选获得的细胞株产生的单克隆抗体,用于小肠结肠炎耶尔森菌O∶9血清型鉴定,具有很好的型特异性,避免了过去免疫血清制备中繁琐的抗原交叉吸收试验。     

吉林省小肠结肠炎耶尔森氏菌生物学特性研究

目的 了解吉林省小肠结肠炎耶尔森氏菌生物学特性。方法 利用血清学、生物化学、分子生物学技术对78株检出菌进行分析。结果 78株小肠结肠炎耶尔森氏菌分出O：3和O：9两个血清型，生物型为3型；毒力基因分布特征为ail^＋、ystA^＋、ystB^-、yadA^＋、virF^＋占60．0％，ail^＋、ystA^＋、ystB^-、yadA^-、virF^-占26．2％，其他型占13．8％；脉冲场凝胶电泳（PFGE）分出2个克隆系7个基因型。结论 利用上述方法能很好分析吉林省小肠结肠炎耶尔森氏菌生物学特性，探讨小肠结肠炎耶尔森氏菌遗传关系，追踪传染源。     

小肠结肠炎耶尔森菌O:9血清型特异性单克隆抗体筛选及其应用

目的利用杂交瘤技术筛选出能分泌小肠结肠炎耶尔森菌O：9血清型特异性单克隆抗体的细胞株,用于该型菌株的鉴定.方法采用ELISA方法筛选克隆株,并用玻片凝集法进行单克隆抗体的特异性鉴定.结果筛选到3株能分泌小肠结肠炎耶尔森菌O：9血清型特异性单克隆抗体的杂交瘤细胞株,分泌的抗体与经鉴定的18株小肠结肠炎耶尔森菌O：9血清型菌株呈阳性反应,而与其他血清型小肠结肠炎耶尔森菌及常见肠道致病菌无交叉凝集反应;应用于小肠结肠炎耶尔森菌野生株分型鉴定时,能准确鉴定出其中的24株O：9血清型菌株,与用日本进口分型血清鉴定、PCR毒力基因检测结果相同.结论筛选获得的细胞株产生的单克隆抗体,用于小肠结肠炎耶尔森菌O：9血清型鉴定,具有很好的型特异性,避免了过去免疫血清制备中繁琐的抗原交叉吸收试验.     

2005-2011年河南省小肠结肠炎耶尔森菌分布状况

目的 了解2005-2011年河南省小肠结肠炎耶尔森菌分布情况.方法 于2005-2011年在监测点郑州、睢县和登封采集腹泻患者粪便标本,各种家禽家畜的粪便标本,苍蝇,以及生、熟肉制品涂抹标本,共6700份.采用冷增菌方法进行目的菌分离.对不同宿主样品中分离到的小肠结肠炎耶尔森菌进行系统生化鉴定、血清学分型、生物分型和毒力基因PCR检测.结果 从11种常见宿主和食品中共分离到216株小肠结肠炎耶尔森菌,29.6％ (64/216)分离自猪.所分离的小肠结肠炎耶尔森菌主要流行的血清型是0∶5和0∶8,所占比例分别为23.2％(50/216)和20.4％(44/216);生物分型以1A型为主,占84.7％ (183/216);不同宿主的优势血清型及生物分型各不相同;猪分离株中致病性菌株最多,为16株,其次是腹泻患者和犬分离株,均为6株.结论 河南省小肠结肠炎耶尔森菌宿主分布广泛,猪是主要宿主.     

哈尔滨市腹泻儿童携带ystB基因Y.e的分子流行病学研究

目的了解哈尔滨市儿童腹泻患者携带ystB基因小肠结肠炎耶尔森菌的分子流行病学特征。方法通过PCR扩增患儿ystB基因,通过血清凝集实验及生化反应分析其血清型和生物型。结果所分析418例腹泻患儿中,有3例为小肠结肠炎耶尔森菌ystB基因阳性表达;均为生物1A型;检测到血清型O∶6者2例,O∶8者1例。结论 ystB基因阳性表达者均为生物1A型小肠结肠炎耶尔森菌;血清型以O∶6略多。     

小肠结肠炎耶尔森氏菌O_3血清型生物3型菌株的致病性

许多国家已经报道小肠结肠炎耶尔森氏菌 O3血清型生物4型、O8血清型生物1型、O9血清型生物2型和 O5∶27血清型生物2型菌株是引起人胃肠炎及导致败血症或继发性后遗症(如关节炎等)的病原菌。在日本,已从临床病例及健康动物中分离到 O3血清型生物4型菌株。但有学者从临床和健康猪体内分离到一种属于 O3血清型生物3型的小肠结肠炎耶尔森氏菌,该菌株发酵乳糖、木糖和山梨糖,VP 反应阴性。本文作者从临床     

1997-2010年宁夏回族自治区小肠结肠炎耶尔森菌致病性的基因特征

目的 了解宁夏回族自治区小肠结肠炎耶尔森菌主要毒力基因分布情况和致病性小肠结肠炎耶尔森菌分子分型特征。方法 于1997-2010年在宁夏回族自治区共分离得到283株小肠结肠炎耶尔森菌,用PCR法分析其黏附侵袭位点基因(ail)、耐热肠毒素A基因（ystA）、ystB、黏附素基因（yadA）、毒力活化因子基因（virF）;应用限制性内切酶Not Ⅰ酶切致病性小肠结肠炎耶尔森菌染色体DNA进行脉冲场凝胶电泳(PFGE),利用BioNumerics软件进行聚类分析。结果 209株O∶3、O∶9血清型小肠结肠炎耶尔森菌中ail、ystA、yadA、virF毒力基因阳性,ystB为阴性的占97.6％( 204/209);O∶8血清型和未开展血清分型的菌株5种毒力基因全部阴性;11株O∶5血清型有9株5种毒力基因全部阴性。将致病性菌株进行PFGE分型,根据染色体DNA的Not Ⅰ酶切图谱,将29株O∶3血清型分成12个PFGE带型,包含5株以上的优势PFGE带型有2种。180株O∶9血清型菌株分成13个PFGE带型,包含10株以上的优势PFGE带型有4种,各自是从同一地区猪与家鼠、猪与犬、猪与野兔分离。结论 宁夏地区O∶3、O∶9血清型小肠结肠炎耶尔森菌具有致病性,O∶3逐步成为如今的优势血清型;O∶5、O∶8与血清未分型的菌株无致病性。     

Brucellosis: serological methods compared.

At least 12 persons contracted clinical, and 4 persons subclinical Brucella melitensis infection during a brucellosis epidemic in the spring and summer of 1983 in Southern Germany, a region which had been free of this disease for the past 20 years. All cases of illness were traced to one infected herd of sheep. The presence of antibodies against B. melitensis was examined in 72 sera of infected patients using the following tests: agglutination, Coomb''s test, two complement fixation tests with different antigen preparations (CFT 1 and 2), IgG and IgM enzyme-linked immunosorbent assay (ELISA), and opsonophagocytosis; and the occurrence of cross-reacting antibodies against Yersinia enterocolitica O 9 was investigated in the agglutination and complement fixation tests. Sera from 100 blood donors and 112 other people with close contact with sheep were also examined. The results revealed the need to consider an intermediate range in the interpretation of ELISA results--due to elevated values of persons in groups at risk but without clinical signs of illness. In all other tests, however, such persons revealed the same cut-off levels as the general population. Results from all initial sera of infected persons revealed titres of optical densities above the baseline levels determined in the present study, with the exception of the Coomb''s and CFT2 tests. The agglutination test, but not brucella CFT2, revealed complete cross-reactivity between Y. enterocolitica O 9 and B. melitensis. ELISA stood out as the only test which is suited to diagnosis of both recent and past infection, since ELISA IgM determination permits conclusions about the time of the onset of illness, and determination of IgG may still yield values above the cut-off level up to 623 days after the onset of illness. In 2 of the 16 infected persons, IgG ELISA was the only test revealing previous infection 424 and 528 days after the onset of illness. A procedural scheme is presented which may help to simplify the diagnosis of brucellosis.     

Association between clinical presentation, biogroups and virulence attributes of Yersinia enterocolitica strains in human diarrhoeal disease.

Traditionally the enteric pathogen Yersinia enterocolitica has been differentiated into biogroups. Despite being considered as non-pathogenic, biogroup 1A isolates have constituted a sizeable fraction of strains from patients with gastroenteritis in many reports. To establish a potential clinical significance for biogroup 1A isolates of Y. enterocolitica, clinical disease in patients with gastroenteritis excreting such isolates was compared with symptoms among patients found infected with pathogenic biogroups. Clinical data and isolates of 66 patients from whom Y. enterocolitica had been isolated by direct plating were available for study. There was an association between patient age below 3 years and infection with ''pathogenic'' Y. enterocolitica. The severity of gastroenteritis and other symptoms, however, did not depend on the biogroup, or the presence of the virulence plasmid in the yersinia strain isolated from the patients. Strains belonging to biogroup 1A of Y. enterocolitica showed two clusters of ribotypes, one of which encompassed most isolates recovered from humans, the other being associated with environmental isolates. This might indicate the existence of human-adapted and potentially pathogenic strains among biogroup 1A of Y. enterocolitica.     

麻疹显性感染的血凝抑制抗体临界滴度的观察

本文报道浙江省临安县青云中学在麻疹显性感染时的HAI抗体临界水平及显性感染后的HAI抗体滴度。初三(1)班27名学生HAI抗体都在1:4以上,GMT=1:28.12,采血后无麻疹病人发生。而初一(2)班42名学生的GMT=1:4.56,群体免疫水平很低,采血后发病的12例麻疹病人中,HAI抗体滴度<1:2的显性感染率为80%;1:2的为43%;1:4的为17%;1:8以上未见显性感染病人。结果表明,有低的HAI抗体者接触麻疹后是可以发生显性感染的。     

2005年枣庄市街头早点卫生状况调查

[目的]掌握枣庄市区早点摊位及其从业者的卫生状况，为卫生监督提供科学依据。[方法]对集中的早点摊位群和市区主要街道散在早点摊位从业者的卫生知识、健康状况、餐具消毒及环境条件进行调查。[结果]街头早点从业人员的卫生知识知晓率为45．0％。从业者中，农民及失业人员下岗人员占85．4％，初中及以下文化水平者占95．4％。无固定房屋者占64．8％。无污水处理措施者达到32．8％。食品卫生许可证办证率90．6％。从业人员健康证持有率85．5％。[结论]市区内街头摊位的食品卫生存有严重问题，对消费者存有健康安全隐患，必须加强监督管理。     

小肠结肠炎耶氏菌0:9,0:3型混合感染引起小儿腹泻的流行病学调查

本文报告从福建省莆田市一例小儿腹泻病人的粪便标本和患家周围放养的猪粪便中,分别分离出相同的两种血清型(0:9,0:3)的耶氏菌菌株;其中:0:9型菌数都占优势,这是一例以0:9型为主的混合感染的病例;该患者其腹泻病程较长,用抗菌素治疗有效。流行病学调查结果表明:猪为该病的主要传染源;因此,加强家畜粪便管理,对控制耶氏菌病有极为重要的意义。     

Infection with influenza A/Victoria virus in Houston families, 1976.

In 1976, an epidemic caused by infections with an influenza virus antigenically similar to A/Victoria/75 (H3N2) occurred in Houston, Texas. During this outbreak, 37 families (155 members) enrolled in the Houston Family Study were under observation. The families lived throughout the metropolitan area (Houston, Texas), and were representative of low income groups. The overall frequency of infection in family members was 27.7%. The frequency of infection was the highest for infants under one year of age and for their older siblings, 14 (37.8%) of 37 and 17 (33.3%) of 51, respectively. Eighteen (48.6%) of the 37 families had at least one infected member. Twelve of the 18 ''infected'' families had school aged children, whereas only three of the 19 ''non-infected'' families had school aged children (P less than 0.01). These infected families were also larger and had increased household density (persons/rooms). The levels of pre-existing HI antibodies to A/Victoria/75 and A/Port Chalmers/73 were inversely related to frequencies of infection and illness associated with A/Victoria/75 virus. Three children required hospitalization as direct consequence of their infection with this H3N2 influenza virus. Antibody response to infection was related to previous experience with antigenically-related influenza A (H3N2) viruses according to Francis'', ''doctrine of original antigenic sin.''     

Improving nutrition at breakfast and after school clubs

Background: The Government's mandatory standards for ‘ school food other than lunches’ were introduced in 2007 (School Food Trust) to ensure there are consistent messages about good, nutritious food across the extended school day. All maintained primary, secondary and special schools in England are legally obliged to comply with the standards. With childhood obesity levels increasing, it is essential that all schools are committed to meeting these standards. The aim of this study was to carry out independent audits of all breakfast and after school clubs at Royal Borough of Kensington and Chelsea primary schools in both 2009 and 2010, aiming to assess whether or not the foods and drinks being served were compliant. Methods: Two separate audit tools were used (one for breakfast and one for after school clubs) to record not only the food and drink items served, but also whether staff were aware of the standards, numbers attending, free school meal entitlement, cost to attend and cooking facilities available. These were developed in‐house by the Nutrition and Dietetics Service. Specific food and drinks observed on the day were recorded and notes made about food and drinks available on other days or at other times of the year. The first round of audits were conducted from February to March 2009, before training on the standards was promoted to all clubs and delivered in January and February 2010. The second round of audits took place between May and July 2010. After each audit, schools were sent a clear and concise report of the findings and given explicit information about whether they were meeting the standards. Results: A total of 18/19 (95%) of breakfast clubs and 15/15 (100%) of after school clubs consented to be audited in 2009. In 2010, audits were carried out in 22/22 (100%) breakfast clubs and 17/17 (100%) of after school clubs. The number of breakfast clubs meeting the standards increased from 50% (9/18) to 68% (15/22). For after school clubs, the increase was from 20% (3/15) to 47% (8/17). Furthermore, the average number of areas in which each club was failing dropped from 1.8 to 1.3 for breakfast clubs and from 3.1 to 2.1 for after school clubs. However, these changes were not associated with attendance of the training session. Club performance against the standard was also not correlated with reported staff awareness of the standards. Discussion: Although there has been much improvement in the standard of food served at breakfast and after school clubs in the past year, many more changes could have been made had some schools been more proactive about the suggestions given in their original reports. Attendance at the training session appeared to have no bearing on staff awareness of the standards or club performance. Key problem areas have been highlighted for both breakfast clubs (fruit provision and drinks) and after school clubs (confectionery items, drinks and fruit), which will be useful in guiding further initiatives to improve menus. A study by Waddington et al. (2003) is one of few published works looking at breakfast club nutrition, although it highlights the substantial contribution a nutritionally balanced breakfast can make to a child's overall intake, and thus the importance of further work with schools to tackle this area. Conclusions: Although the training session provided a wealth of information about the standards, including tools for self‐auditing, staff have indicated that they required more in‐depth support, including information on providing food to fit a tight budget, portion sizes, the types of foods that are permitted, and menu ideas that appeal to children. Providing a nutrition resource with recipes to meet all these requirements may therefore be a good way to ensure that all clubs can meet the standards. References: School Food Trust (2007) A Guide to Introducing the Government's New Food‐Based Standards for All School Food Other than Lunches. Sheffield: School Food Trust. Waddington, S, Rees, G. & Frost, G. (2003) Nutrient intake of children consuming breakfast at school clubs in London. J. Hum. Nutr. Diet. 16 , 368–369.     

Skipping breakfast is associated with diet quality and metabolic syndrome risk factors of adults

The aim of the present study was to assess the effects of skipping breakfast on diet quality and metabolic disease risk factors in healthy Korean adults. Subjects included 415 employees (118 men, 297 women; 30-50 years old) of Jaesang Hospital in Korea and their acquaintances. Data collected from each subject included anthropometric measurements, 3-day dietary intake, blood pressure, and blood analyses. The subjects were classified into three groups based on the number of days they skipped breakfast: ''Regular breakfast eater'', ''Often breakfast eater'', or ''Rare breakfast eater''. Participants in the ''Rare breakfast eater'' group consumed less rice, potatoes, kimchi, vegetables, fish and shellfish, milk and dairy products, and sweets than did participants in the other two groups (P for trend < 0.05) and ate more cookies, cakes, and meat for dinner (P for trend < 0.05). Participants in the ''Rare breakfast eater'' group consumed less daily energy, fat, dietary fiber, calcium, and potassium than did participants in the other groups (P for trend < 0.05). The percent energy from carbohydrates was lower and fat intake was higher in the ''Rare breakfast eater'' group than in the other groups (P for trend < 0.01). When diets were compared using the Acceptable Macronutrient Distribution Range for Koreans, 59.1% of subjects in the ''Rare breakfast eater'' group consumed more energy from fat compared with the other two groups (P < 0.005). According to the Estimated Average Requirements for Koreans, intake of selected nutrients was lower in the ''Rare breakfast eater'' group than in the other two groups (P < 0.05). The risk of elevated serum triglycerides was decreased in the ''Rare breakfast eater'' group (OR, 0.3 [0.1-1.0], P for trend = 0.0232). We conclude that eating breakfast regularly enhances diet quality, but may increase the risk of elevated serum triglycerides.     

内蒙古呼和浩特市中小学学生早餐现状调查

目的了解内蒙地区呼和浩特市中小学学生的早餐现状及对早餐的认识、态度等,为有针对性地开展相关的营养教育提供依据。方法采用分层整群随机抽样方法,对选中的6所中小学校的878名学生进行问卷调查。结果小学生每天吃早餐的占89．2％,初中生占85．4％,高中生占84．7％,差异无统计学意义;早餐中每天和经常有牛奶的小学生占55．1％,初中生占33．o％,高中生占30．3％,差异有统计学意义（x2=203,P=0．000）;认为不吃早餐会对学习状态或身体有影响的小学生占61．1％,初中生占75．2％,高中生占76．1％,差异有统计学意义（x2=22．172,P=0．000）;不吃早餐的原因主要是太忙了没时间吃,初中和高中生的比例分别是55．1％和59．6％;其次是起得早没胃口,初中和高中生的比例分别是16．0％和14．8％。结论学生吃早餐的比例稍低,部分学生对早餐重要性认识不足,学校应对学生及家长进行相关的营养教育,以促进学生的健康成长。     

An outbreak of Trichinella spiralis infection in southern Lebanon.

An outbreak of trichinosis occurred during January 1995 in a south Lebanese village with a population of 800-1000 persons. The estimated number of persons treated for a Trichinella-like illness was 200. Sixty-three persons sought medical attention at a local infirmary: 44 of them were diagnosed as having trichinosis or suspected trichinosis according to their clinical symptoms, signs and laboratory tests. An environmental investigation indicated that the source of infection was pork obtained from a single butcher in the village and consumed uncooked, as an ingredient of ''kubeniye'' (a local dish), during Christmas and New Year''s meals. Sera of patients, suspected patients, and asymptomatic controls were tested for the presence of anti-Trichinella antibodies. Eight (89%) of the 9 tested patients were positive, 1 (11%) was negative. Among the 7 suspected patients, 2 (28.5%) were positive, 3 (42.9%) had equivocal results, and 2 (28.5%) were negative. Among the 20 asymptomatic persons, 3 (15%) were positive, 12 (60%) negative and 5 (25%) had equivocal results. Specimens from the implicated pork meat were examined by microscopy and were found to contain encysted larvae of Trichinella spiralis. This outbreak of trichinosis is one of the largest reported. Previous outbreaks in Lebanon occurred under very similar circumstances, indicating a need to control and prevent the trading of pork meat that is not under veterinary control, and to increase the awareness of the population for this problem.