献血者人类嗜T淋巴细胞病毒Ⅰ／Ⅱ感染情况调查

目的调查苏州地区献血者中人类嗜T淋巴细胞病毒Ⅰ／Ⅱ（HTI-Ⅴ-Ⅰ／Ⅱ）感染状况。方法用酶联免疫吸附试验（ELISA）测定血清中HTI-Ⅴ-Ⅰ／Ⅱ抗体，阳性结果采用免疫印迹法确证。结果随机抽取3608份血清中ELISA初筛阳性11份，经免疫印迹法确证均为阴性。结论苏州地区献血者中未能检出HTI-Ⅴ-Ⅰ／Ⅱ感染者，提示本市人群中HTI-Ⅴ-Ⅰ／Ⅱ感染率低。     

台州地区无偿献血者人类嗜T淋巴细胞白血病病毒感染情况调查

目的了解台州地区无偿献血者中人类嗜T淋巴细胞白血病病毒(HTLV)感染情况。方法采用双抗原夹心酶联免疫法筛检,筛查阳性反应者双孔复检,仍阳性反应者用核酸试验(PCR)及免疫印迹法(WB)进行确证。结果台州本地户籍献血者6 576名发现抗-HTLV-I阳性2例,PCR及WB确证试验仍为阳性(阳性率0.03%),其为无症状定期献血者,均在本市有4次合格献血经历。2例HTLV-I阳性者均分布于台州东南沿海地区。非台州户籍献血者2193名,抗-HTLV结果均为阴性。台州地区无偿献血者抗-HTLV-I阳性率为0.023%。结论目前台州地区无偿献血者人群抗-HTLV感染率尚处于1个较低水平。     

广东中山地区献血人群人类嗜T淋巴细胞病毒感染状况调查

目的了解中山地区人类嗜T淋巴细胞病毒(HTLV)在无偿献血人群中的感染情况。方法对2016年3-12月40 874份在中山地区无偿献血的血液标本,采用酶联免疫吸附试验方法(ELISA)进行HTLV抗体筛查,筛查呈反应性的标本进行双孔复查,复查仍阳性的标本使用免疫化学发光法(CLIA)检测,检测阳性的标本使用免疫蛋白印迹法(WB)进行确证,确证阳性的视为感染。结果中山地区40 874份无偿献血者中HTLV抗体ELISA检测阳性21例,ELISA检测阳性率为0.05%,免疫化学发光法检测阳性5例,WB确证阳性1例,感染率为0.002 4%。结论为了保证输血安全,降低输血感染HTLV,有必要对中山地区的初次献血者进行HTLV的筛查。     

福建省莆田地区献血人群HTL V-Ⅰ/Ⅱ抗体的血清流行率调查

人类嗜T淋巴细胞白血病病毒Ⅰ型和Ⅱ型(HTLV-Ⅰ/Ⅱ)已被认为是T淋巴细胞白血病(ATL)和热带痉挛性下肢瘫痪/HTLV-Ⅰ相关脊髓病(TSP/HAM)的病原因子[1,2,5],可通过血液传播.我国的HTLV-Ⅰ/Ⅱ流行率很低[3], 但已有报道表明福建沿海部分地区有散在流行区[4].为此,笔者进一步调查了莆田地区的献血人群, 发现莆田笏石秀屿一带有较高的流行率,应引起关注.     

贵州黔南地区人群T淋巴细胞白血病病毒Ⅰ/Ⅱ感染情况调查分析

目的调查贵州省黔南地区人群T淋巴细胞白血病病毒Ⅰ/Ⅱ(HTLVⅠ/Ⅱ)的感染情况。方法用酶联免疫吸附试验对贵州省黔南地区一般人群7 280例进行HTLV(Ⅰ/Ⅱ)抗体筛查,阳性结果用蛋白印迹试验(WB)确认。结果经检测有6份标本初检阳性,但经WB确认均为阴性。结论本调查未发现HTLV(Ⅰ/Ⅱ)抗体阳性,要进一步了解感染及流行情况有必要加大调查范围和相关疾病的调查。     

上海地区HTLV-I相关高危人群病毒感染的检测

目的 建立人类T淋巴细胞白血病病毒I(HTLV-I)前病毒的核酸检测方法,对HTLV-I相关高危标本进行检测,初步了解上海地区HTLV-1在相关疾病和高危人群中的流行特点,探讨核酸检测法在HTLV-I高危人群中的检测意义.方法 实验收集了69例淋巴瘤/白血病患者,72例有多次输血史的其他血液病患者以及1例HTLV-I相关脊髓病(HAM)/热带痉挛性下肢瘫痪(TSP)疑诊患者血液标本.采用荧光定量PCR筛查HTLV-1前病毒tax基因,酶联免疫法检测血清HTLV-I/II抗体,对上述2种检测中出现任一阳性结果的标本进一步采用nest-PCR检测HTLV-1前病毒env基因以确定HTLV-I的感染.结果 仅HAM/TSP疑诊患者tax基因扩增出现阳性曲线;ELISA检测标本血清HTLV-I/II抗体均为阴性;nest-PCR扩增env基因未见特异性条带.结论 上海地区小样本HTLV-I相关高危人群中未检出HTLV-I感染;建立的核酸检测方法能对HTLV-I病毒感染进行有效的筛查和确认.     

福建省无偿献血者HTLV-1/2感染情况研究

目的了解福建省无偿献血者人类嗜T淋巴细胞病毒HTLV-1/2的感染情况。方法对福建省9地市血站2016年1月1日至2018年12月31日无偿献血者标本进行抗-HTLV-1/2筛查,抗-HTLV-1/2阳性者留取血浆标本统一送至厦门市中心血站进行Western Blot确认实验;对确认阳性的献血者籍贯、年龄、性别等进行统计和分析。结果福建省2016—2018三年间共有无偿献血者1 015 939人次,抗-HTLV-1/2初筛阳性947例,HTLV-1/2确认阳性254例,总体阳性率为25.0/10万;各地市阳性率差别较大,宁德最高达184.4/10万,漳州最低仅3.7/10万,差异有明显统计学意义(χ²=464.06,P<0.01)。HTLV-1/2阳性献血者籍贯以福建省籍为主(95.8%);HTLV-1/2阳性献血者平均年龄为38.11±9.46,其中福州地区献血者HTLV-1/2阳性率随年龄增长呈上升趋势(χ²=24.16,P<0.01),而厦门地区各年龄段阳性率差异无统计学意义;福州厦门两地男女献血者的阳性率差异都无统计学意义...     

徐州地区TTV感染的流行病学研究

为了探讨徐州地区正常人群中输血传播病毒 (TTV)感染情况及其流行病学特征。用随机整群及分层随机法抽取研究对象 ,在国内首次采用酶联免疫吸附试验 (ELISA)法检测该人群血清中TTVIgG抗体。结果表明 ,对 1268名不同年龄的正常人群调查表明 ,徐州地区正常人群中TTVIgG的总阳性率为 5.36 % ,男女性阳性率分别为 3.81%和 6.67% ,女性略高于男性。年龄、职业、城乡之间TTVIgG阳性率差异无显著性意义。但有手术史和输血史者中TTVIgG阳性率最高 ,分别为 27.27%和 11.48% ,显著高于其它因素者。结果表明 ,徐州地区正常人中TTV感染率与HBV感染率基本相同 ,有手术史和输血史者TTV感染率较高 ,进一步证实血液是TTV传播的重要因素之一 ,同时也提示TTV可能与HBV感染相类似 ,存在“健康携带状态”。     

北京地区献血者HTLV感染情况调查

人类T淋巴细胞白血病病毒(Human T-cell leukemia viruses,HTLV)是20世纪80年代初由美国Poiesz[1]等和日本Miyoshi[2]等分别从成人T细胞白血病患者(ATL)和外周血培养的T细胞中分离出来的一种逆转录病毒。HTLV分为Ⅰ型和Ⅱ型,其感染分布广泛,并呈高度的地方性流行。在我国东南沿海和一些内陆地区有小规模流行     

安徽地区献血人群HTLV感染调查

目的了解安徽地区无偿献血人群人类T淋巴细胞病毒感染状况,为本地区临床用血提供合适的安全筛查策略。方法对安徽省合肥、蚌埠、芜湖、安庆、马鞍山5地区部分献血人群采用ELISA试剂筛查HTLV-Ⅰ/Ⅱ抗体,筛查阳性标本采用蛋白印迹法(Westem blot,WB)确证和核酸检测,同时对献血者进行追踪、检测。结果 5地区共抽检献血者标本100 840份,ELISA法筛查出阳性标本57份,确证结果"不确定"2份,其余全部为阴性;确证阳性率为0%;追踪到献血者8人,结果7人仍为原ELISA试剂筛查阳性,确证结果均无阳性。结论安徽地区为HTLV低流行地区,可以暂不开展献血者HTLV全面筛查。     

Overt and latent HIV 1 and HTLV-I infection in cohorts of at high risk individuals in Argentina

We conducted a survey using serology and polymerase chain reaction assays to detect HIV 1 and/or HTLV-I antibodies and viral DNA, respectively, in 113 intravenous drug abusers and in 62 sexually active high risk individuals attending two Drug Addict Centres and a Centre for Venereal Diseases in Buenos Aires, Argentina. At the time of the survey 137 of these subjects were known to be HIV 1 seropositive but none of them was symptomatic. Serological tests for HTLV-I were found to be positive in 38 (21.7%) of the HIV 1 positive individuals, whereas all of the 38 HIV 1 seronegative subjects were also seronegative for HTLV-I antibodies. Gene amplification assays carried out in blood sample DNA from the 38 HIV 1/HTLV-I seronegative individuals, revealed HIV 1 DNA in six out of 28 intravenous drug abusers (21.5%). One subject (2.6%) was positive for both HIV 1 and HTLV-I DNA sequences, whereas four (10.5%) showed HTLV-I DNA only. To determine whether these individuals were infected with HTLV-I and/or HTLV-II, DNA samples were also amplified with HTLV-II specific primers and no evidence of HTLV-II infection was observed. None of the subjects seroconverted according to conventional serological tests during the 2 year follow-up period. The 10 seronegative subjects belonging to the sexual risk group were negative for both HIV 1 and HTLV-I in polymerase chain reaction assays. We conclude that not only HIV 1, but also HTLV-I is a widely spread infection in intravenous drug abusers and sexually active high risk individuals in Argentina.(ABSTRACT TRUNCATED AT 250 WORDS)     

浙江省余姚市人群乙型病毒性肝炎血清流行病学调查分析

目的　调查余姚市人群乙型病毒性肝炎（乙肝）血清学感染状况。方法　2006年7-9月在余姚市范围内，按照整群随机抽样的方法调查了4个村的1岁以上59岁以下各年龄组自然人群，对1346名对象乙肝疫苗接种情况以及主要危险因素进行问卷调查。采集每名对象静脉血，利用酶联免疫吸附试验检测HBV五项血清学指标。结果　5岁以下儿童HBsAg阳性率为0.74%，调查对象HBsAg、抗 HBs、抗 HBc阳性率以及HBV总流行率分别为5.35％（95%CI:4.15～6.55），54.68％（95%CI:52.02～57.34），35.88％（95%CI:33.32～38.44），36.62％（95%CI:34.05～39.19）；年龄标化率分别为7.46%、51.55%、48.13%和48.92%。结论　乙肝预防和控制工作已取得成效，余姚市5岁以下儿童HBsAg阳性率已降至1％以下，全人群HBsAg阳性率已经降至5.5％以下。     

Factors Secreted by Human T Lymphotropic Virus Type I (HTLV-I)–infected Cells Can Enhance or Inhibit Replication of HIV-1 in HTLV-I–uninfected Cells: Implications for In Vivo Coinfection with HTLV-I and HIV-1

It remains controversial whether human T lymphotropic virus type I (HTLV-I) coinfection leads to more rapid progression of human immunodeficiency virus (HIV) disease in dually infected individuals. To investigate whether HTLV-I infection of certain cells can modulate HIV-1 infection of surrounding cells, primary CD4⁺ T cells were treated with cell-free supernatants from HTLV-I–infected MT-2 cell cultures. The primary CD4⁺ T cells became resistant to macrophage (M)-tropic HIV-1 but highly susceptible to T cell (T)-tropic HIV-1. The CC chemokines RANTES (regulated on activation, normal T cell expressed and secreted), macrophage inflammatory protein (MIP)-1α, and MIP-1β in the MT-2 cell supernatants were identified as the major suppressive factors for M-tropic HIV-1 as well as the enhancers of T-tropic HIV-1 infection, whereas soluble Tax protein increased susceptibility to both M- and T-tropic HIV-1. The effect of Tax or CC chemokines on T-tropic HIV-1 was mediated, at least in part, by increasing HIV Env-mediated fusogenicity. Our data suggest that the net effect of HTLV-I coinfection in HIV-infected individuals favors the transition from M- to T-tropic HIV phenotype, which is generally indicative of progressive HIV disease.     

Evaluation of a combined lysate/recombinant antigen anti-HTLV-I/II ELISA in high and low endemic areas of HTLV-I/II infection

SUMMARY. The Wellcozyme HTLV-I/II ELISA (Murex Diagnostics) was evaluated in 7800 samples of various serum panels. Repeat reactivity was found by Wellcozyme in (A) 1/2181 (0.05%) Dutch blood donors, (B) 44/3036 (1.4%) Curaçao (Caribbean area) blood donors, (C) 46/2533 (1.8%) individuals of different Ethiopian population subsets, (D) 30/30 (100%) confirmed anti-HTLV-I positive samples and (E) 20/20 (100%) HTLV-II PCR-positive samples. All 91 Wellcozyme-positive samples were tested for confirmation by Western blot (WB, Diagnostic Biotechnology). Among Wellcozyme HTLV-I/II ELISA-positive individuals, HTLV-I/II WB positivity was found in 0/1 Dutch blood donors, 40/44 (88.9%) Curaçao blood donors and 20/46 (43.5%) Ethiopian individuals. HTLV-I positivity was found in 40 (1.3%) WB-positive Curaçao blood donors and in 9 (0.35%) Ethiopian individuals. HTLV-II positivity was found in 11 (0.43%) WB-positive Ethiopian individuals. The Wellcozyme HTLV-I/II ELISA had a specificity of 99.95% in Dutch blood donors and a sensitivity of 100% in confirmed HTLV-I- and HTLV-II-positive samples. In Ethiopia 55% of the HTLV-I/II WB-positive individuals were exclusively HTLV-II positive, whereas in Curaçao no HTLV-II infections were found.     

Idiopathic TTP in the Middle East: Epidemiology and clinical outcomes in infection associated episodes

IntroductionLiterature on epidemiology of thrombotic thrombocytopenic purpura (TTP) in the Middle East is scarce.Materials and methodsWe prospectively examined the association between infection and clinical outcomes in 44 patients with idiopathic TTP, with severely deficient ADAMTS13. We also investigated seasonality of the disease, hoping to better understand the epidemiology of idiopathic TTP.ResultsSummer demonstrated significantly lower incidence for idiopathic TTP, compared with other seasons P = 0.0003. Fourteen patients had 15 episodes with a suspected concomitant infection. Five initial episodes were triggered by an infection (33.3 %), all presenting in winter, six episodes were associated with an exacerbation (40 %) and infection triggered a relapse in the other four episodes (26.7 %), with 2 episodes presenting in winter.TTP associated infections included: central line infection, urinary tract infection and post-operative infection. One patient had respiratory tract infection, on both his initial and relapsing episodes. Refractoriness to treatment was demonstrated in 4 patients (28.6 %) and it was associated with dental abscess (one patient), septic shock (one patient) and Mycoplasma pneumonia (2 patients). All 4 patients had markedly elevated CRP values with a median of 335 mg/L.ConclusionMost of the infection associated episodes developed in winter (77.8 %).In patients with idiopathic TTP refractory to conventional treatment, infection should be seriously considered as an additional contributing factor for their initial and /or recurrent episodes, particularly when CRP is markedly elevated.     

严重感染患者急性时相蛋白的临床研究

目的 为了探讨急性时相蛋白在严重感染患者发病过程中的变化及其诊断价值。方法 采用全自动散射比浊定量分析法测定30例严重感染患者CRP.α_1—AT、α_1—AG及HP的含量和动态变化,并与30例轻症医院感染患者及30例正常人对照分析,结果 严重感染患者首次测定CRP、α_1—AT,α_1—AG及HP含量均显著高于轻症感染组和正常组(P值分别<0.01)。动态观察发现急性时相蛋白随着病情好转逐渐降至正常范围,轻症感染患者仅α_1—AG差异显著(P<0.05)。结论 CRP、α_1—AT、α_1—AG及HP的定量分析能尽早发现医院感染,准确判断其严重程度及预后具有重要价值。CRP持续升高、α_1—AG和HP迅速下降则提示病情恶化。     

Epidemiological survey on the route of Coxiella burnetii infection in an animal hospital

The source of Q fever infection, was investigated by serological and polymerase chain reaction (PCR) analysis of specimens from humans and pets in an animal hospital. Two animal health technicians showed a positive serological reaction against Coxiella burnetiiat the start. One of the two positive subjects remained PCR-positive for about 1 year and the other converted to PCR-negative, but the IgG antibody titer remained at 1 : 128 after minocycline treatment. Among animals housed in the hospital, two dogs were PCR-positive at the start, and the infection was transmitted to three cats about 5 months later. All these animals became negative for C. burnetii DNA after minocycline treatment. Furthermore, C. burnetii was isolated from the sera of the two humans and two dogs. C. burnetiiisolates from the humans and dogs were analyzed, and it was found that the sequence homology of the com1 region was high, 99.9%, and the QpH1 plasmid was detected. These results suggest that these isolates were the same type, and it was considered that the infection was derived from the dogs, though the time of infection could not be confirmed.     

重庆城市体检人群幽门螺杆菌感染3年流行趋势分析

目的调查分析重庆城市人口幽门螺杆菌感染三年来的流行病学趋势,为胃肠道疾病的保健预防奠定基础。方法采集统计2008-2010年来我院体检人群血清标本共27177例,用免疫胶体金法检测血清幽门螺杆菌尿素酶抗体,将结果在男、女性别组,各年龄组,职业间以及各年份间分别比较分析。结果三年来,总样本的阳性感染率为34.2%;男女性别感染率分别为35.7%和31.7%;2008-2010年份的总感染率分别为37.1%,33.5%和33.1%。结论男女组性别感染率有显著性差异;年龄组间比较中50-59岁年龄段的感染率有显著性差异（P〈0,05）;感染率和职业相关;三年感染率变化有显著性差异（P〈0.05）,且呈下降趋势。     

艰难梭菌感染：一种新的威胁

艰难梭菌是住院患者抗生素相关性腹泻的重要病因。近年来,由于艰难梭菌高毒力株的出现,导致感染人数明显增多,疾病严重程度增加,已成为一种新的威胁。艰难梭菌感染（clostridium difficile infection,CDI）的诊断应结合临床表现和实验室检查两方面。合理使用抗菌药物是减少CDI最根本有效的方法,另外,应加强院内感染控制措施以控制感染的传播。     

医院分离深部真菌菌株流行病学调查和药敏试验研究

目的了解广东地区医院近年深部真菌感染的动态变化，为临床经验性治疗提供依据。方法回顾分析了1998-2004年我科真菌室接受的疑诊为深部真菌感染的标本9574份，分离出阳性标本3122份（阳性率32．6％），共13个菌种。药敏试验采用浓度梯度法。结果真菌学变化：白念珠菌近3年所占构成比：白念珠菌在2002-2004年组所占构成比与1998-2001年组相比显著下降（76．3％、66．8％比较，r=34．33，P〈0．05）；光滑念珠菌、近平滑念珠菌构成比显著增加（4．2％、11．1％比较，X^2=51．30，P〈0．05，2．2％、4．o％比较,X^2=8．82，P〈0．05）；马内菲青霉菌近年呈现增多趋势。药敏试验：2000-2004年703株真菌菌株药敏试验结果显示，对伊曲康唑、氟康唑、酮康唑、两性霉素的耐药株均无增加趋势，伊曲康唑敏感株显著减少（71．0％、58．2％比较X^2=16．50，P〈0．05），中介株显著增多（7．8％、24．8％比较,X^2=24．8，P〈0．05），其中以白念珠菌、热带念珠菌对伊曲康唑敏感株减少为主。结论白念珠菌近年所占构成比显著下降；光滑念珠菌、近平滑念珠菌构成比显著增加；出现了新的感染菌株马内菲青霉菌。白念珠菌、热带念珠菌对伊曲康唑敏感株显著减少。此种真菌菌学变迁及药敏试验的变化应引起临床医师重视。