2011-2013年阳江市沙门氏菌监测结果分析

目的:了解阳江市腹泻患者沙门氏菌感染血清型分布及耐药情况,为指导临床用药及提高食源性疾病暴发监测及响应能力提供依据.方法:采集监测医院门诊腹泻患者粪便标本进行沙门氏菌分离鉴定,阳性菌株进行血清分型及耐药性检测.结果:2011-2013年共监测病例粪便标本2893份,阳性227份,总体阳性率为7.85%,共分离出沙门氏菌血清型33种,其中鼠伤寒沙门菌变种(占总分离菌株32.6%)和鼠伤寒沙门菌(占总分离菌株21.1%)为主要的血清型.21种测试抗生素药物敏感性试验结果显示,沙门氏菌对美罗培南和舒普深尚未产生耐药,对其余19种测试药物均显示有不同程度的耐药性,其中对氨苄西林,哌拉西林,复方磺胺耐药率超过50%,对头孢唑啉,头孢噻吩,头孢呋辛,庆大霉素,阿米卡星,妥布霉素耐药率100%.结论:鼠伤寒沙门菌变种和鼠伤寒沙门菌是当前本地区主要的感染血清型,当地沙门氏菌耐药现象严重.     

广东省2007年度非伤寒沙门菌监测及病原学特征分析

目的 了解广东省腹泻病患者中非伤寒沙门菌感染情况和菌株的血清型别、分布、耐药性变化.方法 对纳入研究的腹泻病患者进行非伤寒沙门菌检测,对分离到的菌株进行血清分型、药物敏感性试验和脉冲场凝胶电泳(PFGE)分型.结果 2007年度共检测1128份腹泻粪便标本,分离到71株沙门菌,阳性检出率为6.29%;共分得29种血清型,肠炎和鼠伤寒沙门菌居多;大多数沙门菌对常用的头孢类和喹诺酮类抗生素敏感,鼠伤寒沙门菌的耐药率普遍较肠炎和斯坦利沙门菌高;除肠炎沙门菌外,其余的血清型没有同一PFGE型别的菌株;用Xba Ⅰ酶切17株肠炎沙门菌可分为PFGE-XbaⅠ 1～8型,其中PFGE-XbaⅠ 4型为优势型别.用Sfi Ⅰ和Not Ⅰ酶对12株肠炎沙门菌进行再分型,综合用Xba Ⅰ/Sfi Ⅰ/Not Ⅰ三种酶的结果 发现仍有三组菌的PFGE图谱是完全一致的.结论 2007年度广东省非伤寒沙门菌的感染多数为散发病例,头孢类和喹诺酮类抗生素是治疗非伤寒沙门菌感染的首选药物.     

2008-2010年北京市沙门菌血清型和药物敏感分析

目的分析2008-2010年北京市沙门菌血清型及药物敏感性。方法对2008-2010年通过WHO全球沙门菌监测系统及北京市肠道门诊监测系统分离到的沙门菌进行生化试验和血清分型,药敏试验采用Kirby-Bauer法。结果北京市2008-2010年共分离沙门菌菌株220株,分布于39个血清型,其中肠炎沙门菌和鼠伤寒沙门菌为优势菌型,分别占35.00%(77/220)和15.45%(34/220)。191株沙门菌药敏结果显示三代头孢类、二代喹诺酮类抗生素高度敏感,但有耐药菌株出现。氯霉素、四环素、氨苄西林、磺胺异噁唑、链霉素、萘啶酸出现不同程度的耐药,其中萘啶酸耐药性最高,耐药率达51.83%。结论北京市沙门菌血清型以肠炎沙门菌和鼠伤寒沙门菌为主。耐药分析提示应加强沙门菌耐药性监测,对合理选择及使用抗生素提供指导。     

2013年-2014年浙江省仙居腹泻病沙门菌监测结果分析

目的了解浙江省仙居县腹泻病患者沙门菌感染率、血清型分布以及各菌株对抗生素的耐药情况,为疾病预防控制和临床治疗提供参考依据。方法采集腹泻患者新鲜粪便,进行增菌、分离培养、生化鉴定、血清分型及药敏试验。结果从426份标本中检出沙门菌26株,检出率为6.10%。共检出9个血清型,鼠伤寒沙门菌为优势菌,其次是婴儿沙门菌、伦敦沙门菌和肠炎沙门菌。26株沙门菌对头孢曲松、丁胺卡那霉素、氧氟沙星3种药物完全敏感,并发现对某些抗生素具有一定耐药性。结论仙居县腹泻病中沙门菌检出率高,血清型分布广泛,多重耐药以鼠伤寒沙门菌和伦敦沙门菌最为显著;头孢类、喹诺酮类抗生素对沙门菌较为敏感,可作为临床首选药物。     

河南省腹泻患者沙门菌血清型及其耐药性变迁研究

目的了解河南省腹泻患者分离沙门菌的血清分型及耐药性变迁情况。方法以河南省2010年-2014年分离的877株沙门菌为研究对象,进行血清分型和药物敏感试验,以了解沙门菌菌型分布及药物敏感性情况。结果沙门菌在各年龄组均有检出,以0岁~5岁儿童为主,检出率为66.2%;且7月-10月是检出的高发季。877株沙门菌血清型共分为8个群、46种血清型,其中以B群检出为主。每年血清型的分布及种类也不同,但主要血清型为肠炎沙门菌、鼠伤寒沙门菌、阿贡纳沙门菌、科瓦利斯沙门菌、汤卜逊沙门菌。沙门菌菌株对各类抗生素均有不同程度的耐药,对氨苄西林和三代头孢类抗生素(头孢他啶、头孢噻肟、头孢吡肟)的耐药率有逐年上升趋势,而对诺氟沙星的耐药率表现为下降趋势,差异有统计学意义(P0.05)。几乎50%以上的菌株对3种以上的抗生素产生耐药。结论河南省腹泻患者沙门菌血清型分布呈多样性,主要是肠炎沙门菌和鼠伤寒沙门菌。对目前常用的抗菌药物均有耐药菌株出现,应加强耐药性监测,对合理使用抗生素提供指导。     

某儿童医院2014年8月-12月沙门菌属菌群分布及耐药性分析

目的了解深圳市某儿童医院沙门菌的临床分布及耐药特点。方法通过回顾性调查24878例标本培养结果,分析沙门菌的检出率及其血清分型、临床分布和药敏结果。结果24878例标本中共检出沙门菌128株,以粪便为主要检出标本类型,检出的沙门菌主要分布在B群和D群,以鼠伤寒沙门菌和肠炎沙门菌为主,分别占47.66%和30.47%,其次是B群其他血清型和C群沙门菌血清型;感染患儿较高的科室是感染病区;对检出率最高的鼠伤寒沙门菌和肠炎沙门菌进行药敏敏感性分析,提示两种不同血清型沙门菌对氨苄西林的敏感性在8.77%-22.86%之间,对三代头孢如头孢曲松和头孢他定的敏感性介于42.86%和61.40%之间,肠炎沙门菌对碳氢酶烯类100%敏感,检出耐亚胺培南鼠伤寒沙门菌血清型。结论鼠伤寒沙门菌和肠炎沙门菌是深圳市某儿童医院临床分离的主要沙门菌血清型,且以粪便标本为主,二者对抗菌药物的耐药性普遍较高,故需明确病原学的基础上进行目标治疗,同时要加强对儿童沙门菌感染的防控措施。     

肠炎沙门菌临床分离株耐药性与耐药基因分析

目的 对分离自北京、广州、新疆3个地区腹泻病人粪便标本中的肠炎沙门菌菌株进行耐药性监测,并分析其耐药基因的变异情况.方法 应用生化试验、血清凝集试验对分离的疑似沙门菌菌株进行鉴定.采用K-B药敏纸片法对鉴定出的肠炎沙门菌进行抗生素敏感性试验.利用PCR技术扩增其耐药基因DNA促旋酶gyrA基因和拓扑异构酶parC基因,同时进行测序.结果 共分离鉴定出20株肠炎沙门菌,分离菌株对环丙沙星、庆大霉素、头孢他定、亚胺培南的敏感率为100%,对萘啶酸耐药;75%的菌株呈现多重耐药性(multidrug resistance,MDR)序列比对结果显示gyrA基因Asp87及Gly133密码子处发生了点突变,其中Gly133是新的突变点.未发现parC基因密码子突变.结论 肠炎沙门菌临床分离株MDR情况比较严重,对萘啶酸普遍耐药,这可能与20株菌的gyrA基因QRDR的突变相关.为防止多重耐药现象的蔓延和加重,除了应加强耐药性及耐药性相关基因的实验室监测外,临床治疗沙门菌感染时需慎用抗生素.     

深圳市某儿童医院沙门菌属菌群分布及耐药性分析

目的了解深圳市某儿童医院沙门菌的临床分布及耐药特点。方法通过回顾性调查24 878例标本培养结果,分析沙门菌的检出率及其血清分型、临床分布和药敏结果。结果 24 878例标本中共检出沙门菌128株,以粪便为主要检出标本类型,检出的沙门菌主要分布在B群和D群,以鼠伤寒沙门菌和肠炎沙门菌为主,分别占47.66%和30.47%,其次是B群其他血清型和C群沙门菌血清型;感染患儿较高的科室是感染病区;对检出率最高的鼠伤寒沙门菌和肠炎沙门菌进行药敏敏感性分析,提示两种不同血清型沙门菌对氨苄西林的敏感性在8.77%~22.86%之间,对三代头孢如头孢曲松和头孢他定的敏感性介于42.86%和61.40%之间,肠炎沙门菌对碳氢酶烯类100%敏感,检出耐亚胺培南鼠伤寒沙门菌血清型。结论鼠伤寒沙门菌和肠炎沙门菌是深圳市某儿童医院临床分离的主要沙门菌血清型,且以粪便标本为主,二者对抗菌药物的耐药性普遍较高,故需明确病原学的基础上进行目标治疗,同时要加强对儿童沙门菌感染的防控措施。     

2019—2021年河源市某医院腹泻患者沙门菌血清分型及耐药情况

目的 分析2019—2021年河源市某医院2 130例腹泻患者中分离到的沙门菌,探讨沙门菌的感染情况、血清分型及耐药情况。方法 选择2019年1月—2021年12月河源市某医院2 130例腹泻患者为研究对象,采集粪便标本进行肠道病原菌分离,对实验室检测收集到的沙门菌进行血清型分型和药物敏感性测试。结果 170例沙门菌感染患者中年龄以0～10岁居多,其次为60岁以上老年人群,感染时间以7—9月份为主。分离的沙门菌株共有25个血清型,其中鼠伤寒沙门菌变种、鼠伤寒沙门菌和肠炎沙门菌分别为91株、29株和9株,为优势血清型。选取目前临床上常用的4大类抗生素中的8种进行分析,主要有四环素、萘啶酸、氯霉素、环丙沙星、甲氧苄啶/磺胺甲噁唑、庆大霉素、头孢噻肟、头孢西丁。结果表明,四环素的耐药率最高,约为73.17%;其次为萘啶酸,约为55.29%;头孢噻肟较为敏感,敏感率约为73.17%。结论 沙门菌属主要对四环素类、萘啶酸类药物的耐药性较高,临床应进一步加强对腹泻患者沙门菌感染的主动监测。     

深圳市儿童医院儿童粪便分离的459株沙门菌分布特征及耐药性

目的了解儿童粪便分离沙门菌的分布特征及耐药情况。 方法分析2012年1月—2015年10月某院患儿粪便标本分离的沙门菌检出情况,以及沙门菌血清型和对常用抗菌药物的敏感性。 结果7 047例患儿送检粪便标本,459例患儿检出沙门菌,总检出率为6.51%。沙门菌肠炎患儿男女比为2.4︰1,其中3岁以下儿童352例（占76.69%）;459株沙门菌中5—10月份检出374株（占81.48%）,7、8、9月检出数量最多,分别为72、84、78株。沙门菌血清型主要为B群(69.06%)和D群（19.39%）,分别以鼠伤寒沙门菌和肠炎沙门菌血清型为主。未检出耐亚胺培南和厄他培南的菌株,沙门菌属对哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、氨曲南和头孢曲松的敏感率均＞70%,肠炎沙门菌对头孢类抗生素的敏感率低于鼠伤寒沙门菌,但对复方磺胺甲口恶唑的敏感率高于鼠伤寒沙门菌。结论该院儿童粪便检出的沙门菌主要分离自3岁以下婴幼儿,夏秋季节高发,血清型以鼠伤寒和肠炎沙门菌为主,抗菌药物治疗要结合血清型及药敏结果慎重选择。     

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.     

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.     

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.     

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.