2010—2021年深圳市ST314肯塔基沙门菌遗传特征和耐药分析

目的 了解深圳市ST314肯塔基沙门菌流行情况、遗传特性及耐药特征。方法 对2010—2021年深圳市疾病预防控制中心食源性疾病监测网络收集的14株ST314肯塔基沙门菌全基因组测序进行系统发育进化分析、耐药基因及质粒检测;采用微量肉汤法稀释法进行药物敏感性实验。结果 共收集57株肯塔基沙门菌,14株为ST314。ST314肯塔基沙门菌全球系统发育树显示,深圳分离株与越南和泰国等东南亚国家的分离株聚集分布在clade 314.2上,且深圳本地菌株间单核苷酸多态性距离较大,说明为散发。在ST314肯塔基沙门菌基因组检测到9类共17个耐药基因/突变,携带3种产超广谱β-内酰胺酶基因,包括bla_CTX-M-24(14.3%,2/14)、bla_CTX-M-55(7.1%,1/14)、bla_CTX-M-130(14.3%,2/14),均位于质粒上。关于喹诺酮类的耐药因子,在基因组中鉴定出2种质粒介导的喹诺酮耐药基因：qnrB6(71.4%,10/14)和aac(6′)Ib-cr(78.6%,11/14),一种喹诺酮耐药决定区突变T...     

济宁市城区生活污水中沙门菌分布、耐药特征及全基因组测序分析

目的 了解济宁市城区生活污水中沙门菌分布、血清型、耐药特征,并进行全基因组测序分析,为沙门菌的防控提供科学依据。方法 2023年2—3月,每周采集城区3个污水厂进水口污水各2份,每份500 ml,连续采集7周,合计42份污水样本,对污水样本进行沙门菌的培养、分离、鉴定,分离出的沙门菌进行血清凝集试验和荧光定量PCR血清分型,利用微量肉汤稀释法对41株沙门菌进行9类17种药物的最低抑菌浓度(minimum inhibitory concentration,MIC)检测,进行全基因组测序及系统进化分析。结果 济宁市城区生活污水沙门菌分离率较高,42份样本中阳性样本24份,共分离出41株沙门菌,属9种血清型,以阿贡纳和肯塔基为主,李营和济东污水厂有其独有的血清型。只有1株吉韦沙门菌不耐药,其余40株沙门菌均为多重耐药菌,对复方新诺明、四环素、氨苄西林、链霉素耐药率达90%以上,对氨苄西林/舒巴坦耐药率达80%以上,共19种耐药谱,SXT-TET-STR-AMP-AMS占首位,不同血清型沙门菌的耐药谱不同,肯塔基沙门菌、黄金海岸沙门菌、婴儿沙门菌的多重耐药非常严重,同种血清型在不同污水厂中的耐...     

河南省食源和人源革兰氏阴性菌耐药特征和分子分型研究

目的 掌握河南省食源和人源主要革兰氏阴性菌（GNB）分离株耐药和分子分型特征,为指导抗生素的合理使用和聚集性病例识别提供依据。方法 对2021年河南省食品安全风险监测收集到的364株沙门氏菌和致泻性大肠埃希氏菌（DEC）分离株使用微量肉汤稀释法进行药物敏感性试验,使用脉冲场凝胶电泳技术（PFGE）进行分子分型和同源性分析。结果 282株沙门氏菌对15种抗生素的耐药率范围为5.32%～83.69%,氨苄西林最高,亚胺培南最低;食源和人源沙门氏菌对氨苄西林、氨苄西林/舒巴坦、甲氧苄啶/磺胺甲噁唑、庆大霉素、氯霉素、多粘菌素E、阿奇霉素、萘啶酸8种抗生素的耐药率存在统计学差异（P<0.05）。82株DEC耐药率范围为1.22%～64.63%,四环素最高,亚胺培南和多粘菌素E最低;食源和人源DEC对庆大霉素、阿奇霉素、头孢噻肟、头孢唑林、环丙沙星、萘啶酸6种抗生素的耐药率存在统计学差异（P<0.05）。共检出284株多重耐药菌、182种耐药谱;1株全耐药沙门氏菌来源于患者;不同来源沙门氏菌和DEC的多重耐药率存在统计学差异（P<0.05）。沙门氏菌分属23个PFGE型,肠炎沙...     

儿童携带多重耐药及泛耐药鲍曼不动杆菌的耐药性分析

目的:通过对该院儿科和河北省儿童医院临床分离的142株鲍曼不动杆菌的耐药性进行分析,为治疗儿童携带多重耐药及泛耐药鲍曼不动杆菌临床合理使用抗生素、提高抗生素使用效率、减少多重耐药鲍曼不动杆菌的发生、提高治疗效果提供理论依据。方法:采用K-B纸片扩散法对19种抗生素的耐药性进行试验,采用游标卡尺测量完全抑制区的直径包括纸片的直径。抑菌环大小判读参照M100,并报告测试的细菌对药物的耐药情况。结果:142株鲍曼不动杆菌中多重耐药菌72株,泛耐药菌24株,非多重耐药菌46株。多重耐药和泛耐药鲍曼不动杆菌对头孢类、碳氢酶烯类、氨基糖甙类、青霉素类、喹诺酮类、四环素类及磺胺类药物的耐药率均达到41.00%~99.00%,多粘菌素类药物的耐药率为0。结论:儿科病房分离的142株鲍曼不动杆菌对19种抗生素的耐药性逐渐提高,通过耐药性分析建议临床联合用药可以提高临床疗效。     

深圳市2004～2007年分离沙门菌的耐药性分析

目的:分析深圳市2004～2007年分离的67株沙门菌对19种抗生素的敏感性,指导临床合理用药.方法:采用纸片扩散法测定菌株对抗生素的敏感性.结果:对目前临床常用的诺氟沙星、环丙沙星和头孢曲松等敏感率很高.36株菌为耐药菌株,9株菌多重耐药,部分菌株交叉耐药.结论:沙门菌对多种常用抗生素已产生耐药性,临床用药时应予注意.     

合肥市生猪肉沙门菌分离株耐药表型与耐药基因的相关性研究

目的:了解生猪肉中沙门菌分离株耐药表型与耐药基因的携带关系。方法:采用K-B纸片法对生猪肉中26株沙门菌分离株进行22种抗菌药物敏感试验,并应用PCR技术对沙门菌分离株进行耐药基因检测。结果:26株沙门菌总耐药率为61.54%(16/26),其中14株(53.85%)对至少3种以上抗菌药物耐药,属于多重耐药株,强力霉素-四环素-氯霉素-卡那霉素是主要多重耐药谱;3类抗菌药物耐药基因以tetB、Flor和aph(3)-IIa与aadB基因分别检出最高。结论:沙门菌耐药表型测定结果与耐药基因检测结果一致,耐药及多重耐药性与耐药基因的携带相关。     

陆振豸. 我国类鼻疽研究的历史与现状

  目的   了解广东地区类鼻疽伯克霍尔德菌的耐药状况及分子流行病学特征,为该地区类鼻疽病的监测防控、临床诊疗等方面提供理论基础。  方法   对2018 — 2019年收集的8株类鼻疽伯克霍尔德菌采用微量肉汤稀释法进行抗生素药物敏感性试验;利用全基因组测序技术获得菌株耐药基因携带情况,并进行分子分型研究及系统发育进化树的构建。  结果   8株类鼻疽伯克霍尔德菌对四环素、头孢他啶、亚胺培南、阿莫西林 – 克拉维酸、多西环素和复方新诺明这6种抗生素均表现敏感。除菌株19BP04外均检测到耐药基因bla_OXA-59,有3株菌检测到bla_OXA-57耐药基因。MLST分型结果为8种不同ST型（ST271、ST562、ST10、ST46、ST1325、ST830、ST1774、ST1775）,其中ST1774和ST1775为全球新发的首次报道序列型别。全基因组单核苷酸多态性（wgSNPs）系统发育进化分析结果显示,8株类鼻疽伯克霍尔德菌分属于不同聚类分支,与多个不同地理来源分离株具有邻近的亲缘关系。  结论   广东地区类鼻疽伯克霍尔德菌对常用的临床治疗抗菌药物尚未产生耐药,基因组具有较高的遗传多样性,并且变异进化迅速,基因组发生重组等可塑性强。     

脉冲场凝胶电泳与多基因聚类分析在铜绿假单胞菌株亲缘性研究中的应用

目的:了解分离自临床铜绿假单胞菌分子流行病学特性及菌株亲缘性。方法:对分离自临床的32株铜绿假单胞菌采用Kirby-Bauer法测定抗菌药物的敏感性;利用脉冲场电泳和多耐药基因聚类分析菌株的亲缘性。结果:32株铜绿假单胞菌中有17株对8种以上抗生素耐药,占53.1%,8株(25%)铜绿假单胞菌对检测抗生素全部耐药,为同一耐药表型。脉冲场电泳聚类分析显示,铜绿假单胞菌主要为3个克隆株;而多耐药基因聚类分析显示,铜绿假单胞菌主要为2个簇群,二个簇群内已发生衍化,存在3个克隆传播。结论:分离自临床的铜绿假单胞菌耐药严重,亲缘性分析中多基因聚类分析法分辨率高于脉冲场电泳。     

2020年我国20个省份禽肉来源弯曲菌的耐药性及基因组特征分析

目的分析2020年我国20个省份禽肉来源弯曲菌的耐药性及基因组特征。方法收集2020年来自全国零售禽肉制品中的弯曲菌265株(空肠弯曲菌:244株;结肠弯曲菌:21株), 采用琼脂稀释法测定菌株对9种抗生素的耐药表型;对筛选出的38株耐药菌进一步开展全基因组测序, 分析其携带耐药基因、毒力基因、序列型和遗传多样性特征。结果 265株弯曲菌对四环素、萘啶酸和环丙沙星的耐药率最高(84%～100%), 多重耐药率达53.2%;其中结肠弯曲菌对红霉素、阿奇霉素、泰利霉素、庆大霉素、克林霉素的耐药率高于空肠弯曲菌(均P<0.05)。38株弯曲菌基因组中β-内酰胺类(100%, 38/38)、喹诺酮类(94.7%, 36/38)、四环素类(81.6%, 31/38)和氨基糖苷类(50%, 19/38)抗生素耐药基因携带率较高;空肠弯曲菌携带毒力基因种类和数量要明显多于结肠弯曲菌;20株测序空肠弯曲菌共获得19个序列型, 18株测序结肠弯曲菌共获得17个序列型, 共发现5个新的序列型, 菌株表现出较高的遗传多样性。结论我国禽肉来源弯曲菌耐药现象较为严重, 耐药和毒力基因在弯曲菌中分布广泛, ...     

湖南省食源性德尔卑沙门菌耐药谱及PFGE分型研究

目的了解湖南省食源性德尔卑沙门菌的耐药谱及分子分型,建立沙门菌指纹图谱数据库。方法运用肉汤稀释法对食源性德尔卑沙门菌进行药敏试验,并采用脉冲场凝胶电泳法(PFGE)进行分子分型。结果 47株德尔卑沙门菌中,有46株对1种以上抗生素耐药(97.87%),有29株多重耐药菌株(61.70%);德尔卑沙门菌分为32种PFGE型,其中有10种PFGE型的菌株数超过1株。结论湖南省食源性德尔卑沙门菌分离株呈高耐药和多重耐药趋势,PFGE分子型别呈多态性,有同源菌株存在,PFGE分型为食源性疾病溯源和预警提供技术基础。     

Trends in predictors of death due to HIV-related causes among persons living with AIDS in New York City: 1993–2001

To examine trends in predictors of HIV-related mortality among cohorts of persons living with AIDS (PLWA) in New York City (NYC), nine calendar year-specific cohorts of PLWA were created from 1993 to 2001. Cohorts were defined as persons who had been alive at any time during that year and had been diagnosed with AIDS before the end of that year. Predictors of death because of HIV-related causes of death were assessed by examinnng year-specific, stratified death rates per 1,000 PLWA and adjusted relative risks (RRs) from proportional hazards models. We conducted an analysis of AIDS surveillance data PLWA in NYC between 1993 and 2001. Univariate and multivariate Cox proportional hazards models were constructed for each calendar year cohort to evaluate trends in the RR of HIV-related death over the subsequent 5 years, adjusting for sex, reace/ethnicity, age, transmission risk borough of residence, category of AIDS diagnosis [opportunistic illness (OI) or CD4 count <200 cells/μL], time since AIDS diagnosis, and CD4 count at time of AIDS diagnosis. Death rates due to all causes and HIV-related causes declined substantially during 1993–1997 and then stabilized in all subgroups of PLWA between 1998 and 2001. Beginning in 1995, differences in survival emerged in some subgroups, such that by 2001 (1) injecting drug users (IDUs) had poorer survival compared with men who have sex with men (MSM) [RR₂₀₀₁=2.1, 95% confidence intervals (95% CI)=1.8–2.4]; (2) black and Hispanic PLWA had a significantly higher risk of death than white PLWA (RR₂₀₀₁=1.4, 95% CI=1.2–1.6, RR₂₀₀₁=1.2, 95% CI=1.1–1.4, respectively, and (3) PLWA aged 60 and above had poorer survival compared with younger persons (RR₂₀₀₁=2.4, 95% CI=1.9–3.0), after adjustment for other factors. The observed disparities that began to emerge in 1995 may be attributable to differential effects of, access to, or usage of highly active antiretroviral therapy (HAART). More targeted studies are needed to determine why such disparities have emerged.     

Computer and internet use among urban African Americans with type 2 diabetes

Previous studies have identified a “digital divide” between African Americans and whites, with African Americans having substantially lower rates of Internet use. However, use of the Internet to access health information has not been sufficiently evaluated in this population. Therefore, we conducted a telephone survey to determine the prevalence of computer and Internet use among 457 African American adults with type 2 diabetes. Participants were 78% female, with a mean age of 57±11 years, and about one-third had a yearly income ≦$7,500. Forty percent of the participants reported having a computer at home and 46% reported knowing how to use a computer. Most participants (58%) reported that they had, at some point, used a computer, and of those, 40% reported that they used the computer to find health information. In a stratified analysis, participants with lower education levels (<high school) were less likely to have a computer; older participants, men, and individuals with lower education levels were less likely to know how to use a computer and to use it to search for health information (all P<.05). Nonetheless, of the participants who did not know how to use a computer, 66% reported that they would be willing to learn. In addition, 82% reported that they had friends or family in the neighborhood who would let them use a computer. Furthermore, 89% of participants reported that they would use a computer program to manage their diabetes if it were offered free of charge. These data show promise for the willingness of this under-served population to use computers and access health information using the Internet. New programs are needed to explore Internet-based interventions to improve self-management and diabetes care among African Americans.     

A vulnerable population in a time of crisis: Drug users and the attacks on the World Trade Center

In this article, we present preliminary findings from a qualitative study focused on the impact of the World Trade Center attacks on New York City residents who are current or former users of heroin, crack, and other forms of cocaine. In it, we present data describing their responses to and feelings about the attacks, changes in drug use after the attacks, and factors affecting changes in use. Our analysis is based on 57 open-ended interviews conducted between October 2001 and February 2002. The majority of study participants reported that the attacks had a significant emotional impact on them, causing anxiety, sadness, and anger. Several described practical impacts as well, including significant reductions in income. On September 11th and the weeks and months that followed, several participants who had been actively using did increase their use of heroin, crack, and/or other forms of cocaine. Reductions in use were, however, as common over time as were increases. There was some relapse among former users, but this was limited to those who had stopped using drugs within the 6 months immediately preceding the attacks. A diverse set of factors interacted to control use. For some participants, these factors were internal, relating to their individual motivations and drug use experiences. Other participants were essentially forced to limit use by marked reductions in income. For others, access to health and social service professionals, as well as drug treatment, proved to be key. Department of Family Medicine and Community Health at Montefiore Medical Center     

Absorption,metabolism and elimination of N,N-dimethylformamide in humans

Summary Excretion of N,N-dimethylformamide (DMF) and DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethyl-formamide (F) and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) has been monitored in the urine of volunteers during and after their 8-h exposure to DMF vapour at a concentration of 10, 30 and 60 mg · m^–3. The pulmonary ventilation in these experiments was typically about 101 · min^–1 and the retention in the respiratory tract was 90%. After exposure to 30 mg DMF · m^–3, the yield of compound determined in the urine represented 0.3% (DMF), 22.3% (MF), 13.2% (F) and 13.4% (AMCC) of the dose absorbed via the respiratory tract. The excretion curves of the particular compounds attained their maximum 6–8h (DMF), 6–8h (MF), 8–14h (F) and 24–34h (AMCC) after the start of the exposure. The half-times of excretion were approximately 2, 4, 7 and 23 h respectively. In contrast to slow elimination of AMCC after exposure to DMF, AMCC was eliminated rapidly after AMCC intake. This discrepancy could be explained by rate-limiting reversible protein binding of a reactive metabolic intermediate of DMF, possibly methylisocyanate.     

Antimicrobial antibodies in Danish slaughterhouse workers and greenhouse workers

Summary As a consequence of contact with animals and animal products slaughterhouse workers might be at risk of infection with pathogenic microorganisms. This hypothesis has been supported by some earlier studies. In this study 217 slaughtermen and a control group of 113 greenhouse workers were investigated for the prevalence of serum antibodies to Toxoplasma gondii, Campylobacter jejuni (IgA and IgG), Yersinia enterocolitica types 3 and 9, Yersinia pseudotuberculosis types I, II, III, IV, and V, Salmonella typhi, Salmonella paratyphi, Salmonella enteritidis, Salmonella typhimurium, and Borrelia burgdorferi. No significant differences were found concerning either frequency of positive tests or magnitude of titers. The prevalence of toxoplasma antibodies was remarkably high in both groups.     

Biological monitoring of workers exposed to<Emphasis Type="Italic"> N</Emphasis>,<Emphasis Type="Italic">N</Emphasis>-dimethylformamide in synthetic leather manufacturing factories in Korea

Objectives To investigate the relationship between N,N-dimethylformamide (DMF) exposure and excretion of urinary N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) and N-methylformamide (NMF) in workers at synthetic leather manufacturing factories in Korea, for the first time.Methods One-hundred forty-four male workers at nine synthetic leather manufacturing factories were surveyed. Exposure to DMF was evaluated through breathing zone air sampling followed by analysis via a gas chromatograph equipped with a flame ionization detector (GC-FID). The levels of NMF and AMCC were determined by a GC with a flame thermionic detector (GC-FTD). Urine samples were collected at the end of the workshift.Results and Conclusions Geometric mean of workplace air DMF and urinary NMF was 8.8 ppm and 47.5 mg/l, respectively, and the level of DMF and NMF was significantly correlated. The biological exposure limit for NMF (15 mg/ml) was exceeded in 89.5% of urine samples, and 37.9% of air samples exceeded the environmental DMF exposure limit (10 ppm), indicating a serious health risk to the employees of the synthetic leather industry in Korea. Exposure to 10 ppm DMF in the workplace air corresponded to a urinary NMF concentration of 53.4 mg/l. Alcohol intake the day before urine was sampled influenced NMF excretion into urine (40.5 mg/l NMF for the no-alcohol group and 94.6 mg/l for the group consuming more than 63.0 g alcohol/day). We could not find a significant relationship between air DMF and urinary AMCC concentration. Exposure to 10 ppm DMF corresponded to an AMCC concentration of 8.0 mg/l in the urine samples collected on the same day as the air was sampled.     

我国几种非嗜肺军团菌感染的血清流行病学研究

本文报告了1986年对我国五个地区994名健康成人、373名儿童和100例肺炎病人进行三种军团菌抗体检测的结果。健康成人抗体阳性率(≥1:16)Lm为9.26%,Ld为9.05%,Lg为3.32%。儿童Lm为5.36%,Ld为2.14%,Lg为3.75%。肺炎病人抗体阳性率以Ld最高(44%),Lm次之(23%),Lg均阴性。提示我国南方和北方地区人群中均存在这三种军团菌感染的可能性,应予以注意。     

成人灰色小克银汉霉侵袭性毛霉菌病1例并文献复习

目的 探讨灰色小克银汉霉感染导致成人毛霉菌病患者的临床特点及诊治方案。方法 总结某院血液内科收治的1例灰色小克银汉霉感染致成人侵袭性毛霉菌病患者的临床诊疗过程,并检索数据库相关文献进行复习。结果 患者男性,54岁,因“反复乏力1年余,加重伴发热1周”入院,肺组织病理检查可见宽大、不规则、无分隔的菌丝,形态学鉴定为毛霉菌,肺泡灌洗液及外周血宏基因组二代测序(mNGS)检测示灰色小克银汉霉,诊断为灰色小克银汉霉感染致侵袭性毛霉菌病,给予脂质体两性霉素B联合泊沙康唑、卡泊芬净治疗后感染获得控制。检索出符合条件的文献37篇,加上本病例,共纳入44例患者,其中男性26例,女性18例,中位年龄52.5(18～79)岁;基础疾病主要为血液系统疾病(65.9%,29例),进行造血干细胞或实体器官移植者14例;最常见的侵犯部位为肺、脑及皮肤,分别为36、9、9例;组织病理学、真菌培养、直接镜检及分子学检测阳性者分别为28、37、29、17例。41例患者接受了抗真菌治疗,其中8例联合手术治疗;30例死亡,病死率为68.2%,抗真菌治疗联合手术者生存率(62.5%,5/8)高于单独抗真菌治疗者(24.2%,...     

Clinical and laboratory evidence of the importance of the tick D. marginatus as a vector of B. burgdorferi in some areas of sporadic Lyme disease in Bulgaria

56 adult ticks D. marginatus and 38 adult ticks H. punctata were sampled by the flagging method, transferred to the laboratory, dissected and tested for infection with Lyme disease spirochetes. 3 (7.9%) of the adult H. punctata and 2 (3.57%) of the adult D. marginatus were infected with B. burgdorferi (Bb). This report also presents the case of a patient, who developed Lyme disease symptoms after he had been bitten by a D. marginatus tick. The clinical diagnosis was confirmed by serological testing and by a biopsy, taken from the patient's skin lesion. The skin biopsy was examined under an electron microscope and Bb was found in the sections of the deeper strata of the dermis in two structural forms: (a) cylindrical bodies (protoplasm cylinder) with circular ends covered with a three-layered membrane; (b) granules, situated among the collagenous fibres either closely adhered to them or covered with a membrane. The result of the study demonstrates that in single cases in some ecosystems, ticks D. marginatus might be implicated in Bb transmission to humans as secondary vectors.     

DNA relatedness,karyotyping and gene probing of Candida tropicalis,Candida albicans and its synonyms Candida stellatoidea and Candida Claussenii

Isolates of Candida albicans with varied phenotypes, including sucrose-negative variants (C. stellatoidea, serotypes A and B) and avirulent germ tube-negative forms (C. claussenii) showed significant (> 90%) DNA relatedness to classical C. albicans, but insignificant relatedness to C. tropicalis and sucrose-negative C. tropicalis. A transverse alternating-field gel electrophoresis procedure (TAFE) showed discrete karyotype patterns among the phenotypic variants of C. albicans including the sucrose-negative C. stellatoidea. The number of chromosome-sized DNA bands for C. tropicalis (7 bands) were within the range of bands observed for C. albicans (5 to 10 bands). The general DNA-migration pattern for C. albicans appeared distinct from that of C. tropicalis. An aspartyl proteinase (PrA) gene probe from C. albicans hybridized with chromosomal DNA from C. albicans, C. claussenii and C. stellatoidea but not with that from C. tropicalis.