Distribution and characteristics of Escherichia coli clonal group A

Among 1,102 recent Escherichia coli clinical isolates, clonal group A was identified in 17 of 20 (U.S. and non-U.S.) geographic locales, mainly among U.S. isolates (9% vs. 3%; p < 0.001) and those resistant to trimethoprim-sulfamethoxazole (10% vs. 1.7%; p < 0.001). The extensive antimicrobial resistance and virulence profiles of clonal group A may underlie its recent widespread emergence.     

Enteroaggregative Escherichia coli related to uropathogenic clonal group A

Enteroaggregative Escherichia coli (EAEC) are heterogeneous, diarrheagenic E. coli. Of EAEC strains from Nigeria, 10 independent antimicrobial-resistant isolates belonged to the multilocus sequence type 69 clonal complex, to which uropathogenic E. coli clonal group A belongs. This finding suggests a recent common ancestor for these distinct groups of pathogenic E. coli.     

Comparison of Escherichia coli ST131 pulsotypes, by epidemiologic traits, 1967-2009

Escherichia coli sequence type 131 (ST131), an emerging disseminated public health threat, causes multidrug-resistant extraintestinal infections. Among 579 diverse E. coli ST131 isolates from 1967-2009, we compared pulsotypes (>94% similar XbaI pulsed-field gel electrophoresis profiles) by collection year, geographic origin, source, and antimicrobial drug-resistance traits. Of 170 pulsotypes, 65 had >2 isolates and accounted for 85% of isolates. Although extensively dispersed geographically, pulsotypes were significantly source specific (e.g., had little commonality between humans vs. foods and food animals). The most prevalent pulsotypes were associated with recent isolation, humans, and antimicrobial drug resistance. Predominant pulsotype 968 was associated specifically with fluoroquinolone resistance but not with extended-spectrum β-lactamase production or bla(CTX-M-15). Thus, several highly successful antimicrobial drug-resistant lineages within E. coli ST131 have recently emerged and diffused extensively among locales while maintaining a comparatively restricted host/source range. Identification of factors contributing to this behavior of ST131 could help protect public health.     

Global measles control and regional elimination, 1998-1999

In 1989, the World Health Assembly adopted the goal of reducing measles morbidity and mortality by 90% and 95%, respectively, by 1995, compared with estimates of the disease burden in the prevaccine era. In 1990, the World Summit for Children adopted a goal of vaccinating 90% of children against measles by 2000. Three regions of the World Health Organization (WHO) have targeted elimination: in 1994, the American Region (AMR) targeted elimination by 2000; in 1997, the Eastern Mediterranean Region (EMR) targeted elimination by 2010; and in 1998, the European Region (EUR) targeted elimination by 2007. This report updates progress since 1997 toward global measles control and regional elimination of measles, and includes vaccination coverage and disease surveillance data received by WHO as of August 14, 1999. Data for 1998 suggest that routine measles vaccination coverage has declined in some regions, the number of countries reporting cases and coverage to WHO has decreased, and measles continues to be an important cause of morbidity and mortality.     

Antibiotic resistance in Escherichia coli from Nigerian students, 1986 1998

We tested 758 fecal Escherichia coli isolates, recovered from Nigerian students in 1986, 1988, 1990, 1994, and 1998, for susceptibility to seven antimicrobial drugs. The prevalences of strains resistant to tetracycline, ampicillin, chloramphenicol, and streptomycin were 9% to 35% in 1986 and 56% to 100% in 1998. These findings demonstrate that resistance gene reservoirs are increasing in healthy persons.     

2002-2007年尿液分离大肠埃希菌与耐药性分析

目的 了解尿液标本临床大肠埃希菌的分离及耐药性情况,为临床泌尿系统抗感染的预防与治疗提供借鉴.方法 对尿液标本进行细菌培养鉴定以及耐药试验,用WHOENT5软件统计分析2002-2007年尿液标本大肠埃希菌分离及其耐药性情况.结果 尿液标本分离出大肠埃希菌631株,对17种药物的耐药性分析显示,所测大肠埃希菌对亚胺培南耐药率最低,为3.5%;对氨苄西林的耐药率最高,为89.7%;氨苄西林/舒巴坦80.5%、氨曲南64.3%、头孢曲松65.1%、头孢他啶57.4%、头孢噻肟65.1%、头孢唑林72.1%,环丙沙星、庆大霉素、妥布霉素、复方新诺明、头孢吡肟耐药率均>50.0%;其中产ESBLs占63.5%.结论 大肠埃希黹检出率高,耐药日趋严重,其在尿路感染中占有非常莺要的地位,常规检测ESBLs有助于合理选用抗菌药物,降低耐药菌株的产生;临床医师要严格规范抗菌药物的使用,以减少耐药菌株的产生,防止ESBLs的扩散.     

Global Incidence of Carbapenemase-Producing Escherichia coli ST131

We characterized Escherichia coli ST131 isolates among 116 carbapenemase-producing strains. Of isolates from 16 countries collected during 2008–2013, 35% belonged to ST131 and were associated with bla_KPC, H30 lineage, and virotype C. This study documents worldwide incidents of resistance to “last resort” antimicrobial drugs among a common pathogen in a successful sequence type.     

Verocytotoxin-producing Escherichia coli, Japan, 1999-2004

In 1999, an infectious disease prevention law was enacted in Japan that affected the nationwide infectious surveillance system. A total of 19,304 laboratory-confirmed verocytotoxin-producing Escherichia coli cases were reported through 2004. The annual incidence was 2.74/100,000 population; its fluctuation over time and space was associated with climate, socioeconomic, and population factors.     

Active tuberculosis among homeless persons, Toronto, Ontario, Canada, 1998-2007

While tuberculosis (TB) in Canadian cities is increasingly affecting foreign-born persons, homeless persons remain at high risk. To assess trends in TB, we studied all homeless persons in Toronto who had a diagnosis of active TB during 1998-2007. We compared Canada-born and foreign-born homeless persons and assessed changes over time. We identified 91 homeless persons with active TB; they typically had highly contagious, advanced disease, and 19% died within 12 months of diagnosis. The proportion of homeless persons who were foreign-born increased from 24% in 1998-2002 to 39% in 2003-2007. Among foreign-born homeless persons with TB, 56% of infections were caused by strains not known to circulate among homeless persons in Toronto. Only 2% of infections were resistant to first-line TB medications. The rise in foreign-born homeless persons with TB strains likely acquired overseas suggests that the risk for drug-resistant strains entering the homeless shelter system may be escalating.     

从化市1998-2007年法定报告传染病流行病学分析

目的 了解从化市近10年法定报告传染病的流行及变化趋势,为传染病的预防控制工作提供依据.方法 用描述流行病学方法 对从化市1998-2007年法定传染病疫情报告资料进行分析.结果 1998-2007年从化市共报告传染病24种10 997例,年发病率为138.81/10万～281.39/10万,年平均发病率为207.67/10万,甲、乙类传染病近3年有所上升,丙类传染病波动于15.95/10万～80.56/10万之间.肠道传染病发病率不断下降,发病率为10.12/10万～67.20/10万,呼吸道传染病发病率逐年上升,发病率为62.68/10万～146.05/10万,自然疫源和虫媒传染病发病率较低,发病率为0.94/10万～9.17/10万,血源及性传播传染病发病率为26.83/10万～74.78/10万.结论 从化市传染病预防控制工作效果显著,今后必须加大对呼吸道传染病的控制力度,同时注意新发传染病的出现,加强对受社会因素影响较大的血源及性传播传染病的预防控制工作.     

2007-2010年患儿泌尿系统感染大肠埃希菌的分布及耐药性分析

目的分析医院患儿泌尿系统感染大肠埃希菌的分离率和耐药特性,为临床用药提供参考依据。方法收集自2007-2010年住院患儿尿液分离的大肠埃希菌335株,采用VITEK-2Compact全自动微生物分析仪对菌株进行鉴定及药敏分析。结果 2007-2010年患儿泌尿系统大肠埃希菌检出率依次为3.93%、4.04%、4.24%、5.32%,呈现上升趋势;2007-2010年ESBLs检出率分别为44.62%、47.30%、53.57%、64.04%,呈现上升趋势;335株菌对庆大霉素、头孢噻肟、左氧氟沙星、环丙沙星和氨曲南的耐药率均>50.0%,而对头孢吡肟、头孢他啶及头霉素类的耐药率较低,对左氧氟沙星、头孢噻肟、阿米卡星及哌拉西林/他唑巴坦的耐药率均升高了约10.0%,并发现了对亚胺培南和美罗培南的不敏感菌株。结论碳青霉烯类抗菌药物对儿童泌尿系统感染大肠埃希菌仍然保持很高的抗菌活性,但ESBL阳性率的增高应当引起临床的高度重视,应依据药物敏感性合理使用抗菌药物。     

Global distribution of group A rotavirus strains in horses: A systematic review

Group A rotavirus (RVA) is a major cause of diarrhea and diarrhea-related mortality in foals in parts of the world. In addition to careful horse farm management, vaccination is the only known alternative to reduce the RVA associated disease burden on horse farms. The precise evaluation of vaccine effectiveness against circulating strains needs enhanced surveillance of equine RVAs in areas where vaccine is already available or vaccine introduction is anticipated. Therefore, we undertook the overview of relevant information on epidemiology of equine RVA strains through systematic search of public literature databases. Our findings indicated that over 99% of equine RVA strains characterized during the past three decades belonged to two common genotypes, G3P[12] and G14P[12], whereas most of the minority equine RVA strains were probably introduced from a heterologous host by interspecies transmission. These baseline data on RVA strains in horses shall contribute to a better understanding of the spatiotemporal dynamics of strain prevalence in vaccinated and non-vaccinated herds.     

Internal migration and distribution of Chagas disease mortality, Brazil, 1981-1998

In Brazil, mortality from Chagas disease occurs even in regions classified as free of vector transmission. Because death rates refer to residents, and considering that a huge migratory movement has occurred inside the country, this study was intended to quantify the contribution of Brazilian internal migration to overall mortality from Chagas disease, from 1981 to 1998. If the PAHO Southern Cone Initiative actually achieved its objectives, one could expect declining death rates and increasing age at death from this cause. The results showed that out of 68,936 deaths in Brazilians with known birthplace, 32,369 (32%) occurred in people born in States other than those of their current residence (range: from 0.3% in Rio Grande do Sul to 100% in Roraima and Amapá). Most (67%) of the deaths in migrants occurred in individuals born in the States of Minas Gerais (51%) and Bahia (16%). Death rates in residents showed a consistent decline in the Southeast, South, and Central West of the country, but not in the Northeast and North, where median age at death was the lowest.     

2004～2007年广西甲型肝炎流行病学分析

目的 了解广西甲肝流行情况,分析流行病学特征,为有效防控甲肝提供科学依据.方法 利用传染病报告系统报告数据,分析甲肝的流行病学特征.结果 2004～2007年广西累计报告甲肝病例7941例,年平均发病率为4.04/10万;其中死亡11例,死亡率为0.006/10万.发病季节性不明显.贺州、河池、桂林、百色和柳州市发病率明显高于其它地区.病例以青少年和青壮年为主,年龄集中在10～59岁,占病例总数的77.94%(6189/7941);男性多于女性,职业以农民学生和工人居多,占病例总数的80.33%(6379,/7941).结论 防制甲肝应采取以预防接种、疫情监测和卫生宣教为主的综合性防控措施.     

2007-2011年深圳市罗湖区流行性感冒流行特征分析

目的分析2007-2011年深圳市罗湖区流行性感冒流行特征,为流感防制提供科学依据。方法收集罗湖区流感样病例（influenza-like illness,ILI）的监测数据、病原学监测结果和暴发疫情资料进行分析。结果2007年和2008年流感样病例与门诊病例总数的百分比（ILI%）曲线高峰均出现在春夏季,2007年为第20～30周;2008年为第10～30周。由于新甲型H1N1流感流行,2009年ILI%曲线高峰持续时间约7个月（20～49周）,ILI%均值明显高于2007年和2008年相应时段。2010年、2011年流感ILI%曲线均未出现高峰。ILI病例主要集中在0～4岁年龄组（48.75%）、25～59岁年龄组（20.88%）及5～14岁年龄组（19.39%）。5年间流感病毒核酸阳性率为30.88%（382/1 237）,2009年阳性率最高（50.11%,231/461）;2007-2011年共报告流感样暴发疫情140起,72.14%发生在小学。结论罗湖区流感监测结果与深圳市监测结果基本一致;暴发疫情发生时间趋势与ILI%曲线基本一致。2009年新甲型H1N1流感流行后,罗湖...     

Invasive meningococcal capsular group Y disease, England and Wales, 2007-2009

Enhanced national surveillance for invasive meningococcal disease in England and Wales identified an increase in laboratory-confirmed capsular group Y (MenY) disease from 34 cases in 2007 to 44 in 2008 and 65 in 2009. For cases diagnosed in 2009, patient median age at disease onset was 60 years; 39% of patients had underlying medical conditions, and 19% died. MenY isolates causing invasive disease during 2007-2009 belonged mainly to 1 of 4 clonal complexes (cc), cc23 (56% of isolates), cc174 (21%), cc167 (11%), and cc22 (8%). The 2009 increase resulted primarily from sequence type 1655 (cc23) (22 cases in 2009, compared with 4 cases each in 2007 and 2008). cc23 was associated with lpxL1 mutations and meningitis in younger age groups (<25 years); cc174 was associated with nonmeningitis, particularly pneumonia, in older age groups (>65 years). The increase in MenY disease requires careful epidemiologic and molecular monitoring.