黑龙江省部分林区全沟硬蜱复合感染重要蜱媒病原的调查研究

为了研究我国重要蜱媒病的复合感染情况,本文选择黑龙江林区蜱媒疾病高发区域,以莱姆病、森林脑炎、人巴贝西原虫病、埃立克体等蜱媒病原为目标,应用聚合酶链式反应对该地区采集的全沟硬蜱可能感染的蜱媒病原情况进行检测,以探讨这些蜱媒疾病在媒介全沟硬蜱体内的复合感染状况。结果表明,该地区的全沟硬蜱感染有莱姆病、森林脑炎、人巴贝西原虫病、埃立克体、斑点热等5种疾病的病原体,感染阳性率在1.05%~10.5%之间;在这些感染个体中,将近40%的个体属于复合感染,复合感染的类型有双重感染和三重感染。其中,莱姆病螺旋体和其他病原体复合感染的比例很高;没有发现埃立克体和人巴贝西原虫的复合感染现象。我国蜱媒病原的复合感染情况,理应引起预防、临床和公共卫生相关人员的充分关注。     

全沟硬蜱、森林革蜱及嗜群血蜱经卵传播新塔拉塞维奇立克次体的检测研究

本研究旨在明确新塔拉塞维奇立克次体是否可以在全沟硬蜱、森林革蜱及嗜群血蜱3种媒介蜱中经卵传播。以在东北林区采集的牛寄生饱血雌蜱为样本,在实验室条件下人工培育,以获得3种蜱的不同时期的形态,并使用PCR方法检测各虫态中新塔拉塞维奇立克次体的感染情况,从而研究新塔拉塞维奇立克次体在蜱生活周期中的传递规律。共采集牛寄生饱血雌蜱91只,其中全沟硬蜱14只,森林革蜱55只,嗜群血蜱24只。新塔拉塞维奇立克次体感染率为85.71%,5.45%,12.50%。卵的最低感染率分别为全沟硬蜱(2%)、森林革蜱(1.3%)、嗜群血蜱(1.1%),幼蜱的最低感染率分别为全沟硬蜱(5%)、森林革蜱(1.7%)、嗜群血蜱(2.2%)。且3种蜱雌蜱、卵、幼虫均检测到的新塔拉塞维奇立克次体,序列比对一致。感染的幼蜱均可通过叮咬使小鼠感染,三种蜱都能经卵传播新塔拉塞维奇立克次体。全沟硬蜱感染率高可能是东北林区新塔拉塞维奇立克次体的主要媒介蜱。     

我国一些常见蜱种莱姆病螺旋体的分离与鉴定

本文对我国不同地区 8种蜱感染莱姆病螺旋体的情况进行了分离培养 ,从内蒙获得 2个分离株 ,对分离株的 16srDNA基因序列进行分析比较 ,发现新分离的两株莱姆病螺旋体同我国报道的CHY13p株具有高度同源性 ,CHY13p与CHNM4有 2个碱基差异 ,CHY13与CHNM5只有 1个碱基差异 ,而CHNM4和CHNM5两株螺旋体有 2个碱基差异。可初步认定新分离莱姆病螺旋体系Borreliagarinii。     

安徽黄山地区中华硬蜱及其宿主感染莱姆病Borrelia afzelii的检测

利用PCR和病原体分离技术对安徽黄山地区中华硬蜱及其宿主感染莱姆病螺旋体的状况进行了检测,结果从40只黄山林区的中华硬蜱中获得了一株莱姆病螺旋体分离株,寄主动物及其他中华硬蜱均未获得阳性分离结果.以16s rRNA为靶标进行PCR检测,6.78%雌性和5%雄性中华硬蜱发现有阳性感染,2只草兔(92只)和1只麂子(16只)也发现有阳性感染;若蜱和其余宿主动物未发现阳性感染.阳性分离株和扩增获得的168 rRNA序列结果一致,同GenBank中的B.afzelii的系统发育关系最近,提示该分离株螺旋体属于B.afzelii.该结果与前期的实验传播结果提示中华硬蜱是我国南方莱姆病的传播媒介.     

黑龙江省口岸地区蜱类感染嗜吞噬细胞无形体Anaplasma phagocytophila的初步调查

为调查黑龙江省口岸蜱类携带嗜吞噬细胞无形体Anaplasma phagocytophila感染情况,运用聚合酶链式反应方法扩增嗜吞噬细胞无形体柠檬酸合成酶（gltA）基因片段,对黑龙江省各口岸地区采集的蜱标本进行检测,并对阳性结果进行序列分析.共检测蜱1 609只,29只阳性,阳性率为1.80%,结果表明,黑龙江省口岸蜱类除日本血蜱外均有自然感染嗜吞噬细胞无形体的现象.所感染的嗜吞噬细胞无形体gltA 基因与GenBank 中登录的嗜吞噬无形体gltA基因片段,相似性为82%～98%.因此,我国黑龙江省口岸地区存在蜱粒细胞无形体感染.     

肺泡灌洗液病原微生物宏基因检测在儿童重症肺炎治疗中的临床应用分析

目的 探讨肺泡灌洗液病原微生物宏基因检测(mNGS)在儿童重症肺炎治疗中的应用价值.方法 回顾分析2018年12月至2020年12月我院儿科PICU收治的重症肺炎并送检肺泡灌洗液病原学微生物mNGS检测的患儿120例,收集患儿的一般临床资料,分别采用传统检测方法以及mNGS报告判断患儿病原体类型.以临床综合判断(采用肺...     

糖尿病检测的主要方法及临床意义分析

目的：糖尿病作为代谢性内分泌系统疾病,在临床上具有糖尿、高血糖、耐糖量降低、胰岛素分泌障碍等表现,可使人体蛋白质、糖、脂肪、电解质、水等陷入异常状态,若得不到及时有效的治疗,极有可能引发酮症酸中毒、乳酸性酸中毒、高渗性昏迷及其他脏器功能障碍等严重疾病,威胁人类生命。本文通过分析人体患糖尿病时,血液、尿液、胰岛素、血清C-肽以及葡萄糖耐量等几项指标的变化,探讨了各项指标对于检测糖尿病的临床意义,希望可以为临床诊断糖尿病提供有效的借鉴。     

乌鲁木齐地区不同患者UU感染定量检测及流行状况分析

目的分析本地区解脲支原体(UU)感染的流行状况,为预防、诊断和治疗提供参考依据。方法采用实时荧光定量聚合酶链反应(FQ-PCR)技术对本地区2003年~2005年8652例尿道炎患者进行UU定量测定,分析检测结果。结果(1)通过连续3年检测,UU平均感染阳性率为9.98%,3者间检测阳性率和拷贝对数值均无显著性差异(P>0.05);(2)男性患者感染阳性率6.39%,女性阳性率11.80%,女性患者与男性患者相比较,检测阳性率和基因拷贝对数值之间均具有显著性差(P<0.01,P<0.05);⑶维族患者感染阳性率最高,可达到11.40%,哈族患者感染阳性率9.26%,汉族患者感染阳性率为8.30%,其它民族患者感染阳性率为8.39%,维族患者与哈、汉、其它民族患者相比较,其感染阳性率和基因拷贝对数值之间均具有显著性差异(P<0.05)。结论(1)本民族聚居区域2003年~2005年3年间UU感染阳性率基本趋于稳定,平均感染阳性率为9.98%,平均基因拷贝对数值为6.183±1.358;(2)女性UU感染阳性率和基因拷贝对数值显著高于男性患者,提示本区域女性UU感染几率比较大;(3)维族患者UU感染阳性率和基因拷贝对数值显著高于哈、汉等其它民族,提示维族患者在本区域UU感染的高风险性。     

B群链球菌显色培养基在孕产妇感染中的检测效果分析及对母婴健康的影响研究

目的 探讨B群链球菌(GBS)显色培养基在孕产妇感染中的检测效果及对母婴健康的影响.方法 选择2016年3月至2019年2月孕产妇感染患者126例作为对象,所有患者入院后均完成阴道分泌物和肛周分泌物采集,采用血平板(BAP)和B群链球菌选择性显色培养基(STRB)筛查孕产妇感染情况,并完成药敏试验进行常规耐药性分析;对...     

尿镁检测对预防及治疗妊娠高血压综合征的价值分析

目的探讨随机尿镁检测对预防及治疗妊娠高血压综合征的价值。方法随机抽查150名肝肾功能正常、糖筛查正常、无高血压的中孕及晚孕孕妇作为对照组，31名妊娠高血压综合征患者作为观察组，分别对其血镁及尿镁进行测定。结果无论正常中孕及晚孕孕妇还是妊高征患者尿液中镁的浓度与血清镁浓度都成正相关性，且妊娠高血压综合征患者尿镁明显低于对照组。结论随机尿镁检测对预防及治疗妊娠高血压综合征有较好的指导意义，且尿液取材方便、快捷、无痛苦，可进行常规化检测并进行动态观察。     

Detection of Ehrlichia phagocytophila DNA in Ixodes ricinus Ticks from Areas in Switzerland Where Tick-Borne Fever Is Endemic

A total of 1,523 adult Ixodes ricinus ticks were collected from regions where bovine ehrlichiosis is endemic and were examined for Ehrlichia phagocytophila via PCR. Of the ticks from cattle with ehrlichiosis, the ticks from healthy cattle, and the free-living ticks, 26.5% (18 of 68), 4.4% (35 of 802), and 0.8% (5 of 653), respectively, were positive.     

Swiss Army Survey in Switzerland to Determine the Prevalence of Francisella tularensis, Members of the Ehrlichia phagocytophila Genogroup, Borrelia burgdorferi Sensu Lato, and Tick-Borne Encephalitis Virus in Ticks

 A total of 6071 Ixodes ricinus ticks were collected on Swiss Army training grounds in five regions of Switzerland. The aim of the survey was to assess the prevalence of ticks infected with the human pathogens Francisella tularensis, members of the Ehrlichia phagocytophila genogroup, Borrelia burgdorferi sensu lato, and the European tick-borne encephalitis virus. TaqMan PCR (PE Biosystems, USA) and TaqMan RT-PCR (PE Biosystems) analyses were performed on DNA and RNA extracted from pools of ten ticks grouped by gender. Here, for the first time, it is shown that ticks may harbor Francisella tularensis in Switzerland, at a rate of 0.12%. Furthermore, 26.54% of the ticks investigated harbored Borrelia burgdorferi sensu lato, 1.18% harbored members of the Ehrlichia phagocytophila genogroup, and 0.32% harbored the European tick-borne encephalitis virus. A new instrumentation was applied in this study to carry out and analyze more than 2300 PCR reactions in only 5 days. Furthermore, the results reveal that people working in outdoor areas, including army personnel on certain training grounds contaminated with ticks containing tick-borne pathogens, are at risk for different tick-borne diseases.     

中国血蜱属研究(蜱螨目:硬蜱科)( Ixodoidea,Ixodidae)——系统分类与检索

我国的血蜱属Genus Haemaphysalis Koch的蜱种,按Hoogstraal and Kim (1985)的分类系统,归入11个亚属,即异尾血蜱亚属Subgenus Alloceraea Schultze 1918,异盲血蜱亚属Subgenus Allophysalis Hoogstraal1959,原生...     

Detection and Identification of Ehrlichia, Borrelia burgdorferi Sensu Lato, and Bartonella Species in Dutch Ixodes ricinus Ticks

A sensitive and specific PCR hybridization assay was developed for the simultaneous detection and identification of Ehrlichia and Borrelia burgdorferi sensu lato. In separate assays the 16S rRNA gene of Ehrlichia species and the 23S-5S rRNA spacer region of B. burgdorferi sensu lato were amplified and labeled by PCR. These PCR products were used in a reverse line blot hybridization assay in which oligonucleotide probes are covalently linked to a membrane in parallel lines. Hybridization of the samples with the oligonucleotide probes on this membrane enabled the simultaneous detection and identification of Ehrlichia, B. burgdorferi, and Bartonella species in 40 different samples. The application of the assay to DNA extracts from 121 Ixodes ricinus ticks collected from roe deer demonstrated that 45% of these ticks carried Ehrlichia DNA. More than half of these positive ticks carried species with 16S rRNA gene sequences closely related to those of E. phagocytophila and the human granulocytic ehrlichiosis agent. The majority of the other positive ticks were infected with a newly identified Ehrlichia-like species. In addition, 13% of the ticks were infected with one or more B. burgdorferi genospecies. In more than 70% of the ticks 16S rRNA gene sequences for Bartonella species or other species closely related to Bartonella were found. In five of the ticks both Ehrlichia and B. burgdorferi species were detected.     

Blood Safety in the United States: Prevention,Detection, and Pathogen Reduction

The safety and integrity of the blood supply is of paramount importance for delivering optimal medical care. Additionally, blood safety is of utmost importance to the United States public. Pathogen testing of donated blood products has been adapted and developed with the goal of eliminating the risk of transfusion-transmitted infectious disease. Currently, blood safety interventions are focused on excluding persons at risk for transfusion-transmissible infections from donating blood and on detecting the presence of transfusion-transmissible agents in donated blood. These interventions are intended to be complementary and function to isolate, and ideally, eliminate, the risk of exposure to known pathogenic agents by transfused blood components. We provide an overview of the strategies and techniques utilized to ensure the safety of the blood supply in the U.S.     

A Trilocus Sequence Typing Scheme for Hospital Epidemiology and Subspecies Differentiation of an Important Nosocomial Pathogen,Enterococcus faecalis

In this study, we present a trilocus sequence typing (TLST) scheme based on intragenic regions of two antigenic genes, ace and salA (encoding a collagen/laminin adhesin and a cell wall-associated antigen, respectively), and a gene associated with antibiotic resistance, lsa (encoding a putative ABC transporter), for subspecies differentiation of Enterococcus faecalis. Each of the alleles was analyzed using 50 E. faecalis isolates representing 42 diverse multilocus sequence types (ST^M; based on seven housekeeping genes) and four groups of clonally linked (by pulsed-field gel electrophoresis [PFGE]) isolates. The allelic profiles and/or concatenated sequences of the three genes agreed with multilocus sequence typing (MLST) results for typing of 49 of the 50 isolates; in addition to the one exception, two isolates were found to have identical TLST types but were single-locus variants (differing by a single nucleotide) by MLST and were therefore also classified as clonally related by MLST. TLST was also comparable to PFGE for establishing short-term epidemiological relationships, typing all isolates classified as clonally related by PFGE with the same type. TLST was then applied to representative isolates (of each PFGE subtype and isolation year) of a collection of 48 hospital isolates and demonstrated the same relationships between isolates of an outbreak strain as those found by MLST and PFGE. In conclusion, the TLST scheme described here was shown to be successful for investigating short-term epidemiology in a hospital setting and may provide an alternative to MLST for discriminating isolates.Enterococci are commensal members of the gastrointestinal tract flora of humans and animals. Within the last 2 decades, enterococci have emerged as the second to third most frequent cause of nosocomial infections, including endocarditis and bloodstream, urinary tract, and wound infections, among others (8, 15, 19, 24, 39). These organisms are also known to have the ability to acquire and transfer antibiotic resistance genes and virulence-associated genes (37). Although there are more than 30 species of the genus Enterococcus, two species, Enterococcus faecalis and Enterococcus faecium, account for a vast majority of enterococcal clinical and nosocomial infections (15, 21, 35). In the past, several molecular typing studies have shown that specific lineages of pathogenic bacteria arise periodically, proliferate, and spread in the presence of selective pressures (34). Therefore, accurate typing of enterococcal strains is crucial for the identification of particular clones capable of causing infections and with the ability to spread in the hospital environment.A number of phenotypic and genotypic typing methods have been applied to the subspecies differentiation of enterococcal isolates. Phenotypic methods which have been used in the past include serotyping (17, 22, 26) and multilocus enzyme electrophoresis (50). Genotypic methods include, among others (3, 52, 53), ribotyping (14, 38), repetitive sequence-based PCR (25, 35), multilocus variable-number tandem-repeat analysis (49, 54), pulsed-field gel electrophoresis (PFGE) (10, 12, 49), and multilocus sequence typing (MLST) (10, 26, 31, 41). Among these methods, PFGE, based on chromosomal restriction endonuclease digestion patterns, is widely used for the study of hospital outbreaks and is considered by many to be the “gold standard” molecular typing technique (48). However, this methodology has several limitations due to the facts that it is labor-intensive and the results have poor interlaboratory transportability. This technique is also unsuitable for long-term epidemiology and population studies due to changes in restriction sites, genomic rearrangements, and/or acquisition of DNA by a clonal lineage, which may markedly change the restriction pattern (41). A more appropriate typing technique for long-term epidemiology, which is currently also widely used for subspecies differentiation, is MLST. MLST, based on the allelic variations in sequences of multiple loci, unambiguously types strains (23) and offers an advantage over other techniques used for typing, such as PFGE, since the data are objective and easily stored, compared, and shared via the Internet.Two different MLST schemes have been used successfully for differentiation of E. faecalis strains (31, 41). The first scheme, which assessed three antigenic genes and one housekeeping gene, found that the allelic profile of two antigenic genes (ace and salA) was sufficient to discriminate the 22 E. faecalis isolates included therein (31). The second MLST scheme, based on the allelic profiles of seven housekeeping genes, was used to type 110 isolates and provided insight into the population structure as well as long-term epidemiological relationships of E. faecalis strains (41). However, typing studies on other organisms, such as Salmonella enterica serovar Typhimurium and Staphylococcus aureus, have suggested that MLST based on housekeeping genes may not provide enough discriminatory power to study hospital outbreaks or to accurately determine short-term genetic relationships, which can be crucial for hospital epidemiology and infection control purposes (9, 13, 27).Our hypothesis for this work was that a sequence-based methodology applied to genes encoding antigenic or cell surface proteins (rather than housekeeping genes) may potentially be more useful to establish short-term epidemiologic relationships in E. faecalis, since these genes would be more susceptible to evolutionary selective pressures and potentially could identify and discriminate isolates from hospital outbreaks, similar to PFGE.In the present work, the trilocus sequence types (ST^T; sequence type based on three genes) of 50 isolates were compared to their multilocus sequence types (ST^M; sequence type based on seven housekeeping genes). To determine the applicability of trilocus sequence typing (TLST) for a clinical setting, the scheme was also used to type sets of predetermined (by PFGE) clones and was then applied to a collection of hospital isolates from Bogota, Colombia, recently reported by Arias et al. to belong to an ST-2 clonal lineage (1).(Part of this work was presented at the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, IL, 2007.)     

Ticks and antibodies to Borrelia burgdorferi from mammals at Cape Hatteras, NC and Assateague Island, MD and VA.

Results of a survey for ixodid ticks and/or serum antibodies to Borrelia burgdorferi from 14 species of small to large mammals from eastern coastal areas of the United States are presented. Most samples were obtained from July 1987 through June 1989 (excluding December-March) at 3 locales: Assateague Is. National Seashore, Worcester Co., MD., and Accomack Co., VA. (approximately 38 degrees 05' N 75 degrees 10' W), and Cape Hatteras National Seashore, Dare Co., NC (approximately 35 degrees 30' N 76 degrees 35' W). Hosts sampled included opossums (Didelphis virginiana), least shrews (Cryptotis parva), gray foxes (Urocyon cinereoargenteus), red foxes (Vulpes vulpes), raccoons (Procyon lotor), feral cats (Felis sylvestris), feral horses (Equus caballus), sika deer (Cervus nippon), rice rats (Oryzomys palustris), white-footed mice (Peromyscus leucopus), meadow voles (Microtus pennsylvanicus), house mice (Mus musculus), norway rats (Rattus norvegicus) and jumping mice (Zapus hudsonius). An indirect fluorescent antibody test was used for testing sera from opossums, raccoons, and feral cats; enzyme-linked immunosorbent assays were used for sera from foxes, horses, deer, and house and white-footed mice. Antibodies to B. burgdorferi were found in all species tested from each locale. Seasonal data reinforce the contention that P. leucopus is a suitable sentinel species for B. burgdorferi. Ticks on hosts included Ixodes scapularis Say, I. texanus Banks, Dermacentor variabilis (Say), D. albipictus (Packard), and Amblyomma americanum (L.). Males comprised approximately 0-22 and 60-81% of Ixodes sp. and Amblyomma-Dermacentor adults collected from hosts, respectively. All stages of A. americanum, adult D. variabilis, and larval I. scapularis were collected from vegetation. The highest seropositivity rate (67%) was recorded for 45 P. leucopus at Assateague during July, approximately 1 mo. after peak nymphal I. scapularis intensity. Borrelia burgdorferi was isolated from 6 nymphal and 12 female I. scapularis collected from P. leucopus and C. nippon, respectively, on Assateague.     

Audit of oral and maxillofacial surgical conditions seen at Port Harcourt, Nigeria

BACKGROUND: The worldwide pattern of oral and maxillofacial surgical conditions has been rarely reported despite its significance in head and neck medicine. The Niger Delta region comprises 9 of the 36 states in the Federal Republic of Nigeria. There are scanty reports on oral and maxillofacial surgical diseases from the region despite its 95% contribution to Nigeria's oil-revenue. METHODS: This retrospective survey of oral/maxillofacial surgical cases seen at a referral center in Port Harcourt, a city in the Niger delta region of Nigeria. RESULTS: Between 2000 and 2004, our center offered specialized maxillofacial surgical services to 86 patients coming from 5 states in the Niger delta region. These patients made up 20% of all patients seen at the department within the period. There were 110 indications for surgical interventions. Most were complaints of trauma (46.4%). The rest were tumors and allied lesions (39.0%) and cysts (12.7%). Ratio of male to female patients was 1.7:1 while patients were aged between 9 and 85 years (mean 31.2 years, standard deviation +/- 15.4). Most (n? = ?63, 73%) had surgical treatment while a significant proportion (19%) defaulted. Seventy-nine surgical procedures were performed (69 primary and 10 secondary). Primary procedures included maxillo-mandibular fixation (31.9%) and enucleation of tumor/cyst (17.4%). While our series of 86 cases over 4 years appears low, there is likelihood that oral and maxillofacial surgical conditions are as common in the Niger Delta region as in other parts of Nigeria. There is scarcity of skilled manpower and equipments for the management of oral maxillofacial surgical conditions in the region. Health promotion activities are needed to improve awareness for early diagnosis of these conditions. Also, poverty alleviation measures need to be effective as defaults were often due to inability to pay for treatment. CONCLUSION: In many parts of the Niger Delta region of Nigeria, oral and maxillofacial surgical diseases are not uncommon causes of morbidity. However, many parts of the region lack requisite manpower for prevention and curative health activities. Defaults from hospital treatment were due to preference for traditional (unorthodox) measures and financial inability. Poverty alleviation measures need to be stepped up while the state of medical infrastructure should be enhanced in the region.