铜绿假单胞菌消毒剂-磺胺耐药基因检测及对消毒剂的抗性研究

目的了解铜绿假单胞菌Ⅰ类整合子消毒剂-磺胺耐药基因(qacE△1-sull)的携带情况以及阳性菌株对碘伏、戊二醛、氯己定、"84"消毒液的抗性。方法对某院2007年12月-2008年1月连续分离的20株铜绿假单胞菌以聚合酶链反应(PCR)法检测qacE△l-sull基因,测定其阳性菌株对上述4种消毒剂的最低抑菌浓度(MIC)。结果 20株铜绿假单胞菌中检出qacE△1-sull阳性株10株(50.00%)。碘伏、戊二醛、氯己定、"84"消毒液对qacE△1-sull阳性菌株的MIC范围分别为:8.0～128.0μg/mL、16.0～256.0μg/mL、1.0～16.0μg/mL、4.0～64.0μg/mL。结论 qacE△1-sul1基因普遍存在于临床分离的铜绿假单胞菌中,阳性菌株对碘伏、戊二醛、氯己定、"84"消毒液存在抗性差异,应合理使用消毒剂并增加作用时间,以有效控制铜绿假单胞菌的播散。     

烧伤患者铜绿假单胞菌感染株的消毒剂-磺胺耐药基因、Ⅰ类整合酶基因研究

目的铜绿假单胞菌(PAE)感染株的消毒剂-磺胺耐药相关基因qacE△1-sul1和Ⅰ类整合酶基因(intⅠ1)存在状况。方法对分离自天津第四医院烧伤住院患者创面20株PAE菌的qacE△1-sul1i、ntⅠ1基因进行检测。结果20株PAE菌qacE△1-sul1i、ntⅠ1基因均阳性。结论PAE菌全部携带消毒剂-磺胺耐药基因、Ⅰ类整合酶基因。     

多药耐药铜绿假单胞菌消毒剂—磺胺耐药基因检测与临床意义

目的了解多药耐药铜绿假单胞菌消毒剂-磺胺耐药基因（qacE△1 sul1）的存在状况。方法采用纸片扩散（K B）法测定某院临床标本分离的30株铜绿假单胞菌对15种抗菌药物的敏感性;以聚合酶链反应（PCR）法检测qacE△1 sul1基因。结果30株多药耐药铜绿假单胞菌中,qacE△1 sul1基因阳性13株,阳性率43.33%。结论临床分离的铜绿假单胞菌qacE△1 sul1基因携带率较高,应引起高度重视。本结果为山东地区首次报道。     

ICU铜绿假单胞菌耐药性和消毒剂-磺胺耐药基因的检测及分析

目的了解医院ICU铜绿假单胞菌临床分离菌株的耐药特征,检测分析铜绿假单胞菌消毒剂-磺胺耐药基因的携带情况,为指导临床合理应用抗菌药物和合理调整消毒剂的使用提供参考依据。方法选取医院2015年6月-2016年6月ICU病房送检的住院患者包括血、尿、痰、胸腹水及分泌物等各类标本,共获得不重复患者的菌株105株,采用VITEK-2全自动微生物分析仪进行菌株鉴定及药敏试验。结果 105株铜绿假单胞菌对头孢替坦、头孢唑林、磺胺甲噁唑/甲氧苄啶、氨苄西林、氨苄西林/舒巴坦、呋喃妥因耐药率高,均>95.0%;105株铜绿假单胞菌检测qac E△1-sul1基因阳性43株,阳性率40.95%。结论 ICU铜绿假单胞菌的耐药情况已非常严重,应加强对铜绿假单胞菌的耐药性监测,根据药敏结果合理使用抗菌药物,减少耐药株的产生;分离的铜绿假单胞菌qac E△1-sul1基因携带率较高,医院常用消毒剂对铜绿假单胞菌的灭菌效果良好,重症监护室应进一步加强耐消毒剂基因菌株的监控,并根据耐消毒剂情况合理调整消毒剂的使用,尽量避免应用季铵盐类和双胍类消毒剂,严格执行消毒隔离措施,控制医院感染的发生。     

医院感染革兰阴性杆菌耐消毒剂基因研究

目的了解浙江湖州解放军第98医院临床分离的医院感染革兰阴性杆菌中,耐消毒剂基因qacE△1存在状况.方法采用聚合酶链反应(PCR)及序列分析的方法,分析147株革兰阴性杆菌(分别为鲍氏不动杆菌63株、铜绿假单胞菌30株、阴沟肠杆菌20株、嗜麦芽寡养单胞菌19株、黄杆菌属细菌15株)中qacE△1基因.结果147株革兰阴性杆菌qacE△1基因阳性96株,总阳性率为65.3%;阴沟肠杆菌、铜绿假单胞菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌和黄杆菌属细菌qacE△1基因阳性株数分别为17(85.0%)、25(83.3%)、52(82.5%)、2(10.5%)、0.结论临床分离的医院感染革兰阴性杆菌中,耐消毒剂基因qacE△1携带率比较高,应引起我国医院消毒界的重视.     

多药耐药铜绿假单胞菌消毒剂、灭菌剂耐药基因研究

目的调查6种消毒剂、灭菌剂耐药基因(smr、smr-2、qacE△1t、ehA、oqxA、merA)在铜绿假单胞菌分离株中的存在和变化情况。方法收集复旦大学附属上海市第五人民医院2009年5-11月分离自住院患者送检痰液标本的铜绿假单胞菌共20株,采用聚合酶链反应(PCR)及序列分析的方法分析6种消毒剂、灭菌剂耐药基因。结果 20株铜绿假单胞菌中,smr基因均有检出(100%),qacE△1基因和merA基因阳性株数分别为12株(60%)和11株(55%),而smr-2t、ehA、oqxA基因未检出;3种阳性基因以3种阳性模式存在,其中3种基因同时检出的模式:smr+qacE△1+merA检出率最高,共11株(55%);3号株merA基因与美国NCBI中已登录的序列均不同,为新亚型。结论该组铜绿假单胞菌检出消毒剂、灭菌剂耐药基因,且阳性率高,提示该组菌多数已耐消毒剂、灭菌剂,所以要严格控制对泛用消毒剂、灭菌剂的使用;铜绿假单胞菌进行6种消毒剂、灭菌剂耐药基因检测研究为国内首次,检出smr基因亦为国内首次报道。     

ICU铜绿假单胞菌耐药性和消毒剂-磺胺耐药基因的检测及分析北大核心CSCD

目的了解医院ICU铜绿假单胞菌临床分离菌株的耐药特征,检测分析铜绿假单胞菌消毒剂-磺胺耐药基因的携带情况,为指导临床合理应用抗菌药物和合理调整消毒剂的使用提供参考依据。方法选取医院2015年6月-2016年6月ICU病房送检的住院患者包括血、尿、痰、胸腹水及分泌物等各类标本,共获得不重复患者的菌株105株,采用VITEK-2全自动微生物分析仪进行菌株鉴定及药敏试验。结果 105株铜绿假单胞菌对头孢替坦、头孢唑林、磺胺甲噁唑/甲氧苄啶、氨苄西林、氨苄西林/舒巴坦、呋喃妥因耐药率高,均>95.0%;105株铜绿假单胞菌检测qac E△1-sul1基因阳性43株,阳性率40.95%。结论 ICU铜绿假单胞菌的耐药情况已非常严重,应加强对铜绿假单胞菌的耐药性监测,根据药敏结果合理使用抗菌药物,减少耐药株的产生;分离的铜绿假单胞菌qac E△1-sul1基因携带率较高,医院常用消毒剂对铜绿假单胞菌的灭菌效果良好,重症监护室应进一步加强耐消毒剂基因菌株的监控,并根据耐消毒剂情况合理调整消毒剂的使用,尽量避免应用季铵盐类和双胍类消毒剂,严格执行消毒隔离措施,控制医院感染的发生。     

肺炎克雷伯菌抗药基因检测与消毒剂抗性相关性分析

目的 研究医院临床分离及环境检出的肺炎克雷伯菌对消毒剂抗性水平和抗药基因携带的关系.方法 采用最低抑菌浓度(MIC)、最小杀菌浓度(MBC)、聚合酶链反应(PCR)等试验方法,分析临床分离及环境中检出的肺炎克雷伯菌qacE△1-sulI基因携带和对消毒剂的抗性.结果 10株肺炎克雷伯菌中有2株临床分离的多药耐药菌qacE△1-sul I基因为阳性,8株环境检出菌株均为阴性;三氯异氰尿酸对10株肺炎克雷伯菌的MIC、MBC值均为500～1000 mg/L,标准菌株为500 mg/L;聚乙烯吡咯烷酮碘对10株肺炎克雷伯菌的MIC值为200～800 mg/L,标准菌株为400 mg/L;戊二醛对10株肺炎克雷伯菌的MIC值为1250～2500 mg/L,标准菌株为1250 mg/L.结论 临床分离的肺炎克雷伯菌qacE△-sul I基因携带率高于环境检出菌株,部分抗药基因阳性菌株对消毒剂产生抗性.     

多重耐药革兰阴性杆菌耐消毒剂基因qacE△1 sul1监测

目的了解某院临床常见革兰阴性(G-)杆菌多重耐药株耐消毒剂基因qacE△1 sul1的产生情况。方法收集临床分离的G-杆菌235株,包括155株多重耐药株和80株敏感株,采用聚合酶链反应（PCR）法检测qacE△1 sul1基因,并进行DNA测序。结果在50株产超广谱β 内酰胺酶（ESBLs）大肠埃希菌、27株产ESBLs肺炎克雷伯菌、50株多重耐药的铜绿假单胞菌和28株多重耐药的鲍曼不动杆菌中,检出qacE△1 sul1 株分别为37、24、46、28株,检出率分别为74.00％、88.89%、92.00%和100.00％,总的检出率为87.10％;在非产ESBLs的大肠埃希菌、肺炎克雷伯菌以及铜绿假单胞菌和鲍曼不动杆菌的敏感株（各20株）中,分别检出qacE△1 sul1株 16、7、5、13株,检出率分别为80.00％、35.00%、25.00%和65.00％,总的检出率为51.25％。结论该院G-杆菌多重耐药株耐消毒剂基因qacE△1 sul1的携带率较高,加强多重耐药菌对消毒剂耐药性的监测,对临床合理使用消毒剂具有重要意义。     

部队医疗机构室内空气中细菌抗消毒剂基因qacE△1检测

目的 研究西北地区东片部队医疗机构室空气细菌抗消毒剂基因qacE△1的阳性率,为部队医疗机构空气消毒及医院感染预防治疗提供指导依据.方法 用PCR方法检测空气中分离的细菌的qacE△1基因.结果 98株细菌中有23株携带抗消毒剂基因qacE△1,阳性率为23.5％;大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌、表皮葡萄球菌qacE△1的检出率分别为36.7％、36.4％、27.8％、20.0％、10.0％;白色假丝酵母菌、蜡样芽胞杆菌、枯草芽胞杆菌黑色变种芽胞、流感嗜血菌未检出qacEA1基因.结论 西北地区东片部队医疗机构空气中的细菌抗消毒剂基因qacE△1、阳性率不高,但应注意消毒剂的交替使用.     

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.     

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.     

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.     

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.