沙眼衣原体和解脲支原体感染对女性生育的影响——广州市增城地区居民生殖道感染对不孕不育影响的调查（二）

目的通过对增城地区各乡镇当地不孕不育夫妇的流行病学调查,了解生殖道沙眼衣原体和解脲支原体感染对女性不育的影响.方法对该地区543名不育妇女进行不育症流行病学调查以及相关检查化验,并将之与同地区175对已生育妇女的相关资料对比,从中分析沙眼衣原体和解脲支原体感染对女性生育的影响.结果在不孕组中,沙眼衣原体感染率具有显著性增高;其他某些与生育有关的病理改变,两组亦有显著性差异.结论沙眼衣原体感染可以引起女性不育.     

我国六城市性病高危人群生殖支原体感染状况的分子流行病学研究

目的　对我国部分地区不同类型的性病人群进行生殖支原体 (Mg)感染状况检测分析 ,以明确Mg感染在非淋菌性尿道炎中的可能致病作用。 方法　采用两对引物的聚合酶链反应技术 ,根据Mg粘附蛋白基因及支原体种属内核糖体基因序列设计引物 ,收集广东、昆明、上海、南京、常州等地性病门诊和 (或 )性罪错者的泌尿生殖道分泌物标本。结果　性病高危人群的Mg DNA检出率明显高于正常体检组 ( χ2 =7 82 2 ,P <0 0 1) ,其中广东性病门诊及昆明性罪错人群的Mg DNA检出率明显高于南京、上海、常州等地两种人群的检出率 ( χ2 =8 5 3 6,P <0 0 1及 χ2 =5 885 ,P <0 0 5 )。未查到其他相关病原体者亦可查及Mg DNA ;有Mg感染者亦可同时感染其他微生物 ,如衣原体、解脲支原体等 ;有尿道炎症状病例中Mg DNA的检出率高于无尿道炎症状者 ( χ2 =11 667,P <0 0 1)。结论　性病高危人群中存在生殖支原体的感染 ,在不同地区不同类型人群组中Mg感染率有一定差异     

产ESBLs肺炎克雷伯菌ESBLs基因与可移动遗传元件相关性分析

目的 了解产超广谱β-内酰胺酶(extended spectrum beta-lactamases, ESBLs)肺炎克雷伯菌(Klebsiella pneumoniae, Kpn)ESBLs基因与可移动遗传元件(mobile genetic elements, MGEs)标记基因的携带情况及其相关性。方法 收集从住院患者标本中分离出的产与非产ESBLs Kpn非重复菌株各100株，采用PCR检测细菌中4种ESBLs基因与8种MGEs标记基因，并作指标聚类分析。结果 产ESBLs Kpn中，ESBLs基因阳性率高达100%；MGEs标记基因以IS26、ISEcp1、traA、trbC和intI1基因为主，阳性率高于非产ESBLs Kpn(P<0.05)；ESBLs基因与MGEs标记基因的同时检出率明显高于非产ESBLs Kpn (P<0.05)；基因blaSHV-12、blaOXA-1与MGEs基因tnpU、tnp513、merA、intI1相关联，基因blaTEM-1、blaCTX-M-125与MGEs基因ISEcp1、IS26、traA相关联。产与非产ESBLs Kpn均没有只检出MGEs标记基因的菌株。结论 产ESBLs Kpn ESBLs基因和MGEs标记基因携带率高，两者存在相关性，可能是产ESBLs Kpn出现多重耐药的重要原因；MGEs标记基因在Kpn中可能不是单独存在的。     

Streptococcus pneumoniae Peritonitis Postpartum

Summary A peritonitis cause by an ascending infection is a rare complication postpartum. A 37-year-old women presented with a secondary peritonitis due to Streptococcus pneumoniae. The patient had given birth to a healthy boy 4 weeks before and showed no symptoms of a bronchitis on admission. A operation was performed after the patient developed an acute abdomen, showing a diffuse peritonitis. High vaginal swabs and blood cultures taken on admission were positive for S. pneumoniae as well as the specimen taken during the operation. Thus we concluded that this was a case of an ascending infection. After antibiotic therapy with penicillin the patient could be discharged 8 days after the operation. Received: July 6, 1999 · Accepted: January 5, 2000     

川崎病与支原体感染的相关性研究

目的研究川崎病(Kawasaki disease,KD)与支原体感染(Mycoplasma pneumomiae,MP)的相关性。方法回顾性分析2012年3月~2014年2月于我院被确诊为KD的84例患儿的病历资料,其中按照患者是否有支原体感染分为观察组和对照组。观察组KD患者为有支原体感染(43例),对照组KD患者无MP感染(41例)。对两组患者分别进行血白细胞计数(WBC)、超敏C反应蛋白(CRP)、红细胞沉降率(ESR)、血红蛋白(HB)以及血小板计数(PLT)的检测和分析。对两组患者是否存在冠脉损伤进行分析比较。结果观察组无冠脉损伤者占34.9%(15/43),明显低于对照组的58.5%(24/41),观察组冠脉损伤者占比65.1%(28/43),显著高于对照组的41.5%(17/41),差异均有统计学意义(P<0.05);观察组的CRP指标水平为(68.9±14.7)mg/L,明显高于对照组的(52.8±8.2)mg/L,观察组的ESR指标水平为(42.6±15.9)mm/h,显著高于对照组的(21.6±6.1)mm/h,差异均有统计学意义(P<0.05)。结论MP感染为KD的病因之一,MP感染与患者冠脉损伤呈正相关,MP感染引起的免疫介导损伤和炎症反应是发生KD的重要途径。     

儿童肺炎支原体脑炎研究进展

肺炎支原体是儿童社区获得性肺炎的常见致病菌,能引起多种形式的肺外损害.儿童肺炎支原体脑炎是引起神经系统损伤的最常见疾病类型.肺炎支原体脑炎的发病机制仍不清楚,直接侵袭、免疫损伤和神经毒素被认为是可能的发病机制.由于肺炎支原体脑炎具有较高的致死率及神经系统后遗症率,因此提高临床医师对该病的认识,最大限度地避免误诊与漏诊的发生,具有重要意义.     

细菌性脑膜炎的免疫学研究进展

细菌性脑膜炎是小儿时期最常见的中枢神经系统感染性疾病之一,尽管给予积极治疗,其病死率及致残率仍居高不下.研究表明,病原感染后导致宿主免疫失调是该病高致残率的主要因素.补体C3沉积细菌表面并活化是补体介导的细菌清除的关键步骤.脑脊液中C3或C5水平明显变化提示预后不良.致病菌穿过血脑屏障后,细菌细胞组分被模式识别受体识别,刺激机体产生过量细胞因子,介导白细胞募集及氧化应激反应,最终导致神经元不可逆损伤.该文以肺炎链球菌感染为例,综述细菌性脑膜炎的免疫学研究进展.     

Pneumococcemia as the presenting feature of multiple myeloma

Multiple myeloma is associated with a susceptibility to bacterial infections, specifically for encapsulated organisms such as Streptococcus pneumoniae. However, severe bacterial infection as the initial presentation of this disease has been rarely reported. The most common presenting features are anemia, lytic lesions, hypercalcemia, and renal failure. We report two cases of pneumococcal bacteremia as the initial manifestation of an underlying multiple myeloma. The first case is of a 68-year-old woman with pneumococcal pneumonia and bacteremia, presenting with a white blood cell count of 900/microL and mild anemia. Further work-up disclosed monoclonal IgG kappa and 50% plasma cells in bone marrow. Her course was complicated by acute renal failure requiring hemodialysis. The second patient is a 57-year-old man presenting with acute pneumococcal meningitis and bacteremia. Due to prior bacterial epiglottitis, further work-up disclosed IgG lambda monoclonal spike and 40% plasma cells in bone marrow. Both cases responded to antibiotic therapy without complications. These two cases add to the few patients described in the literature with pneumococcemia as the first sign of multiple myeloma. Features that were common in most of these cases, and that should lead to a suspicion of myeloma in an otherwise asymptomatic patient, are S. pneumoniae bacteremia, leukopenia, mild anemia, history of prior bacterial infections, and indirect evidence of a paraproteinemia, such as increased total protein levels with low albumin.     

Spontaneous Spondylodiscitis Caused by Klebsiella pneumoniae

Summary A rare case of spontaneous spondylodiscitis caused by Klebsiella pneumoniae in a 55-year-old man who presented with thoracolumbar pain is described. Increased erythrocyte sedimentation rate and C-reactive protein level were pertinent laboratory findings. Computed tomography revealed a paravertebral mass and destruction of the 10th and 11th vertebrae. Magnetic resonance imaging (MRI) showed spondylodiscitis in the same area. Culture of a biopsy sample from the mass grew Klebsiella pneumoniae, while histological examination confirmed the inflammation. A combination of ceftazidime, amikacin and ciprofloxacin resulted in disappearance of the pain. Two months later, MRI showed substantial improvement of the lesions. Received: March 19, 1999 · Accepted: September 19, 1999     

Outbreak of Mycoplasma pneumoniae at a military academy

In 2019,an outbreak of Mycoplasma pneumoniae (M.pneumoniae) occurred at a military academy in China.The attack rate (10.08％,60/595) was significantly different among the units.High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M.pneumoniae.In-time prevention and control measures effectively controlled the spread of the epidemic.