The incidence of bacterial meningitis in the Netherlands—A comparison of three registration systems, 1977–1982

Data on the incidence of bacterial meningitis (BM) in the Netherlands are important for a cost-benefit analysis of new effective vaccines. During the period 1977-1982 we compared the notifications of meningococcal meningitis, diagnoses on discharge from hospital of all causes of BM (Stichting Medische Registratie, Medical Registration Foundation; SMR) and bacteriological data (Netherlands Reference Laboratory for Bacterial Meningitis; RBM). Notifications of meningococcal meningitis were 42% lower than SMR-data. RBM-registration of meningococcal, haemophilus and pneumococcal meningitis was 20% lower than SMR. Reviewing patient-records we found that these diseases had not been reported in 16% (RBM) and 11% (SMR) of cases. We estimate the incidence of BM during an endemic period at 8.0 per 100 000 population per year, to which the meningococcus contributes 20-25%. In children under 5 years of age the age-specific incidence of haemophilus meningitis is 22/100 000.     

2005—2008年医院感染细菌学监测分析

目的通过医院感染细菌学监测结果分析了解和预防医院感染事件的发生,为医院控制感染提供科学的依据并了解不同消毒方法对空气的灭菌效果。方法消毒后用琼脂平板和增菌肉汤对医院需监测感染环境的空气、物表、手表、碘伏、酒精实施例行监测。结果监测空气标本3216个,检测到菌落1643个,均为杂菌,合格率为92．7％;检测物表标本912个,检测到菌落356个,合格率为95．3％;检测医护人员手表912例,检测到菌落399个,合格率为96．4％,均未检测到致病菌;碘伏和酒精未检测到菌落,合格率为100．0％。结论通过分析2005—2008年医院感染细菌学监测结果,表明消毒灭菌技术合格,医院感染控制措施合理有效。     

The changing pathogens of complicated parapneumonic effusions or empyemas in a medical intensive care unit

Objectives To assess the incidence, pathogens, and outcome of complicated parapneumonic effusions or empyemas in a medical intensive care unit (MICU) patients with pleural effusions. Design and setting Prospective study of febrile MICU patients with pleural effusion carried out in a tertiary care hospital between April 2001 and September 2003. Patients The study included 175 patients with a temperature above 38° for more than 8 h with evidence of pleural effusion confirmed by chest radiography and ultrasound. Intervention Routine thoracentesis and effusion cultures. Results The prevalence of complicated parapneumonic effusions or thoracic empyemas in febrile MICU patients with pleural effusions was 45% (78/175). A total of 78 micro-organisms were isolated from the pleural fluid of 58 patients (positive microbiological culture 74%) including aerobic Gram-negative (n = 45), aerobic Gram-positive (n = 23), anaerobic (n = 5), Myobacterium tuberculosis (n = 3), and Candida (n = 2). The infection-related mortality rate of complicated parapneumonic effusions or empyemic patients in the MICU was 41% (32/78). Conclusion The development of complicated parapneumonic effusions or thoracic empyemas in MICU patients is a high-mortality disease. The increasing incidence of aerobic Gram-negative pathogens in empyema has become a more urgent problem. Electronic supplementary material The electronic reference of this article is . The online full-text version of this article includes electronic supplementary material. This material is available to authorised users and can be accessed by means of the ESM button beneath the abstract or in the structured full-text article. To cite or link to this article you can use the above reference.     

狼疮性肾炎并发医院获得性感染的临床特点及相关因素分析

目的探讨狼疮性肾炎(LN)患者并发医院获得性感染的相关因素和细菌学特点。方法回顾性分析2008~2009年我科住院治疗的121例LN患者感染的可能原因,并分析感染的部位、细菌种类、治疗及转归。结果 121例LN患者中,29例发生医院获得性感染,占23.9%。LN患者医院内感染与疾病活动、大量尿蛋白、低血白蛋白、大剂量使用激素、住院天数显著相关(P<0.05),与年龄、性别、血甘油三酯及球蛋白水平无显著相关(P>0.05)。最常见的感染部位是呼吸道(48.3%)。感染的细菌以革兰阴性杆菌(44.4%)为主,其中最常见的是大肠埃希菌(26.1%)和肺炎克雷伯菌(21.7%)。29例并发医院获得性感染的患者中,治愈26例,2例死亡,1例放弃治疗。结论狼疮性肾炎患者易并发医院获得性感染,易感因素有疾病活动、24 h尿蛋白定量、血白蛋白、肾功能、血IgG、大剂量使用激素、住院天数等。     

实验动物细菌学监测工作中存在的问题及建议

实验动物细菌学质量控制标准是评价实验动物质量的重要指标,本文在分析发达国家实验动物质量标准的基础上,结合目前的检测现状,对我国实验动物细菌学监测标准在检测项目、检测方法、检测频率、取样要求等方面存在的问题进行了分析并提出建议。     

Association of toll-like receptor 10 polymorphisms with pediatric pneumococcal meningitis

We aimed to investigate whether the gene polymorphisms of TLR10 were associated with risk and severity of pneumococcal meningitis (PM) and serum cytokine levels in children. Three single nucleotide polymorphisms (SNPs) of TLR10 rs4129009 (2676A > G), rs10004195 (1018T > A) and rs11466617 (40735A > G) were studied in 95 laboratory-confirmed PM pediatric patients and 330 healthy controls by PCR-based sequencing. Ten serum cytokines were determined by multiplex immunoassay. The frequency of variant haplotype GAG of TLR10 was significantly lower in patients than controls (11.3% vs 33.3%, p < 0.001), although frequencies of the genotypes and alleles of the three SNPs did not differ between patients and controls. Frequency of variant haplotype GAG was significantly lower in patients who had CSF protein >1000 mg/L than those who had CSF protein ≤1000 mg/L (3.50% vs 32.4%, p < 0.001). Moreover, higher frequency of the haplotype GAG was found in patients who had higher levels of inflammatory cytokines such as IFN-γ, TNF-α and IL-1β. Our finding suggested that the variant haplotype GAG in TLR10 is associated with decreased risk of PM in Chinese children.     

The bacterial species associated with aspirated foreign bodies in children

Objective

Inhaled foreign bodies in children are common and may be complicated by secondary airway tract infection. The inhaled foreign body may act as carrier of infectious material and the aim of this study was to explore the bacterial species associated with aspirated foreign bodies in a cohort of children.

On the study of Sendai virus hemolysis. I. Complete Sendai virus lacking in hemolytic activity.

The hemolytic activity of Sendai virus was examined with samples collected at various times after infection of the embryonated eggs. The virus obtained just after the end of the one-step growth cycle (early harvest) was shown to exhibit no hemolytic activity, whereas it expressed full activity of cell fusion and infectivity. Incubation at 36°, freezing and thawing, or sonic treatment enabled the early harvests to be hemolytic. Conversion of the virus from the nonhemolytic state to a hemolytic one was always followed by the alteration of the virus envelope so that it became permeable to the uranyl acetate stain used for the negative staining (UA-particle). The degree of hemolysis and the number of UA-particles of the early harvest increased as freezing and thawing was repeated while the degree of cell fusion and infectivity was decreasing. On the basis of these findings, it was concluded that Sendai virus with intact envelope does not exhibit hemolysis, while it has the potential activity to do so.