骨科感染创面病原菌菌谱分析

目的调查骨科患者感染细菌菌群分布情况,为治疗骨科感染性疾病提供参考。方法收集2005年6月～2007年6月在本科住院患者感染伤口取500份分泌物标本行细菌培养,总结分析感染菌株分布情况。结果送检的500份标本中,培养出细菌248株,其中G＋占43.5%,以金黄色葡萄球菌居首位（占12.9%）;G-杆菌占52.0%,其中铜绿假单孢菌居首（占10.5%）。感染细菌所占比例由高到低排列分别为：金黄色葡萄球菌12.9%,G-肠球菌12.5%,铜绿假单孢菌10.5%,凝固酶阴性葡萄球菌和阴沟肠杆菌各占9.3%,鲍曼氏不动杆菌8.5%,大肠埃希菌6.9%。结论骨科感染病原菌以G-菌占多数,且有上升趋势,临床应严格监测感染细菌菌群变化,合理使用抗生素。     

Correction of the pathogenic mutation in TGM1 gene by adenine base editing in mutant embryos

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Systematic review and Meta-analysis of treating open angle glaucoma with gonioscopy-assisted transluminal trabeculotomy

AIM: To describe the complex, overlapping phenotype of four Chinese patients with inherited retinal dystrophies (IRDs) who harbored two pathogenic genes simultaneously. METHODS: This retrospective study included 4 patients affected with IRDs. Medical and ophthalmic histories were obtained, and clinical examinations were performed. A specific Hereditary Eye Disease Enrichment Panel (HEDEP) based on exome capture technology was used for genetic screening. RESULTS: Four patients were identified to harbor disease-causing variants in two different genes. Patient RP01-II:1 exhibited both classical ABCA4-induced STGD1 and USH2A-associated RP, patient RP02-III:2 exhibited both classical ABCA4-induced STGD1 and CDH23-associated RP, patient RP03-II:1 exhibited both USH2A-induced arRP syndrome and SNRNP200-induced adRP, and patient RP04- II:2 exhibited USH2A-induced arRP syndrome and EYS-induced arRP at the same time. CONCLUSION: Our study demonstrates that genotype–phenotype correlations and comprehensive genetic screening is crucial for diagnosing IRDs and helping family planning for patients suffering from the disease.     

ICU小儿呼吸机相关性肺炎危险因素的Logistic回归分析及耐药研究

目的研究引起ICU小儿呼吸机相关性肺炎的危险因素和病原菌的耐药性。方法2011年2月-2013年2月,广东省妇幼保健院共有120例患儿实施机械通气治疗。治疗后诊断为呼吸机相关性肺炎的患儿共有20例,作为观察组;从未发生呼吸机相关性肺炎的患儿中随机选择20例作为对照组。对可能引起ICUsb）L呼吸机相关性肺炎的危险因素进行单因素及多因素Logistic回归分析,并计算病原菌的耐药率。结果观察组患儿的长期健康评价（APACHE）Ⅱ评分为28．12±3．32,体质量指数为23．78±1．12,均显著高于对照组的24．50±4．24和22．12±1．02,差异均有统计学意义（均P〈0．05）。通过多因素Logistic回归分析,发现插管天数、插管次数、吸痰次数和住院天数与ICU小儿吸机相关性肺炎有关（P〈0．05）。提取20例患儿的尿液标本,从中分离出病原菌49株,对其施用3种抗菌药物。结果发现病原菌对氨苄西林和头孢吡肟的抗药性强,而对亚胺培南敏感。结论ICU小儿呼吸机相关性肺炎与多种危险因素相关,其患病率极高。临床中应严格控制呼吸机的使用,合理使用对病原菌敏感的抗生素,从而降低患儿的死亡率,提高患儿治疗后的生活质量。     

糖尿病合并皮肤及软组织感染的病原菌分布及耐药性分析

目的:对糖尿病合并皮肤及软组织感染的相关情况进行分析,以了解病原菌的分布及耐药性。方法:对我院确诊糖尿病患者合并皮肤及软组织感染部位分泌物分离出的364株病原菌分布及耐药性进行分析。结果:364株病原菌革兰阳性球菌检出率42.86%,其中主要2种致病菌为金黄色葡萄球菌和表皮葡萄球菌,对青霉素类的耐药率较高;分离出的革兰阴性杆菌检出率47.25%,其中2种主要致病菌为铜绿假单胞菌和克雷伯菌属,对于氨苄西林的耐药率最高,分别为95.5%和87.5%。结论:糖尿病患者合并皮肤及软组织感染率较高,且病原菌耐药性高,应根据药敏结果合理用药。     

First Outbreak of an H5N8 Highly Pathogenic Avian Influenza Virus on a Chicken Farm in Japan in 2020

On 5 November 2020, a confirmed outbreak due to an H5N8 highly pathogenic avian influenza virus (HPAIV) occurred at an egg-hen farm in Kagawa prefecture (western Japan). This virus, A/chicken/Kagawa/11C/2020 (Kagawa11C2020), was the first HPAI poultry isolate in Japan in 2020 and had multiple basic amino acids—a motif conferring high pathogenicity to chickens—at the hemagglutinin cleavage site. Mortality of chickens was 100% through intravenous inoculation tests performed according to World Organization for Animal Health criteria. Phylogenetic analysis showed that the hemagglutinin of Kagawa11C2020 belongs to clade 2.3.4.4B of the H5 Goose/Guangdong lineage and clusters with H5N8 HPAIVs isolated from wild bird feces collected in Hokkaido (Japan) and Korea in October 2020. These H5N8 HPAIVs are closely related to H5N8 HPAIVs isolated in European countries during the winter of 2019–2020. Intranasal inoculation of chickens with 10⁶ fifty-percent egg infectious doses of Kagawa11C2020 revealed that the 50% chicken lethal dose was 10^4.63 and the mean time to death was 134.4 h. All infected chickens demonstrated viral shedding beginning on 2 dpi—before clinical signs were observed. These results suggest that affected chickens could transmit Kagawa11C2020 to surrounding chickens in the absence of clinical signs for several days before they died.     

儿童腹泻病原学检测及流行病学特征分析

目的：了解苍南地区儿童腹泻病的病原学分布、对抗生素耐药情况及流行病学分析,为临床医师治疗儿童腹泻提供参考。方法：对2011年1月-2013年12月期间该地区在医院门诊及住院治疗628例腹泻患儿的粪便标本进行分离培养,鉴定病原菌种类并用K-B法进行药敏实验,胶体金试纸法检测轮状病毒抗原,对腹泻发生的季节、年龄等流行病学资料进行分析总结。结果：腹泻患儿粪便病原菌的检出率为58.72%,排名前三位的病原菌依次为沙门菌属（43.88%）、大肠埃希菌属（21.17%）和轮状病毒（13.78%）。病原菌对抗生素的耐药率呈逐渐上升趋势。夏秋是儿童腹泻病的高发季节,且不同年龄段儿童引起腹泻的病原菌所占比例不同。结论：革兰阴性菌和轮状病毒是儿童腹泻的主要病原菌,由于抗生素不合理使用,病原菌对抗生素的耐药性不断增加。季节和年龄是儿童腹泻病发生的影响因素。对患儿进行病原学诊断,有助于合理用药,提高治疗效果。     

2009-2012年达州市食源性致病菌监测结果分析

目的监测达州市主要食源性致病菌污染状况,确定本地区高危食品,为预防控制食源性疾病提供科学依据。方法按照国家食源性致病菌监测工作手册要求,多级分层抽样并按标准操作程序进行检测。结果 4年监测10大类食品975件,检出食源性致病菌7种99株,总检出率为10.15%。检出数较多的依次为金黄色葡萄球菌24株、单增李斯特菌20株、蜡样芽孢杆菌18株,检出率较高的依次为副溶血性弧菌25.00%、阪崎肠杆菌21.62%、蜡样芽孢杆菌14.40%。结论达州市食品存在食源性致病菌污染,其中婴幼儿配方食品、冷冻食品和动物性水产品是主要污染食品品种。     

大面积烧伤患儿静脉导管感染病原菌情况调查与耐药性分析

 目的 探讨大面积烧伤患儿静脉导管感染病原菌情况,分析其耐药性。方法 选取2014-01至2019-01武警辽宁总队医院和解放军总医院第三医学中心烧伤科收治的478例烧伤患儿,收集所有患儿的静脉导管进行细菌培养与鉴定,对按不同因素分类的置管后患儿中心静脉导管感染情况进行对比分析。结果 478例静脉导管中共分离出病原菌304株。其中革兰阳性菌113株(37.17%),革兰阴性菌183株(60.20%),真菌8株(2.63%)。药敏试验显示:金黄色葡萄球菌对万古霉素和利奈唑胺敏感;铜绿假单胞菌对哌拉西林/他唑巴坦和亚胺培南敏感。男女感染率对比差异无统计学意义,不同年龄患儿感染率对比,差异有统计学意义(P<0.05);中心静脉导管穿刺部位股、颈内、锁骨下静脉感染率、导管留置及住院时间不同感染率对比,差异均有统计学意义(P<0.05)。结论 大面积烧伤患儿年龄越小感染率越高,股静脉感染率较重,留置、住院时间越长感染率越高。     

气道支架置入术后相关肺部感染的病原学分析及抗感染策略

目的：探析气道支架置入术后肺部感染的病原学特点及耐药情况,促进合理用药,为并发肺部感染防治提供参考。方法：选取某医院2015年1月至2016年12月收治的气道支架置入术后肺部感染的58名患者为研究对象,回顾性分析下呼吸道分泌物分离培养的病原菌类型及药敏试验。结果：下呼吸道分泌物培养共分离处51株病原菌,革兰阳性球菌占21.57%,革兰阴性杆菌占70.59%,真菌占7.84%。分离率较高的病原菌为：铜绿假单胞菌31.37%、金黄色葡萄球菌（其中MRSA 2例）19.61%、肺炎克雷伯菌属7.84%、流感嗜血杆菌5.88%、大肠埃希菌5.88%和白色假丝酵母菌5.88%。结论：气道支架置入术后肺部感染的病原菌以革兰阴性菌为主,经验性治疗应主要覆盖铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌属,并结合患者生理病理状态,优化气道支架置入术后相关肺部感染的治疗。