An analysis of underlying factors for seasonal variation in gonorrhoea in India: A 6-year statistical assessment

Purpose: A statistical assessment of a disease is often necessary before resources can be allocated to any control programme. No literature on seasonal trends of gonorrhoea is available from India. Objectives: The objectives were (1) to determine, if any, seasonal trends were present in India (2) to describe factors contributing to seasonality of gonorrhoea (3) to formulate approaches for gonorrhoea control at the national level. Materials and Methods: Seasonal indices for gonorrhoea were calculated quarterly in terms of a seasonal index between 2005 and 2010. Ratio-to-moving average method was used to determine the seasonal variation. The original data values in the time-series were expressed as percentages of moving averages. Results were also analyzed by second statistical method i.e. seasonal subseries plot. Results: The seasonally adjusted average for culture-positive gonorrhoea cases was highest in the second quarter (128.61%) followed by third quarter (108.48%) while a trough was observed in the first (96.05%) and last quarter (64.85%). The second quarter peak was representative of summer vacations in schools and colleges. Moreover, April is the harvesting month followed by celebrations and social gatherings. Both these factors are associated with increased sexual activity and partner change. A trough in first and last quarter was indicative of festival season and winter leading to less patients reporting to the hospital. Conclusion: The findings highlight the immediate need to strengthen sexual health education among young people in schools and colleges and education on risk-reduction practices especially at crucial points in the calendar year for effective gonorrhoea control.     

成都地区女性生殖道感染研究

目的:了解成都地区女性生殖道感染的基本状况。方法:随机调查5598例在我院就诊的妇科、产科和计划生育科病人,通过阴道分泌物检查了解滴虫性阴道炎(TV)、假丝酵母菌外阴阴道炎(VVC)、细菌性阴道病(BV)及淋病的感染率。结果:BV、VVC、TV及淋病的感染率依次为17·1%、12·9%、2·7%、0·3%;合并感染率中,BV合并VVC感染率为10·2%,显著高于其它合并感染率(P<0·05)。结论:BV是女性生殖道最常见的感染性疾病,且易于与VVC合并感染,应引起临床医生的高度重视。     

Of stewardship,motherhood and apple pie

Antibiotic stewardship is universally agreed to be desirable, but optimal models for stewardship remain uncertain. UK stewardship targets the particular antibiotic families—cephalosporins and fluoroquinolones—blamed for the selection of Clostridium-difficile-associated disease. To balance this there have been dramatic increases in the use of penicillin–β-lactamase inhibitor combinations. By channelling selection pressure in this way, we hazard destroying the utility of these antibiotic classes in turn, as happened with gonorrhoea where penicillins, fluoroquinolones and cefixime were sequentially lost as therapies. Strikingly, in context, almost all carbapenemase-producers are highly resistant to penicillin–β-lactamase inhibitor combinations, which may select for them. There is an urgent need to explore an alternative stewardship model, seeking to limit total antibiotic use but to maintain heterogeneity in what is used, avoiding concentrated selection pressure. There is also a great need to improve and accelerate diagnostics for infection and resistance, reducing or removing the need for protracted empirical treatment with broad-spectrum agents.     

Disseminated gonococcal infection in a married couple

Summary The rare occurence of disseminated gonococcal infection in a married couple is reported. These cases support the concept that bacterial rather than host factors are more important in determining the disease manifestations in gonorrhoea.     

淋球菌、支原体和沙眼衣原体在急性尿道炎中的感染分布及耐药性分析

目的了解淋球菌、支原体和沙眼衣原体在急性尿道炎中的感染分布和耐药情况。方法用培养法对淋球菌和支原体进行分离鉴定和药敏试验，用头孢硝噻吩法对淋球菌进行口一内酰胺酶检测，用单克隆抗体胶体金标法测定沙眼衣原体。支原体药敏试验用支原体药敏试剂盒检测，淋球菌药敏试验采用中K—B法。结果在389份尿道口分泌物标本中，阳性分离率为94．6％。淋球菌β-内酰胺酶的产生率为29．0％，对青霉素的敏感率为2．9％，对氧氟沙星和环丙沙星的敏感率为6．8％和7．2％，对壮观霉素、头孢菌素和头孢西丁的敏感性均较高。支原体对乙酰螺旋霉素、红霉素、环丙沙星、左氧氟沙星和司巴沙星以及壮观霉素的敏感率均不超过50．0％，而对四环素、强力霉素、罗红霉素、美满霉素、交沙霉素和阿奇霉素的敏感率均超过70．0％。结论急性尿道炎患者主要以淋球菌感染为主，支原体和沙眼衣原体可引起混合感染。监测淋球菌和支原体的耐药性对指导临床合理使用抗生素有重要意义。     

太原地区妇女儿童淋球菌感染调查及基因快速诊断

改进并建立快速检测淋球菌基因的聚合酶链反应，同时用涂片染色筛查和培养法作鉴定比较，对太原地区１９８６￣１９９５年妇女儿童淋球菌感染状况作调查分析，对９２０４例妇女儿童生殖道感染者作直接涂片染色检菌，阳性率为２６．５％，其中１２２０例同时用培养与ＰＣＲ法检测，阳性率为１２．４％和２１．０％，用ＰＣＲ直接检测临床标本ＮＧ－ＤＮＡ，具有简便，快速、敏感特异之优点。     

湖南省部分医疗机构梅毒和淋病病例报告与诊断调查

目的了解湖南省梅毒和淋病病例的诊疗和疫情报告质量,及时发现性病监测工作中存在的问题与困难,为政府制定性病预防控制规划及防治措施提供科学依据。方法现场抽查全省医疗机构84家,其中市级综合医院14家、妇幼保健机构14家、县级综合医院28家、妇幼保健机构28家,2010年1-9月份诊治的梅毒和淋病病例记录。与同期该机构在《中国疾病预防控制信息系统》上报的病例数据进行比较,核查传染病报告卡填写完整性、上报的及时性、准确性,同时问卷调查实验室采用的诊断方法。结果被抽查的84家医疗机构1-9月份网络直报梅毒1 472例,现场核查1 837例,漏报率24.8%。网络直报淋病331例,现场核查566例,漏报率70.9%。69.1%梅毒和15.8%淋病有实验室诊断结果。结论湖南省医疗机构性病病例报告和诊断质量令人担忧,卫生行政部门应加大对相关医疗机构性病诊疗服务及网络直报管理。     

淋球菌外膜Porin I蛋白多价抗血清的制备及其临床应用初探

目的 制备淋球菌外膜GST-PI融合蛋白多价抗血清,并探讨该多价抗血清与临床泌尿生殖道分泌物标本的结合情况.方法 重组的淋球菌外膜GST-PI融合蛋白免疫家兔,获得多价抗血清;并用双向免疫扩散法鉴定家兔多价抗血清的效价.家兔多价抗血清与临床泌尿生殖道分泌物标本的结合采用试管凝集法,出现棉絮状沉淀则为阳性;并把同一标本的试管凝集法结果与淋球菌培养结果相比较,观察两者的阳性符合率.同时以生理盐水和非淋菌性尿道炎患者的泌尿生殖道分泌物标本作为对照.结果 成功免疫家兔并获得了PI蛋白多价抗血清,经鉴定多价抗血清的效价达1：8;淋球菌培养阳性的35例分泌物标本中,试管凝集法阳性23例,两方法结果符合率为65.71%.而对照组试管凝集法结果均为阴性.结论 淋球菌外膜PI蛋白不仅具有一定的免疫原性,而且其免疫家兔产生的多价抗血清与淋病患者的分泌物标本有良好的结合率,特异性高.有望经纯化、标记后得到一种新的简单快速的淋病诊断试剂盒.     

淋病患者中支原体和衣原体感染频率的初步血清学调查

对123例淋病患者和108名健康人的血清应用PHA进行Mh和Ct抗体检测。结果表明,淋病患者的Mh抗体阳性率为23.58%,GMT为1:7.60;Ct抗体阳性率为72.35%,GMT为1:8.71。显著高于健康人的Mh和Ct抗体水平(P<0.05)。提示柳州地区淋病病人生殖道Ct和Mh感染较为普遍,在性病防治工作中应予重视。此外,还对探讨生殖道Mh和Ct感染的意义、分布特点和淋病患者Mh和Ct感染的高发原因进行了讨论。     

淋病奈瑟菌标准株外膜蛋白NspA基因重组质粒构建和生物信息分析

[目的]研究淋病奈瑟菌标准株(NG 29403和NG 29400)外膜蛋白NspA基因和NspA融合蛋白结构特点,为淋病奈瑟菌疫苗靶蛋白的选择提供依据。[方法]PCR扩增淋病奈瑟菌标准株NG 29400和NG 29403 NspA基因,与表达质粒pET-30c(g )构建重组子NspA-pET-30c( ),阳性克隆子经双酶切鉴定后进行基因测序。以生物软件对NspA基因进行生物信息分析,并在线预测其蛋白质结构。[结果]成功构建NspA-pET-30c( )重组质粒,双酶切获得0.5kb和5.4kb预期产物。基因序列分析表明淋病奈瑟菌NspA基因有较高同源性,两标准株与GenBank已有序列均有98%同源性,且与脑膜炎奈瑟菌NspA基因高度近似。蛋白预测显示NspA融合蛋白有40%以上为环状结构,可能为主要功能区。三级结构与脑膜炎奈瑟菌NspA相似。[结论]淋病奈瑟菌NspA基因具有高度保守性,与脑膜炎奈瑟菌NspA基因同源性高,蛋白结构相似,有望成为淋病奈瑟菌疫苗的候选抗原。