石家庄市儿童呼吸道感染病原体IgM抗体结果分析

目的分析石家庄市儿童呼吸道感染病原体的流行特点,为临床预防和治疗呼吸道感染提供病原学依据。方法纳入就诊于儿科的呼吸道感染患儿936例,运用间接免疫荧光法检测儿童血清的八种呼吸道病原体的IgM型抗体。根据不同季节、不同年龄和不同性别分组,分析其病原体阳性率和感染类型。结果 936例患儿血清标本中,检出病原体IgM抗体共424例,阳性率为45.30%。其中肺炎支原体阳性率(28.63%)最高,其次依次为流感病毒B型、呼吸道合胞病毒、流感病毒A型、肺炎衣原体、腺病毒、副流感病毒,未检出嗜肺军团菌。不同季节病原体的阳性率有差异,冬季的病原体阳性率(50.33%)显著高于夏、秋季的阳性率(33.71%和41.46%),差异均有统计学意义;不同年龄组中,婴儿组病原体阳性率(16.05%)显著低于其他3个年龄组,差异均有统计学意义;检出病原体的424例阳性患儿中,单一病原体感染类型者为290例(30.98%),混合感染者134例(14.32%);全部936例患儿中,男童病原体阳性率(42.33%)显著低于女童阳性率(52.29%);病原体混合感染类型中以肺炎支原体和流感病毒B型混合感染最常见,其中婴儿组混合感染病原体检出率均显著低于幼儿组、学龄前组和学龄组。结论肺炎支原体全年在儿童呼吸道感染中占主要地位。年龄和性别是石家庄市儿童呼吸道病原体感染的特异性因素,冬季为呼吸道病原体感染高峰期。     

小儿下呼吸道感染的常见病原体及发病机制

引起小儿下呼吸道感染的常见病原体有肺炎链球菌、流感嗜血杆菌、金黄色葡萄球菌,卡他莫拉菌和肺炎支原体等。了解各种病原体的病原学特点及发病机制,并及时、正确的治疗,对临床防治下呼吸道感染具有重要意义。     

肺部真菌病的实验室诊断——真菌镜检与培养

1标本采集 肺部感染的病原学诊断技术包括临床标本采集和实验室对病原体的检测两个部分。临床上应按疑似或需检测的肺部感染的病原体种类，采集相应的临床标本和采取相宜的实验室检测方法。     

肺炎支原体和沙眼衣原体致儿童急性下呼吸道感染的研究

本文旨在研究儿童社区获得性急性下呼吸道感染(ALRTI)中肺炎支原体(MP)和沙眼衣原体(CT)的感染特征。采用实时荧光定量聚合酶链反应(PCR)检测2006年10月～2008年2月因ALRTI收入复旦大学附属儿科医院的患儿呼吸道标本中MP和CT的DNA,并分析2种病原体感染患儿的临床特征与实验室检查结果。在1312份深部鼻咽分泌物标本中,MP和CT检出率分别为7.85%(103/1312)和2.97%(39/1312)。MP在5岁以上患儿中的检出率为33.33%(30/90),而CT在3个月以内患儿中的检出率为6.28%(31/494)。MP感染后易出现40℃以上高热,较少发生发绀与重症呼吸道感染;白细胞计数常无明显升高,但C反应蛋白升高较多见。CT感染后40℃以上高热和重症呼吸道感染少见,C反应蛋白升高也较少见。结果提示,在5岁以上儿童的社区获得性ALRTI中,MP是重要的病原体;而在3个月以内儿童中,CT为常见病原体之一。     

肺炎支原体感染的研究进展

肺炎支原体是引起呼吸道感染的常见病原体之一。近年来,肺炎支原体感染的发病率呈逐年增长趋势。肺炎支原体是介于病毒和细菌之间的原核生物,传播途径是呼吸道飞沫或气溶胶。感染该疾病后主要表现为上呼吸道感染、鼻咽炎、支气管炎、肺炎及严重的肺外并发症,如免疫性溶血性贫血、脑膜脑炎、心肌炎、心包炎、肾炎,严重感染者甚至可导致死亡。肺炎支原体有很强的传染性,经常在儿童集居地及家庭成员中交叉感染,导致久治不愈。对支原体肺炎进行早期诊断不仅可以避免并发症的发生率,也可遏制其继续传播。本文就肺炎支原体感染的致病机制及检测方法的研究,探讨了其对于支原体肺炎的早期诊断和病程监测的意义,将研究现状及展望作一综述。     

恒温扩增芯片法在重症监护病房肺部感染患者诊断中的应用

目的评价恒温扩增芯片法在重症监护病房肺部感染患者下呼吸道感染病原体检测中的效果。方法收集合格痰标本146例,通过恒温扩增芯片法和细菌培养法检测病原体,对两种方法检测结果进行分析。结果 146例痰液标本中,恒温扩增芯片法检出阳性标本114例(阳性率为78.1%),其中单一致病菌感染42例,2种及以上致病菌混合感染72例。45例标本检测到mecA基因,其中13例为耐甲氧西林金黄色葡萄球菌。146例痰标本中,有109例痰标本同时进行了痰培养检测,痰培养阳性率为67.9%(74/109),相应的恒温扩增芯片法检测阳性率为82.6%(90/109);痰培养结果阴性共计35例,与之相符合的恒温扩增芯片法检测阴性共计16例(阴性符合率45.7%)。恒温扩增芯片法对肺炎链球菌、肺炎克雷伯菌、铜绿假单胞菌、嗜麦芽窄食单胞菌、流感嗜血杆菌的阳性检出率明显高于痰培养,差异具有统计学意义。恒温扩增芯片法检测到2例结核分枝杆菌复合群、1例军团菌、1例肺炎支原体,痰培养检测到3例奇异变形杆菌。结论本实验室所开展的恒温扩增芯片法在重症监护病房肺部感染者下呼吸道病原体检测方面的优势体现在阳性率高、检测时间短,可为临床肺部感染诊断提供及时准确的参考依据。     

肺炎支原体实验室检测方法研究进展

肺炎支原体(Mycoplosma pneumonia,MP)为人类非典型肺炎的病原体,是引起呼吸道感染的重要病原体。但是支原体肺炎与其他病原体感染的肺炎,在临床症状、影像学上并无特异性差别,且其对一般治疗肺炎、上呼吸道感染的药物有耐药性,因此肺炎支原体及时、准确的实验室检测对于支原体肺炎的诊断治疗显得尤为重要。目前MP的实验室检测方法不断推陈出新,但各种方法均有其优势与不足,临床可选择两种不同的方法同时检测。比如:血清学抗体的检测结合MP快速培养药敏的方法;血清学抗体的检测结合PCR的方法,不同方法相互补充为临床的早期诊断、治疗提供依据。而MP药敏试验的检测和耐药机制的研究对于临床用药方案的选择,减少耐药株的产生和流行具有重要意义。     

北京地区成人呼吸道感染病原体的检测分析

目的探讨北京地区成人呼吸道感染的病原学流行特点,为临床诊疗提供病原学依据。方法采用间接免疫荧光法检测人血清中8种呼吸道病原体的Ig M抗体,根据不同性别、年龄、年份和季节的病原体阳性率进行统计分析。结果 1 219例患者中呼吸道病原体阳性率为49.4%,其中甲型流感病毒阳性率最高,其他依次为嗜肺军团菌、乙型流感病毒、肺炎支原体、副流感病毒、肺炎衣原体、腺病毒和呼吸道合胞病毒;呼吸道感染患者中男性患者病原体阳性率显著高于女性患者(P0.01);不同年龄组病原体阳性率比较差异有统计学意义,以18~39岁年龄组最高,其次为40~59岁年龄组,上述两组病原体阳性率显著高于其他两个年龄组(P0.01);不同年份病原体阳性率比较差异有统计学意义,2014年显著高于2013年(P0.01);不同季节病原体的阳性率比较差异有统计学意义,春季显著高于夏季、秋季和冬季(P0.01)。结论本地区成人呼吸道感染病原体阳性率在性别、年龄、年份和季节性存在差异,病原体以甲型流感病毒和嗜肺军团菌为主。     

呼吸道感染住院患儿Merkel细胞多瘤病毒检测及临床研究

目的:了解北京地区Merkel细胞多瘤病毒(MCPyV)在呼吸道感染住院儿童中的流行情况和临床特点。方法:采集北京友谊医院儿科呼吸道感染住院患儿的鼻咽抽吸物样本200份,并收集相应的患儿临床资料,采用TaqMan real-time PCR方法检测MCPyV LTAg基因,并经测序确认;MCPyV阳性样本同时检测常见的人呼吸道病毒混合感染情况。结果:200份标本中共检出MCPyV阳性6例,检出率3%;感染儿童年龄从6月到5岁,其中年龄≤3岁的占83.3%(5/6)。诊断包括支气管肺炎和急性支气管炎,临床表现包括发热、咳嗽、喘息。6例阳性样本均与其他呼吸道病毒混合感染,A型流感病毒和呼吸道合胞病毒混合感染最常见,6例阳性样本MCPyV载量均低于10拷贝/μL。结论:real-time PCR方法检测呼吸道感染住院患儿中MCPyV的感染率为3%,6例MCPyV阳性样本均与其他呼吸道病毒混合感染且MCPyV载量较低,不能认为MCPyV是儿童呼吸道感染的病因。     

0~7岁住院儿童九项呼吸道非细菌性病原体IgM检测分析

目的分析患儿九项病原体血清IgM检测结果,初步得出本地区的感染谱及流行特征,为临床诊治提供依据。方法检测标本来自2013年11月至2014年3月住院的0~7岁儿童,共1 150例,间接免疫荧光法检测血清中IgM,统计分析各病原体的阳性率以及混合感染情况,比较不同性别、年龄组感染率差异。结果 1 150例检测标本,共检出阳性461例,阳性率为40.1%;阳性率前三位的分别是:肺炎支原体(24.6%),腺病毒(11.3%),甲型流感病毒(10.3%);阳性标本中单一感染率为65.9%(304/461);女性儿童感染率(48.0%)显著高于男性儿童(34.4%),2~7岁组主要的4种病原体阳性率均显著高于0~1岁年龄组。结论肺炎支原体、腺病毒、甲型流感病毒是本地区住院儿童呼吸道感染主要的非细菌性病原体,女童较男童更为易感,2~7岁较0~1岁更为易感。     

基于CRISPR/Cas系统的纸基分析在快速检测食源性致病菌中的应用

由食源性致病菌引起的食品安全事件严重影响人类健康,开发针对食源性致病菌的快速检测技术十分必要。成簇间隔短回文重复序列（clustered regularly interspaced short palindromic repeats,CRISPR）及相关蛋白（CRISPR-associated protein,Cas）是原核生物的适应性免疫系统,具有特异性识别并切割核酸序列的功能。纸基分析方法作为一种简便性好、成本低廉的分析检测工具,在快速检测领域展现出良好的前景。因此,将CRISPR/Cas系统的高效识别能力和纸基分析方法的简便性相结合可实现对食源性致病菌的快速灵敏检测。本文简要介绍了CRISPR/Cas系统用于核酸检测的概况,对第二类单Cas效应蛋白系统的特点及原理进行概述,重点综述基于CRISPR/Cas系统的试纸分析、侧向流动分析和纸基微流控装置在检测食源性致病菌方面的应用,并讨论了CRISPR/Cas系统结合纸基分析建立检测方法的优势、当前的挑战及未来的发展前景。     

Gene Specific DNA Sensors for Diagnosis of Pathogenic Infections

Gene specific DNA based sensors have potential applications for rapid and real time monitoring of hybridization signal with the target nucleic acid of pathogens. Different types of DNA based sensors and their applications have been studied for rapid and accurate detection of pathogens causing human diseases. These sensors are based on surface plasmon resonance, quantum-dots, molecular beacons, piezoelectric and electrochemical etc. Curbing epidemics at an early stage is one of the massive challenges in healthcare systems. Timely detection of the causative organism may provide a solution to restrain mortality caused by the disease. With the advent of interdisciplinary sciences, bioelectronics has emerged as an effective alternative for disease diagnostics. Gene specific DNA sensors present themselves as cost-effective, sensitive and specific platforms for detection of disease causing pathogens. The mini review explores different transducer based sensors and their potential in diagnosis of acute and chronic diseases.     

LC3相关吞噬作用与病原微生物感染

LC3相关吞噬作用(LC3-associated phagocytosis,LAP)是一种宿主细胞吞噬和降解病原体的高效过程。近年来越来越多的研究表明,LAP在清除病原微生物感染过程中具有非常重要的作用,其作用机制不同于传统的吞噬作用和自噬作用。在外源刺激下,宿主细胞通过招募自噬相关的蛋白实现LC3向单层膜吞噬泡的聚集,从而提高其吞噬和杀伤病原体的效率。不同病原微生物应对LAP的杀伤作用的方式是不同的,本文对LAP发生的一般规律、各种微生物感染过程中LAP发生的不同情况及其近期研究进展予以综述。     

Are molecular tools solving the challenges posed by detection of plant pathogenic bacteria and viruses?

Plant pathogenic bacteria, phytoplasmas, viruses and viroids are difficult to control, and preventive measures are essential to minimize the losses they cause each year in different crops. In this context, rapid and accurate methods for detection and diagnosis of these plant pathogens are required to apply treatments, undertake agronomic measures or proceed with eradication practices, particularly for quarantine pathogens. In recent years, there has been an exponential increase in the number of protocols based on nucleic-acid tools being those based on PCR or RT-PCR now routinely applied worldwide. Nucleic acid extraction is still necessary in many cases and in practice inhibition problems are decreasing the theoretical sensitivity of molecular detection. For these reasons, integrated protocols that include the use of molecular techniques as screening methods, followed by confirmation by other techniques supported by different biological principles are advisable. Overall, molecular techniques based on different types of PCR amplification and very especially on real-time PCR are leading to high throughput, faster and more accurate detection methods for the most severe plant pathogens, with important benefits for agriculture. Other technologies, such as isothermal amplification, microarrays, etc. have great potential, but their practical development in plant pathology is still underway. Despite these advances, there are some unsolved problems concerning the detection of many plant pathogens due to their low titre in the plants, their uneven distribution, the existence of latent infections and the lack of validated sampling protocols. Research based on genomic advances and innovative detection methods as well as better knowledge of the pathogens' lifecycle, will facilitate their early and accurate detection, thus improving the sanitary status of cultivated plants in the near future.     

Microfluidic devices for sample preparation and rapid detection of foodborne pathogens

Rapid detection of foodborne pathogens at an early stage is imperative for preventing the outbreak of foodborne diseases, known as serious threats to human health. Conventional bacterial culturing methods for foodborne pathogen detection are time consuming, laborious, and with poor pathogen diagnosis competences. This has prompted researchers to call the current status of detection approaches into question and leverage new technologies for superior pathogen sensing outcomes. Novel strategies mainly rely on incorporating all the steps from sample preparation to detection in miniaturized devices for online monitoring of pathogens with high accuracy and sensitivity in a time-saving and cost effective manner. Lab on chip is a blooming area in diagnosis, which exploits different mechanical and biological techniques to detect very low concentrations of pathogens in food samples. This is achieved through streamlining the sample handling and concentrating procedures, which will subsequently reduce human errors and enhance the accuracy of the sensing methods. Integration of sample preparation techniques into these devices can effectively minimize the impact of complex food matrix on pathogen diagnosis and improve the limit of detections. Integration of pathogen capturing bio-receptors on microfluidic devices is a crucial step, which can facilitate recognition abilities in harsh chemical and physical conditions, offering a great commercial benefit to the food-manufacturing sector. This article reviews recent advances in current state-of-the-art of sample preparation and concentration from food matrices with focus on bacterial capturing methods and sensing technologies, along with their advantages and limitations when integrated into microfluidic devices for online rapid detection of pathogens in foods and food production line.     

Virulence signatures: microarray-based approaches to discovery and analysis

Rapid, accurate, and sensitive detection of biothreat agents requires a broad-spectrum assay capable of discriminating between closely related microbial or viral pathogens. Moreover, in cases where a biological agent release has been identified, forensic analysis demands detailed genetic signature data for accurate strain identification and attribution. To date, nucleic acid sequences have provided the most robust and phylogentically illuminating signature information. Nucleic acid signature sequences are not often linked to genomic or extrachromosomal determinants of virulence, a link that would further facilitate discrimination between pathogens and closely related species. Inextricably coupling genetic determinants of virulence with highly informative nucleic acid signatures would provide a robust means of identifying human, livestock, and agricultural pathogens. By means of example, we present here an overview of two general applications of microarray-based methods for: (1) the identification of candidate virulence factors; and (2) the analysis of genetic polymorphisms that are coupled to Bacillus anthracis virulence factors using an accurate, low cost solid-phase mini-sequencing assay. We show that microarray-based analysis of gene expression can identify potential virulence associated genes for use as candidate signature targets, and, further, that microarray-based single nucleotide polymorphism assays provide a robust platform for the detection and identification of signature sequences in a manner independent of the genetic background in which the signature is embedded. We discuss the strategy as a general approach or pipeline for the discovery of virulence-linked nucleic acid signatures for biothreat agents.     

Development and comparison of two assay formats for parallel detection of four biothreat pathogens by using suspension microarrays

Microarrays provide a powerful analytical tool for the simultaneous detection of multiple pathogens. We developed diagnostic suspension microarrays for sensitive and specific detection of the biothreat pathogens Bacillus anthracis, Yersinia pestis, Francisella tularensis and Coxiella burnetii. Two assay chemistries for amplification and labeling were developed, one method using direct hybridization and the other using target-specific primer extension, combined with hybridization to universal arrays. Asymmetric PCR products for both assay chemistries were produced by using a multiplex asymmetric PCR amplifying 16 DNA signatures (16-plex). The performances of both assay chemistries were compared and their advantages and disadvantages are discussed. The developed microarrays detected multiple signature sequences and an internal control which made it possible to confidently identify the targeted pathogens and assess their virulence potential. The microarrays were highly specific and detected various strains of the targeted pathogens. Detection limits for the different pathogen signatures were similar or slightly higher compared to real-time PCR. Probit analysis showed that even a few genomic copies could be detected with 95% confidence. The microarrays detected DNA from different pathogens mixed in different ratios and from spiked or naturally contaminated samples. The assays that were developed have a potential for application in surveillance and diagnostics.     

In situ-synthesized virulence and marker gene biochip for detection of bacterial pathogens in water

Pathogen detection tools with high reliability are needed for various applications, including food and water safety and clinical diagnostics. In this study, we designed and validated an in situ-synthesized biochip for detection of 12 microbial pathogens, including a suite of pathogens relevant to water safety. To enhance the reliability of presence/absence calls, probes were designed for multiple virulence and marker genes (VMGs) of each pathogen, and each VMG was targeted by an average of 17 probes. Hybridization of the biochip with amplicon mixtures demonstrated that 95% of the initially designed probes behaved as predicted in terms of positive/negative signals. The probes were further validated using DNA obtained from three different types of water samples and spiked with pathogen genomic DNA at decreasing relative abundance. Excellent specificity for making presence/absence calls was observed by using a cutoff of 0.5 for the positive fraction (i.e., the fraction of probes yielding a positive signal for a given VMG). A split multiplex PCR design for simultaneous amplification of the VMGs resulted in a detection limit of between 0.1 and 0.01% relative abundance, depending on the type of pathogen and the VMG. Thermodynamic analysis of the hybridization patterns obtained with DNA from the different water samples demonstrated that probes with a hybridization Gibbs free energy of approximately -19.3 kcal/mol provided the best trade-off between sensitivity and specificity. The developed biochip may be used to detect the described bacterial pathogens in water samples when parallel and specific detection is required.