2007年北京地区儿童手足口病病原的初步筛查

2007年4～6月儿童手足口病流行期间,对北京地区51例皮损症状典型、伴/不伴发热、无重症合并症的手足口病患儿采样,建立RT-PCR方法,以5'非编码区(5'UTR)肠道病毒通用引物、CA16和EV71 VP1区特异性引物直接对82份临床标本进行了初步筛查,肠道病毒阳性率达70.6%。检测病例中CA16阳性25例(25/51)、EV71阳性4例(4/51)、非CA16和EV71的肠道病毒阳性病例7例(7/51),三者比例约为6:1:2。2007年北京地区儿童轻症手足口病主要病原包括CA16和EV71,同时还存在一定比例其它肠道病毒。部分EV71毒株经测序验证及系统进化分析显示为C4基因亚型。     

Influence of Food Microorganisms on Staphylococcal Growth and Enterotoxin Production in Meat

Forty-four microorganisms were studied for their influence on staphylococcal growth and enterotoxin production. Inhibition was found to be more common than stimulation. Two types of inhibition were observed: inhibition of staphylococcal growth, and inhibition of enterotoxin formation with no apparent effect on growth. By use of a plate test, 12 of the 44 food microorganisms were found to inhibit staphylococcal growth at 35 C. Of the 12, 3 also inhibited growth at 25 C. No significant differences in inhibition were observed with the 15 strains of enterotoxigenic staphylococci. In meat slurries, inhibition of staphylococcal growth was found to be greater at 25 C than at 35 C. Results on inhibition obtained from the plate test could not be correlated with the effect of the organisms in slurries. Environmental conditions were found to affect markedly the influence of food microorganisms on staphylococci. Of the 44 food microorganisms studied, only Bacillus cereus was observed to stimulate significantly staphylococcal growth and enterotoxin formation. Stimulation was more pronounced with Staphylococcus aureus 196E than with other strains of enterotoxigenic staphylococci. Bacillus megaterium and Brevibacterium linens were inhibited by staphylococci. These organisms were completely inhibited when inoculated in mixed cultures with staphylococci. In pure cultures, good staphylococcal growth was found to be accompanied by enterotoxin production; however, in the presence of food microorganisms, good staphylococcal growth occurred without the formation of detectable levels of enterotoxin A.     

Staphylococcal accessory gene regulator (sar) as a signature gene to detect enterotoxigenic staphylococci

AIMS: To evaluate the use of a staphylococcal accessory gene regulator (sar) as a means of detecting enterotoxigenic staphylococci. METHODS AND RESULTS: SarA gene-specific primers were designed and applied in PCR, which resulted in the detection of 49 sar-positive isolates from a total of 67 natural food isolates of staphylococci. Colony hybridization using PCR-generated Digoxigenin (DIG)-labelled sarA probe tested in spiked samples of khoa (a traditional heat-concentrated milk product) comprising a mixed microflora ensured the specificity of the probe. Validation experiments with the commercial samples of khoa also demonstrated the specificity of the probe. PCR characterization for enterotoxins A-D revealed the presence of at least one of the toxin-encoding genes in all the sarA-positive isolates tested. CONCLUSION: The study indicated that sarA gene could be an ideal marker gene either in colony hybridization or in PCR, for an effective detection of potentially enterotoxigenic strains of staphylococci in a food system. SIGNIFICANCE AND IMPACT OF THE STUDY: As an alternative to targeting the individual toxin genes, a regulatory gene responsible for controlling the synthesis of various virulence factors may be a suitable target gene for screening potentially toxigenic staphylococci in food system using nucleic acid-based methods.     

Staphylococcal enterotoxin production in the presence of non-enterotoxigenic staphylococci.

Enterotoxigenic Staphylococcus aureus strains were grown with a non-enterotoxigenic strain in laboratory medium, in milk, and in ham. Differences in pigmentation were used to differentiate the enterotoxigenic strains from the non-enterotoxigenic ones. Enterotoxin was detectable in milk when the colony counts of the non-enterotoxigenic strain were 15 to 20 times greater than those of the enterotoxigenic ones and in ham when the ratio was 60 to 77:1. Enterotoxin was detectable in milk when the enterotoxigenic strains reached counts of 10(7) colony-forming units per ml and in ham when the counts reached 10(8) colony-forming units per ml. It may be necessary in some food poisoning outbreaks to examine many isolates (up to 50 or 60) for enterotoxin production to be able to detect the enterotoxigenic staphylococci.     

Enterotoxigenic potential of Staphylococcus intermedius.

Staphylococcal food poisoning (SFP) caused by enterotoxigenic staphylococci is one of the main food-borne diseases. In contrast to Staphylococcus aureus, a systematic screening for the enterotoxins has not yet been performed on the genomic level for the coagulase-positive species S. intermedius. Therefore, the enterotoxigenic potential of 281 different veterinary (canine, n = 247; equine, n = 23; feline, n = 9; other, n = 2) and 11 human isolates of S. intermedius was tested by using a multiplex PCR DNA-enzyme immunoassay system targeting the staphylococcal enterotoxin genes sea, seb, sec, sed, and see. Molecular results were compared by in vitro testing of enterotoxin production by two immunoassays. A total of 33 (11.3%) S. intermedius isolates, including 31 (12.6%) canine isolates, 1 equine isolate, and 1 human isolate, tested positive for the sec gene. In vitro production of the respective enterotoxins was detected in 30 (90.9%) of these isolates by using immunological tests. In contrast, none of 65 veterinary specimen-derived isolates additionally tested and comprising 13 (sub)species of coagulase-negative staphylococci were found to be enterotoxigenic. This study shows on both molecular and immunological levels that a substantial number of S. intermedius isolates harbor the potential for enterotoxin production. Since evidence for noninvasive zoonotic transmission of S. intermedius from animal hosts to humans has been documented, an enterotoxigenic role of this microorganism in SFP via contamination of food products may be assumed.     

Evaluation of the usefulness of selected commercial systems for identification of Staphylococcus species

The aim of the study was the assessment of the usefulness of commercially available systems for rapid identification of staphylococci. API STAPH (bioMerieux, France), ID 32 STAPH (bioMerieux, France), GPL (HTL, Poland) and Staph-Zym (Rosco, Denmark). The identifications were carried out according to producer's instruction. The material for the study comprised 76 staphylococcal strains, coagulase-positive and coagulase-negative. The strains were isolated from throat, nasal, wound, bone slivers, pus and blood of inpatients and from throat and nasal swabs of outpatients. Besides that, for the study staphylococcal strains were obtained from the American Collection of Typical Cultures (ATCC) and from the Polish Collection of Microorganisms (PCM). All tested strains were identified on the basis of classic biochemical tests. In the light of obtained results it is concluded that the commercial system most suitable for identification of staphylococci was ID 32 STAPH (bioMerieux), which has a wide spectrum of species identifiable with it and the highest percent (95%) of correctly identified species. The least suitable system was the GPL 15 (HTL, Poland).     

Comparative Evaluation of Five Selective and Differential Media for the Detection and Enumeration of Coagulase-Positive Staphylococci in Foods

Five selective media for the detection and enumeration of coagulase-positive staphylococci were evaluated for their efficiency in the recovery of 17 strains of coagulase-positive staphylococci from foods. They were Staphylococcus Medium 110 (SM-110), tellurite-glycine-agar (TGA), egg-tellurite-glycine-pyruvate-agar (ETGPA), tellurite-egg-agar (TEA), and tellurite-polymyxin-egg yolk-agar (TPEY). Statistical analysis by the rank correlation method of the efficiency with which these media recovered staphylococci from pure 24-hr Brain Heart Infusion cultures revealed the following efficiencies in descending order: (i) TPEY, (ii) ETGPA, (iii) TGA, (iv) TEA, (v) SM-110. Growth of 17 strains of coagulase-negative cocci on these media showed the following approximate descending order of inhibition to these organisms: (i) ETGPA, (ii) TEA, (iii) SM-110, (iv) TGA, (v) TPEY. The appearance of colonies of the various coagulase-negative strains on each medium was studied for the degree to which they could be confused with colonies of coagulase-positive strains. Nineteen food contaminants, including Proteus vulgaris, Bacillus sp., Escherichia coli, Erwinia sp., fecal streptococci, and others, were also studied for similarities in appearance to staphylococci and for ability to grow on the selective media. The influence of five sterile food homogenates (frozen chicken and tuna pies, custard, smoked ham, and raw whole egg) on recovery of 1,500 enterotoxigenic staphylococci (three strains) per milliliter was determined by statistical analysis. Three main effects (culture, media, and food) and three interactions (media with food, food with cultures, and media with culture) were found to be significant. Recovery on TPEY was influenced less by food than the other selective media and showed optimal recovery ability from sterile custard, eggs, and ham. TGA recovered well from sterile chicken pie and custard, SM-110 from sterile custard, and TEA from sterile ham. None of the media was outstanding in recovering staphylococci from tuna pie. The ability of the five selective media to recover 1,500 enterotoxigenic staphylococci (three strains) per ml from three sterile foods in the presence of 10 strains of contaminating bacteria added at the 0, 10⁵, and 10⁶ levels per milliliter was also studied and analyzed statistically. Only three factors were significant under these conditions—cultures, foods, and the interaction of media with the level of added contamination. Efficiency of recovery of TGA, SM-110, and ETGPA was found not to be dependent upon the level of contamination. Recovery on TPEY decreased with increases in the number of contaminants. TEA increased in efficiency at the 10⁵ level, but decreased at the 10⁶ level. When recovery on Trypticase Soy Agar was considered to be 100%, the average percentage of recovery by each of the selective media under all experimental conditions was determined.     

Pyogenic cocci in infantile eczema throughout one year.

To determine the source of pyococci causing attacks of sepsis in infantile eczema 20 patients with continuing eczema were followed up for one year, regular swabs being taken from the skin, nose, throat, and family contacts. The staphylococci were phage typed and the streptococci serologically typed. Staphylococci of the same phage type in most cases remained in reservoir sites on the skin and coincidently in the nose. Staphylococci causing attacks of clinical sepsis arose from these persistently colonized sites. Staphylococci of the same phage type were also common in family contacts. Streptococci of the same group in most cases did not remain on the skin. Streptococci causing attacks of clinical sepsis arose as new infections from external sources, sometimes from throat infections in the patient or family contacts. Strains of streptococci which are known to be associated with glomerulonephritis were isolated. It has been confirmed that staphylococci resistant to neomycin and sodium fusidate quickly emerge after the topical use of these antibiotics. Streptococci are highly resistant to neomycin and gentamicin, and moderately resistant to sodium fusidate, so the use of these antibiotics in topical steroid preparations will have little effect in preventing further attacks of clinical sepsis in these patients.     

Antibiotic sensitivity of beta-hemolytic streptococci isolated from throat swabs and purulent material

The aim of this study was to evaluate the prevalence and susceptibility of beta-hemolytic streptococci isolated from throat swabs (142--29.9%) and purulent material (333--70.1%) taken from patients treated at University Hospital dr. A. Jurasz in Bydgoszcz Collegium Medicum. L. Rydygier in Bydgoszcz, Nicolaus Copernicus University in Torun in 2005-2009. Of the 475 tested strains, 156 (32.8%) were identified as S. pyogenes. This species accounted for 38.8% of strains isolated from purulent material and 19.0% of swabs from the throat. Among the strains isolated from throat swabs of 62 (43.7%) were identified as Streptococcus group C. Only 5.1% strains were identified as Streptococcus group F. All strains of beta-hemolytic streptococci were susceptible to ampicillin or penicillin, fluoroquinolones, vancomycin and linezolid. Erythromycin-susceptible strains was 83.8%, and 89.1% for clindamycin. A total of 51.3% of erythromycin resistance strains had the cMLS(B) phenotype (63.3% for strains from throat swabs and 46.3% of the purulent materials). Sensitivity to tetracycline was characterized by 51.2% of strains of beta-hemolytic streptococci. The percentage of strains susceptible to this antibiotic among isolates from throat swabs was 63.1%, and purulent material--48.0%. The lowest percentage of strains susceptible to tetracycline (14.1%) were found among S. agalactiae and Streptococcus group G (33.6%) strains. During the study time, saw an increase in the percentage of strains susceptible to tetracycline and erythromycin.     

Occurrence of Staphylococcus aureus enterotoxigenic strains isolated from pregnant women with pathology

137 S. aureus strains, isolated from the larynx of pregnant women in cases of pathology, were studied for the formation of staphylococcal enterotoxins of types A and B (SEA and SEB) by the indirect hemagglutination test. The study revealed that SEA was produced by 35.0% and SEB, by 56.6% of the strains under study. The proportion of SEA and SEB producers among staphylococci isolated from mothers and children was, respectively, 18.4% and 20.0%, 89.41% and 67.5%. The number of enterotoxigenic staphylococci in the upper respiratory tract of newborn infants and mothers practically coincided with that in mothers. The occurrence of SEA- and SEB-producing enterotoxigenic strains in the medical personnel was 25.5% and 62.7% respectively.     

Public transport as a reservoir of methicillin‐resistant staphylococci

Aims: The aim of this study was to explore the occurrence of methicillin‐resistant staphylococci in a large urban public transport system. Methods and Results: Samples were taken from hand rails, which passengers hold onto when they are standing. In total, 1400 swabs taken from 55 vehicles (trolleybuses, trams and buses) were examined. As many as 30·1% samples were positive for the presence of methicillin‐resistant coagulase‐negative staphylococci (MRCoNS), but none for methicillin‐resistant Staphylococcus aureus (MRSA). MRCoNS were isolated from all 55 vehicles. Nearly 50% of MRCoNS isolates displayed resistance not only to beta‐lactams, but at least to two or more other classes of antimicrobials as well. Conclusions: This study demonstrated widespread occurrence of MRCoNS on hand rails in public transport vehicles. MRSA was not detected. Significance and Impact of the Study: The recovery of methicillin‐resistant staphylococci from public transport system implies a potential risk for transmission of these bacteria in an out‐hospital environment.     

Detection of enterotoxic strains of Escherichia coli in children with diarrhea treated at the Child Health Center 1986-1988

Studies on detection of enterotoxigenic strains of E. coli were carried in 1986-1988. During this time 2324 rectal swabs from children with diarrhoea symptoms were tested. On the whole 701 E. coli were selected. The ability to produce thermolabile enterotoxin by E. coli strains was evaluated by three methods: Elek test, passive immunohemolysis and ELISA. Among selected E. coli strains enterotoxigenic strains accounted for 21.8% in 1986, 16.3% in 1987 and 28.2% in 1988.     

Growth of enterotoxigenic Staphylococcus aureus in povi masima, a traditional Pacific island food

AIMS: To obtain preliminary data on the microbiology and hurdles to pathogen growth in the traditional Pacific Island food, povi masima, which is essentially beef brisket cured in brine. METHODS AND RESULTS: Six containers of povi masima were prepared and two were inoculated with five enterotoxigenic strains of Staphyloccocus aureus. The povi masima were divided into two lots each containing two uninoculated control and an inoculated container. Lot 1 was incubated at room temperature (20 degrees C) and lot 2 under refrigeration (4-5 degrees C) for up to 98 days. During storage, samples were removed and tested for aerobic plate count, coagulase-producing Staphylococci, Clostridium perfringens, staphylococcal enterotoxin and various chemical parameters of the food. Coagulase-producing Staphylococci and aerobic plate counts grew to high levels in both the inoculated and uninoculated lots stored at room temperature, but enterotoxin was only detected at one time point in these lots and this may represent a false positive result. The concentration of NaCl in the meat increased with time as concentrations equilibrated, and nitrite was rapidly lost in those lots stored at room temperature. Storage at 4-5 degrees C prevented proliferation of coagulase-producing Staphylococci. CONCLUSIONS: For safe curing and storage, this food should be kept under refrigeration as this prevented growth of staphylococci. Optimum storage would also be achieved with improved attempts to ensure equal distribution of NaCl prior to storage. SIGNIFICANCE AND IMPACT OF THE STUDY: Under conditions traditionally used to cure and store this food, enterotoxigenic staphylococci can grow to numbers where toxigenesis might occur, especially during the early stages of curing where the salt has not diffused from the brine into the meat.     

Evaluation of the NucliSens miniMAG RNA extraction and real-time NASBA applications for the detection of Mycoplasma pneumoniae and Chlamydophila pneumoniae in throat swabs

Nucleic acids were extracted from 215 throat swabs from patients with community-acquired pneumonia by the manual Boom extraction, the NucliSens miniMAG and the Qiagen DNA blood kit and amplified respectively by in-house real-time NASBA, NucliSens EasyQ reagents, and real-time PCR for the detection of Mycoplasma pneumoniae and Chlamydophila pneumoniae. Five out of 215 throat swabs were found to be C. pneumoniae positive by all techniques used. A total of 11 out of 215 throat swabs were positive for M. pneumoniae; 10/215 by Qiagen extraction and PCR amplification and 9/215 by NucliSens miniMAG and NucliSens EasyQ amplification. The NucliSens miniMAG and NucliSens EasyQ applications were successfully coupled to detect both organisms in throat swabs.     

Viral infections of the Kenya baboon (Papio cynocephalus) in its natural habitat

Stools, rectal swabs, throat swabs, and tissues were collected from 508 baboons (Papio cynocephalus) in 17 areas of Kenya and Tanzania during 5 field trips between 1961 and 1968. A total of 11 isolations were made: nine agents were recovered from 508 fecal samples and 2 from 468 throat swabs. These isolates were identified as adenovirus serotypes AA153, SA7, SV15 and SV23. SV23 was found only in throat swabs and never from fecal material while AA153, SA7 and SV15 were recovered only from fecal material. One rectal specimen produced 2 serotypes, SV15 and SA7. No isolates were recovered from necropsy samples from 19 animals.     

Detection of Group A Streptococci in Throat Swabs by Direct Fluorometry

A direct fluorometric test for the rapid detection of group A streptococci from throat swabs was compared with the microscopic fluorescent-antibody test. Formalinized throat swab cultures (490) were examined by the two methods, and the results agreed on 84% of the specimens. In another comparison, 15-hr broth cultures of 103 freshly taken throat swabs were tested by both methods. Of the specimens tested, 101 (98%) were either positive or negative by both methods. In all cases, the latter results correlated with the demonstration of presence or absence of group A streptococci in the specimens by cultural isolation and precipitin grouping tests. It may be feasible to use the direct fluorometric test in a diagnostic laboratory as described or possibly to adapt it for automatic processing of throat swab cultures.     

Isolation of varicella-zoster virus from pharyngeal and nasal swabs in varicella patients

Thirteen children aged 5 months to 4 years were observed during a varicella epidemic in an Infants' Hospital; except for two normal individuals, the children had various forms of congenital defects. Eleven of the children developed varicella. During the first 3 days of exanthem, a total of 17 VZ virus strains were isolated: 12 from vesicular fluid, 3 from 23 nasal and 2 from 22 pharyngeal swabs. No strain was isolated during the incubation period despite 57 and 56 swabs having been collected from the throat and nose, respectively; nor was VZ virus isolated from 6 pharyngeal and 7 nasal swabs taken on the first day of exanthem. Isolation attempts performed from vesicular fluid to control quality of the isolation conditions gave a positivity rate of 100%. Under these optimal isolation conditions VZ virus was found in the nose or throat alongside skin vesicles in four of the 11 ill children. Besides VZ virus, the pharyngeal and nasal swabs yielded, respectively, four and four cytomegalovirus strains. The cytomegalovirus infections were inapparent.     

Enterotoxigenic Bacteria in Food and Water from an Ethiopian Community

Food and water samples from an Ethiopian community were screened for the presence of enterotoxin-producing bacteria. Using the Chinese hamster ovary cell assay, 40 of 213 isolates (18.8%) produced heat-labile (LT) enterotoxin. These LT-producing isolates comprised 33 of 177 (18.6%) strains from 24 of 68 food samples (35.3%) and 7 of 36 (19.4%) isolates of 4 of 17 water samples (23.5%). One LT-producing strain each of Salmonella emek and of Shigella dysenteriae was found. Three pseudomonads, all LT producers, produced heat-stable enterotoxin as gauged by the suckling mouse test. Two strains of LT-enterotoxigenic Escherichia coli O68 were found in water samples. No enterotoxigenic E. coli were isolated from food samples, but 13 of the LT-producing strains were Enterobacter, Klebsiella, Serratia, and Proteus species, and 7 food samples yielded more than one species of enterotoxigenic bacterium. Of the enterotoxigenic isolates from food, 15 were oxidase-positive strains of the genera Aeromonas, Pseudomonas, Achromobacter, Flavobacterium, and Vibrio. LT-enterotoxigenic Enterobacter, Acinetobacter, Klebsiella, Proteus, Providencia, and Serratia species represented 20 of the food and water isolates. Culture supernatant fluids of representative strains of oxidase-positive and oxidase-negative species giving positive reactions in Chinese hamster ovary cell tests induced fluid accumulation in rabbit ileal loops. Eight of the food samples and two of the water samples contained more than one isolate or species of enterotoxigenic bacterium. The stability of the LT production by oxidase-positive bacteria and non-E. coli strains was assessed by the rabbit skin and adrenal cell tests after 9 months and 1 year of storage, respectively, in Trypticase soy broth with glycerol at −70°C. Only 33% of the oxidase-positive strains were still LT enterotoxigenic. Of the oxidase-negative strains, 50 and 33% were LT producing at 9 months and 1 year, respectively. None of the E. coli isolates, both enterotoxigenic and nonenterotoxigenic, possessed K88, K99, or colonization factor antigen. The survey demonstrates the presence in food and water of enterotoxigenic bacteria of the same species as those isolated from cases of infantile diarrhea in the same community, although a correlation between these sources and infantile diarrhea remains to be established.     

Enterotoxin production by staphylococci isolated from healthy goats

The ability of 342 staphylococcal isolates from different anatomical sites in healthy goats to produce staphylococcal enterotoxins (SE) was investigated. SE were produced by 74.3% of the 70 coagulase-positive strains and by 22% of the coagulase-negative strains studied. Most enterotoxigenic strains were isolated from the skin of udders and teats and from milk. SEC was the SE type most frequently produced, either alone (67.9%) or in combination with others. Five coagulase-negative species not previously reported as SE producers were identified (Staphylococcus chromogenes, S. warneri, S. sciuri, S. saprophyticus, and S. lentus). SEA, SEB, and SEC were detected in the milk of 17 of the 133 healthy goats studied. These results suggest that the goat is an important reservoir of enterotoxigenic staphylococci, most of which produce SEC.     

Enterotoxin production by staphylococci isolated from healthy goats.

The ability of 342 staphylococcal isolates from different anatomical sites in healthy goats to produce staphylococcal enterotoxins (SE) was investigated. SE were produced by 74.3% of the 70 coagulase-positive strains and by 22% of the coagulase-negative strains studied. Most enterotoxigenic strains were isolated from the skin of udders and teats and from milk. SEC was the SE type most frequently produced, either alone (67.9%) or in combination with others. Five coagulase-negative species not previously reported as SE producers were identified (Staphylococcus chromogenes, S. warneri, S. sciuri, S. saprophyticus, and S. lentus). SEA, SEB, and SEC were detected in the milk of 17 of the 133 healthy goats studied. These results suggest that the goat is an important reservoir of enterotoxigenic staphylococci, most of which produce SEC.