主要医院感染病原菌与社区感染株耐药性比较

目的比较主要医院感染(HAI)病原菌与社区感染(CAI)株的耐药性,指导合理使用抗菌药物。方法收集永康市第一人民医院2003年1月至2006年6月所有标本中分离的主要HAI菌及其CAI株,分别统计其药物敏感试验。采用美国Dade Behring Microscan Walkaway 40全自动细菌鉴定及药敏测试仪及其配套药敏鉴定板测定MIC值。全国医院感染监测网软件和χ2统计分析。结果主要HAI菌为前4种革兰阳性(G )菌依次是金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌、溶血葡萄球菌,前5种革兰阴性(G-)菌依次是大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌。HAI株耐药率普遍高于CAI株,不同的细菌耐药率各具特点。不论HAI株还是CAI株,G 菌对万古霉素的耐药率最低,G-菌对亚胺培南的耐药率均较低,且两者耐药率差异均无显著性。金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌4种HAI株对大多数抗菌药物的耐药率明显高于CAI株,其余5种细菌HAI株仅对少数抗菌药物的耐药率高于CAI株。结论HAI菌株耐药性比CAI菌株强,临床应区分感染性质合理使用抗菌药物,有针对性控制感染,从而减少抗菌药物的滥用和细菌耐药性的产生。     

先天性巨细胞病毒感染的研究进展

巨细胞病毒(cytomegalovirus, CMV)在世界范围内均有较高的感染率,是最常见的先天性感染。先天性CMV感染可继发于母体原发性感染或非原发性感染。高达40%～50%的感染新生儿是在妊娠早期原发感染, 之后出现长期后遗症,主要包括先天性CMV感染相关听力损伤和神经后遗症。血清学检查对于确定原发性CMV感染至关重要。产前超声检查发现胎儿异常要警惕先天性CMV感染的可能性,磁共振成像有助于发现CMV相关脑异常。羊膜穿刺术是诊断胎儿CMV感染的金标准。加强育龄妇女及孕妇的卫生健康知识教育、减少CMV感染及抗病毒治疗是目前预防先天性CMV感染的主要措施。更昔洛韦及缬更昔洛韦是目前治疗CMV感染最有效的药物。高免疫球蛋白及CMV疫苗预防先天性 CMV 感染的作用尚无明确结论。     

Characterization of acute and latent herpes simplex virus infection of dorsal root ganglia in rats.

The characteristics of HSV type-1 infection following subcutaneous inoculation in the dorsum of one hind paw of Sprague-Dawley rats were studied to determine whether infection in rats might more closely parallel the infection in man than is seen in other animals. The serologic and virologic characteristics of acute and latent ganglion infection conformed to those of human infection. Immunohistochemical studies suggested that sensory ganglion infection arose via centripetal axonal migration of virus as is hypothesized in man. In rat, small type B neuronal cell bodies appeared central to the maintenance of latent infection and reactivation observed during cocultivation of lumbar ganglia. Acute and latent lumbar sensory ganglion infection in rats after subcutaneous hind paw injection of HSV-1 appears to be another suitable model of this infection in man.     

Infection periods in relation to the natural development of hop downy mildew (Pseudoperonospora humuli)

The relationships between temperature and surface wetness and subsequent infection of hop tissues by P. humuli were examined on potted plants and detached leaves kept in temperature-controlled growth rooms. Periods of wetness which would just allow leaf infection ranged from 1 1/2 h at 30d? to 24 h at 5d?. The corresponding ranges for shoots were: light infection, 3 h at 19–23d? to 6 h at 8–10d?; severe infection, 4 h at 19–23d? to 8 h at 12–13d?. These data were used to relate the development of downy mildew in an unsprayed hop garden during 1967 and 1968 to periods with temperature/surface wetness suitable for minimum (minor infection periods) and severe infection (major infection periods). In 1967 a sudden outbreak of infected basal shoots (spikes) was related to an isolated major infection period. By contrast, early in 1968, major shoot infection periods did not arise and spikes appeared gradually in response to a succession of minor infection periods. More spikes were formed in 196 than in 1967; this was not related to the incidence of infection periods but probably reflected the relatively higher concentrations of airborne sporangia early in 1968. In both years outbreaks of leaf and lateral shoot infection could be traced to major infection periods caused by rain; sudden disease increases again originated from isolated infection periods. There was a close similarity between the incubation period for each principal disease outbreak and that expected from growth-room experiments. Major infection periods occurred more frequently at the end of June 1968, resulting in a higher final concentration of diseased tissue than in 1967. Predicted major infection periods failed to induce large disease increases when dew alone provided wetness or when no airborne sporangia could be detected.     

PCT、IL-6及CRP对新生儿宫内细菌感染的诊断价值

目的:探讨新生儿宫内细菌感染采用降钙素原(PCT)、白细胞介素-6(IL-6)、及C反应蛋白(CRP)诊断的临床价值。方法:根据感染结局将2013年3月~2014年9月在我院分娩且有宫内感染高危因素的179例新生儿分为感染组(34例)和无感染组(145例),检测两组的PCT、IL-6及CRP水平,并比较各项指标对宫内细菌感染的诊断价值。结果:感染组脐带血PCT、IL-6、CRP水平均高于无感染组,差异有统计学意义(P0.05)。感染组各单个指标阳性率、两指标联合的阳性率高于无感染组,差异均有统计学意义(P0.05),感染组中PCT、IL-6阳性率高于CRP,PCT+IL-6的阳性率高于PCT+CRP、IL-6+CRP,差异均有统计学意义(P0.05)。PCT+IL-6的灵敏度、准确率高于单个指标及其他两个指标联合检测的结果,差异有统计学意义(P0.05),各项指标检测的特异性比较,差异无统计学意义(P0.05)。结论:新生儿宫内感染采用脐带血PCT检测具有灵敏度高,特异性好的特点,联合IL-6检测是临床诊断新生儿宫内感染的最有效的方式。     

The identification of three sizes of core proteins during the establishment of persistent hepatitis C virus infection in vitro

Similar to Hepatitis C virus (HCV) infection in humans, HCVcc infection can also result in persistent and chronic infection. The core protein is a variable protein and exists in several sizes. Some sizes of core proteins have been reported to be related to chronic HCV infection. To study the possible role of the core protein in persistent HCV infection, a persistent HCVcc infection was established, and the expression of the core protein was analysed over the course of the infection. The results show that there are three sizes of core proteins (p24, p21 and p19) expressed during the establishment of persistent HCVcc infection. Of these, the p21 core protein is the mature form of the HCV core protein. The p24 core protein is the phosphorylated form of p21. The p19 core protein appears to be a functional by-product generated during the course of infection. These three core proteins are all localized in the cytoplasm and can be encapsidated into the HCV virion. The appearance of the p19 and p24 core proteins might be related to acute HCVcc infection and chronic infection respectively and may play an important role in the pathology of a HCV infection.     

Parameters of human immunodeficiency virus infection of human cervical tissue and inhibition by vaginal virucides

Heterosexual transmission of human immunodeficiency virus (HIV) is the most frequent mode of infection worldwide. However, the immediate events between exposure to infectious virus and establishment of infection are still poorly understood. This study investigates parameters of HIV infection of human female genital tissue in vitro using an explant culture model. In particular, we investigated the role of the epithelium and virucidal agents in protection against HIV infection. We have demonstrated that the major target cells of infection reside below the genital epithelium, and thus HIV must cross this barrier to establish infection. Immune activation enhanced HIV infection of such subepithelial cells. Furthermore, our data suggest that genital epithelial cells were not susceptible to HIV infection, appear to play no part in the transfer of infectious virus across the epithelium, and thus may provide a barrier to infection. In addition, experiments using a panel of virucidal agents demonstrated differential efficiency to block HIV infection of subepithelial cells from partial to complete inhibition. This is the first demonstration that virucidal agents designed for topical vaginal use block HIV infection of genital tissue. Such agents have major implications for world health, as they will provide women with a mechanism of personal and covert protection from HIV infection.     

Early eradication of persistent Salmonella infection primes antibody-mediated protective immunity to recurrent infection

Typhoid fever is a systemic, persistent infection caused by host-specific strains of Salmonella. Although the use of antibiotics has reduced the complications associated with primary infection, recurrent infection remains an important cause of ongoing human morbidity and mortality. Herein, we investigated the impacts of antibiotic eradication of primary infection on protection against secondary recurrent infection. Using a murine model of persistent Salmonella infection, we demonstrate protection against recurrent infection is sustained despite early eradication of primary infection. In this model, protection is not mediated by CD4(+) or CD8(+) T cells because depletion of these cells either alone or in combination prior to rechallenge does not abrogate protection. Instead, infection followed by antibiotic-mediated clearance primes robust levels of Salmonella-specific antibody that can adoptively transfer protection to na?ve mice. Thus, eradication of persistent Salmonella infection primes antibody-mediated protective immunity to recurrent infection.     

Effects of mannan oligosaccharide on the physiological responses,HSP70 gene expression and disease resistance of Allogynogenetic crucian carp (Carassius auratus gibelio) under Aeromonas hydrophila infection

We evaluated the effect of dietary supplementation with mannan oligosaccharide (MOS) on the resistance to Aeromonas hydrophi1a infection in Allogynogenetic crucian carp. The fish were randomly divided into five groups: a control group was fed with basal diet, and four treatment groups fed with basal diet supplemented with 60, 120, 240, 480 mg/kg MOS for 10 weeks, respectively. We then challenged the fish with A. hydrophi1a and recorded the mortality and the changes in serum cortisol, T3, T4, lysozyme, alkaline phosphatase (ALP), globin and hepatic total anti-oxidative capacity, superoxide dismutase (SOD), malondialdehyde (MDA) and the relative expression of heat shock protein 70 (HSP70) mRNA for a period of 7 d. Supplementation with 240 mg/kg MOS significantly increased serum ALP activity before infection, 1d and 2d after infection, serum globin concentration prior to infection, 1d and 7d after infection, serum lysozyme activity at 2d after infection, T3 concentration at 2d after infection, hepatic total anti-oxidative capacity prior to infection, hepatic SOD activity at 7d after infection and reduced serum cortisol concentration at 2d after infection, hepatic malondialdehyde content at 1d and 2d after infection. Supplementation with 480 mg/kg MOS significantly increased serum ALP activity before infection, 1d and 2d after infection, T3 content 1d after infection, T4 content prior infection and 7d after infection, serum globin concentration prior to infection, 1d and 7d after infection, serum lysozyme activity prior infection and 1d after infection, serum total anti-oxidative capacity prior to infection and 7d after infection, hepatic SOD activity at 7d after infection and the relative level of hepatic HSP70 mRNA at 2d and 7d after infection, had decreased levels of serum cortisol concentration before the infection, at 2d after infection, T4 concentration at 1d and 2d after infection, hepatic malondialdehyde content at 1d and 2d after infection. Mortality was significantly lower in the group of 240 and 480 mg/kg MOS than the control. Our results suggest that ingestion of a basal diet supplemented with 240–480 mg/kg MOS can enhance resistance against pathogenic infections in Allogynogenetic crucian carp.     

传染病医院血液净化中心的医院感染管理

目的：探讨传染病医院血液净化中心的医院感染管理方法。方法：我院血液净化中心自2010年1月～2012年1月加强医院感染管理,制定了相关的制度及规范,现对感染管理措施进行总结分析,并统计医院感染发生率。结果：通过加强血液净化中心的医院感染管理,可有效防止医院感染的发生,医院感染的发生率为11.68%。结论：完善医院管理制度和规范,制定严格的管理措施,提高医务人员风险意识等可有效提高医院感染的管理水平,预防医院感染的发生。     

Effect of antiviral treatment with entecavir on age- and dose-related outcomes of duck hepatitis B virus infection

Entecavir (ETV), a potent inhibitor of the hepadnaviral polymerases, prevented the development of persistent infection when administered in the early stages of duck hepatitis B virus (DHBV) infection. In a preliminary experiment, ETV treatment commenced 24 h before infection showed no significant advantage over simultaneous ETV treatment and infection. In two further experiments 14-day-old ducks were inoculated with DHBV-positive serum containing 10(4), 10(6), 10(8), or 5 x 10(8) viral genomes (vge) and were treated orally with 1.0 mg/kg of body weight/day of ETV for 14 or 49 days. A relationship between virus dose and infection outcome was seen: non-ETV-treated ducks inoculated with 10(4) vge had transient infection, while ducks inoculated with higher doses developed persistent infection. ETV treatment for 49 days did not prevent initial infection of the liver but restricted the spread of infection more than approximately 1,000-fold, a difference which persisted throughout treatment and for up to 49 days after withdrawal. Ultimately, three of seven ETV-treated ducks resolved their DHBV infection, while the remaining ducks developed viremia and persistent infection after a lag period of at least 63 days. ETV treatment for 14 days also restricted the spread of infection, leading to marked and sustained reductions in the number of DHBV-positive hepatocytes in 7 out of 10 ducks. In conclusion, short-term suppression with ETV provides opportunity for the immune response to successfully control DHBV infection. Since DHBV infection of ducks provides a good model system for HBV infection in humans, it seems likely that ETV may be useful in postexposure therapy for HBV infection aimed at preventing the development of persistent infection.     

浅谈眼科手术室患者感染危险因素 及防控措施

摘要：目的 分析眼科手术室患者感染危险因素,讨论感染风险管理对策。方法 回顾2017年7月至2018年8月我院眼科手术室患者的感染情况,分析感染危险因素并制定应对策略。结果 2017年7月至2018年8月我院共实施眼科手术1 987只眼,均未发生感染。空气污染,医疗器械污染,防控意识薄弱可能是患者发生感染的危险因素。结论 规范流程可以有效规避眼科手术感染,注重细节管理是预防眼科手术感染的关键。     

Cell death and inflammation during infection with the obligate intracellular pathogen, Chlamydia

Infections by Chlamydia are followed by a strong inflammatory response, which is necessary to eliminate the infection, but at the same time is responsible for the pathology of infection. Resistance of infected cells against apoptosis induced by external ligands, together with the effects of IFNgamma secreted during infection, would be expected to contribute to persistence of infection. Secretion of TNFalpha plays an important role during clearance of the chlamydiae, but also triggers apoptosis of uninfected cells in infected tissues. Apoptosis of infected host-cells towards the end of the infection cycle is thought to participate in the release of chlamydiae from infected cells and propagation of the infection. Dysregulation of the apoptotic program during infection leads to a less efficient infection, but paradoxically, results in a higher inflammatory response and more severe pathology.     

汉中市汉台区无症状儿童幽门螺杆菌感染率的 流行病学调查

目的研究陕西省汉中地区无症状儿童幽门螺杆菌(H.pylori)感染的流行病学特点及其影响因素。方法采用酶联免疫吸附法(ELISA)检测2013年1月至2018年1月间我院328例无消化道症状儿童Hp-IgG水平情况,分析其流行病学特点,并行问卷调查研究幽门螺杆菌感染的影响因素。结果 328例无消化道症状儿童H.pylori感染率为18.90%。其中男童169例,感染率21.89%;女童159例,感染率15.72%;城市儿童137例,感染率20.44%;农村儿童191例,感染率17.80%。经Logstic回归分析,年龄3～4岁、饭前便后洗手、父母具有大学文化水平均为H.pylori感染的保护性因素;啃手指、公用洗漱杯、直系亲属胃病史均为H.pylori感染的独立危险因素,差异均有统计学意义(P0.05)。结论 H.pylori感染在儿童中较为常见,生活中不良习性与H.pylori感染密切相关。H.pylori感染相关高危因素的分析对于儿童H.pylori感染的防控具有重要临床意义。     

1724例女性生殖道支原体感染调查及耐药性分析

目的了解本地区女性生殖道支原体的感染现状及耐药情况,为临床用药提供指导。方法采用生殖道支原体检测试剂盒,对2012年8月至2013年4月解放军第44医院妇科门诊就诊的1 724例女性生殖道标本进行支原体培养及药敏检测,并对结果做统计学分析。结果 1 724例女性生殖道支原体感染率为43.6%,其中单纯Uu感染占85.1%;单纯Mh感染占3.7%;Uu合并Mh感染占11.2%。感染人群中21-40岁年龄段占85.2%。支原体对交沙霉素、强力霉素、美满霉素耐药率较低,对环丙沙星、左氧氟沙星、红霉素及司帕沙星的耐药率较高,单纯Mh及Uu合并Mh感染对抗菌药物的耐药率高于单纯Uu感染。结论女性生殖道支原体感染以单纯Uu为主,感染人群多见于21-40岁,支原体对常用抗菌药物出现了不同程度的耐药性,建议临床根据药敏结果合理用药,以减少耐药菌株的产生。     

关于HCMV 潜伏感染与激活感染研究的新进展

人巨细胞病毒(HCMV)是疱疹病毒科中最大的病毒,结构复杂,其感染在人群中非常普遍,近年来免疫妥协(immunocompromised)群体尤其是移植群体中的HCMV潜伏感染和激活感染越来越受到临床重视。本文就HCMV的感染与免疫、HCMV的致病机制、宿主的抗感染与免疫、HCMV的免疫逃逸、HCMV的潜伏与激活及HCMV相关研究的困境与展望近年来此方面研究新进展作一简要综述。     

Dynamics of tuberculosis in a naturally infected Badger population

The dynamics of bovine tuberculosis infection in a wild Badger population have been studied since 1981. Faeces are sampled regularly to determine the distribution of infection in the study area. Badgers in known infected social groups, plus the neighbouring groups, are periodically caught and subjected to full clinical and bacteriological examination to monitor the progression of infection within and between groups of Badgers. The interim results of this study are presented and discussed. During 5 years (1981–1985), the temporal spread of infection between social groups in the study area was slow and restricted. Some clinically affected Badgers have survived for long periods. Evidence of infection in individual Badgers indicates that pseudo-vertical (mother to cub) transmission may be important in the maintenance of infection in the Badger population. There is also evidence of horizontal transmission by bite wounding and aerosol infection. Badger mortality due to Mycobacterium bovis infection was low, and the prevalence of infection in male Badgers is greater than in females. The data accumulated so far show no apparent relationship between Badger population density and the prevalence of M. bovis infection, nor is there any evidence to support the hypothesis that M. bovis infection acts to depress Badger population density significantly below disease-free levels. Cattle and infected Badgers can co-exist for long periods without the disease necessarily being transmitted to cattle.     

控制人巨细胞病毒感染的策略

人巨细胞病毒（HCMV）感染对免疫受损人群危害极大,本综述了目前控制HCMV感染的策略,其中包括药物控制和免疫控制。阐述了使用药物控制HCMV感染的效果,疫苗在控制HCMV感染及引发疾病方面的作用及通过被动免疫控制HCMV感染的现状与进展。对这些策略的了解对控制HCMV感染具有重要意义。     

Synthesis of Viral Ribonucleic Acid During Restricted Adenovirus Infection

The mechanism by which simian virus 40 converts the abortive adenovirus type 7 infection of monkey cells into an efficient lytic infection has been investigated. Analysis of ribonucleic acid (RNA) synthesis during unenhanced and enhanced infection of monkey cells has shown that adenovirus RNA synthesized in the abortive infection contains both "early" and "late" sequences. In hybridization competition experiments, early adenovirus RNA from human cells prevented the hybridization of only 20% of the adenovirus RNA transcribed in unenhanced infection. Further, the RNA from unenhanced cells was able to completely block the hybridization of RNA synthesized during enhanced infection. Finally, virus-associated RNA, which is a late RNA transcribed in lytic adenovirus infection, is also produced in the unenhanced infection. An accompanying paper describes a marked deficiency in adenoviral capsid protein synthesis in the unenhanced infection. We conclude that RNA sequences, which are sufficient to code for the synthesis and assembly of structural proteins of adenovirus, are transcribed but are not efficiently translated in the unenhanced adenovirus infection of monkey cells.     

阑尾炎术后医院感染危险因素分析

目的探讨阑尾炎术后医院感染情况及其主要危险因素。方法对普外科和肝胆外科在2005年1月1日至2007年1月1日之间的386例阑尾炎患者进行回顾性调查分析。结果被研究的病例中有28例发生院感（院感率为7.25%）,急性单纯性阑尾炎197例有3例发生院感,院感率为1.50%,化脓性阑尾炎189例中有25例发生医院感染,感染率为13.23%。发生院感的病例中,切口感染有12例,占42.85%,其余为上呼吸道感染（1例）、皮肤与软组织感染（1例）、其他感染（14例）。结论两种阑尾炎的院感率差异有显著性。引起阑尾炎院感的危险因素是抗生素使用时间过久和种类过多。