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Prevalence and Factors Associated with Multidrug-Resistant Tuberculosis (MDR-TB) among Presumptive MDR-TB Patients in Tigray Region, Northern Ethiopia 埃塞俄比亚北部提格雷地区推定耐多药结核病患者中耐多药结核病的患病率和相关因素
K. Mehari, Tsehaye Asmelash, Haftamu Hailekiros, Tewolde Wubayehu, H. Godefay, Tadele Araya, M. Saravanan
Background Tuberculosis (TB) is one of the major public health problems. There are alarming reports of increasing multidrug-resistant tuberculosis (MTR-TB) from various parts of the globe, including Ethiopia. This study was designed to determine the prevalence and factors associated with MDR-TB among presumptive MDR-TB cases in Tigray Regional State, Ethiopia. Methods A cross-sectional study was conducted in Tigray Regional State from 2015 to 2016. Two hundred sputum samples were collected, transported, processed using 2% N-acetyl-L-cysteine-sodium hydroxide, and cultured in LJ medium. Besides, the microscopic examination was performed after ZN staining. Moreover, drug susceptibility test was done using molecular line probe assay. Descriptive statistics and binary and multivariable logistic regression were done. A statistical test was regarded as significant when the P value was <0.05. Results The prevalence of MDR-TB was found to be 18.5%. About one-fourth (26.5%) of the study participants had sputum smear positive for acid-fast bacilli (AFB). TB culture was positive in 37% of the samples, and rifampicin mono-resistant cases accounted for 3.5% of the presumptive MDR-TB cases. Three (1.5%) were new MDR-TB cases, while the rest had been treated previously for TB. Most (63.5%) of the MDR-TB cases were from 15 to 44 years of age. Age was associated with MDR-TB with a crude odds ratio of 1.06 (CI: 1.02–1.10) and adjusted odds ratio of 1.06 (CI: 1.00–1.11). Conclusions The prevalence of MDR-TB was found to be high. Preventive measures should be taken to prevent the transmission of MDR-TB in the community.
结核病(TB)是主要的公共卫生问题之一。有令人震惊的报告称,包括埃塞俄比亚在内的全球各地耐多药结核病(MTR-TB)正在增加。本研究旨在确定埃塞俄比亚提格雷地区州推定耐多药结核病病例中耐多药结核病的患病率和相关因素。方法2015 - 2016年在提格雷地区州进行横断面研究。收集200份痰样本,运输后用2% n -乙酰- l-半胱氨酸-氢氧化钠处理,并在LJ培养基中培养。锌染色后进行显微检查。采用分子线探针法进行药敏试验。描述性统计和二元及多变量logistic回归分析。当P值<0.05时,认为有统计学意义。结果耐多药结核病患病率为18.5%。约四分之一(26.5%)的研究参与者痰涂片抗酸杆菌(AFB)阳性。在37%的样本中结核培养呈阳性,利福平单药耐药病例占推定耐多药结核病病例的3.5%。3例(1.5%)为耐多药结核病新发病例,其余病例以前曾接受过结核病治疗。大多数耐多药结核病例(63.5%)年龄在15至44岁之间。年龄与耐多药结核病相关,粗比值比为1.06 (CI: 1.02-1.10),校正比值比为1.06 (CI: 1.00-1.11)。结论该地区耐多药结核病患病率较高。应采取预防措施,防止耐多药结核病在社区传播。
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引用次数: 24
Molecular Detection of Bartonella spp. in China and St. Kitts 中国和圣基茨巴尔通体的分子检测
Ke Huang, P. Kelly, Jilei Zhang, Yi Yang, Weiguo Liu, Anwar A. Kalalah, Chengming Wang
Bartonella are vector-borne hemotropic bacteria that infect a wide variety of hosts, including people. While there are PCR assays that can identify individual or groups of Bartonella, there is no reliable molecular method to simultaneously detect all species while maintaining genus specificity and sensitivity. By comparing highly conserved 16S rRNA sequences of the better-recognized Bartonella spp. on GenBank, we selected primers and probes for a genus-specific pan-Bartonella FRET-qPCR. Then, a gltA-based Bartonella PCR was established by selecting primers for a highly variable region of gltA, of which the sequenced amplicons could identify individual Bartonella spp. The pan-Bartonella FRET-qPCR did not detect negative controls (Brucella spp., Anaplasma spp., Rickettsia spp., Coxiella burnetii, and Wolbachia) but reliably detected as few as two copies of the positive control (Bartonella henselae) per reaction. There was complete agreement between the pan-Bartonella FRET-qPCR and the gltA-based Bartonella PCR in detecting Bartonella in convenience test samples from China and St. Kitts: cats (26%; 81/310), Ctenocephalides felis (20%; 12/60), cattle (24%; 23/98), and donkeys (4%; 1/20). Sequencing of the gltA-based Bartonella PCR products revealed B. henselae (70%; 57/81) and B. clarridgeiae (30%; 24/81) in cats and C. felis (67%; 8/12, and 33%; 4/12, respectively) and B. bovis in cattle (23.5%; 23/98) and donkeys (4.0%; 1/24). The pan-Bartonella FRET-qPCR and gltA-based Bartonella PCR we developed are highly sensitive and specific in detecting recognized Bartonella spp. in a single reaction. The pan-Bartonella FRET-qPCR is convenient requiring no gel electrophoresis and providing copy numbers, while the gltA-based Bartonella PCR reliably differentiates individual Bartonella species. The use of these PCRs should greatly facilitate large-scale surveillance studies and the diagnosis of infections in clinical samples.
巴尔通体是媒介传播的嗜血细菌,可感染多种宿主,包括人。虽然有PCR检测可以识别单个或群体巴尔通体,但没有可靠的分子方法可以同时检测所有物种,同时保持属的特异性和敏感性。通过比较GenBank上高度保守的巴尔通体16S rRNA序列,选择引物和探针构建属特异性泛巴尔通体fet - qpcr。然后,通过选择gltA高度可变区域的引物,建立了基于gltA的巴尔通体PCR,测序扩增子可以识别单个巴尔通体,泛巴尔通体FRET-qPCR不能检测到阴性对照(布鲁氏菌、无形体、立克次体、伯纳氏杆菌和沃尔巴克氏体),但每次反应可以可靠地检测到两份阳性对照(亨selae巴尔通体)。泛巴尔通体FRET-qPCR与基于glta的巴尔通体PCR在中国和圣基茨的方便检测样本中检测巴尔通体的结果完全一致:猫(26%;81/310),猫头线虫(20%;12/60),牛(24%;23/98)和驴子(4%;1/20)。基于glta的巴尔通体PCR产物测序显示:亨selae (70%;57/81)和黑僵杆菌(30%;24/81) (67%;8/12, 33%;分别为4/12)和牛b型牛(23.5%;23/98)和驴(4.0%;1/24)。我们建立的泛巴尔通体FRET-qPCR和基于glta的巴尔通体PCR在单次反应中检测识别的巴尔通体具有很高的灵敏度和特异性。泛巴尔通体FRET-qPCR无需凝胶电泳且提供拷贝数,而基于glta的巴尔通体PCR可靠地区分单个巴尔通体物种。这些pcr的使用将极大地促进大规模监测研究和临床样本感染的诊断。
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引用次数: 11
Antibiotic Resistance of Enteric Bacteria in HIV-Infected Patients at the Banka Ad-Lucem Hospital, West Region of Cameroon 喀麦隆西部地区Banka Ad-Lucem医院艾滋病毒感染患者肠道细菌的抗生素耐药性
O. J. T. Ngalani, A. Mbaveng, Wiliane J T Marbou, Roland Y. Ngai, V. Kuete
Human immunodeficiency virus (HIV) infection is a serious problem throughout the world and especially in developing countries. This study was conducted to define the bacterial aetiologies of enteric disorders and their association with CD4+ T-lymphocyte cell count and serum hs-CRP in HIV-seropositive patients coming for consultation at the AD-Lucem Banka Hospital. Stool samples from one-hundred HIV-positive patients with enteric disorders and forty HIV negative patients with enteric disorders were examined for the presence of bacteria by different diagnostic techniques. CD4+ T-lymphocyte count and serum hs-CRP of HIV-positive and HIV-negative patients were examined, respectively, by flux cytometry and the ELISA solid-phase direct sandwich method. Among all the participants, 39 (26.35%) were males and 109 (73.65%) were females. HIV-seropositive mean age (43.79 years) was significantly higher compared to HIV-seronegative (27.13 years) patients (p < 0.000). The average values of CD4+ T-cell count (p < 0.0001), lymphocytes (p=0.0258), monocytes (p=0.0317), and total WBC count (p=0.0277) were significantly higher in HIV− patients compared to HIV+ patients. Salmonella sp., Escherichia coli, and Klebsiella pneumoniae were more isolated in HIV+ patients 5 (83.33), 18 (75.00), and 37 (71.15) compared to HIV− patients 1 (16.67), 6 (25.00), and 15 (28.85), respectively. Majority of isolates were susceptible to IPM, NOR, and CIP. Klebsiella pneumoniae, the most prevalent isolate, showed resistance to AMC (45.95) in HIV+ patients, whereas in HIV− patients, Enterobacter aerogenes and Shigella sp. showed resistance to AMC (80.00% and 85.71%, respectively) and to CFM (80.00% and 57.14%, respectively). Enterobacter aerogenes (40.00%) and Shigella sp. (14.29) isolates showed multidrug resistance in HIV− patients, whereas Escherichia coli (5.56%) and Klebsiella pneumoniae (2.70%) showed multidrug resistance in HIV+ patients. Understanding the burden of bacteria disease in HIV patients as shown in the present study is important for planning effective control programs for the overall reduction of bacteria diseases in HIV-infected patients.
人类免疫缺陷病毒(HIV)感染是全世界特别是发展中国家的一个严重问题。本研究旨在确定在AD-Lucem Banka医院就诊的hiv血清阳性患者肠道疾病的细菌病原学及其与CD4+ t淋巴细胞计数和血清hs-CRP的关系。采用不同的诊断技术对100例HIV阳性肠道疾病患者和40例HIV阴性肠道疾病患者的粪便样本进行细菌检测。采用流式细胞术和ELISA固相直接夹心法分别检测hiv阳性和hiv阴性患者CD4+ t淋巴细胞计数和血清hs-CRP。其中男性39人(26.35%),女性109人(73.65%)。hiv血清阳性患者的平均年龄(43.79岁)明显高于hiv血清阴性患者(27.13岁)(p < 0.000)。HIV -患者CD4+ t细胞计数(p < 0.0001)、淋巴细胞计数(p=0.0258)、单核细胞计数(p=0.0317)和白细胞总数(p=0.0277)的平均值均显著高于HIV -患者。HIV阳性患者5(83.33)、18(75.00)、37(71.15)分别比HIV阴性患者1(16.67)、6(25.00)、15(28.85)分离出更多的沙门氏菌、大肠杆菌和肺炎克雷伯菌。大多数分离株对IPM、NOR和CIP敏感。在HIV阳性患者中,肺炎克雷伯菌对AMC的耐药率为45.95%,而在HIV阴性患者中,产气肠杆菌和志贺氏菌对AMC的耐药率分别为80.00%和85.71%,对CFM的耐药率分别为80.00%和57.14%。产气肠杆菌(40.00%)和志贺氏菌(14.29%)在HIV -患者中表现为多药耐药,而大肠杆菌(5.56%)和肺炎克雷伯菌(2.70%)在HIV+患者中表现为多药耐药。了解本研究显示的HIV患者细菌性疾病负担对于规划有效的控制方案以全面减少HIV感染患者细菌性疾病具有重要意义。
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引用次数: 8
Cytological and Wet Mount Microscopic Observations Made in Urine of Schistosoma haematobium-Infected Children: Hint of the Implication in Bladder Cancer. 对血吸虫感染儿童尿液的细胞学和湿装显微镜观察:膀胱癌的暗示。
Patience B Tetteh-Quarcoo, Benjamin K Akuetteh, Irene A Owusu, Solomon E Quayson, Simon K Attah, Robert Armah, Emmanuel Afutu, Ama Afrah, Kantanka Addo-Osafo, Cecilia Smith, Richard K Gyasi, Patrick F Ayeh-Kumi

Background: Schistosomiasis is the second major human parasitic disease next to malaria, in terms of socioeconomic and public health consequences, especially in sub-Saharan Africa. Schistosoma haematobium (S. haematobium) is a trematode and one of the species of Schistosoma that cause urogenital schistosomiasis (urinary schistosomiasis). Although the knowledge of this disease has improved over the years, there are still endemic areas, with most of the reported cases in Africa, including Ghana. Not much has been done in Ghana to investigate cytological abnormalities in individuals within endemic communities, although there are epidemiologic evidences linking S. haematobium infection with carcinoma of the bladder.

Aim: The aim of this study was to identify microscopic and cytological abnormalities in the urine deposits of S. haematobium-infected children.

Methodology: Three hundred and sixty-seven (367) urine samples were collected from school children in Zenu and Weija communities. All the samples were examined microscopically for the presence of S. haematobium eggs, after which the infected samples and controls were processed for cytological investigation.

Results: S. haematobium ova were present in 66 (18.0%) out of the 367 urine samples. Inflammatory cells (82%, 54/66), hyperkeratosis (47%, 31/66), and squamous cell metaplasia (24%, 16/66) were the main observations made during the cytological examination of the S. haematobium-infected urine samples.

Conclusion: Cytological abnormalities in S. haematobium-infected children may play an important role in the severity of the disease, leading to the possible development of bladder cancer in later years, if early attention is not given. Therefore, routine cytological screening for urogenital schistosomiasis patients (especially children) at hospitals in S. haematobium-endemic locations is recommended.

背景:就社会经济和公共卫生后果而言,血吸虫病是仅次于疟疾的第二大人类寄生虫病,尤其是在撒哈拉以南非洲地区。血吸虫(S. haematobium)是一种吸虫,也是导致尿路血吸虫病(泌尿系统血吸虫病)的血吸虫种类之一。尽管多年来人们对这种疾病的认识有所提高,但仍有一些地方病流行地区,报告的大多数病例都发生在非洲,包括加纳。尽管有流行病学证据表明血吸虫感染与膀胱癌有关,但加纳在调查流行社区内个体细胞学异常方面所做的工作并不多:方法:从 Zenu 和 Weija 社区的学龄儿童中收集了 367 份尿液样本。对所有样本进行显微镜检查,以确定是否存在血孢子虫卵,然后对感染样本和对照样本进行细胞学检查:结果:367 份尿液样本中有 66 份(18.0%)存在血吸虫卵。在对受血孢子虫感染的尿液样本进行细胞学检查时,主要发现了炎性细胞(82%,54/66)、角化过度(47%,31/66)和鳞状细胞增生(24%,16/66):结论:受血吸虫感染儿童的细胞学异常可能对疾病的严重程度起到重要作用,如果不及早重视,可能会导致日后膀胱癌的发生。因此,建议在血吸虫病流行地区的医院对泌尿系统血吸虫病患者(尤其是儿童)进行常规细胞学筛查。
{"title":"Cytological and Wet Mount Microscopic Observations Made in Urine of <i>Schistosoma haematobium</i>-Infected Children: Hint of the Implication in Bladder Cancer.","authors":"Patience B Tetteh-Quarcoo, Benjamin K Akuetteh, Irene A Owusu, Solomon E Quayson, Simon K Attah, Robert Armah, Emmanuel Afutu, Ama Afrah, Kantanka Addo-Osafo, Cecilia Smith, Richard K Gyasi, Patrick F Ayeh-Kumi","doi":"10.1155/2019/7912186","DOIUrl":"10.1155/2019/7912186","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis is the second major human parasitic disease next to malaria, in terms of socioeconomic and public health consequences, especially in sub-Saharan Africa. <i>Schistosoma haematobium</i> (<i>S. haematobium</i>) is a trematode and one of the species of <i>Schistosoma</i> that cause urogenital schistosomiasis (urinary schistosomiasis). Although the knowledge of this disease has improved over the years, there are still endemic areas, with most of the reported cases in Africa, including Ghana. Not much has been done in Ghana to investigate cytological abnormalities in individuals within endemic communities, although there are epidemiologic evidences linking <i>S. haematobium</i> infection with carcinoma of the bladder.</p><p><strong>Aim: </strong>The aim of this study was to identify microscopic and cytological abnormalities in the urine deposits of <i>S. haematobium</i>-infected children.</p><p><strong>Methodology: </strong>Three hundred and sixty-seven (367) urine samples were collected from school children in Zenu and Weija communities. All the samples were examined microscopically for the presence of <i>S. haematobium</i> eggs, after which the infected samples and controls were processed for cytological investigation.</p><p><strong>Results: </strong><i>S. haematobium</i> ova were present in 66 (18.0%) out of the 367 urine samples. Inflammatory cells (82%, 54/66), hyperkeratosis (47%, 31/66), and squamous cell metaplasia (24%, 16/66) were the main observations made during the cytological examination of the <i>S. haematobium</i>-infected urine samples.</p><p><strong>Conclusion: </strong>Cytological abnormalities in <i>S. haematobium</i>-infected children may play an important role in the severity of the disease, leading to the possible development of bladder cancer in later years, if early attention is not given. Therefore, routine cytological screening for urogenital schistosomiasis patients (especially children) at hospitals in <i>S. haematobium</i>-endemic locations is recommended.</p>","PeriodicalId":22481,"journal":{"name":"The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91134360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology of Plague: Problems with the Use of Mathematical Epidemiological Models in Plague Research and the Question of Transmission by Human Fleas and Lice. 鼠疫流行病学:在鼠疫研究中使用数学流行病学模型的问题以及人类跳蚤和虱子的传播问题。
Ole J Benedictow

This article addresses the recent use of mathematical epidemiological SIR or SEIR models in plague research. This use of S(E)IR models is highly problematic, but the problems are not presented and considered. Serious problems show in that such models are used to "prove" that historical plague was a (1) Filoviridae disease and (2) a bacterial disease caused by Yersinia pestis which was transmitted by human fleas and lice. (3) They also support early-phase transmission (by fleas). They purportedly consistently disprove (4) the conventional view that plague is/was a rat-and-rat-flea-borne disease. For these reasons, the focus is on methodological problems and on empirical testing by modern medical, entomological, and historical epidemiological data. An important or predominant vectorial role in plague epidemics for human fleas and lice requires that several necessary conditions are satisfied, which are generally not considered by advocates of the human ectoparasite hypothesis of plague transmission: (1) the prevalence and levels of human plague bacteraemia (human plague cases as sources of infection of feeding human ectoparasites); (2) the general size of blood meals ingested by human fleas and lice; (3) the consequent number of ingested plague bacteria; (4) the lethal dose of bacteria for 50% of a normal sample of infected human beings, LD50; and (5) efficient mechanism of transmission by lice and by fleas. The factual answers to these crucial questions can be ascertained and shown to invalidate the human ectoparasite hypothesis. The view of the standard works on plague has been corroborated, that bubonic plague, historical and modern, is/was a rat-and-rat-flea-borne disease caused by Yersinia pestis. These conclusions are concordant with and corroborate recent studies which, by laboratory experiments, invalidated the early-transmission hypothesis as a mechanism of transmission of LDs to humans in plague epidemics and removed this solution to the problem of transmission by human fleas.

本文讨论了最近在鼠疫研究中使用数学流行病学 SIR 或 SEIR 模型的情况。S(E)IR 模型的使用存在很大问题,但这些问题并未被提出和考虑。严重的问题表现在,这些模型被用来 "证明 "历史上的鼠疫是一种 (1) Filoviridae 疾病和 (2) 由鼠疫耶尔森菌引起的细菌性疾病,由人类跳蚤和虱子传播。(3) 他们还支持早期传播(通过跳蚤)。(4) 据称,它们一致推翻了鼠疫是/曾经是一种鼠蚤传播疾病的传统观点。由于这些原因,本文的重点在于方法论问题以及现代医学、昆虫学和历史流行病学数据的实证检验。人类跳蚤和虱子在鼠疫流行中扮演重要或主要的媒介角色需要满足几个必要条件,而鼠疫传播的人类体外寄生虫假说的倡导者通常不考虑这些条件:(1) 人类鼠疫菌血症的流行率和水平(人类鼠疫病例作为摄食人类外寄生虫的传染源);(2) 人类跳蚤和虱子摄取的血餐的一般大小;(3) 因此摄取的鼠疫细菌数量;(4) 50%正常感染人类样本的细菌致死剂量,即 LD50;(5) 虱子和跳蚤的有效传播机制。这些关键问题的事实答案可以确定,并证明人类外寄生虫假说是无效的。鼠疫标准著作的观点已经得到证实,即鼠疫,无论是历史上的还是现代的鼠疫,都是由鼠疫耶尔森菌引起的一种鼠蚤传播疾病。这些结论与最近的研究相一致并得到了证实,最近的研究通过实验室实验,宣布早期传播假说作为鼠疫流行病中LD传播给人类的机制无效,并取消了这一通过人类跳蚤传播问题的解决方案。
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引用次数: 0
Antibiotic Resistance Profiles of Haemophilus influenzae Isolates from Children in 2016: A Multicenter Study in China. 2016 年儿童流感嗜血杆菌分离株的抗生素耐药性概况:中国多中心研究。
Hong-Jiao Wang, Chuan-Qing Wang, Chun-Zhen Hua, Hui Yu, Ting Zhang, Hong Zhang, Shi-Fu Wang, Ai-Wei Lin, Qing Cao, Wei-Chun Huang, Hui-Ling Deng, Shan-Cheng Cao, Xue-Jun Chen

Background and objective: Haemophilus influenzae (HI) is a common cause of community-acquired pneumonia in children. In many countries, HI strains are increasingly resistant to ampicillin and other commonly prescribed antibiotics, posing a challenge for effective clinical treatment. This study was undertaken to determine the antibiotic resistance profiles of HI isolates from Chinese children and to provide guidelines for clinical treatment.

Methods: Our Infectious Disease Surveillance of Pediatrics (ISPED) collaboration group includes six children's hospitals in different regions of China. The same protocols and guidelines were used by all collaborators for the culture and identification of HI. The Kirby-Bauer method was used to test antibiotic susceptibility, and a cefinase disc was used to detect β-lactamase activity.

Results: We isolated 2073 HI strains in 2016: 83.9% from the respiratory tract, 11.1% from vaginal secretions, and 0.5% from blood. Patients with respiratory isolates were significantly younger than nonrespiratory patients (P < 0.001). Of all 2073 strains, 50.3% were positive for β-lactamase and 58.1% were resistant to ampicillin; 9.3% were β-lactamase-negative and ampicillin-resistant. The resistance rates of the HI isolates to trimethoprim-sulfamethoxazole, azithromycin, cefuroxime, ampicillin-sulbactam, cefotaxime, and meropenem were 71.1%, 32.0%, 31.2%, 17.6%, 5.9%, and 0.2%, respectively.

Conclusions: More than half of the HI strains isolated from Chinese children were resistant to ampicillin, primarily due to the production of β-lactamase. Cefotaxime and other third-generation cephalosporins could be the first choice for the treatment of ampicillin-resistant HI infections.

背景和目的:流感嗜血杆菌(HI)是儿童社区获得性肺炎的常见病因。在许多国家,流感嗜血杆菌菌株对氨苄西林和其他常用抗生素的耐药性越来越强,给有效的临床治疗带来了挑战。本研究旨在确定中国儿童分离的 HI 菌株的抗生素耐药性情况,并为临床治疗提供指导:我们的儿科传染病监测(ISPED)协作组包括中国不同地区的六家儿童医院。所有合作者均采用相同的方案和指南进行 HI 的培养和鉴定。柯比鲍尔法用于检测抗生素敏感性,头孢酶盘用于检测β-内酰胺酶活性:2016年,我们共分离出2073株HI菌株:83.9%来自呼吸道,11.1%来自阴道分泌物,0.5%来自血液。呼吸道分离菌株的患者明显比非呼吸道患者年轻(P < 0.001)。在所有 2073 株菌株中,50.3% 的β-内酰胺酶呈阳性,58.1% 对氨苄西林耐药;9.3% β-内酰胺酶阴性且对氨苄西林耐药。HI分离株对三甲双氨-磺胺甲噁唑、阿奇霉素、头孢呋辛、氨苄西林-舒巴坦、头孢他啶和美罗培南的耐药率分别为71.1%、32.0%、31.2%、17.6%、5.9%和0.2%:从中国儿童中分离出的 HI 菌株有一半以上对氨苄西林耐药,主要原因是产生了 β-内酰胺酶。头孢噻肟和其他第三代头孢菌素可作为治疗耐氨苄西林 HI 感染的首选药物。
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引用次数: 0
Development of a Predictive Model of Tuberculosis Transmission among Household Contacts 家庭接触者间结核病传播预测模型的建立
Saibin Wang
Background Household contacts of patients with tuberculosis (TB) are at great risk of TB infection. The aim of this study was to develop a predictive model of TB transmission among household contacts. Method This was a secondary analysis of data from a prospective cohort study, in which a total of 700 TB patients and 3417 household contacts were enrolled between 2010 and 2013 at two study sites in Peru. The incidence of secondary TB cases among household contacts of index cases was recorded. The LASSO regression method was used to reduce the data dimension and to filter variables. Multivariate logistic regression analysis was applied to develop the predictive model, and internal validation was performed. A nomogram was constructed to display the model, and the AUC was calculated. The calibration curve and decision curve analysis (DCA) were also evaluated. Results The incidence of TB disease among the contacts of index cases was 4.4% (149/3417). Ten variables (gender, age, TB history, diabetes, HIV, index patient's drug resistance, socioeconomic status, spoligotypes, and the index-contact share sleeping room status) filtered through the LASSO regression technique were finally included in the predictive model. The model showed good discriminatory ability, with an AUC value of 0.761 (95% CI, 0.723–0.800) for the derivation and 0.759 (95% CI, 0.717–0.796) for the internal validation. The predictive model showed good calibration, and the DCA demonstrated that the model was clinically useful. Conclusion A predictive model was developed that incorporates characteristics of both the index patients and the contacts, which may be of great value for the individualized prediction of TB transmission among household contacts.
背景结核病患者的家庭接触者感染结核病的风险很大。本研究的目的是建立家庭接触者之间结核病传播的预测模型。方法:对一项前瞻性队列研究的数据进行二次分析,该研究于2010年至2013年在秘鲁的两个研究地点共纳入了700名结核病患者和3417名家庭接触者。记录指示病例家庭接触者中继发结核病例的发病率。采用LASSO回归方法对数据进行降维和变量过滤。采用多元逻辑回归分析建立预测模型,并进行内部验证。构造图表示模型,计算曲线下面积(AUC)。并对标定曲线和决策曲线分析(DCA)进行了评价。结果指示病例接触者结核发病率为4.4%(149/3417)。通过LASSO回归技术筛选的10个变量(性别、年龄、结核病史、糖尿病、HIV、指标患者耐药性、社会经济地位、spoligotypes、指标-接触者共用卧室状态)最终被纳入预测模型。该模型具有良好的判别能力,推导的AUC值为0.761 (95% CI, 0.723-0.800),内部验证的AUC值为0.759 (95% CI, 0.717-0.796)。预测模型显示出良好的校准,DCA证明该模型在临床上是有用的。结论建立了结合指标患者和接触者特征的预测模型,对家庭接触者间结核病传播的个体化预测具有重要价值。
{"title":"Development of a Predictive Model of Tuberculosis Transmission among Household Contacts","authors":"Saibin Wang","doi":"10.1155/2019/5214124","DOIUrl":"https://doi.org/10.1155/2019/5214124","url":null,"abstract":"Background Household contacts of patients with tuberculosis (TB) are at great risk of TB infection. The aim of this study was to develop a predictive model of TB transmission among household contacts. Method This was a secondary analysis of data from a prospective cohort study, in which a total of 700 TB patients and 3417 household contacts were enrolled between 2010 and 2013 at two study sites in Peru. The incidence of secondary TB cases among household contacts of index cases was recorded. The LASSO regression method was used to reduce the data dimension and to filter variables. Multivariate logistic regression analysis was applied to develop the predictive model, and internal validation was performed. A nomogram was constructed to display the model, and the AUC was calculated. The calibration curve and decision curve analysis (DCA) were also evaluated. Results The incidence of TB disease among the contacts of index cases was 4.4% (149/3417). Ten variables (gender, age, TB history, diabetes, HIV, index patient's drug resistance, socioeconomic status, spoligotypes, and the index-contact share sleeping room status) filtered through the LASSO regression technique were finally included in the predictive model. The model showed good discriminatory ability, with an AUC value of 0.761 (95% CI, 0.723–0.800) for the derivation and 0.759 (95% CI, 0.717–0.796) for the internal validation. The predictive model showed good calibration, and the DCA demonstrated that the model was clinically useful. Conclusion A predictive model was developed that incorporates characteristics of both the index patients and the contacts, which may be of great value for the individualized prediction of TB transmission among household contacts.","PeriodicalId":22481,"journal":{"name":"The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77793242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Application of kDNA Minicircle PCR-RFLP to Characterize Leishmania donovani Clinical Isolates Obtained from Post-Kala-Azar Dermal Leishmaniasis in Eastern Nepal 应用kDNA微环PCR-RFLP鉴定尼泊尔东部黑热病后皮肤利什曼原虫临床分离株
Ojesh Pokhrel, K. Rai, N. Bhattarai, S. Rijal, A. Rijal, B. Khanal
Post-kala-azar dermal leishmaniasis (PKDL) is a skin manifestation of visceral leishmaniasis (VL) which develops after apparent cure in some patients. PKDL is considered as the potential reservoir for the VL infection. Molecular epidemiological characterization of L. donovani isolates obtained from VL and PKDL isolates is essentially required in order to understand the transmission dynamics of the VL infection. To date, genetic variation among the VL and PKDL L. donovani isolates was not fully elucidated. Therefore, 14 clinical isolates from VL and 4 clinical isolates from PKDL were speciated by hsp70 and rDNA genes. Further characterization of L. donovani by haspB PCR demonstrates two different genotypes. All PKDL isolates have the same genetic structure. kDNA PCR-RFLP assay revealed 18 different genotypes; however, structural analysis showed the two distinct kDNA genotype population (k = 2). The kDNA fingerprint patterns of parasites from hilly districts were clustered separately from low-land districts. Therefore, further study with a large number of samples is urgently required for systematic characterization of the clinical isolates to track the molecular epidemiology of the Leishmania donovani causing VL and the role of PKDL as a reservoir.
黑热病后皮肤利什曼病(PKDL)是内脏利什曼病(VL)的一种皮肤表现,在一些患者明显治愈后发生。PKDL被认为是VL感染的潜在宿主。从VL和PKDL分离株中获得的多诺瓦利菌分离株的分子流行病学特征是了解VL感染传播动力学的必要条件。迄今为止,VL和PKDL L. donovani分离株之间的遗传变异尚未完全阐明。因此,14株VL临床分离株和4株PKDL临床分离株被hsp70和rDNA基因指定。通过haspB PCR进一步鉴定了多诺瓦杆菌的两种不同的基因型。所有的PKDL分离株具有相同的遗传结构。kDNA PCR-RFLP分析显示18个不同的基因型;然而,结构分析显示两个不同的kDNA基因型群体(k = 2)。丘陵区寄生虫的kDNA指纹图谱与低地区不同。因此,迫切需要进一步开展大量样本的研究,对临床分离株进行系统表征,以追踪引起VL的多诺瓦利什曼原虫的分子流行病学以及PKDL作为宿主的作用。
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引用次数: 0
Helicobacter pylori: Infection and New Perspective for the Treatment 幽门螺杆菌:感染及治疗新方向
T. Fasciana, P. Di Carlo, A. Jouini, M. Di Giulio
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引用次数: 2
Association between Elevated Serum Tau Protein Level and Sepsis-Associated Encephalopathy in Patients with Severe Sepsis 严重脓毒症患者血清Tau蛋白水平升高与脓毒症相关脑病的关系
Teng Zhao, Yan Xia, Da-wei Wang, L. Pang
Sepsis-associated encephalopathy (SAE) is a common complication of sepsis. It is imperative to recognize, diagnose, and effectively manage SAE at the early stages. The aim of this study was to evaluate the potential of using the serum tau protein level in the diagnosis of SAE and the prediction of SAE outcomes. This was a retrospective and observational study. The patients included in this study were diagnosed with severe sepsis or septic shock. The serum tau protein level was measured using a commercial enzyme-linked immunosorbent assay. The association between the level of serum tau protein and SAE was assessed by multiple logistic regression analysis. One hundred nine patients with severe sepsis were enrolled during a period of two years. Of the 109 enrolled patients, 27 developed SAE. The serum tau protein level was significantly higher in the patients with SAE than that of the non-SAE group. The serum tau protein level and the sequential organ failure assessment (SOFA) score were independent factors that were associated with SAE. The combined use of the serum tau protein level with the SOFA score improved the accuracy in distinguishing SAE from non-SAE patients. A cutoff value serum tau protein level of 75.92 pg/mL had 81.1% sensitivity and 86.1% specificity in predicting the 28-day mortality in patients with severe sepsis. We identified a close association between the serum tau protein level with the appearance of SAE in patients with severe sepsis. The serum tau protein level can be useful in the prediction of poor outcomes in patients with sepsis.
脓毒症相关脑病(SAE)是脓毒症的常见并发症。在早期阶段对SAE进行识别、诊断和有效管理势在必行。本研究的目的是评估使用血清tau蛋白水平在SAE诊断和SAE预后预测中的潜力。这是一项回顾性观察性研究。本研究纳入的患者均诊断为严重脓毒症或感染性休克。采用商用酶联免疫吸附法测定血清tau蛋白水平。采用多元logistic回归分析评估血清tau蛋白水平与SAE之间的关系。在两年的时间里,109名严重败血症患者被纳入研究。109例入组患者中,27例发生SAE。SAE患者血清tau蛋白水平明显高于非SAE组。血清tau蛋白水平和顺序器官衰竭评分(SOFA)是与SAE相关的独立因素。联合使用血清tau蛋白水平和SOFA评分提高了区分SAE与非SAE患者的准确性。血清tau蛋白水平的临界值为75.92 pg/mL,预测严重脓毒症患者28天死亡率的敏感性为81.1%,特异性为86.1%。我们发现血清tau蛋白水平与严重脓毒症患者SAE的出现密切相关。血清tau蛋白水平可用于预测脓毒症患者的不良预后。
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引用次数: 13
期刊
The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale
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