Malaria is considered as one of the main health problem in the Republic of Yemen. In February 2006 National Malaria Control Program started freely distribution of Long Lasting Impregnated Nets (LLINs) for vulnerable g...Malaria is considered as one of the main health problem in the Republic of Yemen. In February 2006 National Malaria Control Program started freely distribution of Long Lasting Impregnated Nets (LLINs) for vulnerable groups to malaria infection (pregnant women and children under 5 years). After one year of distribution, there is a need to measure the use rate among vulnerable groups and explore factors affecting their use. The aim of the study was to investigate the use rate of long lasting impregnated nets among children under five years and pregnant women in Al Moneera city and Al Koozi villages of Hodieda governorate. <strong>Methodology:</strong> Cross section study with multistage sample, Random selection of one urban and one rural locality. 768 housewives were interviewed, proportionally allocated sample according to the number of vulnerable groups in each locality. Systematic random sample to select households. <strong>Results:</strong> The use rate of LLINs for vulnerable groups was 74.3% CI (71.2 - 77.4). There was no statistically significant association between the use of LLINs and residence, also with ages of housewives, occupation, type of house, but there is strong statistically significant association between use of LLINs and having correct information about how to use and to take care of them P value < 0.001, also with educational status of housewives;P value 0.03 and educational status of fathers;P value 0.01. (84%) have correct information about how to use and take care of LLINs and the main source of information was health workers who distributed them. Only 13.4% realized pregnant women as a vulnerable group to malaria infection while about 77.9% realized children as a vulnerable group to malaria infection. The main reason of LLINs use (84.8%) was protection from nuisance of insects. <strong>Conclusion and recommendations: </strong>There is shortage in the information about the protective effect of LLINs from malaria infection and the main reason of using them is protection from nuisance of inse展开更多
2022年末世界卫生组织通报多国猩红热等A族链球菌(group A Streptococcus,GAS)感染增多,以10岁内儿童多见,死亡病例也超过预期,引起了国际社会的普遍关注。该文梳理此次GAS疾病暴发的现状,以及发生的原因和应对措施,希望能引起我国临床...2022年末世界卫生组织通报多国猩红热等A族链球菌(group A Streptococcus,GAS)感染增多,以10岁内儿童多见,死亡病例也超过预期,引起了国际社会的普遍关注。该文梳理此次GAS疾病暴发的现状,以及发生的原因和应对措施,希望能引起我国临床工作者的重视,提高认知和警惕性,及早发现新型冠状病毒感染(coronavirus disease 2019)管控措施优化后可能出现的感染性疾病异常的流行病学变化,以保障儿童健康。展开更多
目的探究妊娠晚期阴道B族链球菌(group B Streptococcus,GBS)的感染对肠道菌群和妊娠结局的影响。方法选取2018年3月至2019年11月大连市中心医院孕检并分娩的妊娠妇女744人为对象,调查并统计B族链球菌的感染率;筛选有和没有B族链球菌感...目的探究妊娠晚期阴道B族链球菌(group B Streptococcus,GBS)的感染对肠道菌群和妊娠结局的影响。方法选取2018年3月至2019年11月大连市中心医院孕检并分娩的妊娠妇女744人为对象,调查并统计B族链球菌的感染率;筛选有和没有B族链球菌感染妊娠妇女各47人,调查不良妊娠结局的发生率;选取信息匹配的妊娠晚期阴道B族链球菌感染和未感染的妊娠妇女,采集粪便样本,提取菌群DNA,用16S rDNA方法分析菌群变化。结果744名妊娠妇女中B族链球菌检出49例,感染率为6.59%;B族链球菌感染组总的不良妊娠发生比例为76.6%,正常组发生比例为27.7%(χ^2=5.491,P<0.05)。B族链球菌感染组妊娠妇女胎膜早破(χ^2=16.177,P<0.01)、难产(χ^2=21.134,P<0.01)和羊水异常(χ^2=22.989,P<0.05)的发生率与未感染组比较显著增高。B族链球菌感染组妊娠妇女肠道菌群发生显著变化。结论妊娠晚期阴道B族链球菌的感染可能引起肠道菌群紊乱,增加不良妊娠结局。展开更多
BACKGROUND:Splenectomy in patients with liver cirrhosis(LC)is expected to become more common owing to its efficacy on portal hemodynamics.In this report we describe an alarming case of group B streptococcus(GBS)infect...BACKGROUND:Splenectomy in patients with liver cirrhosis(LC)is expected to become more common owing to its efficacy on portal hemodynamics.In this report we describe an alarming case of group B streptococcus(GBS)infection after splenectomy in a patient with LC.METHODS:A 72-year-old woman with a history of LC was admitted to our emergency department because of respiratory failure.The patient had received left lateral segmentectomy of the liver and splenectomy three months before admission.Pulmonary examination revealed significant wheezing during inspiration and expiration,but no crackles and stridor.Chest radiography and CT showed no infiltrates.A presumptive diagnosis of bronchial asthma caused by upper respiratory infection was made.Four days after admission,GBS infection was confirmed by blood culture and penicillin G was administered.Antibiotics were given intravenously for a total of 12 days.RESULTS:The patient was discharged on the 12th day after admission.CONCLUSIONS:Although efficacy of splenectomy in patients with LC has been reported,immune status should be evaluated for a longer period.Patients who have undergone splenectomy are highly susceptible to bacteria;moreover,LC itself is an independent risk factor for mortality in patients with sepsis.Since prophylaxis against GBS has not been established,immediate action should be taken.Emergency physicians should be aware of invasive GBS infection in the context of the critical risk factors related to splenectomy and LC,particularly the expected increase of splenectomy performed in LC patients.展开更多
目的探讨B族链球菌(Group B Streptococcus,GBS)感染孕妇血清分型、菌株多位定点分型(Multi Site Typing of Strains,MLST)、耐药基因对其耐药性检测筛查结果的影响。方法筛选湖南省妇幼保健院2018年2月-2019年8月可能因GBS感染就诊于...目的探讨B族链球菌(Group B Streptococcus,GBS)感染孕妇血清分型、菌株多位定点分型(Multi Site Typing of Strains,MLST)、耐药基因对其耐药性检测筛查结果的影响。方法筛选湖南省妇幼保健院2018年2月-2019年8月可能因GBS感染就诊于妇产科的孕妇984例,采集孕妇阴道拭子984份进行培养,采用选择性培养基,触酶试验、培养特性试验完成GBS鉴定;K-B纸片扩散法对GBS阳性标本进行药敏试验;乳胶凝集实验对GBS阳性标本进行血清分型,基因测序技术对菌株进行多位点分析;聚合酶链式反应技术检测菌株的所耐药物的耐药基因。结果 984份阴道拭子进行培养,共鉴定菌株642株;K-B纸片扩散法结果显示642株菌株对头孢曲松、氨苄西林、青霉素、氨苄青霉素、氯霉素、万古霉素、替加环素耐药率为零,对四环素、克林霉素、红霉素、左氧氟沙星、环丙沙星耐药率高;GBS阳性患者血清分型共有Ⅲ型、Ib型、Ia型、V型4种血清分型,耐药菌株血清分型Ⅲ型、Ib型、V型广泛流行,与其他血清分型差异具有统计学意义(P<0.05);MLST分型结果显示共有5种,ST10、ST19、ST485、ST12、ST3,耐药菌株分子分型ST10型、ST19型、ST12型广泛流行,与其他分子分型差异具有统计学意义(P<0.05)。结论血清分型、菌株多位定点分型(MLST)、耐药基因是孕妇感染的GBS产生耐药性的重要因素。展开更多
目的系统评价中国不同地区孕妇B族链球菌(group B streptococcus,GBS)感染对妊娠结局的影响及相关性,旨在为临床医师筛查GBS提供理论依据。方法检索各个数据库从建库至2023年1月关于GBS感染与妊娠结局关系的相关文献,由两名研究员独立...目的系统评价中国不同地区孕妇B族链球菌(group B streptococcus,GBS)感染对妊娠结局的影响及相关性,旨在为临床医师筛查GBS提供理论依据。方法检索各个数据库从建库至2023年1月关于GBS感染与妊娠结局关系的相关文献,由两名研究员独立筛选文献、提取资料(第一作者、发表年份、地区、研究类型、入组孕周、样本量、GBS检测方法、主要结局指标),采用Stata 16.0进行Meta分析,用纽卡斯尔-渥太华质量评价量表(Newcastle-Ottawa Scale,NOS)对文献质量进行评估。采用漏斗图及Egger检验评估发表偏倚。结果共纳入18篇文献,包含我国17个地区,其中GBS阳性患者1722例,阴性患者8343例,文献质量整体在中等及以上。Meta分析结果显示,与GBS阴性患者相比,阳性患者更容易发生宫内感染、胎膜早破、胎儿窘迫、羊水污染、产后出血、早产和产褥感染。结论GBS感染是我国17个地区妊娠妇女不良妊娠结局的重要危险因素,应重视GBS感染的早期筛查与诊治。展开更多
目的检测新生儿B族链球菌(group B streptococcus,GBS)感染所致化脓性脑膜炎(purulent meningitis,PM)血清中维生素D、白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和C反应蛋白(c-reactive ...目的检测新生儿B族链球菌(group B streptococcus,GBS)感染所致化脓性脑膜炎(purulent meningitis,PM)血清中维生素D、白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和C反应蛋白(c-reactive protein,CRP)的表达水平,并探讨其临床价值。方法选取2017年5月至2020年5月在秦皇岛市第一医院出生的59例GBS感染的PM新生儿纳入观察组,同期59例非GBS感染的PM新生儿(晚发败血症)纳入对照组。检测所有受试者血清维生素D、CRP、IL-6、IL-10和TNF-α水平,并进行Pearson相关性分析;利用受试者操作特征(receiver operating characteristic,ROC)曲线分析血清维生素D和炎性细胞因子对新生儿GBS感染所致PM的诊断价值。统计学方法采用t检验、χ^(2)检验和Pearson相关性分析。结果观察组与对照组孕产妇胎膜早破[47.5%(28/59)与5.1%(3/59),χ^(2)=27.345]、产时窒息[52.5%(31/59)与18.6%(11/59),χ^(2)=14.787]和产褥感染[(44.1%(26/59)与(22.0%(13/59)),χ^(2)=6.473]的发生率比较,观察组明显高于对照组(P<0.05)。观察组血清维生素D水平显著低于对照组[(13.3±2.1)μg/L与(21.1±5.0)μg/L,t=11.345],IL-6[(87.1±14.5)μg/L与(63.9±11.9)μg/L,t=9.507]、IL-10[(49.6±15.2)μg/L与(29.3±10.0)μg/L,t=8.596]、TNF-α[(76.8±19.0)μg/L与(50.0±10.8)μg/L,t=9.410]和CRP[(21.5±5.0)μg/L与(13.7±3.7)μg/L,t=9.702]水平显著高于对照组(P值均<0.05)。Pearson相关性分析结果显示,观察组血清维生素D水平分别与IL-6、IL-10、TNF-α和CRP水平呈负相关(r=-0.662、-0.644、-0.564、-0.643,P<0.05);血清维生素D、IL-6、IL-10、TNF-α和CRP单独诊断GBS感染新生儿PM的曲线下面积(area under the curve,AUC)分别为0.831(95%CI:0.757~0.904)、0.887(95%CI:0.830~0.944)、0.859(95%CI:0.793~0.925)、0.888(95%CI:0.821~0.955)、0.879(95%CI:0.820~0.938),5项联合检测的AUC为0.991(95%CI:0.978~1.000)。结论GBS感染所致的PM新生儿血清中维生素D水平降低,炎性细胞因子水平增加,展开更多
文摘Malaria is considered as one of the main health problem in the Republic of Yemen. In February 2006 National Malaria Control Program started freely distribution of Long Lasting Impregnated Nets (LLINs) for vulnerable groups to malaria infection (pregnant women and children under 5 years). After one year of distribution, there is a need to measure the use rate among vulnerable groups and explore factors affecting their use. The aim of the study was to investigate the use rate of long lasting impregnated nets among children under five years and pregnant women in Al Moneera city and Al Koozi villages of Hodieda governorate. <strong>Methodology:</strong> Cross section study with multistage sample, Random selection of one urban and one rural locality. 768 housewives were interviewed, proportionally allocated sample according to the number of vulnerable groups in each locality. Systematic random sample to select households. <strong>Results:</strong> The use rate of LLINs for vulnerable groups was 74.3% CI (71.2 - 77.4). There was no statistically significant association between the use of LLINs and residence, also with ages of housewives, occupation, type of house, but there is strong statistically significant association between use of LLINs and having correct information about how to use and to take care of them P value < 0.001, also with educational status of housewives;P value 0.03 and educational status of fathers;P value 0.01. (84%) have correct information about how to use and take care of LLINs and the main source of information was health workers who distributed them. Only 13.4% realized pregnant women as a vulnerable group to malaria infection while about 77.9% realized children as a vulnerable group to malaria infection. The main reason of LLINs use (84.8%) was protection from nuisance of insects. <strong>Conclusion and recommendations: </strong>There is shortage in the information about the protective effect of LLINs from malaria infection and the main reason of using them is protection from nuisance of inse
文摘2022年末世界卫生组织通报多国猩红热等A族链球菌(group A Streptococcus,GAS)感染增多,以10岁内儿童多见,死亡病例也超过预期,引起了国际社会的普遍关注。该文梳理此次GAS疾病暴发的现状,以及发生的原因和应对措施,希望能引起我国临床工作者的重视,提高认知和警惕性,及早发现新型冠状病毒感染(coronavirus disease 2019)管控措施优化后可能出现的感染性疾病异常的流行病学变化,以保障儿童健康。
文摘目的探究妊娠晚期阴道B族链球菌(group B Streptococcus,GBS)的感染对肠道菌群和妊娠结局的影响。方法选取2018年3月至2019年11月大连市中心医院孕检并分娩的妊娠妇女744人为对象,调查并统计B族链球菌的感染率;筛选有和没有B族链球菌感染妊娠妇女各47人,调查不良妊娠结局的发生率;选取信息匹配的妊娠晚期阴道B族链球菌感染和未感染的妊娠妇女,采集粪便样本,提取菌群DNA,用16S rDNA方法分析菌群变化。结果744名妊娠妇女中B族链球菌检出49例,感染率为6.59%;B族链球菌感染组总的不良妊娠发生比例为76.6%,正常组发生比例为27.7%(χ^2=5.491,P<0.05)。B族链球菌感染组妊娠妇女胎膜早破(χ^2=16.177,P<0.01)、难产(χ^2=21.134,P<0.01)和羊水异常(χ^2=22.989,P<0.05)的发生率与未感染组比较显著增高。B族链球菌感染组妊娠妇女肠道菌群发生显著变化。结论妊娠晚期阴道B族链球菌的感染可能引起肠道菌群紊乱,增加不良妊娠结局。
文摘BACKGROUND:Splenectomy in patients with liver cirrhosis(LC)is expected to become more common owing to its efficacy on portal hemodynamics.In this report we describe an alarming case of group B streptococcus(GBS)infection after splenectomy in a patient with LC.METHODS:A 72-year-old woman with a history of LC was admitted to our emergency department because of respiratory failure.The patient had received left lateral segmentectomy of the liver and splenectomy three months before admission.Pulmonary examination revealed significant wheezing during inspiration and expiration,but no crackles and stridor.Chest radiography and CT showed no infiltrates.A presumptive diagnosis of bronchial asthma caused by upper respiratory infection was made.Four days after admission,GBS infection was confirmed by blood culture and penicillin G was administered.Antibiotics were given intravenously for a total of 12 days.RESULTS:The patient was discharged on the 12th day after admission.CONCLUSIONS:Although efficacy of splenectomy in patients with LC has been reported,immune status should be evaluated for a longer period.Patients who have undergone splenectomy are highly susceptible to bacteria;moreover,LC itself is an independent risk factor for mortality in patients with sepsis.Since prophylaxis against GBS has not been established,immediate action should be taken.Emergency physicians should be aware of invasive GBS infection in the context of the critical risk factors related to splenectomy and LC,particularly the expected increase of splenectomy performed in LC patients.
文摘目的探讨B族链球菌(Group B Streptococcus,GBS)感染孕妇血清分型、菌株多位定点分型(Multi Site Typing of Strains,MLST)、耐药基因对其耐药性检测筛查结果的影响。方法筛选湖南省妇幼保健院2018年2月-2019年8月可能因GBS感染就诊于妇产科的孕妇984例,采集孕妇阴道拭子984份进行培养,采用选择性培养基,触酶试验、培养特性试验完成GBS鉴定;K-B纸片扩散法对GBS阳性标本进行药敏试验;乳胶凝集实验对GBS阳性标本进行血清分型,基因测序技术对菌株进行多位点分析;聚合酶链式反应技术检测菌株的所耐药物的耐药基因。结果 984份阴道拭子进行培养,共鉴定菌株642株;K-B纸片扩散法结果显示642株菌株对头孢曲松、氨苄西林、青霉素、氨苄青霉素、氯霉素、万古霉素、替加环素耐药率为零,对四环素、克林霉素、红霉素、左氧氟沙星、环丙沙星耐药率高;GBS阳性患者血清分型共有Ⅲ型、Ib型、Ia型、V型4种血清分型,耐药菌株血清分型Ⅲ型、Ib型、V型广泛流行,与其他血清分型差异具有统计学意义(P<0.05);MLST分型结果显示共有5种,ST10、ST19、ST485、ST12、ST3,耐药菌株分子分型ST10型、ST19型、ST12型广泛流行,与其他分子分型差异具有统计学意义(P<0.05)。结论血清分型、菌株多位定点分型(MLST)、耐药基因是孕妇感染的GBS产生耐药性的重要因素。
文摘目的系统评价中国不同地区孕妇B族链球菌(group B streptococcus,GBS)感染对妊娠结局的影响及相关性,旨在为临床医师筛查GBS提供理论依据。方法检索各个数据库从建库至2023年1月关于GBS感染与妊娠结局关系的相关文献,由两名研究员独立筛选文献、提取资料(第一作者、发表年份、地区、研究类型、入组孕周、样本量、GBS检测方法、主要结局指标),采用Stata 16.0进行Meta分析,用纽卡斯尔-渥太华质量评价量表(Newcastle-Ottawa Scale,NOS)对文献质量进行评估。采用漏斗图及Egger检验评估发表偏倚。结果共纳入18篇文献,包含我国17个地区,其中GBS阳性患者1722例,阴性患者8343例,文献质量整体在中等及以上。Meta分析结果显示,与GBS阴性患者相比,阳性患者更容易发生宫内感染、胎膜早破、胎儿窘迫、羊水污染、产后出血、早产和产褥感染。结论GBS感染是我国17个地区妊娠妇女不良妊娠结局的重要危险因素,应重视GBS感染的早期筛查与诊治。
文摘目的检测新生儿B族链球菌(group B streptococcus,GBS)感染所致化脓性脑膜炎(purulent meningitis,PM)血清中维生素D、白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和C反应蛋白(c-reactive protein,CRP)的表达水平,并探讨其临床价值。方法选取2017年5月至2020年5月在秦皇岛市第一医院出生的59例GBS感染的PM新生儿纳入观察组,同期59例非GBS感染的PM新生儿(晚发败血症)纳入对照组。检测所有受试者血清维生素D、CRP、IL-6、IL-10和TNF-α水平,并进行Pearson相关性分析;利用受试者操作特征(receiver operating characteristic,ROC)曲线分析血清维生素D和炎性细胞因子对新生儿GBS感染所致PM的诊断价值。统计学方法采用t检验、χ^(2)检验和Pearson相关性分析。结果观察组与对照组孕产妇胎膜早破[47.5%(28/59)与5.1%(3/59),χ^(2)=27.345]、产时窒息[52.5%(31/59)与18.6%(11/59),χ^(2)=14.787]和产褥感染[(44.1%(26/59)与(22.0%(13/59)),χ^(2)=6.473]的发生率比较,观察组明显高于对照组(P<0.05)。观察组血清维生素D水平显著低于对照组[(13.3±2.1)μg/L与(21.1±5.0)μg/L,t=11.345],IL-6[(87.1±14.5)μg/L与(63.9±11.9)μg/L,t=9.507]、IL-10[(49.6±15.2)μg/L与(29.3±10.0)μg/L,t=8.596]、TNF-α[(76.8±19.0)μg/L与(50.0±10.8)μg/L,t=9.410]和CRP[(21.5±5.0)μg/L与(13.7±3.7)μg/L,t=9.702]水平显著高于对照组(P值均<0.05)。Pearson相关性分析结果显示,观察组血清维生素D水平分别与IL-6、IL-10、TNF-α和CRP水平呈负相关(r=-0.662、-0.644、-0.564、-0.643,P<0.05);血清维生素D、IL-6、IL-10、TNF-α和CRP单独诊断GBS感染新生儿PM的曲线下面积(area under the curve,AUC)分别为0.831(95%CI:0.757~0.904)、0.887(95%CI:0.830~0.944)、0.859(95%CI:0.793~0.925)、0.888(95%CI:0.821~0.955)、0.879(95%CI:0.820~0.938),5项联合检测的AUC为0.991(95%CI:0.978~1.000)。结论GBS感染所致的PM新生儿血清中维生素D水平降低,炎性细胞因子水平增加,
