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Objective:To investigate the distribution of pathogen species isolated from cerebrospinal fluid culture (CSF) in children and analyze the antibiotic-resistance of the main isolates in vitro, which provides reference for interpreting the pathogens and choosing antibiotics in empiric therapy for pediatric patients. Methods:The results of cerebrospinal fluid culture were collected by checking laboratory information system of the Children′s Hospital of Zhejiang University and the clinical characteristics of these children were analyzed retrospectively by checking electronic medical record system.Results:A total of 1 312 isolates were detected, including 1 294 isolates of bacteria and 18 isolates of fungi. A total of 497 (37.9%) isolates were pathogenic microorganisms, of which 288 (57.9%) isolates were gram-positive, 200 (40.3%) isolates were gram-negative, and 9 (1.8%) isolates were fungi. The top 5 pathogens were Escherichia coli (102 isolates, 20.5%), Streptococcus pneumoniae (64 isolates, 12.9%), Streptococcus agalactiae (52 isolates, 10.5%), Enterococcus faecium (33 isolates, 6.6%) and Staphylococcus aureus (28 isolates, 5.6%). Most of the Streptococcus pneumoniae strains were isolated from children more than 1 year old (76.6%, 49/64), while the other top 4 bacteria were mainly isolated from infants less than 1 year old, with the rate of 95.1%(97/102) for Escherichia coli, 98.1%(51/52) for Streptococcus agalactiae, 81.8%(27/33) for Enterococcus faecium and 71.4% (20/28) for Staphylococcus aureus. A total of 815 (62.1%) isolates were considered to be contaminated pathogens according to the analysis on clinical manifestations and other laboratory findings in CSF, and coagulase-negative Staphylococcus (680 isolates), Micrococcus (50 isolates), Corynebacterium (28 isolates) and Enterococcus faecium (23 isolates), which accounted for 41.1% (23/56) of the total detected Enterococcus faecium, were the top 4 contaminated bacteria. During the study period, the isolation rate of the pathogenic microorganisms increased year by year (χ2=34.84, P<0.001), while the isolation rate of the contaminated pathogens, which detected mainly in summer and autumn, decreased year by year (χ2=13.26, P<0.001). Conclusions:The predominant bacteria causing pediatric purulent meningitis were Escherichia coli, Streptococcus pneumoniae, Streptococcus agalactiae, Enterococcus faecium and Staphylococcus aureus. Coagulase-negative Staphylococcus, Micrococcus, Corynebacterium and Enterococcus faecium were common contaminated bacteria in CSF culture, therefore clinicians should interpret the results of CSF culture cautiously according to the bacterial species and clinical manifestations.
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Objective:To study the drug resistance patterns of Bordetella pertussis in vitro, and to know the clinical characteristics of pediatric pertussis and evaluation the treatment outcomes, which may provide references for experiential diagnosis and treatment of this disease. Methods:Nasopharyngeal swabs of the hospitalized children with suspected pertussis in Children′s Hospital, Zhejiang University School of Medicine in 2017 were collected for culture. And the clinical data of the children were collected. The strains were identified by pertussis-specific antiserum agglutination and finally confirmed by mass spectrometry. The drug sensitivity test was performed using the E-test method. The efficacy of therapy with antibiotic was evaluated after two weeks of treatment. Statistical analysis was performed with Mann-Whitney U test and chi-square test. Results:Of 1 029 children, 211 (20.5%) nasopharyngeal swabs were positive for Bordetella pertussis culture, and the isolation rate of the specimens was highest (31.2%, 45/144) in July. Of the 211 pertussis patients, 105 (49.8%) were male and the age were 3.8 (2.2, 6.9) months, 114 (54.0%) were not vaccinated with pertussis diphtheria tetanus mixed vaccine and 192 (91.0%) were prescribed with previous antibiotics. There were 142 (67.3%) children from families with two or more than two children, and 136 (95.8%) of which were the youngest siblings. One hundred and fifty-nine (75.4%) patients had paroxysmal cough and 61 (28.9%) had whooping. The white blood cell counts were higher than 20×10 9/L in 94 (44.5%) patients, and the lymphocyte counts were higher than 10×10 9/L in 97 (46.0%) of patients. The drug susceptibility results showed that 138 (65.4%) strains were against erythromycin, azithromycin and clindamycin with minimum inhibitory concentration (MIC)>256.000 mg/L. The MIC 90 of the isolates to ampicillin, ceftriaxone, cefoperazone/sulbactam, meropenem and trimethoprim/sulfamethoxazole were 0.190 mg/L, 0.190 mg/L, 0.094 mg/L, 0.094 mg/L and 0.750 mg/L, respectively. All strains had a MIC of <0.016 mg/L for piperacillin/tazobactam. After treatment, symptoms were improved in 195(92.4%) patients when they were discharged from hospital. Seventy-six (57.1%) children whose symptoms did not improve after seven-day treatment with macrolides, were prescribed with other antibiotics or other antibiotic with macrolides in combination. Compared with the patients treated with macrolides, more patients treated with cefoperazone/sulbactam or piperacillin/tazobactam had negative nasopharyngeal culture results after two weeks of therapy (46/48(95.8%) vs 46/57(80.7%)), or on day seven (45/46(97.8%) vs 39/47(83.0%)) and on day 14 (45/45(100.0%) vs 41/47(87.2%)) since discharged. The differences were all statistically significant ( χ2=5.50, 5.86 and 6.15, respectively, P=0.019, 0.015 and 0.013, respectively). Conclusions:The majority of children with pertussis do not have whooping, and the resistant rate of Bordetella pertussis to macrolides is high. Further study is needed to evaluate the feasibility and reasonability of cefoperazone/sulbactam and piperacillin/tazobactam in treating pediatric pertussis caused by macrolides-resistant Bordetella pertussis.
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The coronavirus disease 2019 (COVID-19) has caused a global pandemic. All people including children are generally susceptible to COVID-19, but the condition is relatively mild for children. The diagnosis of COVID-19 is largely based on the epidemiological evidence and clinical manifestations, and confirmed by positive detection of virus nucleic acid in respiratory samples. The main symptoms of COVID-19 in children are fever and cough; the total number of white blood cell count is usually normal or decreased; the chest imaging is characterized by interstitial pneumonia, which is similar to other respiratory virus infections and infections. Early identification, early isolation, early diagnosis and early treatment are important for clinical management. The treatment of mild or moderate type of child COVID-19 is mainly symptomatic. For severe and critical ill cases, the oxygen therapy, antiviral drugs, antibacterial drugs, glucocorticoids, mechanical ventilation or even extracorporeal membrane oxygenation (ECMO) may be adopted, and the treatment plan should be adjusted timely through multi-disciplinary cooperation.
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Child , Humans , Betacoronavirus , Coronavirus Infections , Diagnosis , Pathology , Therapeutics , Pandemics , Pneumonia, Viral , Diagnosis , Diagnostic Imaging , Pathology , TherapeuticsABSTRACT
Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae ( CRE) isolated from children in China. Methods CRE strains were collected in 10 ter-tiary children's hospitals of China from January 1, 2016 to December 31, 2017. Antimicrobial susceptibility of the clinical strains was detected with disk diffusion method ( KB method) and automated method. The re-sults were analyzed according to the Clinical and Laboratory Standards Institute ( CLSI) Standards published in 2017. WHONET 5. 6 software was used to retrospectively analyze the distribution characteristics and drug resistance of these strains. Results A total of 3065 CRE clinical strains were isolated from children with an overall prevalence of 7. 7％ and among them, 13. 5％ were isolated in neonatal group and 5. 8％ in non-neo-natal group. The detection rate of CRE in 2017 was higher than that in 2016 (9. 7％ vs 5. 7％). Among the 3065 CRE strains, there were 1912 strains of Klebsiella pneumoniae (62. 0％), 667 strains of Escherichia coli (22. 0％), 206 strains of Enterobacter cloacae (7. 0％), 56 strains of Klebsiella aerogenes (1. 8％) and 47 strains of Serratia marcescens (1. 5％). Most of the strains were isolate in neonatology departments including neonatal intensive care units (NICU) and intensive care units (ICU), accounting for 44. 8％ and 19. 7％, respectively. Respiratory tract (61. 8％), urine (19. 4％) and blood (5. 7％) specimens were the main sources of CRE isolates. Results of antimicrobial susceptibility test showed that the CRE strains were highly resistant to carbapenem antibiotics such as imipenem, meropenem and ertapenem, as well as penicillins and most cephalosporins (79. 6％-100％), especially those isolated in the neonatal group (P<0. 05). Children had relatively low resistance rates to aminoglycosides such as amikacin (19. 7％) and fos-fomycin (11. 9％), fluoroquinolones such as levofloxacin (37. 7％) and ciprofloxacin (43. 3％), and tige-cycline (3. 8％). Currently, no polymyxin B-resistant strains were isolated. Conclusions The prevalence of common CRE strains in children in 2017 was higher than that in 2016, especially in newborns. Drug re-sistance in CRE strains isolated from neonates to common antibiotics was more severe, suggesting that great attention should be paid to it and timely measures should also be taken.
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Objective@#To investigate the clinical characteristics of invasive Haemophilus influenzae (HI) infection in children.@*Methods@#The clinical manifestations, laboratory examinations and treatment outcomes of 84 children with HI infection confirmed by bacterial culture in 7 tertiary children′s hospitals from 2014 to 2018 were analyzed retrospectively.@*Results@#Among the 84 cases, 50 were males. The age was 1.54 years (ranged from 5 days to 13 years).Twenty cases (24%) had underlying diseases and 48 cases (57%) had not received antibiotics before collecting specimens. Eighty-two cases (98%) had fever and 75 cases (89%) had clear infection foci, among which 31 cases (37%) had meningitis and 27 cases (32%) had pneumonia. Blood culture was positive in 62 cases (74%), cerebrospinal fluid culture was positive in 10 cases (12%), blood culture and cerebrospinal fluid culture were both positive in 11 cases (13%). Antibiotics susceptibility test showed that 27% (22/82) of all HI strains produced β-lactamases and 48% (37/77) strains were resistant to ampicillin. The drug resistance rates to cefuroxime, ampicillin-sulbactam, trimethoprim-sulfamethoxazole and azithromycin were 25% (20/80) , 20% (9/45) , 71% (44/62) and 19%(11/58), respectively. All strains were sensitive to meropenem, levofloxacin and ceftriaxone. After sensitive antibiotic therapy, 83% (70/84) of all patients were cured and improved, the mortality rate and loss of follow-up rate were 13% (11/84) and 4% (3/84) respectively.@*Conclusions@#Meningitis and pneumonia are common presentation of invasive HI infections in children. Mortality in HI meningitis children is high and the third generation of cephalosporins, such as ceftriaxone can be used as the first choice for the treatment of invasive HI infection.
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Objective To investigate the incidence of Acinetobacter baumannii induced paediatric bacterial meningitis and to explore the characteristics,treatment,and prognosis of Acinetobacter baumannii menin-gitis. Methods The cerebrospinal fluid specimens and the clinical data about patients who acquired intracranial infection of Acinetobacter baumannii were collected from 10 children′s hospital,and analysed by WHONET. Results A total of 318 positive cerebrospinal fluid specimens from 10 hospitals were collected,and 16(5%) of Acinetobacter baumannii were detected. Acinetobacter baumannii was completely resistant to Aztreonam (100%),Cefotetan(100%) and Cefazolin(100%),and the resistance rates of Acinetobacter baumannii to Ceftriaxone and Ciprofloxacin were above 80%,and the resistance rates of Acinetobacter baumannii to Cefta-zidime and Cefepime were all 68. 8%,and the resistance rates of Acinetobacter baumannii to Meropenem, Imipenem,Cefoperazone/Sulbactam were 69. 2%,68. 8% and 53. 3%,respectively. In 16 cases of intracrani-al infection caused by Acinetobacter baumannii,11 cases(68. 8%) had underlying diseases such as intracrani-al tumor,hydrocephalus,craniocerebral injury and intracranial hemorrhage,and all 11 cases underwent surgi-cal intervention,such as surgical resection and hydrocephalus drainage. Among 16 cases,14 cases(87. 5%) were admitted to SICU,PICU or NICU and other intensive care units,and the lengths of stay were all ＞20 d. Under the combined treatment of multiple antibiotics,16 cases of intracranial infection caused by Acinetobact-er baumannii,6 cases died,with a mortality of 37. 5%. Conclusion Acinetobacter baumannii meningitis is becoming an increasingly common clinical entity recently. Because of the resistance to antibiotics,the therapy for Acinetobacter baumannii infection encounters arduous challenge. Insisting on multi-center monitoring and using antibiotics reasonably and effectively appears to be particularly important.
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Objective@#To improve the understanding of clinical characteristics of streptococcal toxic shock syndrome (STSS) caused by Streptococcus pyogenes (S. pyogenes) in children.@*Methods@#A retrospective study was conducted to analyze the clinical data of STSS caused by S. pyogenes (culture-confirmed) in 7 tertiary hospitals during 2010—2017 in China. Clinical and laboratory data were collected by reviewing the medical records.@*Results@#Fifteen cases of STSS, including 9 males, were confirmed and the ages of the patients ranged from 6 months to 15 years, with median age of 3 years. All cases had the positive blood culture for S. pyogenes and only 3 cases had short course of β-lactam treatment before blood culture. Medical evaluation was initiated within (5.1±4.6) days after symptom onset. All patients had fever, and 13 patients had multiple organ dysfunction and 10 patients had disseminated intravascular coagulationl (DIC). Twelve cases had severe pneumonia with or without skin and (or) soft tissue infections. Underlying conditions included giant hemangioma of the skin in 2 patients and varicella in 1 patient. All isolated strains in 14 cases were sensitive to penicillin G, ceftriaxone/cefotaxime, vancomycin, but 12 and 13 isolates were resistant to clindamycin and erythromycin, respectively. Eight patients died, and 5 of them died within 24 hours after admission. One patient was lost to follow-up after intended discharge against medical advice.@*Conclusion@#STSS caused by S. pyogenes in children is a severe syndrome with rapid clinical progression and high mortality rate, and thus the pediatricians should be aware of STSS and immediately initiate aggressive treatment for the suspected cases.
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Objective@#To analyze the antimicrobial resistance profile in Chinese children.@*Methods@#This was a prevalence survey. From January 1 through December 31, 2016, the isolates were collected from 10 tertiary children hospitals in China. Antimicrobial susceptibility testing was carried out by routine laboratory methods. The penicillin susceptibility of streptococcus pneumonia and Meropenem susceptibility of gram-negative bacteria were detected by E-test and disk diffusion method respectively. Antimicrobial susceptibility results were interpreted according to the criteria of Clinical and Laboratory Standards Institute (CLSI) Guideline 2016. The data of antimicrobial susceptibility testing of isolates from either the different patients (neonatal group and non-neonatal group) or various sources were analyzed by WHONET 5.6 software.@*Results@#A total of 56 241 isolates were collected, of which 41.5% (23 328 isolates) were gram-positive organisms and 58.5% (32 886 isolates) gram-negative organisms. The five leading pathogens were Escherichia coli (7 995/56 214, 14.2%), Straphylococcus aureus (6 468/56 214, 11.5%), Streptococcus pneumonia (6 225/56 214, 11.1%), Haemophilus influenza (5 435/56 214, 9.7%) and Klebsiella pneumonia (4 523/56 214, 8.0%). The Meropenem resistance rates of Klebsiella pneumonia, Enterobacter cloacae, Escherichia coil, Pseudomonas aeruginosa, Acinetobacter baumonia isolates were 27.4% (326/1 189) , 8.1% (29/358) , 2.0% (27/1 362) , 19.5% (34/174) , 49.7% (230/463) in neonatal group and 15.4% (512/3 327) , 4.8% (40/841) , 2.3% (151/6 564) , 13.7% (252/1 840) , and 53.4% (860/1 611) in non-neonatal group. The Methicillin-resistant Staphylococcus aureus (MRSA) rates of neonatal group and non-neonatal group were 46.2% (649/1 404) and 33.3% (1 668/5 010) . The penicillin non-susceptible rates of Streptococcus pneumonia in the two groups were 17.6% (6/34) and 18.2% (1 121/6 158) respectively. The β-lactamase positive rates of Haemophilus pneumonia isolates in the neonatal group and non-neonatal groups were 33.8% (47/139) and 44.4% (2 345/5 282) respectively.@*Conclusion@#This investigation highlights the worrisome trend of antimicrobial resistance in children, especially among neonatal patients in China.
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Objective To explore the common pathogens distribution and the drug resistance pattern in vitro from cerebrospinal lfuid culture in children. Methods The results of cerebrospinal lfuid culture in hospitalized children from January 2007 to December 2014 were retrospectively analyzed. Bacteria identiifcation and antimicrobial susceptibility were assayed by Vitek system from Bio Mrieux Company. Some bacterial strains were tested by disk diffusion method. Results Cerebrospinal lfuid from 23099 patients were tested at least one time during research period. 671 strains of bacteria were isolated with positive rate of 2 . 9%, among which there were 579 strains of gram positive bacteria ( 86 . 3%) and 92 strains of gram negative bacteria ( 13 . 7%). The top ifve bacteria were coagulase negative Staphylococcus ( 399 strains, 58 . 9%), Micrococcus ( 37 strains, 5 . 5%), Streptococcus pneumoniae (34 strains, 5.1%), Escherichia coli (32 strains, 4.8%), and Enterococcus faecium (26 strains, 3.9%). The positive rates of cerebrospinal lfuid culture in 8 consecutive years showed a downward trend (χ2?=?10 . 410 , P=?0 . 001 ). The positive rates of coagulase negative Staphylococci showed annual decline trend (χ2?=?31 . 200 , P
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Objective To investigate the clinical manifestations and the antibiotics resistance patterns in children with positive blood culture of Escherichia coli. Methods The clinical data of children with positive blood culture of Escherichia coli were retrospectively analyzed from Jan.2007 to Dec.2014. Results In a total of 154774 children who had blood culture in the study period, 8446 children were positive, among whom 408 (4.83%) children were isolated Escherichia coli. The children with the positive blood culture of Escherichia coli mainly were under one year old (51.72%), of which 36.77%was neonates. There were 275 children had underlying diseases, and the most common disease was Leukemia. 199 (48.77%) Escherichia coli strains were producing extended spectrumβ-lactamase (ESBLs) and 85.23%were resistant to ampicillin. All strains were susceptible to meropenem. Conclusions Septicemia caused by Escherichia coli is usually occurred in children with leukemia or in neonates. Since blood infections of Escherichia coil had high rate of ESBLs, the use of carbapenem antibiotics should be cautious.
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Objective To measure the concentrations of antibodies against outer membrane protein P6 and its T-and B-combined antigenic epitopes of nontypeable Haemophilus influenzae ( NTHi) in children and adults of different ages and to evaluate the differences among different subjects for further investigation on NTHi multiple antigenic peptide vaccine .Methods A prokaryotic expression system was established to ex-press the recombinant outer membrane protein P 6 of NTHi.The expressed protein was purified by using Ni-NTA affinity chromatography .T-and B-cell epitopes in protein P6 were predicted with Epitope prediction software 1.0 and ANTIGENIC program and were used to synthesize T-and B-combined antigenic epitopes .A total of 605 subjects aged from 1 day to 103 years old were recruited from October 2013 to March 2014 .Ser-um concentrations of antibodies against protein P 6 and its T-and B-combined antigenic epitopes were meas-ured by using ELISA .Mann-Whitney U test was used to analyze the differences between groups .Pearson product-moment correlation coefficient was used for correlation analysis .Results Four T-and B-combined antigenic epitopes including P 6-2, P6-61, P6-95 and P6-122 were predicted and synthesized .The levels of antibodies against NTHi P6 and P6-2, P6-61, P6-95 and P6-122 were significant lower in the <1 months group than those in the 1-6 months group (all P<0.001) and 7 months-3 years group (all P<0.001).Three groups including 7 months-3 years group , 4-6 years group and 7-14 years group showed significant differ-ences regarding to the antibodies levels , among the 7 months-3 years group showed the highest levels , fol-lowed by the 4-6 years group and the 7-14 years group.However, no significant difference was found be-tween other adjacent groups .Concentrations of antibodies against P 6-2, P6-61, P6-95 and P6-122 were pos-itively correlated with the level of antibody against P 6 (P<0.0001).Conclusion The distribution of anti-bodies against T-and B-combined antigenic epitopes in P6 was highly in accord with those against P6, which indicated good immunogenicity of those epitopes .The highest antibodies levels were found in subjects aged 7 months to 3 years old , which might correlate with the high risk of NTHi infection at that stage .
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Objective To evaluate the clinical efficacy of tigecycline combinated with isepamicin for treatment of pneumonia caused by multidrug-resistant Acinetobacter baumannii.Methods A retrospective analysis was performed in adult patients with multidrug-resistant Acinetobacter baumannii pneumonia in two general hospitals from January 2012 to January 2014.Total eighty-four patients with MDR-Acinetobacter baumannii pneumonia were randomly divided into two groups(n=42).One group was treated with tigecycline combinated with isepamicin(termed combination therapy group),and another group was administrated with cefoperazone sulbactam (termed control group ).The clinical cure rates,microbiological eradication rates and adverse events were collected and compared. Results There was no difference in APACHEⅡ score between two groups.The clinical cure rates in combination therapy group was significantly higher than that in control group(88% vs 61%,P<0.05),and with a higher rate of microbiological eradication(59.5% vs 35.7%,P <0.05 ).However,the occurence rate of adverse events was similar in the two groups (7.1% vs 1 1.9%). Conclusion With a higher rate of clinical efficacy and a lower rate of adverse events,the combination therapy with tigecycline and isepamicin would be a promising alternative for treatment with MDR-Acinetobacter baumannii pneumonia.
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Objective To analyze the clinical features and the plasma secretory leukocyte proteinase inhibitor (SLPI) levels in children with Mycoplasma pneumoniae pneumonia (MPP). Methods Clinical data and plasma SLPI levels of 136 children with MPP were retrospectively analyzed. Results From July 2011 to June 2013,136 children (male 80, female 56) with MPP were included in the study. The onset ages of all children ranged from 11 months to 14 years (mean age, 6.2±3.0 years), and 82.4%of the cases were at the age of 4 to 14 years. One hundred and twenty six cases (92.7%) with long-last high fever, 83.8%with cough, 74.3%with rale were found in the study. Small or large patchy shadows in chest X-ray radiography were found in all the cases. At the acute phase, 72.1%with low white blood cell count, 59.6%with normal neutrophil cell and 63.2%with higher high sensitive C-reactive protein (hs-CRP) were observed. The SLPI level at the acute phase in 85 cases was (9.3±8.8) ng/ml, which was signiifcant lower than that at the convalescent phase (11.8±8.0 ng/ml, Z=3.08, P=0.002). Conclusions The clinical features of MPP are usually presented with high fever, cough, higher hs-CRP, normal or lower white blood cell and neutrophil cell count, small or large patchy shadows in chest X-ray radiography. The plasma SLPI level at the acute phase was signiifcantly lower than that in convalescent phase in children with MPP.
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Objective Clinical effect analysis of low dose dopamine(LDD)and dobutamine (DOB)subsidiary in the treatment of 86 cases of Children serious pneumonia.Methods From July 2011 to July 2013,86 CSP patients who were diagnosed with CSP in People's Hospital of Wenzhou were selected.Patientas were randomly divided into observation group(n=43)and control group(n=43)according to the random number method.Both groups were treated with routine treatment,then observation group on the basis with LDD and DOB subsidiary,then compared efficacy of two groups at 1 week after treatment,as well as the time of symptoms and signs which had improvements,and changes of levels of Interleukin-6(IL-6),Interleukin-8(IL-8), C-reactive protein(CRP)and Tumor necrosis factor-α(TNF-α)before and after treatment. Results The efficacy in observation group was significantly better than that of control group(P<0.05 ).And time of symptoms and signs which had improvement in the observation group was significantly less than control group(P<0.05).After treatment,IL-6,IL-8,CRP and TNF-αlevels were lower than before,but the observation group had a greater degree of reducing(P<0.05).Conclusion Routine treatment combined with LDD and DOB for CSP patients,can significantly improve the therapeutic effect,and relieve the clinical symptoms.
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Objective To investigate the association between genetic polymorphisms and protein levels of mannose-binding lectin (MBL) and the sensitivities of common infections in a pediatric Han population lived in Zhejiang Province.Methods MBL genetic polymorphisms of patients and controls were detected by PCR-based sequencing.MBL protein levels were measured using MBL ELISA Kit.Results No mutations at positions +223 and +239 of the exon 1 were detected in either patients or controls.No mutation at position +4 of the promoter was detected in controls.The frequencies of the three genotypes HH,HL,and LL at position-550 of the promoter were different between patients and controls(P＜0.05).The frequencies of genotypes YA and XB relevant to MBL protein levels were also different between patients and controls(P＜0.05).Comparing the frequencies of genotypes YA and XB in separate infectious disease with controls,significant differences were found in the group of RRI and CMV infection.The distributions of serum MBL level frequencies in patients and controls were both characterized by skewed distributions.MBL levels of patients with CMV infection were lower than those of controls(P＜0.05).Inversely,MBL levels of patients with acute respiratory infection and localized abscess were higher than those of controls (P＜O.05).Conclusion Genetic polymorphism of MBL gene is seemed to be relative to the sensitivity of common infections in children.
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256?g/ml.Oxacillin-resistance rate in adults was significantly higher than that in children(?2=54.15,P
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Objective To analyze the single nucleotide polymorphisms(SNPs) in promoter region,5' untranslated region,exon 1 and haplotypes of mannose binding-lectin(MBL) gene in Han nationality and Hui etheic children in China.Methods Sixty nine Hui ethnic children from Ningxia Huizu Auto.Reg.and 105 Han children from Zhejiang Prov.were enrolled in the present study.Whole blood samples(1.5 ml) were collected into potassium-EDTA tubes.SNPs in promoter region,5' untranslated region and exon 1 of MBL gene were determined by sequence analysis using BigDye Mix 3730 genetic analyzer,and genetic analysis was performed using SHEsis software.Results The variant allele frequencies at-221 sites in Han and Hui objects were 0.091 and 0.123,respectively,with no difference between the two groups(?2=0.684,P=0.408).No mutation was found at sites +223 and +239 in exon 1 of MBL gene in the study.The variant frequency at +230 site in Hui children(0.268) was significantly higher than that in Han objects(0.167,?2=5.223,P=0.022).The most common haplotype was YA,and the frequencies of YA haplotype in Han and Hui ethnic were 0.770 and 0.669,respectively,with significant difference between the two groups(?2=4.312,P=0.038).Conclusion The variant allele frequency at +230 sites in exon 1 in Hui ethnic children is higher than that in Han subjects.The most common haplotype is YA,and the frequency of YA haplotype is higher in Han children than that in Hui subjects.
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Objective:To analyze the gene polymorphisms at code 54 of exon 1 in mannose-binding lectin(MBL) gene and the palsma MBL concentrations in Mongols and Huis in China.Methods:MBL plasma concentrations were measured by ELISA method with human MBL ELISA kit,Single nucleotide polymorphisms of MBL gene were determined with sequence analysis method.Geneticanalysis was deployed with SHEsis software,and the statistics package for social science,SPSS11.0 was used in the study.Results:The median values of MBL plasma in 79 Mongols and 69 Huis were 1 686 ng/ml and 1 909 ng/ml respectively and no significant difference was found between them(Z=0.63,P=0.4).In 79 Mongols,the variant allele frequencies of the codon 54 of MBL gene was 0.203,62.0% of the 79 cases were A/A exon type,while 35.4% were A/B type and 2.50% were B/B type instead.In all 69 Huis,the variant allele frequencies was 0.268,58.0% of 40 cases were A/A exon type,while 30.4% were A/B type and 11.6% were B/B type instead.The frequency of point mutation at +230 site was 0.203.No significant difference of variant allele frequencies was found between the Mongols and Huis nationalities(?2=1.772,P=0.183).Neither C nor D exon type were found in the study.The A/A wild type was associated with the highest plasma concentration with median values,the A/B type was associated with lower MBL levels and the B/B type with the lowest levels(?2=86.526,P