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Objective:To evaluate a novel distraction reductor in the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution.Methods:From January 2019 to December 2020, 27 patients with unstable distal radius fracture complicated with metaphyseal volar comminution were treated at Department of Orthopaedics, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences. They were 6 males and 21 females, with an age of (69.4±9.4) years. All fractures were unilateral and closed, involving the right side in 17 cases and the left side in 10 cases. All patients were treated by internal fixation with an anatomical locking plate through the volar approach and the novel distraction reductor was used to reduce the fracture ends. Regular imaging examinations were performed to evaluate the reduction, maintenance and union of fractures after surgery. One year after operation, the curative efficacy was assessed by evaluation of the range of wrist motion, Disabilities of the Arm, Shoulder and Hand (DASH) score, Gartland-Werley score and Bartra radiology score.Results:All the operations went on successfully with a duration of (92.3±8.9) min. All the incisions healed primarily. The follow-up time was (15.9±2.9) months. The radial height, palmar tilt, ulnar inclination and articular surface step-off immediately after operation [(11.23±1.51) mm, 12.10°±3.44°, 20.54°±3.44°, and (0.95±0.42) mm] were not significantly lost compared with those one year after operation [(11.22±1.55) mm, 12.07°±3.44°, 20.51°±3.33°, and (0.93±0.40) mm] (all P>0.05). One year after operation, the range of wrist motion was good with dorsiflexion of 59.7°±5.5°, palm flexion of 63.0°±9.1°, pronation of 66.5°±5.5°, supination of 61.2°±5.6°, radial deviation of 22.7°±4.8°, and ulnar deviation of 30.3°±6.1°; DASH score was 13.5±5.5; Bartra radiology score was 88.6±6.5, giving an excellent and good rate of 88.9% (24/27);Gartland-Werley score was 2.7±2.1, giving an excellent and good rate of 92.6% (25/27). Follow-ups observed no poor fracture healing, internal fixation failure, tendon or nerve injury or traumatic arthritis. Conclusion:In the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution, the novel distraction reductor can lead to ideal reduction of displaced fractures and effectively correct the shortening caused by volar cortex comminution to achieve satisfactory functional effects in clinic.
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Objective:To explore the serotype distribution and drug resistance of Shigella in stool samples of children under five years old with diarrhea from 2008 to 2017 in Sui County, Henan Province. Methods:A total of 4 721 stool samples of children under five years old with diarrhea were collected from Doufuyuan Clinic of Sui County during 2008 to 2017, and Shigella strains were isolated through bacterial culture. The slide agglutination test was used for serotyping of Shigella strains. Two hundred of seventy-one Shigella strains were selected in proportion, and multiple gradient polymerase chain reaction was used to detect virulence genes and Kirby-Bauer agar method was used for drug sensitivity. Trend chi square test was used to analyze the annual trend of drug resistance. Results:The detection rate of Shigella strains in 4 721 fecal samples was 20.69% (977/4 721). A total of 977 Shigella strains were divided into 13 serotypes in two groups, including 77.79%(760/977) Shigella flexneri strains and 22.21%(217/977) Shigella sonnei strains.The top three serotypes detected alternately every year.The dominant gene pattern of Shigella flexneri was Shigella enterotoxin ( shET)-1+ , shET-2+ , invasion plasmid antigen H ( ipaH)+ , invasion-associated locus ( ial)+ , accounted for 84.04%(179/213) and that of Shigella sonnei was shET-1-, shET-2+ , ipaH+ , ial+ , accounted for 46.55%(27/58). The drug resistance rates of 271 Shigella strains to ampicillin, nalidixic acid and tetracycline were more than 90% and the strains were more sensitive to cefepime and ceftazidime.The drug resistance rates to cefotaxime, cefepime, ciprofloxacin, chloramphenicol and sulfamethoxazole/trimethoprim increased year by year, and all had statistically significant differences ( χ2=24.027, 7.232, 6.039, 4.764 and 6.809, respectively, all P< 0.05). There were 98.52%(267/271) strains resistant to more than three kinds of drugs. The resistance rates of Shigella flexneri to ciprofloxacin, norfloxacin, and chloramphenicol were higher than those of Shigella sonnei, and the resistance rates to gentamicin and sulfamethoxazole/trimethoprim were lower than those of Shigella sonnei. The differences were statistically significant ( χ2=31.866, 14.868, 83.036, 68.534 and 14.738, respectively, all P<0.01). Conclusions:The major serotypes of Shigella in children under five years old in Sui County are constantly changing from 2008 to 2017. The dominant gene patterns of different serotypes are different. Most isolated strains have multiple drug resistances, and different serotypes have different resistance profiles.
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The aim of this study was to evaluate the safety and immunogenicity of the first domestic ACYW135 meningococcal conjugate vaccine and a control vaccine named AC group meningococcal conjugate vaccine for 3 months (90-119 days) infants. From February 2017 to June 2018, a randomized, blinded, and similar vaccine-controlled clinical trial design was adopted at the Henan Vaccine Clinical Research Base. The subjects were 3 months old healthy infants, a total of 720, based on a 1∶1 ratio. The random allocation table for entry was randomly assigned to the experimental group and the control group. According to the 3, 4, and 5 month-old vaccination procedures, the subjects were vaccinated with test vaccine (ACYW135 group meningococcal conjugate vaccine) and control vaccine (group A group C meningococcal polysaccharide conjugate vaccine), of which 720 were given the first dose, 696 were given the second dose (test group: 346; control group: 350), and 692 were given the third dose (test group: 344; Control group: 348). The overall adverse reaction rate of the test vaccine was 21.90% (230 cases), which was lower than the 32.04% (339 cases) of the control vaccine (0.05). Group Y and W135 was 88.17% (298 cases), 99.41% (336 cases), respectively. The GMT results showed that the test vaccine group A was 56.24, the control vaccine was 57.43 (>0.05); the group C test vaccine (43.53) was higher than the control group (27.28) (<0.001). The group Y and W135 are 89.22 and 140.66, respectively. Among them, the proportion of the group C GMT antibody ≥ 1∶128 for test vaccine (31.07%, 105 cases) was higher than the control vaccine (16.22%, 55 cases) (<0.001). ACYW135 group meningococcal conjugate vaccine has more safety and immunogenicity after application to 3 month old infants.
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Humans , Infant , Antibodies, Bacterial , Meningococcal Vaccines , Allergy and Immunology , Vaccines, ConjugateABSTRACT
Objective To investigate the distribution and etiological characteristics of Yersinia en-terocolitica in Henan province between 2011 and 2017 and to analyze the homology among pathogenic strains. Methods A total of 12728 samples, including stool specimens from patients with diarrhea and domestic animals, flies, and smear specimens from raw and cooked meat products, were collected. Cold enrichment method was used to isolate Yersinia enterocolitica. The isolated strains were analyzed by biochemical identifi-cation, biotyping, serotyping and virulence gene detection with PCR. Pulsed-field gel electrophoresis ( PFGE) was performed for molecular typing of pathogenic strains. Results There were 390 strains of Yersinia enterocolitica isolated from the 12728 specimens with a detection rate of 3. 06％, including 13 hu-man strains and 377 animal strains. Most of the strains were isolated from pig and chicken feces and both ac-counted for 25. 13％ (98/390). The predominant biotype was 1A and the serotypes of the strains were main-ly O : 5 and O : 8. Results of the virulence gene analysis showed that 21 strains of O : 3 serotype were path-ogenic, including one human strain and 20 pig strains. After NotⅠdigestion, these pathogenic strains were divided into three band types with a band similarity of 94％-100％. Conclusions Yersinia enterocolitica ex-isted in both human population and many kinds of animals in Henan province. Pig was the main host of path-ogenic strains and there was a high homology among these strains.
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Objective To investigate the etiological,antimicrobial resistance status and pulsed field gel electrophoresis (PFGE) patterns of S.enteritidis strains in Henan Province.Methods Totally 82 strains of S.enteritidis strains were isolated from seven sentiel hospitals which were able to detect multiple pathogens from April,2013 to December,2015.According to Salmonella K-B drug susceptibility testing and molecular typing method published by the USA clinical and Laboratory Standards Institute (2015),the drug sensitivity to 7 kinds of antimicrobial agents and PFGE molecule characteristics of 82 S.enteritidis strains were tested.The PFGE patterns were analyzed by BioNumerics 6.0 software based on international PulseNet bacterial infectious disease monitoring network.Results Forty-seven strains of S.enteritidis were isolated from male patients,35 strains isolated from female patients.A total of 56 S.enteritidis strains were isolated from young children aged from 0 to 5 years old,including 29 strains isolated from 6 months to 2 years old.The strains were mainly isolated between May and November of the year,and 15 (18.3％) strains were isolated between March and April,27(32.9％) strains between May and July,34 (41.5％) strains between August and October,6 (7.3％) strains were isolated in the rest time of the year,with a typical seasonal characteristics of summer and autumn.Sxity-four (78.0％)strains of S.enteritidis were resistant to ampicillin;23 (28.0％) strains were resistant to ceftazidime;39 (47.6％) strains were resistant to cefotaxime:13 (15.9％) strains were resistant to cefepime;55 (67.1％) strains were resistant to nalidixic acid;24 (29.3％) strains were resistant to ciprofloxacin;32 (39.0 ％) strains were resistant to gentamicin;14 (17.1 ％) strains were resistant to chloramphenicol;47 (57.3％) strains were resistant to methicillin benzyl ammonium;13 (15.9％) strains were resistant to sulfamethoxazole and trimethoprim;21 (25.6 ％) strains were resistant to tetracycline.All strains weremuhi-drug resistant,and 21 (25.6％) isolates were resistant to 3-4 kinds of antibiotics,32 (39.0％)isolates were resistant to 5-6 kinds of antibiotics, 29 (35.4 ％) isolates were resistant to 7-8 kinds ofantibiotics.These 82 strains of S.enteritidis were divided into 25 molecular patterns by digestion withXba Ⅰ enzyme.Each pattern contained 1 to 26 strains with similarity ranged from 59.33％-100.00％.EN1 and EN2 were the main PFGE belt types and included 26 and 16 strains,respectively.Conclusions The drug resistance of clinical isolates of S.enteritidis in Henan province is serious.PFGE patterns show polymorphism and the dominant patterns,part of which are associated with drug-resistance spectrum and show aggregation.
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Objective@#To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China.@*Methods@#In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR. Epidemiological information (including demographic information such as age, sex and clinical symptoms) was also collected from the patients and analyzed.@*Results@#Group A rotavirus was detected in 30.9% (785/2 541) of diarrhea samples from children. The detection rate was higher in October (54.8%, 345/629) and lower in July (5%, 5/101) each year from 2008 to 2015. The group A rotavirus infection rate was higher in boys (30.6%, 451/1 476) than in girls (31.4%, 334/1 065) (χ2=0.18, P=0.664). Infection mainly occurred in 4-12 months old patients (61.3%, 481/785) (χ2=196.69, P<0.001), and the infection rate was lower in cities (26%, 258/992) compared with rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). G typing of 785 strains of group A rotavirus revealed the following types: G1 (13.5%, 106 strains), G2 (11.1%, 87 strains), G3 (29.7%, 233 strains), and G9 (57.5%, 451 strains); P typing revealed the predominance of P[4] (11.3%, 89 strains) and P[8] (84.7%, 665 strains); gene type combinations comprised mainly G9P[8], G2P[4], G3P[8], G1P[8], respectively accounted for 52.9% (415), 9.7% (76), 17.3% (136), 11.3% (89). Gene type combinations G1 [8] and G3P[8] have been decreasing in prevalence since 2008 and G9P[8] has become the dominant gene type of group A rotavirus in Henan province. Among the group A rotavirus infection samples, the male:female infection ratio was 1.4∶1 (451/334), with no significant difference in the infection rate (χ2=0.18, P=0.664); the infection rate was higher in 4- 12 months old patients (61.3%, 481/785), with a significant difference detected between age groups (χ2=196.69, P<0.001). The rate of detection was lower in cities (26.0%, 258/992) than in rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). Clinical analysis revealed a body temperature of below 37 degrees in 75.7% of positive cases (594 patients), 37.0- 37.5 degrees in 17.2% of cases (135 patients), 37.6-38.0 degrees in 2.0% of cases (16 patients), and above 38 degrees in 5.1% of cases (40 patients), with most cases showing no fever or a mild fever. The frequency of episodes of diarrhea among the patients was 0- 3 times (21.1%, 166 cases), 4- 6 times (65.6%, 515 cases), 7- 9 times (8.0%, 63 cases), or 10- 15 times (5.2%, 41 cases), mainly showing mild and moderate diarrhea. Vomiting also varied in frequency among the patients from no vomiting (86.9%, 682 cases), 1-2 times (11.8%, 92 cases), 3 times (6.0%, 47 cases), and more than 3 times (0.4%, 3 cases). The occurrence of dehydration varied from no dehydration (86.9%, 682 cases), mild dehydration of 1%- 5% (12.1%, 95 cases), to severe dehydration of ≥5% (1.0%, 8 cases).@*Conclusion@#A higher infection rate of group A rotavirus was detected in children younger than five years of age with acute diarrhea in sentinel hospitals in Henan province, including part-mixed infection cases. A predominance of cases was detected in the autumn, and secondly the spring of each year. Gene type G9P[8] was most frequently isolated. The majority of patients displayed no fever, vomiting or dehydration. The cases with clinical symptoms of fever, diarrhea, vomiting and dehydration often showed mild disease.
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Objective To understand the distribution of Salmonella in external environment in Henan province,and explore the distribution of different serotypes of the Salmonella and their homology.Methods A total of 4 488 samples were collected form animal dung,meat products and kitchen utensils,and identified by biochemical tests and serotyped by serum agglutination reaction.The predominant serotypes were further typed by PFGE.Results A total of 324 Salmonella strains were detected in these samples,the detection rate was 7.21％.The 324 Salmonella isolates belonged to 39 serotypes,S.enteritidis (24.07％,78/324) and S.derby (20.37％,66/324) were predominant.Forty six strains ofS.enteritidis and 30 strains of S.derby were divided into 12 and 17 molecular patterns by digestion with Xba Ⅰ,while chicken and swine were the predominant animal hosts.Conclusions Serotyping of external environment Salmonella were phenotypically diverse and the serotype of Salmonella from different sources were different.The same clone was prevalent in same area.It is necessary to strengthen supervision and surveillance to ensure food safety.
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Objective To investigate the infection status of human rotavirus,calicivirus,astrovirus and enteric adenovirus in children aged ＜5 years in disease surveillance areas in Henan province from 2013 to 2015.Methods A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR,while rotavirus (group B,C),calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR.The epidemiological data of positive cases were statistically analyzed.Results A total of 594 positive samples were detected,including 24 mixed infection samples,370 rotavirus positive samples (42.0％);162 calicivirus positive samples (18.4％);69 astrovirus positive samples (7.8％) and 17 enteric adenovirus positive samples (1.9％).The overall positive rate of four viruses was significantly higher in urban area than in rural area,but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group.G9P [8] was the major genotype of group A rotavirus,there were two seasonal infection peaks in autumn and spring.Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring.Viral diarrhea cases were distributed in different age groups,mainly in age groups 0-12 months (rotavirus) and 3-5 years (calicivirus).The main clinical symptoms included fever,diarrhea and vomiting.The etiological characteristics differed with gender and area.Conclusions The infection rate of diarrheal viruses was higher in young children ＜5 years old in disease surveillance areas.The epidemiological and clinical features varied with the type of pathogen.
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Objective To analyze the serotypes and antibiotic resistance phenotypes of non-typhi Salmonella strains in Henan province from 2011 to 2015.Methods The stool samples were collected from diarrhea patients,and enriched with SBG enrichment broth and the pathogen isolation was conducted with CHROMAgar selective culture medium at 37 ℃ for 18-24 hours using KIA/MIU biochemical action and API20E biochemical system slab to identify Salmonella strains.The serotypes of all the positive strains were detected with SSI Salmonella typing sera.According to K-B drug susceptibility testing method published by USA clinical and Laboratory Standards Institute (CLSI),the antibiotics resistant phenotype of the positive strains were analyzed.Results A total of 1 351 strains of non-typhi Salmonella were isolated,in which 811 were from males,540 were from females.The ratio of men to women was 1.5 ∶ 1.Children and young adults were mainly affected.The pathogen isolation was mainly in May-October during a year.The 1 351 strains of non-typhi Salmonlla were divided into 58 serotypes.S.enteritidis,S.typhimurium,S.agona,S.derby,S.indiana,S.senfienberg and S.thompson ranked 1st-7th.The drug-resistance rate of the 1 351 strains was 46.1％ to synthetic broad-spectrum penicillin ampicillin (AMP),19.5％ and 21.2％ to the three generation cephalosporin ceftazidime (CAZ) and cefotaxime (CTX),8.8％ to the four generation cephalosporins cefepime (FEP),58.7％ to the one generation of quinolones nalidixic acid (NAL),14.7％ to the three generation fluoroquinolone ciprofloxacin (CIP) and norfloxacin (NOR),25.0％ and 35.6％ to aminoglycoside antibiotic gentamicin (GEN) and streptomycin (STR),35.4％ to amphenicols (CHL),31.7％ to sulfonamide trimethoprim (TMP) and 37.8％ to tetracycline (TET).Totally 879 strains were multidrug resistant (65.1％):350 strains were resistant to 3-4 kinds of antibiotics (25.9％),309 strains were resistant to 5-7 kinds of antibiotics (22.9％),174 strains were resistant to 8-10 kinds of antibiotics (12.9％) and 48 strains were resistant to 11-12 kinds of antibiotics (3.6％).Conclusion The serotypes of non-typhi Salmonella strains isolated from Henan province varied,some strains were resistant to 12 kinds of antibiotics commonly used in clinical treatment and the multidrug resistance has become serious.
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Objective To investigate the drug tolerance and PFGE patterns of Salrnonella (S.) paratyphi A strains isolated from sentinel hospitals in Dengfeng,Henan province,during 2009-2015.Methods Venous blood samples were collected from paratyphoid patients and cultured in double phase blood culture bottle.Suspicious strains were identified and used for Salomonella.O antigen and H1/2 phase flagellum-induced serum agglutination test with API20E biochemical systems and SSI Salmonella typing sera.According to Salmonella molecular typing and K-B drug susceptibility testing method published by PulseNet China bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute,we analyzed the drug susceptibility and PFGE molecule characteristics of S.paratyphiA strains isolated from the patients.Results A total of126 strains of S.paratyphi A were isolated from 248 blood samples,the antigen modes of them were 1,2,12:a:-.The resistance rate of 126 strains of S.paratyphi A was 83.3％ to ampicillin;29.4％ to ceftazidime,31.2％ to cefotaxime,17.5％ to cefepime;62.6％ to nalidixic acid;19.3％ to ciprofloxacin,26.4％ to norfloxacin;22.8％ to gentamicin,47.9％ to streptomycin;19.2％ to chloramphenicol,24.2％ to methicillin benzyl ammonium,58.6％ to compound sulfamethoxazole and 46.7％ to tetracycline.The 126 strains of S.paratyphi A had different levels of resistance to 8 kinds of antibiotics,109 strains were multidrug resistant (86.5％),9 strains were resistant to 2-3 kinds of antibiotics (7.1％),76 strains were resistant to 5-8 kinds of antibiotics (60.3％),17 strains were resistant to 9-10 kinds of antibiotics (13.5％),7 strains were resistant to 11-12 kinds of antibiotics (5.6％).The 126 strains of S.paratyphi A were divided into 14 molecular patterns by digestion with Xba I and pulsed field gel electrophoresis.The antibiotics resistance to third generation cephalosporin (CAZ,CTX),one generation and three generation of quinolones (NAL,CIP,NOR) and aminoglycosides antibiotics (STR) showed an upward trend.Each pattem contained 1-98 strains with similarity ranged from 64.10％ to 100.00％.PTYA 1,6,9 and 10 were the main PFGE belt types.Conclusion The drug resistance of clinical isolates ofS.paratyphi A was serious in Dengfeng,Henan province,PFGE pattems showed a diversity,but predominant patterns could also be found.The PFGE patterns of some strains had clustering and were related with their antidrug spectrums.
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Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.
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<p><b>OBJECTIVE</b>To investigate the antimicrobial resistance status and pulsed field gel electrophoresis (PFGE) patterns of Salmonella Enteritidis (S.Enteritidis) strains in Henan province.</p><p><b>METHODS</b>S. Enteritidis strains were isolated from seven sentinel hospitals from March 2011 to December 2013. According to molecular typing and Salmonella (Kirby-Bauer, K-B) drug susceptibility testing method published by the international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI), we analyzed drug sensitivity of 8 kinds antibiotics and PFGE molecule characteristics of 120 S. Enteritidis isolates from seven sentinel hospitals.</p><p><b>RESULTS</b>Among 120 strains of S. Enteritidis, 77 were isolated from male patients, 43 from female patients. A total of 78 strains S. Enteritidis were isolated from young children ranged from 0 to 5 years old (65.0%), including 57 strains isolated from 6 months to 2 years old (47.5%). The isolated time mainly centralized on May to October of the year, 11 strains isolated in March-April (9.2%), 48 were in May-July (40.0%),54 in August-October (45.0%), 7 in other months, with a typical summer seasonal characteristics. The resistance rate of 120 strains S. Enteritidis to ampicillin was 50.0% (n=60); to ceftazidime was 14.2% (n=17), to cefotaxime was 18.3% (n=22); to cefepime was 5.8% (n=7); to nalidixic acid was 61.7% (n=74); to ciprofloxacin was 8.3% (n=10), to norfloxacin was 5.8% (n=7); to gentamicin was 42.5% (n=51); to streptomycin was 21.7% (n=26); to chloramphenicol was 30.0% (n=36); resistance to methicillin benzyl ammonium was 11.7% (n=14), compound sulfamethoxazole resistance rate was 71.7% (n=86); the tetracycline resistant rate was 47.5% (n=57). All 120 strains of S. Enteritidis had different levels of resistance to 8 kinds of antibiotics, all strains were multidrug resistant strains, 28 isolates were resistant to 3-4 kinds of antibiotics (23.3%), 38 isolates were resistant to 5-6 kinds of antibiotics (31.7%), 39 isolates were resistant to 7-8 kinds of antibiotics (32.5%). All 120 strains of S. Enteritidis were divided into 44 molecular patterns by digestion with XbaI and pulsed field gel electrophoresis. each pattern contained 1-35 strains with similarity ranged from 54.3%-100%. EN14 and EN19 were the main PFGE types, including 35 and 29 strains respectively.</p><p><b>CONCLUSION</b>The status of drug resistance of clinical isolates of Salmonella in Henan province was rather serious, PFGE patterns showed advantages and partial strain's corresponding resistant spectrum have certain relevance and the same aggregation relationship.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Anti-Bacterial Agents , Pharmacology , China , Drug Resistance, Bacterial , Electrophoresis, Gel, Pulsed-Field , Microbial Sensitivity Tests , Molecular Typing , Salmonella Infections , Microbiology , Salmonella enteritidis , ClassificationABSTRACT
Objective To understand the distribution of Salmonella in external environment in Henan province,and explore the distribution of different serotypes of the Salmonella and their homology.Methods A total of 4 488 samples were collected form animal dung,meat products and kitchen utensils,and identified by biochemical tests and serotyped by serum agglutination reaction.The predominant serotypes were further typed by PFGE.Results A total of 324 Salmonella strains were detected in these samples,the detection rate was 7.21％.The 324 Salmonella isolates belonged to 39 serotypes,S.enteritidis (24.07％,78/324) and S.derby (20.37％,66/324) were predominant.Forty six strains ofS.enteritidis and 30 strains of S.derby were divided into 12 and 17 molecular patterns by digestion with Xba Ⅰ,while chicken and swine were the predominant animal hosts.Conclusions Serotyping of external environment Salmonella were phenotypically diverse and the serotype of Salmonella from different sources were different.The same clone was prevalent in same area.It is necessary to strengthen supervision and surveillance to ensure food safety.
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Objective To investigate the infection status of human rotavirus,calicivirus,astrovirus and enteric adenovirus in children aged ＜5 years in disease surveillance areas in Henan province from 2013 to 2015.Methods A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR,while rotavirus (group B,C),calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR.The epidemiological data of positive cases were statistically analyzed.Results A total of 594 positive samples were detected,including 24 mixed infection samples,370 rotavirus positive samples (42.0％);162 calicivirus positive samples (18.4％);69 astrovirus positive samples (7.8％) and 17 enteric adenovirus positive samples (1.9％).The overall positive rate of four viruses was significantly higher in urban area than in rural area,but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group.G9P [8] was the major genotype of group A rotavirus,there were two seasonal infection peaks in autumn and spring.Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring.Viral diarrhea cases were distributed in different age groups,mainly in age groups 0-12 months (rotavirus) and 3-5 years (calicivirus).The main clinical symptoms included fever,diarrhea and vomiting.The etiological characteristics differed with gender and area.Conclusions The infection rate of diarrheal viruses was higher in young children ＜5 years old in disease surveillance areas.The epidemiological and clinical features varied with the type of pathogen.
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Objective To analyze the serotypes and antibiotic resistance phenotypes of non-typhi Salmonella strains in Henan province from 2011 to 2015.Methods The stool samples were collected from diarrhea patients,and enriched with SBG enrichment broth and the pathogen isolation was conducted with CHROMAgar selective culture medium at 37 ℃ for 18-24 hours using KIA/MIU biochemical action and API20E biochemical system slab to identify Salmonella strains.The serotypes of all the positive strains were detected with SSI Salmonella typing sera.According to K-B drug susceptibility testing method published by USA clinical and Laboratory Standards Institute (CLSI),the antibiotics resistant phenotype of the positive strains were analyzed.Results A total of 1 351 strains of non-typhi Salmonella were isolated,in which 811 were from males,540 were from females.The ratio of men to women was 1.5 ∶ 1.Children and young adults were mainly affected.The pathogen isolation was mainly in May-October during a year.The 1 351 strains of non-typhi Salmonlla were divided into 58 serotypes.S.enteritidis,S.typhimurium,S.agona,S.derby,S.indiana,S.senfienberg and S.thompson ranked 1st-7th.The drug-resistance rate of the 1 351 strains was 46.1％ to synthetic broad-spectrum penicillin ampicillin (AMP),19.5％ and 21.2％ to the three generation cephalosporin ceftazidime (CAZ) and cefotaxime (CTX),8.8％ to the four generation cephalosporins cefepime (FEP),58.7％ to the one generation of quinolones nalidixic acid (NAL),14.7％ to the three generation fluoroquinolone ciprofloxacin (CIP) and norfloxacin (NOR),25.0％ and 35.6％ to aminoglycoside antibiotic gentamicin (GEN) and streptomycin (STR),35.4％ to amphenicols (CHL),31.7％ to sulfonamide trimethoprim (TMP) and 37.8％ to tetracycline (TET).Totally 879 strains were multidrug resistant (65.1％):350 strains were resistant to 3-4 kinds of antibiotics (25.9％),309 strains were resistant to 5-7 kinds of antibiotics (22.9％),174 strains were resistant to 8-10 kinds of antibiotics (12.9％) and 48 strains were resistant to 11-12 kinds of antibiotics (3.6％).Conclusion The serotypes of non-typhi Salmonella strains isolated from Henan province varied,some strains were resistant to 12 kinds of antibiotics commonly used in clinical treatment and the multidrug resistance has become serious.
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Objective To investigate the drug tolerance and PFGE patterns of Salrnonella (S.) paratyphi A strains isolated from sentinel hospitals in Dengfeng,Henan province,during 2009-2015.Methods Venous blood samples were collected from paratyphoid patients and cultured in double phase blood culture bottle.Suspicious strains were identified and used for Salomonella.O antigen and H1/2 phase flagellum-induced serum agglutination test with API20E biochemical systems and SSI Salmonella typing sera.According to Salmonella molecular typing and K-B drug susceptibility testing method published by PulseNet China bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute,we analyzed the drug susceptibility and PFGE molecule characteristics of S.paratyphiA strains isolated from the patients.Results A total of126 strains of S.paratyphi A were isolated from 248 blood samples,the antigen modes of them were 1,2,12:a:-.The resistance rate of 126 strains of S.paratyphi A was 83.3％ to ampicillin;29.4％ to ceftazidime,31.2％ to cefotaxime,17.5％ to cefepime;62.6％ to nalidixic acid;19.3％ to ciprofloxacin,26.4％ to norfloxacin;22.8％ to gentamicin,47.9％ to streptomycin;19.2％ to chloramphenicol,24.2％ to methicillin benzyl ammonium,58.6％ to compound sulfamethoxazole and 46.7％ to tetracycline.The 126 strains of S.paratyphi A had different levels of resistance to 8 kinds of antibiotics,109 strains were multidrug resistant (86.5％),9 strains were resistant to 2-3 kinds of antibiotics (7.1％),76 strains were resistant to 5-8 kinds of antibiotics (60.3％),17 strains were resistant to 9-10 kinds of antibiotics (13.5％),7 strains were resistant to 11-12 kinds of antibiotics (5.6％).The 126 strains of S.paratyphi A were divided into 14 molecular patterns by digestion with Xba I and pulsed field gel electrophoresis.The antibiotics resistance to third generation cephalosporin (CAZ,CTX),one generation and three generation of quinolones (NAL,CIP,NOR) and aminoglycosides antibiotics (STR) showed an upward trend.Each pattem contained 1-98 strains with similarity ranged from 64.10％ to 100.00％.PTYA 1,6,9 and 10 were the main PFGE belt types.Conclusion The drug resistance of clinical isolates ofS.paratyphi A was serious in Dengfeng,Henan province,PFGE pattems showed a diversity,but predominant patterns could also be found.The PFGE patterns of some strains had clustering and were related with their antidrug spectrums.
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Objective To investigate the antibiotic resistance and pulsed field gel electrophoresis (PFGE) patterns of clinical isolates of Salmonella (S.) typhi and S.paratyphi in Henan province during 2009-2011.Methods According to molecular typing and Salmonella K-B drug susceptibility test method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI),the drug susceptibility and PFGE molecule characteristics of 78 S.typhi and S.paratyphi strains isolated from sentinel hospitals in Henan were analyzed.Results The 78 strains orS.typhi and S.paratyphi were resistant to 13 kinds of antibiotics,in which 62 were multidrug resistant (79.5％),4 were resistant to 2-3 kinds of antibiotics (5.1％),41 were resistant to 5-8 kinds of antibiotics (52.6％),14 were resistant to 9-10 kinds of antibiotics (17.9％),3 were resistant to 11-12 kinds of antibiotics (3.8％).The resistant rate to cephalosporins,quinolones and other 3 kinds of antibiotic showed an increase trends.Seventy two strains ofS.typhi and S.paratyphi could be divided 14 molecular patterns by digestion with Xba Ⅰ and PFGE,each pattem contains 1-47 strains which shared the similarity of 66.03％-100.00％.Conclusions The drug resistance of clinical isolates of S.typhi and S.paratyphi was serious in Henan.The PFGE patterns showed diversity,but the predominant patterns could be still found.The PFGE patterns of some strains were associated with their drug resistance.
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Objective To detect and analyze the distribution of virulence factors,antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of Shigella sonnei,isolated in Henan province from 2011 to 2014.Methods Samples of diarrhea patients were collected and isolated with SS selective culture medium in 37 ℃ for 18-24 hours.All strains were identified under the Kligler iron agar/motility-indol-urea biochemical action and API20E biochemical system.Serological typing and prepared DNA template were carried out with thermal cracking method and multiplex PCR,to detect the virulence genes of Shigella sonnei.According to the molecular typing method and K-B drug susceptibility testing method published by the international PulseNet bacterial infectious disease monitoring network and USA clinical and Laboratory Standards Institute,antimicrobial susceptibility tests and PFGE molecular characteristics of these positive strains isolated from sentinel hospitals patients stool samples were analyzed.Results Among the 98 strains of Sonnei type Ⅰ and 118 strains of Sonnei type Ⅱ,all the strains carried carry different virulence genes including SHET-1B,SHET-2,ial,ipaH genes,with 4 kinds of virulence gene combination types.All the 216 strains of Shigella sonnei belonged to the multi-drug resistant strains,including 34 isolates resistant to 2-4 kinds of antibiotics (15.7％),147 isolates to 5-8 kinds of antibiotics (68.1％),24 to 9-10 kinds of antibiotics (11.1％),7 to 11 kinds of antibiotics (3.2％),and 4 to 13 kinds of antibiotics (1.9％).A total of 100 strains of Shigella sonnci were divided into 31 molecular patterns,digested by Xba Ⅰ and PFGE.Each pattern contained 1-13 strains with similarities ranged from 68.6％-100.0％.Conclusions All the Shigella sonnei strains carried virulence pathogenic factors,presenting serious status on drug resistance.PFGE fingerprinting patterns showed high polymorphism and dominant characteristics.PFGE patterns of partial strains and corresponding antidrug spectrum presented certain relevance and with same aggregation relationship.
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Objective To evaluate a new self-designed device to assist closed reduction of femoral shaft fracture.Methods From January 2012 to June 2014,18 cases of femoral shaft fracture received closed reduction and internal fixation with anterograde intramedullary nails on a popular fluoroscopic orthopedic table.The new self-designed distraction reduction device was used during the operation.The patients contained 14 males and 4 females,aged from 21 to 48 years (mean,33.6 years).Fracture AO classification was type 32A2 in 8 cases,32A3 in 5 cases,32B1 in 3 cases and 32B2 in 2 cases.Mean pre-operation time was 5.5 days (range,3-10 days).Results Operation time ranged from 85 to 130 minutes (mean,96 minutes).Intraoperative bleeding ranged from 120 to 180 ml (mean,150 ml).X-ray fluoroscopy time ranged from 20 to 40 seconds (mean,25 seconds).Frequency of nailing into the distal fracture end was 1 to 3 times (mean,1.5 times).One case had additional small incision for open reduction.Fourteen cases experienced external rotational deformity of the femur from 2° to 6° (mean,3.6°) after surgery,and four cases were free of rotational deformity.All patients were followed up for 6 to 20 months (mean,12.8 months).All patients had fracture healing in a period of 4.5 to 8.5 months (mean,5.5 months).No iatrogenic fracture,infections,nail breakage or other complications occurred.At the final follow-up,knee score according to the system of hospital for special surgery (HSS) was found to be excellent in 12 cases,good in 4,and fair in 2,giving an excellent-togood rate of 89％.Conclusion The new self-designed distraction device is an easy-to-operate instrument that is useful in assisting distraction and reduction of the femoral shaft fracture diffictlt to be fixed with routine methods as well as intramedullary nailing just on a popular fluoroscopic orthopedic table.
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To investigate the infection of Yersinia enterocolitica in Dengfeng City ,the strains were isolated from livestock and poultry .The strains were detected with biochemiological methods ,serological methods ,and virulence genes were detected with PCR .A total of 105 strains of Yersinia enterocolitica were classified from 1 285 stool samples ,the total isolation rate was 8 .17% .Among the total isolated strains ,17 strains were classified from dogs with a rate of 17 .35% and 35 strains from pigs with 13 .62% .Twelve strains were O ∶3 serotype (13 .48% ) ,12 strains were O ∶5(13 .48% ) ,and 14 strains were O ∶8 (15 .73% ) .Ail+ ,ystA+ ,yadA+ and virF+ accounted for 12 .36% ,and ystB+ accounted for 42 .70% .In conclusion ,the pigs and dogs were important animal hosts ,which may play the major role in humans'infection .