Complete Sequences and Characterization of Two Novel Plasmids Carrying aac(6')-Ib-cr and qnrS Gene in Shigella flexneri.

The complete sequences of two previously reported plasmids carrying plasmid-mediated quinolone resistance genes from Shigella flexneri in China have not been available. The present study using the p5-C3 assembly method revealed that (1) the plasmid pSF07201 with aac(6')-Ib-cr had 75,335 bp with antibiotic resistance genes CTX-M-3, TEM-1, and FosA3; (2) seven fragments of pSF07201 had more than 99% homology with the seven corresponding plasmids; (3) the other plasmid pSF07202 with qnrS had 47,669 bp with antibiotic resistance gene TEM-1 and 99.95% homology with a segment of pKF362122, which has the qnrS gene from location 162,490 to 163,146. A conjugation and electrotransformation experiment suggested that these two plasmids might horizontally transfer between and coexist in Escherichia coli J53 and S. flexneri 2a 301. Either the aac(6')-Ib-cr or qnrS gene contributed to, but only the coexistence of the two genes conferred to the resistance to ciprofloxacin in these two strains. To the best of our knowledge, this is the first report of the complete sequences of the aac(6')-Ib-cr- and qnrS-positive plasmids in Shigella isolates. Our findings indicate that two genes probably evolve through horizontal plasmid transfer between the different bacterial types.

[Influencing factors on the voluntary premarital medical examination among Chinese population].

OBJECTIVE: To explore the factors influencing the premarital medical examination in Chinese population and to discuss the related possible intervention strategies. METHODS: Data were collected through self-designed questionnaires on 2572 newly married respondents, selected under a stratified randomized sampling method, at Marriage Registration Office in 12 counties in Zhejiang province. Predictive factors were derived from the integrating complementary constructs of Health Belief Model, Theory of Reasoned Action as well as individual demographic characteristics. Multiple logistic multilevel analyses was used as the main statistical method, with individuals as the 'low' and counties as the 'high' levels. RESULTS: Behaviors on premarital medical examination showed a clustering trait at the county level (P = 0.018) and variance partition coefficients (VPC) of each variables was between 15.40% and 17.58%. There were no statistical significances found in the rates of premarital medical examination among gender, age, residence of Household Registration, education, income, health insurance and history of premarital medical examination. However, significant correlation was seen on occupation of the respondents. The rate of premarital medical examination among the respondents who had not attended medical examination during the last six moths was 1.31 times (95% confidence intervals, 1.05 - 1.65) more than those who had, with OR (odds ratio) as 1.51 (95%CI: 1.14 - 2.00) for the pregnant respondents in their first marriage and 0.35 (95%CI: 0.23 - 0.51) for remarried respondents, compared with women at first marriage but remained unpregnant. Regarding premarital medical examination, the respondents reported greater benefits, less barriers, greater positive behavioral attitudes and normative beliefs to it, with an ORs as 2.32 (95%CI: 1.18 - 4.60), 0.71 (95%CI: 0.57 - 0.90), 1.69 (95%CI: 1.10 - 2.58) and 1.72 (95%CI: 1.34 - 2.20) respectively, but with no significant association with perceived susceptibility, perceived severity and motivation to comply. CONCLUSION: Factors such as individual perceived benefits, barriers, attitudes and normative beliefs etc., were determinants of premarital medical examination accompanied by minor (16%) influence coming from the geographical environment.

[A multilevel analysis on the association between socioeconomic status and psychiatric disorders].

OBJECTIVE: To explore the association between psychiatric disorders and socioeconomic status such as education, income, employment and area of community settings in Zhejiang province. METHODS: Data were from the epidemiological survey of mental illnesses aged 15 and older in 2001 (n = 14 632). Psychiatric disorders were measured by GHQ-12 with a cut-point 4. Logistic multilevel analysis was the main statistical method being used. RESULTS: The overall prevalence of psychiatric disorders was 18.5%(95% confidence intervals, 17.9% to 19.1%), higher than the data from Hebei province (u = 4.39, P < 0.001). Annual household income and employment were strongly associated with psychiatric disorders especially for those with low income (odds ratio 3.45, 95%CI: 1.72 - 6.67) and unemployment (odds ratio 2.03, 95%CI: 1.73 - 2.40). Factors as regional effect and education level showed weak or inconsistent association with psychiatric disorders after controlling on other indicators. CONCLUSION: Inverse gradient relation between psychiatric disorders and SES seemed as the main result of low SES individual characteristics and some minor effects at the county level.

[Multiplex PCR assay for dissemination and diversity of extended-spectrum beta-lactamase genes in Shigella isolates].

OBJECTIVE: To develop a rapid and simple multiplex polymerase chain reaction (PCR) method which discriminates extended-spectrum beta-lactamases (ESBLs) genes in sporadic Shigella isolates from 1998 to 2007 in Hangzhou city, China. METHODS: After ESBLs screening according to the Clinical and Laboratory Standards Institute (CLSI) method, CTX-M, TEM, SHV and OXA-1 encoding genes were detected by using a multiplex PCR method, and the results were verified by 8 single gene PCR amplification. RESULTS: Seventeen isolates harbored ESBLs genes among 195 Shigella isolates (8.72%). Genes encoding CTX-M (17 strains), TEM (2 strains), OXA-1 (10 strains) and SHV (0 strains) were discriminated with multiplex PCR analysis, which coincided with eight single gene PCR analysis at 94.12%. CONCLUSION: Multiplex PCR should be a suitable tool for initial rapid screening and discriminating ESBLs genes in Shigella isolates. With similar trend of national surveillance data, the proportion of sporadic Shigella isolates harbouring ESBLs genes might probably be on increase.

[A multilevel cross-sectional study of mental disorder in community settings in Zhejiang Province].

OBJECTIVE: To investigate the prevalence of mental disorder through the 12-item general health questionnaire (GHQ-12) survey and its related factors in community settings in Zhejiang Province. METHODS: A muti-level model was analyzed using data of 14,632 respondents nested in counties (cities), townships (urban districts), villages (urban neighborhoods) from the epidemiological survey of mental illnesses above 15 years old. RESULTS: The mean score measured by GHQ-12 was (1.54 +/- 2.15), which was lower than that of samples from four cities of Guangzhou, Chongqing, Taiyuan and Hangzhou (U = 11.08, P < 0.01). The mental disorder clustered within county (city) level, which represented 4.3% (chi(2) = 3.94, P < 0.05) of the total variance including four levels. After controlling for the county level, the mental disorder was associated with age, marital status, residency patterns, education, occupation and household incoming. In particular, it was reported that higher household incoming was significantly associated with better mental disorder among population in community settings. CONCLUSION: The prevalence of mental disorder clustered at the county (city) level is relatively lower with vulnerable groups including divorced, widowed, unemployed, retired, lower-income ones in community settings in Zhejiang Province.