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Objective To investigate etiologic characteristics of hand, foot, and mouth disease (HFMD) in a sentinel hospital in Guangzhou from 2017 to 2021, and to provide a scientific basis for the prevention and control of HFMD. Methods Descriptive epidemiologic methods were used to analyze the etiologic characteristics of mild cases of HMFD during 2017-2021. Results A total of 1 633 specimens of mild cases of HMFD were collected from 2017 to 2021. The total enterovirus (EV) positive rate was 78.41%, among which the positive rates of the main pathogen Cox A6, Cox A16, Cox A10, and EV71 were 40.83%, 17.68%, 6.13%, and 1.62%, respectively. The total positive rate of enteroviruses and the positive rate of enteroviruses of all types in each year were statistically different (P<0.001). In 2017-2021, the prevalence of HFMD in Guangzhou was mainly Cox A6, followed by Cox A16 which had the highest positive rate in 2018 (24.62%). The positive rate of EV71 decreased year by year. Cox A6 was highly prevalent from June to December every year, while the detection rate of Cox A16 was high from April to August every year. The positive detection rate of EV71 was high from January to May in 2017 and low from 2018 to 2021, with no epidemic peak. Conclusion From 2017 to 2021, the main pathogen of HMFD in Guangzhou is Cox A6, not EV71 or CoxA16, which suggests that it is of great significance to strengthen the monitoring of epidemic trend of HFMD for the prevention and control of HFMD.
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Objective@#To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS.@*Methods@#Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software.@*Results@#A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ2=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children’ hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ2=14.47, P<0.001 in stool specimen; χ2=31.99, P<0.001 in throat swab; χ2=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases.@*Conclusions@#Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.
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Objective To investigate the clinical severity,etiological classification and risk factors of severe cases with hand,foot and mouth disease (HFMD).Methods A total of 1 489 records on severe and fatal HFMD cases reported to the national pilot surveillance system of HFMD were used to analyze the demographic,medical treatment,etiological classification of the cases.Treatment outcome related risk factors were also studied with multi-variable stepwise logistic regression method.Results Seven out of the 1 489 severe HFMD cases died of this disease.A total of 960 (72.9％) were under three years old and 62.9％ were male and most of the cases (937,62.9％) resided in rural areas.Among all the cases,494 (33.2％) went to seek the first medical assistance at the institutions of village or township level.Durations between disease onset and first medical attendance,being diagnosed as the disease or diagnosed as severe cases were 0(0-1) d,1 (0-2) d and 2 (1-4) d,respectively.In total,773 (51.9％) of the severe HFMD cases were diagnosed as with aseptic meningitis,260 (17.5％) with brainstem encephalitis,377 (25.3 ％) with non-brainstem encephalitis,6 (0.4％) with encephalomyelitis,1 (0.1％) with acute flaccid paralysis,4 (0.3％) with pulmonary hemorrhage/pulmonary edema and 68 (4.6％) with cardiopulmonary failure.Of the etiologically diagnosed 1 217 severe and fatal HFMD cases,642 (52.8％) were with EV71,other enterovirus 261 (21.5％),Cox A16 36 (3.0％),1 (0.1％) with both EV71 and Cox A16.However,277 (22.8％) showed negative on any pathogenic virus.Complication (Z=3.15,P=0.002) and duration between onset and diagnosed as severe cases (Z=3.95,P＜0.001) were shown as key factors related to treatment outcomes.Conclusions Most severe HFMD cases appeared in boys,especially living in the rural areas.Frequently seen complications would include aseptic meningitis,non-brainstem encephalitis and brainstem encephalitis.EV71 was the dominant etiology for severe and fatal cases.Early diagnosis and complication control were crucial,related to the treatment outcome of HFMD.
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Objective To investigate the clinical severity,etiological classification and risk factors of severe cases with hand,foot and mouth disease (HFMD).Methods A total of 1 489 records on severe and fatal HFMD cases reported to the national pilot surveillance system of HFMD were used to analyze the demographic,medical treatment,etiological classification of the cases.Treatment outcome related risk factors were also studied with multi-variable stepwise logistic regression method.Results Seven out of the 1 489 severe HFMD cases died of this disease.A total of 960 (72.9％) were under three years old and 62.9％ were male and most of the cases (937,62.9％) resided in rural areas.Among all the cases,494 (33.2％) went to seek the first medical assistance at the institutions of village or township level.Durations between disease onset and first medical attendance,being diagnosed as the disease or diagnosed as severe cases were 0(0-1) d,1 (0-2) d and 2 (1-4) d,respectively.In total,773 (51.9％) of the severe HFMD cases were diagnosed as with aseptic meningitis,260 (17.5％) with brainstem encephalitis,377 (25.3 ％) with non-brainstem encephalitis,6 (0.4％) with encephalomyelitis,1 (0.1％) with acute flaccid paralysis,4 (0.3％) with pulmonary hemorrhage/pulmonary edema and 68 (4.6％) with cardiopulmonary failure.Of the etiologically diagnosed 1 217 severe and fatal HFMD cases,642 (52.8％) were with EV71,other enterovirus 261 (21.5％),Cox A16 36 (3.0％),1 (0.1％) with both EV71 and Cox A16.However,277 (22.8％) showed negative on any pathogenic virus.Complication (Z=3.15,P=0.002) and duration between onset and diagnosed as severe cases (Z=3.95,P＜0.001) were shown as key factors related to treatment outcomes.Conclusions Most severe HFMD cases appeared in boys,especially living in the rural areas.Frequently seen complications would include aseptic meningitis,non-brainstem encephalitis and brainstem encephalitis.EV71 was the dominant etiology for severe and fatal cases.Early diagnosis and complication control were crucial,related to the treatment outcome of HFMD.
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Objective To describe the clinical characteristics and outcomes of dengue virus infection during pregnancy . Methods A retrospective study was performed based on the clinical data of manifestations ,pregnancy outcomes and neonates in patients with dengue virus infection during pregnancy from January 1st ,2014 to December 31th ,2014 at maternity ward in Guangzhou .Results The most common manifestations in patients with dengue virus infection during pregnancy were fever (100 .0％ ) , body soreness (42 .9％ ) ,headache (41 .3％ ) ,cutaneous rash (41 .3％ ) ,fatigue (34 .9％ ) and muscle pain or arthralgia (17 .5％ ) , nausea and vomiting (12 .7％ ) . The decline proportions of leukocyte , platelet and neutrophil count were 17 .5％ ,20 .6％ and 6 .3％ ,respectively ,and the lowest point was observed on 5 — 6 days after the onset of illness .Miscarriage was observed in 3 pregnant patients (4 .8％ , all in the first trimester ) ,intra-uterine death in one patient (1 .6％ ,at 22 weeks of gestation) and artificial abortion in 2 cases .A total of 48 patients delivered ,among whom caesarean section rate was 37 .5％ , prematurity rate was 12 .5％ and low birth weight rate was 8 .2％ .Maternal – foetal vertical transmission happened in 2 cases .Sequence alignment demonstrated that the homologies of the nucleic acids and amino acids within each dengue virus vertical transmission mother-infant pairs were > 99 .9％ .Conclusions The manifestations of dengue virus infected women with pregnancy are not specific .Early detection and early diagnosis should be made according to the history of epidemiology for women with reproductive age in endemic areas .Maternal dengue virus infection during pregnancy might cause vertical transmission and is correlated with bad outcomes of pregnancy , including miscarriage , intra-uterine death and premature birth .Perinatal infection might cause maternal-foetal vertical transmission .
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Objectives To analyze the distribution and drug resistance of pathogenic bacteria in neonatal department,and to provide criteria for rational clinical use of antibiotics. Methods Totally 15,796 specimens ob-tained from neonates were cultured according to the operation specification. The isolated pure strains were identified and their drug susceptibility was tested by VITEK-2 automated microorganism identification system. Results A to-tal of 1,125 strains of bacteria were isolated and the total detection rate was 7.1%. Of the total,742(66.0%)were gram-negative bacteria ,355(31.6%)gram-positive bacteria and 28(2.4%)fungi. K pneumonia was the most fre-quently isolated pathogen in gram-negative bacteria ,and staphylococcus the most frequently isolated pathogen in gram-positive bacteria. G-bacteria were highly resistant to ampicillin ,1st and 2nd generation cephalosporin. The re-sistant rates of K pneumonia,P aeruginosa and A baumannii to imipenem were>24.0%.Among the staphylococ-cus,35.7%were MRSA and 73.3%MRSCN. The antibiotic sensitivities of staphylococcusto vancomycin,Rina thia-zole alkanes and Tigecycline were 100.0%,but those to penicillin,cephalosporin and erythromycin low. Conclu-sion The dominant bacteria isolated from specimens obtained from neonates are gram-negativebacteria ,and they present extensive antibiotic resistance.
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Objectives To analyze the distribution and drug resistance of pathogenic bacteria in neonatal department,and to provide criteria for rational clinical use of antibiotics. Methods Totally 15,796 specimens ob-tained from neonates were cultured according to the operation specification. The isolated pure strains were identified and their drug susceptibility was tested by VITEK-2 automated microorganism identification system. Results A to-tal of 1,125 strains of bacteria were isolated and the total detection rate was 7.1%. Of the total,742(66.0%)were gram-negative bacteria ,355(31.6%)gram-positive bacteria and 28(2.4%)fungi. K pneumonia was the most fre-quently isolated pathogen in gram-negative bacteria ,and staphylococcus the most frequently isolated pathogen in gram-positive bacteria. G-bacteria were highly resistant to ampicillin ,1st and 2nd generation cephalosporin. The re-sistant rates of K pneumonia,P aeruginosa and A baumannii to imipenem were>24.0%.Among the staphylococ-cus,35.7%were MRSA and 73.3%MRSCN. The antibiotic sensitivities of staphylococcusto vancomycin,Rina thia-zole alkanes and Tigecycline were 100.0%,but those to penicillin,cephalosporin and erythromycin low. Conclu-sion The dominant bacteria isolated from specimens obtained from neonates are gram-negativebacteria ,and they present extensive antibiotic resistance.
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OBJECTIVE To study the shelf life of paper-plastic packing items after steam sterilization in different time and different environment.METHODS From Jan to Dec 2005,monthly take ten samples which deposited in central sterilization supply department,emergency room and postpartum room at the same time for bacterial culture.Every time we took ten sterility packs in each department as mentioned,paper-plastic packing had been adopted for the sterility packs in steam sterilization.RESULTS The sterility packages in clinical departments started to grow bacteria from the 9th month.And packages in supply room had no bacteria even at the 12th month.CONCLUSIONS In order to ensure the sterilization quality of paper-plastic packing with steam sterilization,we should choose high quality package material,ensure the cleaning quality,supply favorable storage environment and decrease the artificial pollution.