ABSTRACT
<p><b>OBJECTIVE</b>To establish a gap ligase chain reaction (G-LCR) assay for the detection of Chlamydia trachomatis (Ct) in neonates with pneumonia.</p><p><b>METHODS</b>A G-LCR DNA amplification assay that targeted the outer major membrane protein gene (omp1) of Ct was developed to detect Ct. The sensitivity and specificity of the G-LCR test was examined by the use of highly purified elementary bodies (EBs). Nasopharyngeal swabs taken from 328 neonates with pneumonia were analyzed by Gap-LCR and cell culture.</p><p><b>RESULTS</b>The detection limit of G-LCR was 2 EBs. G-LCR could detect five species of Ct and was not cross-reacted with C psittaci and other bacteria. The prevalence of Ct in 328 neonates with pneumonia, using an expanded gold standard of a positive cell culture or two confirmed positive non-culture tests, was 21% (69/328). After analysis of discrepant results, the sensitivity, specificity, and positive and negative predictive values for the G-LCR were 98.6%, 100%, 100% and 99.6%, respectively; whereas those for culture were 86.9%, 100%, 100% and 96.6%, respectively.</p><p><b>CONCLUSION</b>This study demonstrated that the G-LCR was a highly sensitive nonculture technique and good alternative test for the detection of chlamydial infections.</p>
Subject(s)
Female , Humans , Infant, Newborn , Male , Chlamydia Infections , Diagnosis , Microbiology , Chlamydia trachomatis , Genetics , Ligase Chain Reaction , Methods , Sensitivity and SpecificityABSTRACT
Objective To explore the diagnostic value of Gap-ligase chain reaction(LCR)-enzyme linked immunosorbent assay(ELISA)for Chlamydia trachomatis(CT) pneumonia in infants(28 days-3 months old baby was 16.9%(27/160 cases),and the incidence in 3-6 months old baby was 8.1%(12/149 cases).The clinical symptoms included that 25 cases(51.0%) had fever,48 cases(98.0%) with paroxysmal cough,45 cases(91.8%) with rhinocleisis,45 cases(91.8%) with spitting foam,49 cases(100%) with tachypnea,28 cases(57.1%) with lips cyanosis,26 cases(53.1%) with medium and moist rales,24 cases(49.0%) with dry rales,18 cases(36.7%) with phlegm whimper,29 cases(59.2%) with rough breath sounds in both lungs and there were 13 cases(26.5%) with conjunctivitis.Chest film and paper capacitor showed that bilateral extensive interstitial and(or) alveolar infiltration,over-inflation 23 cases(46.9%) had no lobal consolidation or pleural effusion.The WBC counts were normal or slightly high.All children were treated with cephalothin or penicillin before confirmation with CT infection.Eleven cases were treated with azithromycin after diagnosis with CT pneumonia and were cured 9 days after treatment and the others were not treated with azithromycin so their course prolonged from 15 to 44 days,among them there were 11 out-patients who were treated many times because of repeated cough.Conclusions CT is important pathogenic organism to cause pneumonia in neonatal and small infants.It is important to pay attention to the possibility of pneumonia caused by CT and make the diagnosis in early period as soon as possible and treat them with sensitive drug to shorten the course.
ABSTRACT
Objective To search for the reasons of high positive rate of amotile bacteria and the diagnosis of septicemia in new-born Methods The blood was drawn from the different site of the new-born with septicemia and carricd out blood culture. The drug sensitivity test had been done by the method of paper stripdiffusion. The plasmids of bacteria were extracted rapidly by medified Birnboim method and the plasmid analyss was carried out. The plasmids's DNA of 35 epidemic strain was cut off by both restriction enzyme of Hind Ⅲ and EcoR Ⅰ. The outer membrane protein (OMP) was determined by SDS-polyacrylamide gel electrophoresis.Results There are 51 patients with positive blood culture amotile bacterium,of them, pollution; 35 cases (68．6%), septicemia: only 16 cases (31．4%),54．8% (57/104) strains bacteria have drug resistance to more of 12 drugs. 87．3% (165/189) strains bacteria have plasmids. They are cut off as 6 DNA fragments (1．9,2,4,5, 8．5 and 18Kb) by Hind Ⅲ restrietion enzyme. and as 5 DNA fragments (2,2．6,3．2, 6．3 and 22 Kb) by EcoR Ⅰrestrietion enzyme, it is showed that they come from a same clone. The epidemic strain include 10 slips OMP, but non-epidemic strain have 11 slip OMP, increase a 25Kd belt. The amotile bacteria with above-mentioned plasmid spectrum, restriction enzyme spectrum and OMP spectrum are only seen in the air, therapeutic dish and syringe needle.Conclusion The pollution is an important reason of amotile bactorium high positiye rate in new-born.Diagnosing septicemia should depend on bacteria culture, plasmid analysis restriction enzyme analysis of plasmid DNA, oMP determination and combining medical history and clinical manifestation.
ABSTRACT
This paper reports 17 cases of hypomagnesemic convulsiens of the newhorn that were admitted from Se-Ptember 1981 to January 1983. Only 2 patients were breast-fed.Symptoms and signs of hypomagnesemia are indistinguishable from these of hypocalcemia unless the serum magne-sium is determ ined. Serum magnes iumlevels had been determined in 50 normal children. The average value-2 standard deviation=2.17-2?0.34=1.49mEq/L.We defined hypomagnesemia as the serum magnesium lcvels below 1.48mEg/L. The serum magnesium levels of 17 patients varied from 0.65 to 1.46m Eq/L. Of 10 cases serum calcium le-vel6mg/dl.2.5%MgSO_4 was given intraveno-usly by continuous infusion in a dose of 2-4ml/kg every 12 hours. After the convulsions had been controlled a dose of 25% MgSO_4 was given intramuscul-arly in a dose of 0.4ml/kg twice daily Convulsions usually ceased after 1--4doses of MgSO_4, but the serum magne-sium levels did not rise to normal le-vels until 2-6 days. The convulsions could not be controlled by repeated ad-ministrations of calcium gluconate in 5 patients who had both hypomagnes-emja and hypocalcemia. Only after theadministiation of MgSO_4 did the serum calicum levels rise to the normal level and the convulsions cease.Electrocardjograms recorded in 7 patients all were abnormal but 1 case,so we should pay attention to the inf-luence of magnesium upon the heart.