Comparison of clinical features and co-infection between pneumonia caused by influenza virus A and pneumonia caused by influenza virus B among children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the clinical features and co-infection between pneumonia caused by influenza virus A (IVA) and pneumonia caused by influenza virus B (IVB) among children.</p><p><b>METHODS</b>A total of 165 children with pneumonia caused by influenza virus (IV) were included in the study. These subjects were divided into IVA(n=71) and IVB pneumonia groups (n=94) according to the subtypes of IV. The IVA pneumonia group was further divided into simple infection (n=14) and co-infection subgroups (n=57), and the IVB pneumonia group was also further divided into simple infection (n=27) and co-infection subgroups (n=67). Co-infection rate and pathogen spectrum were analysed in children with IV pneumonia.</p><p><b>RESULTS</b>The IVB pneumonia group had significantly increased mean age of onset and significantly prolonged mean duration of fever compared with the IVA pneumonia group (P<0.05). Co-infection rate among children with IV pneumonia was 75.2%, who were co-infected with bacteria (44.2%), Mycoplasma pneumoniae (MP, 21.8%) and other viruses (45.5%). Respiratory syncytial virus (RSV) was most common in children co-infected viruses (89% ). The rate of co-infection with RSV was significantly higher in the IVA pneumonia group than in the IVB pneumonia group. There were no significant differences in age, length of hospital stay, duration of fever, percentage of neutrophils, prealbumin, C-reactive protein, alanine aminotransferase, and creatine kinase-MB between the simple infection and co-infection subgroups of each group.</p><p><b>CONCLUSIONS</b>Children with IVB pneumonia have prolonged duration of fever and increased age of onset compared with those with IVA pneumonia. Co-infection rate is high among children with IV pneumonia, who may be co-infected with bacteria, viruses and MP. Co-infection with RSV is more common in children with IVA pneumonia. It is difficult to identify the presense of co-infection using clinical indices.</p>

Clinical and laboratory features of pediatric acute myeloid leukemia with inversion of chromosome 16 / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical and laboratory features of pediatric inv(16) acute myeloid leukemia (AML) retrospectively.</p><p><b>METHOD</b>Dual color fluorescence in situ hybridization (D-FISH) using a LSI CBFβ inv(16) break apart probe labeled by Spectrum red and Spectrum green was performed in 15 acute myeloid leukemia cases, including 13 cases with or without abnormal eosinophils but with positive core binding factor β (CBFβ)-MYH11 fusion transcript detected by RT-PCR, and 2 cases with trisomy 8 (+8). The results were compared with the morphology, immunophenotype, karyotype and RT-PCR.</p><p><b>RESULT</b>Morphologically, 12 cases were diagnosed as M(4)EO, 2 as M(4), and 1 as M(2a). Immunophenotypically, all 13 AML cases with inv(16) showed positive expression of CD(13) and CD(33), but without the expression of any lymphoid lineage antigens. Karyotyping analysis with G-banding detected inv(16) in 10 AML cases, including 9 M(4)EO cases and 1 M(2a), but only 5 positive cases were detected using R-banding technique. Among them, 2 cases had simultaneous +8 and trisomy22 (+22), one had +22 only in addition to inv(16). D-FISH revealed a CBFβ-MYH11 rearrangement in 13 cases of AML with positive RT-PCR results, and the mean positive rate of cell detection was 55.15% (range 37.0% - 86.0%). The complete remission rate (CR) and median survival period in this series of inv(16) AML were 81.5%and 11 months, respectively, of whom, 8 cases were still in CR. Relapse and karyotypic evolution were seen in case 5 with +8, +22 in addition to inv(16).</p><p><b>CONCLUSION</b>AML with inv(16) is a special subtype. Most cases belong to M(4)EO. Its prognosis is good in general, but it seems to be an unfavorable feature for AML with inv(16) and +8, +22 simultaneously, especially with karyotypic evolution. For detection of inv(16), G-banding technique is evidently superior to R-banding technique. D-FISH combined with RT-PCR are more sensitive and reliable than chromosome banding analysis.</p>

Monitoring of influenza virus B and clinical features of pediatric pneumonia caused by influenza virus B only / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological features of influenza virus B (IVB) in the winter and the clinical features of pediatric pneumonia caused by IVB only.</p><p><b>METHODS</b>A retrospective study was performed on the clinical data of children with respiratory infection who received pathogen testing and therapy at Soochow University Affiliated Children's Hospital during the winters of 2008, 2009, 2010 and 2011.</p><p><b>RESULTS</b>The positive rates of influenza viruses A and B in the winters of 2008, 2009, and 2010 were 0.89%, 5.49%, and 6.24% respectively; the positive rate of influenza viruses A and B in the winter of 2011 was 8.72%, significantly higher than those in 2008-2010. The positive rates of IVB in the winters of 2008, 2009, and 2010 were 0%, 0%, and 0.21% respectively; the positive rate of IVB in the winter of 2011 was 5.36%, which was significantly higher than in the years 2008 to 2010. Pneumonia caused by IVB was confirmed in 94 children during the winter of 2011, including 27 cases of pneumonia caused by IVB only. Most of children with pneumonia caused by IVB only were aged over 6 months. The common symptoms in the 27 children caused by IVB only were fever (85%), runny nose (89%), and cough (100%). Wheezing (26%) and dyspnea (7%) were also seen in some cases. Among the 27 children, 19% showed abnormal white blood cell count, 30% showed increased C-reactive protein, 70% showed decreased prealbumin, and none showed visible organ dysfunction. No specific imaging findings were seen in the children with pneumonia caused by IVB only. However, many abnormal humoral and cellular immunological parameters were found in the majority of these children. The average length of hospital stay was approximately one week, there were no critical patients and the prognosis was good.</p><p><b>CONCLUSIONS</b>Influenza viruses were at a peak level in inpatient children in the winter of 2011. IVB infection rate was gradually increasing. In children with pneumonia caused by IVB only, there are few critical patients, the symptoms are nonspecific and the prognosis is good.</p>

Characteristics and the prevalence of respiratory viruses and the correlation with climatic factors of hospitalized children in Suzhou children's hospital / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the epidemiological characteristics of respiratory virus infection and its relations to climatic factors in Suzhou.</p><p><b>METHODS</b>From 2006 to 2009, viral etiology surveillance was conducted among 6655 children hospitalized with acute respiratory tract infections (ARIs). Direct immunofluorescence method was used to test respiratory secretion samples for respiratory syncytial virus (RSV), influenza viruses A and B (Inf-A, Inf-B), parainfluenza virus types I, II, and III (Pinf-I, Pinf-II, Pinf-III) and adenovirus. Samples were tested for human metapneumovirus (hMPV) with reverse transcription polymerase chain reaction (RT-PCR). Samples from Jan 2006 to Dec 2009 were also tested for human bocavirus (HBoV). Climatic factors, including mean temperature, relative humidity, rainfall amount, sum of sunshine and mean wind velocity were collected monthly. The relationship between activity of each virus and climatic factors were analyzed by linear regression and stepwise regression analysis.</p><p><b>RESULTS</b>From 2006 to 2009, in the total virus detection rate was 32.2% (2142/6655) in Suzhou. RSV was the most common virus and the average detection rate was 15.7% (1048/6655), followed by hMPV 8.9% (596/6655), HBoV 7.8% (148/1883), Pinf-III 2.7% (183/6655), Inf-A 2.4% (161/6655), ADV 1.3% (89/6655), Pinf-I 0.4% (29/6655), Inf-B 0.37% (25/6655) and Pinf-II 0.16% (11/6655). The positive rates of RSV, hMPV and ADV were significantly different in four years (χ(2) = 17.71, 33.23, 8.42, all P values < 0.05). Different virus has different epidemiological characteristics and distinct seasonality. The detection rate of RSV, hMPV, Inf-A were higher in Winter as 37.2%, 13.2%, 4.4%, respectively. ADV and Pinf-III were higher in summer as 2.3% and 4.6% respectively. The peak of HBoV existed in Autumn as 3.3%. The total virus detection rate showed significant inverse correlation with month average temperature (r = -0.732, P < 0.001) and a weak inverse correlation with average wind velocity was also found (r = -0.36, 0.01 < P < 0.05). The highest month total virus detection rate was from 47.6% to 84.4% when average temperature was from 3.2°C to 9.4°C and mean wind velocity was from 1.2 - 1.9 m/s. The associations of average temperature, sum of sunshine and wind velocity with RSV activity were statistical significant (r = -0.88, P < 0.001; r = -0.43, P < 0.01; r = -0.47, P < 0.01). The highest rate was from 24.3% to 58.2%, when mean temperature was from 5.3°C to 19.9°C, mean wind velocity was from 1.3 - 2.4 m/s and sum of sunshine was 61.0 to 153.4 hours. hMPV detection rate was inversely correlated with mean temperature and rain account (r = -0.43, P < 0.01; r = -0.29, P < 0.05). The rate was highest from 11.7% to 31.6% when mean temperature was from 5.3°C to 21.9°C and rain account was from 27.5 millimeter to 150.9 millimeter. Only mean temperature was positively correlated with Pinf-III (r = 0.53, P < 0.001). The rate was from 2.8% to 7.2% when mean temperature was between 11.9°C and 30.4°C. ADV detection rate was positively correlated with mean temperature and sum of sunshine, but negatively correlated with wind velocity (r = 0.35, P < 0.05; r = 0.30, P < 0.05; r = -0.32, P < 0.05). The rate was from 2.2% to 6.6% when mean temperature was between 15.9°C and 30.4°C, and sum of sunshine between 93 hours to 240.7 hours and mean wind velocity was from 1.1 - 2.8 m/s. Average temperature and relative humidity showed interactions on the detection rate of ADV (r = 0.36, P = 0.0093; r = -0.34, P = 0.016), but temperature showed higher effect on ADV detection rate. ADV detection rate was high at higher temperature (15.9 - 30.4°C) and low humidity (56% - 71%).</p><p><b>CONCLUSION</b>RSV was one of the most common viruses among hospitalized children in Suzhou, and hMPV and HBoV also played an important role in respiratory tract infection of children. Different virus has different cycle and seasonality. Climatic factors, especially mean temperature, was the main factor affecting the virus prevalence.</p>

Comparative studies on the composition and antibiotic-resistance of pathogenic bacteria between children with community-acquired and hospital-acquired pneumonia / 中华预防医学杂志

<p><b>OBJECTIVE</b>This research was to explore the difference between children with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in the composition and antibiotic-resistance of pathogenic bacteria.</p><p><b>METHODS</b>241 CAP and 116 HAP with positive sputum culture who were hospitalized from January to December in 2008 in Children's Hospital Affiliated to Suzhou University were selected in this study. The bacteria were identified by traditionally manual method and antibiotic sensitivity tests were performed by K-B method. The chi-square or Fisher's exact test were used for statistical test.</p><p><b>RESULTS</b>In 241 CAP, Streptococcus pneumoniae and haemophilus influenza accounted for (42.2%, 106/251) and (12.4%, 31/251) infection, respectively; however in 116 HAP, Enterobacteriaceae and Non-fermenters accounted for (88.2%, 127/144). In addition, methicillin-resistant Staphylococcus aureus weren't isolated, however, its detection rate was 66.7% in HAP. The drug resistance was 1.5 times higher in HAP than that in CAP for several types of antibiotics, such as ceftazidime (37.5% (6/16) vs 75.6% (31/41)), cefepime (37.5% (6/16) vs 78.0% (32/41)), aztreonam (50.0% (8/16) vs 90.2% (37/41)), cefoperazone/sulbactam (12.5% (2/16) vs 51.2% (21/41)) and piperacillin/tazobactam (12.5% (2/16) vs 56.0% (23/41)). Klebsiella pneumoniae isolated from HAP had higher drug resistance than that isolated from CAP against some antibiotics, for example, gentamicin (0 vs 63.6% (7/11)), SMZ + TMP (20.0% (1/5) vs 63.6% (7/11)) and cefoperazone/sulbactam (0 vs 54.5% (6/11)). We also found Enterobacter cloacae isolated from HAP showed high drug resistance than that isolated from CAP against imipenem (0 vs 46.7% (7/15)), aztreonam (9.1% (1/11) vs 60.0% (9/15)) and cefoperazone (18.2% (2/11) vs 80.0% (12/15)) and Pseudomonas aeruginosa from HAP had higher resistance than that from CAP against gentamicin (0 vs 50.0% (9/18)), amikacin (0 vs 38.9% (7/18)), ceftazidime (0 vs 55.6% (10/18)), cefepime (0 vs 50.0% (9/18)) and cefoperazone (33.3% (2/6) vs 94.4% (17/18)). The detection rates of ESBLs for Escherichia coli were 84.6% (11/13) and 93.3% (14/15) in CAP and HAP, respectively (χ(2) = 0.553, P > 0.05); while for Klebsiella pneumoniae, they were 81.3% (13/16) and 95.1% (39/41), respectively (χ(2) = 2.767, P > 0.05).</p><p><b>CONCLUSION</b>CAP was mainly comprised of Streptococcus pneumoniae and haemophilus influenza; while HAP was mainly comprised of Enterobacteriaceae and Non-fermenters. The drug resistance of gram-negative bacilli was higher in HAP than that in CAP.</p>

Characteristics of human metapneumovirus respiratory tract infection in children and the relationship between the infection and meteorological conditions / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the epidemiology of human metapneumovirus (hMPV) infection in children and its relations with meteorological conditions in Suzhou.</p><p><b>METHOD</b>Samples obtained from 6655 children hospitalized with acute respiratory tract infections (ARIs) during the period from 2006 to 2009, were tested for virus pathogens. Nasopharyngeal aspirates were obtained from the children according to a standard protocol and were tested for respiratory syncytial virus (RSV), influenza viruses (IFV) A and B, parainfluenza virus (PIV) types 1, 2, and 3 and adenovirus (ADV) with direct immunofluorescence assay. Samples were tested for hMPV with reverse transcription polymerase chain reaction (RT-PCR). Meteorological conditions including mean temperature, relative humidity, rainfall amount, sum of sunshine and mean wind velocity were collected monthly. The relationship between activity of the virus and meteorological conditions was analyzed by linear regression and stepwise regression analysis.</p><p><b>RESULT</b>Viral pathogens were identified in 32.2% of 6655 specimens. The positive rate of hMPV was 8.9%, RSV was 15.7%, IFV, PIV and ADV detection rates were less than that of hMPV. The annual positive rate of hMPV from 2006 to 2009 was 8.2%, 8.1%, 12.7%, 7.4% respectively (χ(2) = 33.23, P < 0.05). The hMPV positive rate of the four seasons was 11.6%, 7.6%, 4.7% and 11.7%, respectively, detection rate in winter and spring was significantly higher than those in summer and autumn (χ(2) = 74.67, P < 0.001). The positive rate of hMPV and the monthly mean temperature was moderately correlated (r = -0.43), and the monthly average rainfall (r = -0.29), monthly mean relative humidity (r = -0.27), monthly average sunshine duration (r = -0.11), the monthly average wind speed (r = -0.13) had low correlations.</p><p><b>CONCLUSION</b>hMPV was the second most common viral pathogen of acute respiratory tract infection in children in Suzhou, which prevailed predominantly in the winter and spring. Climatic factors, especially temperature and rainfall may affect the prevalence of hMPV.</p>

Chest imaging findings in children with influenza A [H1N1]

To assess imaging findings at presentation in children diagnosed with influenza A [H1N1] infection. This is a retrospective observational cohort study conducted at The Children's Hospital affiliated to Soochow University, Suzhou, China between September 2009 and March 2010. Nasopharyngeal swabs and bronchial aspirate samples from 81 children with acute respiratory infections were tested positive for influenza A [H1N1] using quantitative real-time polymerase chain reaction. Chest imaging for these patients was analyzed retrospectively by 2 independent radiologists for the presence and distribution of abnormalities. Chest radiograph findings consisted of bilateral patchy areas of consolidation [n=48], diffuse areas of air-space consolidation [n=18], and lobar consolidation [n=7]. Eight chest x-rays were normal. Abnormalities were observed more frequently in the lower lobes [bilateral [n=66], unilateral [n=7]]. Computed tomography [CT] scans were performed in 18 cases with air-space consolidation and interstitial opacities. Cases with diffuse areas of airspace consolidation were followed-up after 3 months by high resolution CT imaging, which showed interstitial thickening. The predominant imaging findings in childhood influenza A [H1N1] were bilateral patchy areas of consolidation, followed by diffuse areas of airspace consolidation, normal radiographs, and lobar consolidation

Effects of amino acid substitutions of penicillin-binding proteins 2B, 1A, 2X on minimal inhibitory concentration of beta-lactams against Streptococcus pneumoniae / 中华儿科杂志

<p><b>OBJECTIVE</b>To observe the effect of amino acid substitution in conserved sequence of penicillin-binding protein (PBP) 1A, 2B, 2X on antimicrobial activity of beta-lactams against Streptococcus pneumoniae (SP).</p><p><b>METHOD</b>Minimal inhibitory concentration (MIC) of 6 beta-lactams was determined by the E-test in 59 SP strains. The penicillin-binding protein genes pbp1a, 2b, 2x in every SP strain were amplified by nested-polymerase chain reaction (nPCR), then the PCR products were sequenced using automatic genetic analyzer directly. To analyze the amino acid substitutions, the DNA sequences were converted to protein sequences and aligned by Clustalx software. According to amino acid substitution in conserved sequence of PBP2B, 3 phenotypes were observed, including: PBP2B phenotype I (no amino acid substitution); PBP2B phenotype II (Glutamine 432-->Leucine and/or Threonine 445/451-->Alanine/Serine, Glutamic 481-->Glycine, 1 strain had proline insertion between residues 431/432); PBP2B phenotype III (Alanine 624-->Glycine with the addition of phenotype II). According to amino acid substitution in conserved sequence of PBP1A, 3 phenotypes were observed, including: PBP1A phenotype I (no amino acid substitution); PBP1A phenotype II (Threonine 574-->Asparagine, Serine 575-->Threonine, Glutamine 576-->Glycine, Phenylalanine 577-->Tyrosine, 574TSQF-->NTGY); PBP1A III (Threonine 371-->Alanine/Serine, Proline 432-->Threonine with the addition of 574TSQF-->NTGY). According to amino acid substitution in conserved sequence of PBP2X, 4 phenotypes were observed, including: PBP2X phenotype I (no amino acid substitution); PBP2X phenotype II (Histidine 394-->Leucine or Threonine 338-->Alanine); PBP2X phenotype III (Threonine 338-->Alanine, Isoleucine 371-->Threonine, Arginine 384-->Glycine and Leucine 546-->Valine); PBP2X phenotype IV (Methionine 339-->Phenylalanine, Methionine 400-->Threonine with the addition of PBP2X phenotype III).</p><p><b>RESULT</b>Among 59 SP strains antibacterial activities distribution (sensitive strains, intermediate strains and resistant strains) of 6 beta-lactams were penicillin (12, 29, 18); amoxicillin(49, 9, 1); cefuroxime (16, 16, 27); ceftriaxone (47, 1, 11); cefotaxime (47, 3, 9); imipenem (49, 10, 0). beta-lactam antibiotics insensitive strains (intermediate + resistant strain) in PBP2B phenotype III, PBP1A phenotype III, PBP2X phenotype III and IV were significantly increased, the MIC(50) of these strains were significantly higher than that of the others.</p><p><b>CONCLUSION</b>The amino acid substitutions in or vicinal conserved sequence of PBP of SP increase MIC for beta-lactam antibiotics.</p>

Prevalence and clinical features of human metapneumovirus infection in hospitalized pediatric patients with respiratory tract infection in Suzhou area / 中华儿科杂志

<p><b>OBJECTIVE</b>To determine whether human metapneumovirus (hMPV) was circulating in Suzhou area and the epidemiology and clinical features associated with hMPV infection.</p><p><b>METHOD</b>Samples were collected from January 2006 to December 2007; respiratory specimens were tested for the presence of hMPV by reverse-transcription polymerase Chain reaction (RT-PCR). PCR products of hMPV N gene from some patients were randomly selected for sequencing analysis, and the sequences of the nucleotides and deduced amino acids were compared with those in the GenBank.</p><p><b>RESULT</b>Of the 4702 patients screened, 8% had evidence of hMPV infection. The positive rate in 2006 and 2007 was 8.4% and 7.6%, respectively. The positive rates detected during January to March, November and December were higher. The median age of patients was 22. 56 months. The infected children were diagnosed as having upper respiratory tract infection (3.2%), laryngitis (2.1%), bronchiolitis (27.1%), pneumonia (55.9%), and asthma exacerbation (11.7%). Sequence analysis of these hMPV N genes showed 99%-100% homology with the registered sequence in GenBank.</p><p><b>CONCLUSION</b>(1) hMPV accounted for a significant proportion of respiratory tract infection in infants and children. (2) hMPV prevailed predominantly in the winter and spring time. (3) Clinically, hMPV infection can not be discriminated from the infection with other respiratory tract viruses.</p>

Viral pathogens of acute respiratory infection in hospitalized children from Suzhou / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the viral pathogens of acute respiratory infection (ARI) in hospitalized children from Suzhou of China.</p><p><b>METHODS</b>The nasopharyngeal aspirate samples were obtained from 1,668 hospitalized children with ARI. Common respiratory viruses, including respiratory syncytial virus (RSV), influenza virus A and B, parainfluenza viruses 1, 2 and 3 and adenovirus, were detected using direct immunofluorescence. Human metapneumovirus (hMPV) gene fragments were detected by RT-PCR.</p><p><b>RESULTS</b>Viral agents were identified in 597 cases (35.8%). RSV was the most frequent (17.6%). RSV infection is more common in children less than 1 year old. A highest detection rate of RSV was found during winter and spring. hMPV was detected in 10.6% of the cases, with a peak detection rate between March and May. Single viral infection was found in 561 cases (33.6%) and mixed viral infection in 36 cases (including 27 cases at age of less than 1 year). RSV and hMPV co-infection was common (n=22).</p><p><b>CONCLUSIONS</b>RSV is common pathogen of ARI in children from Suzhou. RSV viral activity peaks during winter and spring. The children at age of less than 1 year are susceptible to RSV. hMPV is also an important pathogen of ARI, with a peak detection rate between March and May. Mixed viral infection is common in children less than 1 year old.</p>

Etiology of pneumonia in hospitalized patients less than 3 years of age / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To understand the etiology of pneumonia in hospitalized patients less than 3 years of age.</p><p><b>METHODS</b>A total of 316 children with pneumonia admitted to the Children's Hospital of Suzhou University in Jiangsu Province from March, 2006 to January, 2007 were enrolled in this study. Sputum samples were obtained by deep nasotracheal aspiration technique for bacterial and viral cultures.</p><p><b>RESULTS</b>Of the 316 samples, specific microbial etiology was obtained in 192 cases (60.8%). Bacterial infection was found in 162 cases (51.3 %), viral infection in 19 cases (6.3%)and compound infection with virus and bacteria in 11 cases (3.5 %). Haemophilus influenzae was the most common agent (46 cases; 14.6%) in bacterial infection, followed by Streptococcus pneumoniae (32 cases; 10.1%). Respiratory syncycial virus (RSV) was the most common agent (12 cases; 4.0%) in viral infection, followed by adenovirus (11 cases; 3.6%).</p><p><b>CONCLUSIONS</b>Bacterial infection was a leading cause of pneumonia in children less than 3 years of age in Suzhou area. Haemophilus influenzae was the most common agent, followed by Streptococcus pneumoniae.</p>

Epidemiological study on respiratory syncytial virus and its bronchopneumonia among children in Suzhou / 中华预防医学杂志

<p><b>OBJECTIVE</b>To probe the epidemiological trend of respiratory syncytial virus (RSV) and cellular immunological change of RSV bronchopneumonia among children in Suzhou in the past five years.</p><p><b>METHODS</b>10,205 children with acute respiratory tract infection from January 2001 to December 2005 were enrolled into the study. Nasopharyngeal aspirates were obtained from the respiratory tract by aseptic vacuum aspiration. Direct immuno-fluorescence assay was employed to detect seven kinds of virus antigens including RSV antigen. CD3, CD4, CD8, CD19, CD16 and CD56 in peripheral blood mononuclear cells of 30 patients with RSV bronchopneumonia (1.5-24.0 months old group) were analyzed by flow cytometry analysis, and 15 normal infants (1.5-24.0 months old group) were enrolled as control group.</p><p><b>RESULTS</b>The annual positive rate of RSV was 24.94%, 25.83%, 24.05%, 25.39% and 27.30% respectively from 2001 to 2005. It also found that the peak season for RSV infection was spring or winter (January to March or November to December). The positive rate of RSV was significantly higher in 1-12 months old group than that in > 12 months old group (chi2 = 97.320, P < 0.01), as well as the groups between 1-12 months old (chi2 = 7.804, P < 0.05, the highest positive rate was occurred at 3-6 months old group). The positive rate of RSV was significantly higher in boys than that in girls (chi2 = 9.693, P < 0.01). The percentages of CD3+, CD4+, CD8+ and NK (CD16 + 56)+ cells were significantly lower in RSV bronchopneumonia than those in control group (t = 3.199, P < 0.01; t = 2.215, P < 0.05; t = 2.619, P < 0.05 and t = 5.240, P < 0.01, respectively). While the percentage of CD19+ cells was significantly elevated in RSV bronchopneumonia than that in control group (t = 2.875, P < 0.01).</p><p><b>CONCLUSION</b>RSV infection is of obvious seasonal changes. The younger the patient, the higher positive rates of RSV infection is, while and the cellular immunity function is lower. The effective measures for preventing RSV infection are important, especially for the infants. Further investigation is necessary to understand the causes of the variations for RSV infections between boys and girls.</p>

Study on the molecule epidemiological between resistances of 7 genes interrelated 4 antibiotic to isolated Streptococcus pneumoniae in children / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the molecule epidemic for 7 genes interrelated penicillin, erythromycin, tetracycline, vancomycin resistance of isolated Streptococcus pneumoniae (SP) in children at Suzhou area.</p><p><b>METHODS</b>(1) Thirty-one pneumococcal isolates were collected from respiratory tract secretions of children with respiratory diseases from Nov 2002 to Apr 2003 at the Children's Hospital of Suzhou University (reference strain ATCC49619). (2) Penicillin susceptibility was determined by E-test, while erythromycin, tetracycline, vancomycin were determined by K-B disk. (3) The detecting of pbp2B, ermA/B, mefA, tetM, vanA, vanB genes by PCR, Sequencing pbp2B genes, Contrasting pbp2B DNA sequences among pneumococcal isolates and SP R6 [penicillin sensitive (www.ncbi.nlm.gov/nucleotide, NC-003098)].</p><p><b>RESULTS</b>Of thirty-one isolates studied, the results were shown as follows; (1) Penicillin sensibility 38.7% (n = 12), penicillin resistance 61.3% (n = 19), pbp2B mutation 64.5% (n = 20); (2) Erythromycin sensibility 9.7% (n = 3), erythromycin resistance 90.3% (n = 28), ermA/B 71% (n = 22), mefA 32.1% (n = 10), ermA/B + mefA 87.1% (n = 27); (3) Tetracycline sensibility 9.7% (n = 3), tetracycline resistance 90.3% (n = 28), tetM 90.3% (n = 28); (4) Vancomycin sensibility 100% (n = 31), vanA, vanB all 0%.</p><p><b>CONCLUSION</b>Among pneumococcal isolates at our area, penicillin, erythromycin, tetracycline resistance were high, vancomycin was sensitive. Detecting 7 genes interrelated penicillin, erythromycin, tetracycline, vancomycin resistance expressed genotypies for antibiotic resistances in pneumococcal isolates.</p>

Relation of pbp2B, ermB, ermA/B, mefA genes with resistance to penicillin and erythromycin among Streptococcus pneumoniae isolates from children / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the relation of pbp2B, ermB, ermA/B and mefA genes to penicillin and erythromycin resistance among isolated Streptococcus pneumoniae (Sp) in children.</p><p><b>METHODS</b>Twenty-six strains of Sp were collected from September 2002 to April 2003 at the Children Hospital of Suzhou University. (1) Twenty-six pneumococcal isolates were obtained from respiratory tract secretions of children with respiratory diseases. (2) Susceptibility of the isolates to penicillin, cefuroxime, ceftriaxone, cefotaxime and erythromycin was determined by E-test. (3) The genes pbp2B, ermB, ermA/B and mefA of the isolates were detected with PCR. (4) The PCR product of pbp2B gene was sequenced. (5) DNA sequences of pbp2B of pneumococcal isolates were compared with those of SpR6 [penicillin sensitive (www.ncbi.nlm.gov/nucleotide, NC-003098)].</p><p><b>RESULTS</b>Among the 26 isolates studied, pbp2B gene mutation was found in 15(58%) isolates, all were point mutation of A, B, C and D genotypes which were seen in 11(73%), 2(13%), 1(7%) and 1(7%), respectively. The numbers of isolates susceptible to penicillin, cefuroxime, ceftriaxone and cefotaxime were 9(82%), 10(91%), 11(100%) and 11(100%), of 11 non-mutation isolates;numbers of isolates resistant to penicillin, cefuroxime, ceftriaxone, and cefotaxime were 13(87%), 11(73%), 1(7%) and 1(7%) out of 15 isolates with mutation.ErmB, ermA/B, mefA and erm/mef genes were positive in 9(35%), 16(62%), 7(27%) and 21(81%)isolates. MIC of erythromycin was 2 to > 256 mg/L among pneumococcal isolates with erm/mef genes.</p><p><b>CONCLUSION</b>Among antibiotic resistant pneumococcal isolates in the area, the main basis of penicillin resistance was the mutation of pbp2B genes. Genotype A mutation had the highest rate among the isolates with mutation and manifested as resistance to penicillin and cefuroxime. Expression of either all or any of the ermA, ermB and mef genes led to erythromycin resistance. Antibiotics resistant Sp strains in this area are forming a challenge to efficacy of penicillin and erythromycin.</p>

Study on the molecular epidemiology of beta-lactamase TEM gene in isolated Streptococcus pneumoniae / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the beta-lactamase TEM gene of isolated Streptococcus pneumoniae (Sp) in Suzhou area.</p><p><b>METHODS</b>Twenty-three strains of Sp were collected from respiratory tract secretions of children with respiratory diseases in Nov 2002 to Apr 2003 at Children's Hospital of Suzhou University (reference strain ATCC49619) to build TEM polymerase chain reaction (PCR) system (reference strain E. coli. 9-j53R1 with TEM gene) TEM gene of 23 strains was detected to comparo the sequences with published TEM gene sequences in GenBank for analyzing TEM gene model.</p><p><b>RESULTS</b>Twenty-one strains had TEM gene with a positive rate of 91.3% (21/23). TEM-129 gene were confirmed from No.17 (SR017, penicillin resistance) TEM sequence. New discovered TEM-129 sequence had a modification (ATG[M]-->ATA[I]) at No.182 code and published (GenBank: www.ncbi.nlm.nih.gov/nucleotide, AY452662). TEM-1 genes were confirmed from other TEM sequences. New discovered TEM-1 gene of isolated Sp had been published (GenBank: www.ncbi.nlm.nih.gov/nucleotide, AY392531) too.</p><p><b>CONCLUSION</b>Isolated Sp had TEM gene (TEM-129, EM-1 genotype) with a positive rate of 91.3%. The result enriched the understanding of isolated Sp with penicillin resistance.</p>