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Objective:To analyze the cause and epidemiological characteristics of an outbreak of cutaneous anthrax in Caoxian County, Heze City, Shandong Province, and to provide scientific basis for anthrax prevention and control.Methods:Using on-site epidemiological investigation methods and the "Anthrax Epidemiological Case Investigation Form", case investigations were conducted based on the epidemiological contact history and close contacts of suspected anthrax cases reported by the national health care system ( n = 83). Scorched skin smears, diseased cattle tissues, soil samples from the slaughter site and smears from slaughter utensils were collected from cases for Real-time PCR testing and pathogenic bacteria isolation and culture, respectively. Anthrax determination criteria were carried out with reference to "Anthrax Diagnosis" (WS 283-2020). Results:A total of 13 cases of cutaneous anthrax were found in this outbreak, including 12 clinically diagnosed cases and one confirmed case (positive Real-time PCR test and isolation of a strain of Bacillus anthracis). The epidemiological investigation determined that the source of infection in this outbreak was diseased cattle, the transmission route was through slaughter of diseased cattle, contact with contaminated utensils and related cattle products, and the patients were mainly engaged in occupations related to cattle slaughter or cattle product collection and sale. A total of 84 samples were collected, including 13 skin scabs, 64 environmental samples and 7 beef samples. Thirty-six positive PCR tests were performed, with a positive rate of 42.86% (36/84). Among them, 100.00% (13/13) were positive for skin scab smear specimens, 29.69% (19/64) for environmental samples and 4/7 for beef samples. A total of 8 strains of Bacillus anthracis were isolated, including 6 environmental specimens, 1 suspected case and 1 beef strain, with an overall detection rate of 9.52% (8/84). Eighty-three close contacts were investigated. Thirteen households involved in the epidemic were disinfected by spraying (200 ml/m 2) with chlorine-containing disinfectant (5 000 mg/L), and a total of 40 households involved in the epidemic were disinfected, covering an area of about 10 765 m 2. Forty-five pieces of suspected contaminated clothing were burned and disposed of, and 152 pieces of kitchenware were soaked. Conclusions:Slaughter of infected cattle, contact with contaminated utensils and related cattle products are the main causes of this skin anthrax outbreak. Strengthening market supervision, deepening inter-animal epidemic prevention, carrying out publicity and education on anthrax prevention and control, and enhancing practitioners' awareness of disease prevention is the key to prevent anthrax from occurring.
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Objective:To learn about the epidemiological and spatial clustering characteristics of brucellosis in Shandong Province, and to provide a reference for scientific prevention and control of brucellosis.Methods:The epidemic data of human brucellosis in Shandong Province from January 2015 to December 2020 were collected from the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System, and the data were analyzed by descriptive epidemiology and spatial clustering analysis.Results:A total of 18 811 cases of human brucellosis were reported in Shandong Province from 2015 to 2020, and the average annual incidence rate was 3.16/100 000. Human brucellosis occurred in every month of the year, and the peak incidence was from March to August, accounting for 66.31% (12 474/18 811). The top 5 counties (districts) with average annual incidence rates were Lijin County (32.39/100 000), Kenli District (11.02/100 000), Wudi County (10.35/100 000), Zhanhua District (9.59/100 000) and Shanghe County (8.80/100 000). There were 13 436 males and 5 375 females, with a male-female sex ratio of 2.50 ∶ 1.00; the age was mainly concentrated in 30-69 years old, accounting for 83.23% (15 656/18 811); farmer was the main occupation, accounting for 85.82% (16 144/18 811). The results of global spatial autocorrelation analysis showed that the annual incidence rates of brucellosis in Shandong Province showed a spatial clustering distribution from 2015 to 2020; and the local spatial autocorrelation analysis showed that the high incidence of human brucellosis was mainly concentrated in the north of Shandong Province.Conclusions:The incidence of brucellosis in Shandong Province is mainly concentrated in spring and summer, most of them are farmers, and the high incidence areas have spatial clustering. Key prevention and control measures should be taken for high incidence seasons, high-risk population and northern high clustering areas to reduce the incidence of brucellosis.
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Objective:To study the epidemiological characteristics and spatio-temporal aggregation of hemorrhagic fever with renal syndrome (HFRS) in Shandong Province, and to provide reference for formulating reasonable prevention and control strategies.Methods:Retrospective analysis was used to collect HFRS surveillance data and confirmed case data in Shandong Province from 2017 to 2020 in the "China Disease Prevention and Control Information System Infectious Disease Surveillance System". Geoda 1.18 software was used for global and local spatial autocorrelation analysis, SaTScan 9.6 software was used for spatio-temporal scanning analysis, and ArcGis 10.7 software was used for map drawing and visual display.Results:A total of 3 753 cases of HFRS were reported in Shandong Province from 2017 to 2020, including 56 deaths. The annual incidence rate was 1.26/100 000, 1.22/100 000, 0.75/100 000 and 0.53/100 000, respectively, with an average annual incidence rate of 0.94/100 000. The incidence of HFRS was obviously seasonal, mainly concentrated in autumn and winter from October to December, accounting for 50.41% (1 892/3 753). The age of onset was mainly 30-59 years old, accounting for 61.68% (2 315/3 753). The male to female ratio was 2.76 ∶ 1.00 (2 756 ∶ 997). The occupation distribution was mainly farmers, accounting for 81.99% (3 077/3 753). The global spatial autocorrelation analysis showed that HFRS showed spatial aggregation areas in each year from 2017 to 2020 (Moran' I = 0.38, 0.33, 0.59, 0.46, Z = 7.47, 7.23, 10.69, 8.66, P < 0.001). The local spatial autocorrelation analysis showed that "high-high" aggregation areas were mainly concentrated in central and southeast of Shandong Province, while "low-low" aggregation areas were mainly concentrated in northwest of Shandong Province. Spatio-temporal scanning analysis revealed 1 type Ⅰ agglomerations and 2 type Ⅱ aggregation areas. The type Ⅰ aggregation areas occurred from October to November 2018, covering 22 counties (districts) of 5 cities in Qingdao, Yantai, Weifang, Weihai and Rizhao. The first type Ⅱ aggregation area occurred from October to November 2017, involving 23 counties (districts) of 8 cities in Jinan, Zibo, Zaozhuang, Weifang, Jining, Tai 'an, Rizhao and Linyi. The second type Ⅱ aggregation area occurred in Jinxiang County, Jining City from February to March 2017. Conclusion:The incidence of HFRS in Shandong Province from 2017 to 2020 has obvious spatio-temporal aggregation, and the hot spots are concentrated in central and southeast of Shandong Province, which should be regarded as a key area for prevention and control of HFRS.
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Objective@#To analyze the antimicrobial resistance and multilocus sequence typing (MLST) results of extended-spectrum β-lactamase (ESBLs)-producing Escherichia coli in rural residents in villages with pig breeding farms in a county of Shandong province.@*Methods@#Antimicrobial susceptibility testing was performed with agar dilution method by using 360 ESBLs-producing E. coli strains from fresh stool samples of rural residents in villages with pig breeding farms in a county of Shandong. PCR was conducted to amplify the CTX-M, TEM, SHV genes and capillary electrophoresis was used to screen positive strains in July, 2016. MLST was performed for molecular typing analysis, and eBURST v3.0 software was used for cluster analysis.@*Results@#Among 360 strains of ESBLs-producing E. coli, the resistance rates to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and florfenicol were 100.0% (360/360), 82.2% (296/360), 81.1% (292/360) and 80.3% (289/360), respectively. The positive rate of CTX-M gene was 99.2% (357/360), in which the positive rate of CTX-M-9 was 35.6% (128/360) and the positive rate of CTX-M-1 was 24.4% (88/360). The positive rate of TEM gene was 26.9% (97/360). A total of 132 STs were identified through MLST. The predominant ST was ST10, accounting for 12.5% (45/360). Cluster analysis showed that CC10 was the most important clone group, including 39 ST clones, involving 148 strains (41.1%).@*Conclusions@#The drug resistances of ESBLs-producing E. coli to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and flurfenicol are serious in this rural area. There is a small-scale clustering of CC10 and transmission mode from animals to humans might exist.
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Objective@#To understand the infection status, characteristics and drug resistance of non-O157 Shiga toxin-producing E. coli (STEC) in animal feces in Shandong Province.@*Methods@#From 2015 to 2016, convient sampling method was used to collect 1 022 fresh feces of animals in Weishan county and Laizhou city, and 24 non-O157 STEC were isolated. The serotypes of non-O157 STEC strains were confirmed through serum agglutination test. The susceptibility was explored through the antimicrobial sensitivity experiments. ESBLs activity was confirmed by double-disc diffusion. PCR method was used to detect the resistance genes. PFGE typing was operated to assess the relatedness and variability of the strains. The multi-locus sequence typing (MLST) was adopted to get the allelic profile and ST sequence of strains. Analysis was made on the evolutionary relationship between different ST groups was made through CLC Sequence Viewer and Counting Express.@*Results@#A total of 24 non-O157 STEC were isolated from animal feces. 23 strains were from pig feces, and 1 strain was from cow feces, and the serotypes were more dispersed. All of the 24 strains carried stx2 genes. The highest resistance rate was sulfamethoxazole(22 strains), the mount of cotrimoxazole and nalidixic acid was 18 strains, chloramphenicol was 13 strains, tetracycline was 19, and there was a phenomenon of multiple drug resistance. The drug resistance spectrum was sulfamethoxazole tetracycline-compound novammin-naphthidine-chloramphenicol. All strains were sensitive to cefepime and imipenem. The ESBLs confirmatory test showed that 4 strains of non O157 STEC produced beta lactamase. PCR detected 7 resistance genes, and 4 tetracycline resistance genes (Tet A, Tet B, tetC and tetD) were detected. The beta lactamase resistance genes (blaSHV-1, bla CTX-M, bla TEM) were all negative. 24 strains were divided into 15 PFGE types, and their clustering results were more dispersed and no dominant PFGE type. There were 11 kinds of MLST types, most of them are ST540 and ST5133 types, each of which was 4 strains, and clustered into 1 MLST genomes.@*Conclusion@#The serotypes of non-O157 STEC in animal feces O157 STEC were dispersed, and the resistant rate to common antibiotic was high. MLST typing results presents obvious polymorphism. Surveillance and manage ment of these strains should be strengthened.
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Human papillomavirus (HPV) is an infection that can be sexually transmitted and result in health consequences. Persistent high-risk HPV infection can lead to various cancers and is the essential cause of cervical cancer. HPV vaccine can prevent the HPV infection and thus the incidence of cervical cancer. In this review we introduced the prevalence of HPV infection and vaccination, and the prevention and early detection of cervical cancer. We also introduced the present knowledge and awareness of HPV infection and HPV vaccine in Chinese. Propaganda all over China should be performed on HPV vaccination to improve the vaccination rate, thus preventing the incidence of cervical cancer.
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Objective@#To determine the serotypes and drug resistance profiles of Shiga toxin-producing Escherichia coli (STEC) in animal stools from the Weishan area in Shandong Province, China. To provide the basis for further study.@*Methods@#Five hundred animal stool samples (from pigs, cattle, sheep, dogs and birds) were collected from the Weishan area and STEC strains were isolated from these samples. Strains were serotyped by a serum agglutination test, and their drug resistance profiles were determined through antimicrobial sensitivity experiments. In this study, PCR was used to detect tetracycline resistance genes (tetA, tetB, tetC, tetD) and beta-lactam resistance genes (blaSHV-1, blaCTX-M, blaTEM).@*Results@#Sixteen strains of STEC were isolated from animal stool samples. Thirteen strains were isolated from pig stool samples, two from bovine stool samples and one from a sheep stool sample. Two of the strains were identified as E. coli O157:H7, and other 14 strains were non-O157 STEC of different serotypes. Antimicrobial sensitivity experiments showed that 15 of the strains were multidrug resistant. The rates of resistance were as follows: nalidixic acid (12/16 strains), sulfisoxazole (11/16), trimethoprim and sulphame-thoxazole (11/16), doxycycline (9/16), azithromycin (9/16), tetracycline (9/16), chloramphenicol (8/16) and streptomycin (8/16). Therefore, nalidixic acid showed the highest rate of resistance among the strains, followed by trimethoprim and sulphame-thoxazole, and sulfisoxazole. Resistance to cefepime or imipenem was not detected. In total, three types of drug resistance genes (tetA, tetB and tetC) were detected among the 16 strains.@*Conclusion@#The results showed that STEC strains isolated from animals in the Weishan area were of a range of serotypes. The 16 strains of STEC isolated from animal stools in this area were resistant to a number of antibiotics, with many strains displaying multidrug resistance.
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Objective To discuss the spatial-temporal distribution and epidemic trends of autumn-winter type scrub typhus in Shandong province,and provide scientific evidence for further study for the prevention and control of the disease.Methods The scrub typhus surveillance data during 2006-2014 were collected from Shandong Disease Reporting Information System.The data was analyzed by using software ArcGIS 9.3 (ESRI Inc.,Redlands,CA,USA),GeoDa 0.9.5-i and SatScan 9.1.1.The Moran' s I,log-likelihood ratio (LLR),relative risk (RR) were calculated and the incidence choropleth maps,local indicators of spatial autocorrelation cluster maps and space scaning cluster maps were drawn.Results A total of 4 453 scrub typhus cases were reported during 2006-2014,and the annual incidence increased with year.Among the 17 prefectures (municipality) in Shandong,13 were affected by scrub typhus.The global Moran' s I index was 0.501 5 (P＜0.01).The differences in local Moran' s I index among 16 prefectures were significant (P＜0.01).The "high-high" clustering areas were mainly Wulian county,Lanshan district and Juxian county of Rizhao,Xintai county of Tai' an,Gangcheng and Laicheng districts of Laiwu,Yiyuan county of Zibo and Mengyin county of Linyi.Spatial scan analysis showed that an eastward moving trend of high-risk clusters and two new high-risk clusters were found in Zaozhuang in 2014.The centers of the most likely clusters were in the south central mountainous areas during 2006-2010 and in 2012,eastem hilly areas in 2011,2013 and 2014,and the size of the clusters expanded in 2008,2011,2013 and 2014.One spatial-temporal cluster was detected from October 1,2014 to November 30,2014,the center of the cluster was in Rizhao and the radius was 222.34 kilometers.Conclusion A positive spatial correlation and spatial agglomerations were found in the distribution of autumn-winter type scrub typhus in Shandong.Since 2006,the epidemic area of the disease has expanded and the number of high-risk areas has increased.Moreover,the eastward moving and periodically expanding trends of high-risk clusters were detected.
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Objective To study the molecular-biologic characteristics and epidemiological status of iatrogenic related Community-acquired methicillin-resistant Staphylococcus (S.) aureus (CA-MRSA) in China through Meta-analysis.Methods Data through systematic searching for peer-reviewed articles published before December 3rd,2015 from 4 main electronic databases including China National Knowledge Infrastructure (CNKI),Wanfang Data,PubMed and Web of Science Core Collection was collected,for this Meta-analysis.PRISMA guidelines were followed and the proportion of MRSA,CA-MRSA,hospital-acquired MRSA (HA-MRSA) and panton-valentine leucocidin (PVL) gene in certain populations were quantitatively analyzed by Stata 13.0 software.Results Average proportion of CA-MRSA from S.aureus was 12％ (95％CI:8％-16％).CA-MRSA in MRSA was 18％ (95％CI:12％-24％).42.1％ (95％CI:20.4％-63.7％) of the CA-MRSA carried a PVL gene,and the number was higher than general MRSA (t =-2.99,P=0.011).Conclusion CA-MRSA was in lower proportion than HA-MRSA,both seen in general MRSA and in S.aureu.s,but under higher proportion of carrying the PVL gene.Transmission of CA-MRSA could be prevented within the general population through conducting effective surveillances and preventive programs.
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Objective To discuss the spatial-temporal distribution and epidemic trends of autumn-winter type scrub typhus in Shandong province,and provide scientific evidence for further study for the prevention and control of the disease.Methods The scrub typhus surveillance data during 2006-2014 were collected from Shandong Disease Reporting Information System.The data was analyzed by using software ArcGIS 9.3 (ESRI Inc.,Redlands,CA,USA),GeoDa 0.9.5-i and SatScan 9.1.1.The Moran' s I,log-likelihood ratio (LLR),relative risk (RR) were calculated and the incidence choropleth maps,local indicators of spatial autocorrelation cluster maps and space scaning cluster maps were drawn.Results A total of 4 453 scrub typhus cases were reported during 2006-2014,and the annual incidence increased with year.Among the 17 prefectures (municipality) in Shandong,13 were affected by scrub typhus.The global Moran' s I index was 0.501 5 (P＜0.01).The differences in local Moran' s I index among 16 prefectures were significant (P＜0.01).The "high-high" clustering areas were mainly Wulian county,Lanshan district and Juxian county of Rizhao,Xintai county of Tai' an,Gangcheng and Laicheng districts of Laiwu,Yiyuan county of Zibo and Mengyin county of Linyi.Spatial scan analysis showed that an eastward moving trend of high-risk clusters and two new high-risk clusters were found in Zaozhuang in 2014.The centers of the most likely clusters were in the south central mountainous areas during 2006-2010 and in 2012,eastem hilly areas in 2011,2013 and 2014,and the size of the clusters expanded in 2008,2011,2013 and 2014.One spatial-temporal cluster was detected from October 1,2014 to November 30,2014,the center of the cluster was in Rizhao and the radius was 222.34 kilometers.Conclusion A positive spatial correlation and spatial agglomerations were found in the distribution of autumn-winter type scrub typhus in Shandong.Since 2006,the epidemic area of the disease has expanded and the number of high-risk areas has increased.Moreover,the eastward moving and periodically expanding trends of high-risk clusters were detected.
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Objective To study the molecular-biologic characteristics and epidemiological status of iatrogenic related Community-acquired methicillin-resistant Staphylococcus (S.) aureus (CA-MRSA) in China through Meta-analysis.Methods Data through systematic searching for peer-reviewed articles published before December 3rd,2015 from 4 main electronic databases including China National Knowledge Infrastructure (CNKI),Wanfang Data,PubMed and Web of Science Core Collection was collected,for this Meta-analysis.PRISMA guidelines were followed and the proportion of MRSA,CA-MRSA,hospital-acquired MRSA (HA-MRSA) and panton-valentine leucocidin (PVL) gene in certain populations were quantitatively analyzed by Stata 13.0 software.Results Average proportion of CA-MRSA from S.aureus was 12％ (95％CI:8％-16％).CA-MRSA in MRSA was 18％ (95％CI:12％-24％).42.1％ (95％CI:20.4％-63.7％) of the CA-MRSA carried a PVL gene,and the number was higher than general MRSA (t =-2.99,P=0.011).Conclusion CA-MRSA was in lower proportion than HA-MRSA,both seen in general MRSA and in S.aureu.s,but under higher proportion of carrying the PVL gene.Transmission of CA-MRSA could be prevented within the general population through conducting effective surveillances and preventive programs.
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Objective To explore the spatial distribution and spatial clustering of brucellosis in Zibo,2013-2015.Methods Spatial autocorrelation analysis was used to analyze the surveillance data of brucellosis at town level.Township as a spatial analysis unit,spatial distribution of brucellosis in small scale in Zibo City was analyzed.Results The global Moran's I indexes of brucellosis were not significantly different in 2013-2015.According to local Moran's Ⅰ statistic,the high-high regions were Xindian Street and Jiangjunlu Street in 2013.The high-high regions were Tangfang Town,Jinshan Town,Luocun Town,Zhaili Town,Xihe Town and Longquan Town in 2014.The high-high region was Wangcun Town in 2015.Condusions Our study has showed that the spatial distribution of brucellosis is local clustered in Zibo.The detection of hotspots could provide guidance for formulating regional prevention and control strategies.
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Objective To explore the spatial and temporal characteristics of human brucellosis in Shandong province and to provide scientific basis for the development of related regional public health strategies.Methods 1 802 diagnosed cases of human brucellosis patients were selected based on the data that was collected by Diseases Reporting Information System between year 2004 and 2012 in Shandong province.Methods on spatial thematic mapping,spatial autocorrelation analysis,spatial clustering analysis,and temporal clustering analysis were applied to describe the temporal and spatial distribution on human brucellosis cases.Results The incidence rate of human brucellosis increased from 0.038 2/100 000 (35 cases) to 0.620 5/100 000 (598 cases),with annual average incidence rate as 0.211 1/100 000 and the incidence was evidently increased.The value of M (0.375 3) showed that this disease was seasonal,with the epidemic months between March and June,accounting for 56.27％ (1 014/1 802).The Global Moran' s I index was 0.198 901 (P=0.000 120),showing that there was a positive correlation between space and the incidence of brucellosis.The incidence rates in 2006,2007,2009 and 2012 and the space distribution appeared a positive correlation (P＜0.05) in Shandong province.The local Moran's I index showed that there were 8 “High-High” (HH) clustering areas,which were proved to have statistical significance (P＜0.05).Local indicators of spatial association (LISA) revealed that southwest and north districts of Shandong were highly clustered districts of brucellosis and the areas paralleled to the areas that having higher incidence rates.There were two spatial clustering areas in this study,one as the center of Juanchen with radiation radius at 33.83 km whose RR was 9.78 (P＜0.05) and the other was the center of Binchen with radiation radius at 62.78 km with RR as 4.99 (P＜0.05).All the 8 HH counties (districts) were included in the two cluster regions.Conclusion Incidence of human brucellosis showed an obvious increase in Shandong during year 2004-2012.Months with epidemics were between March and June.The incidence of brucellosis in counties (districts) was non-randomly distributed.A positive spatial correlation and the feature of clusters was noticed.
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<p><b>OBJECTIVE</b>To describe the molecular characteristics of group A Streptococcus (GAS) isolated from patients and asymptomatic carriers of scarlet fever in Shandong province, 2013, and to explore the relationships between emm types and other molecular types.</p><p><b>METHODS</b>72 strains of GAS were isolated from throat swabs of children with scarlet fever or asymptomatic carriers of GAS. All the strains were typed by emm typing, multilocus sequence typing (MLST), super-antigen (SAg) genes detections and pulsed-field gel electrophoreses (PFGE).</p><p><b>RESULTS</b>Among the 72 strains, emm1 (41.67%) and emm12 (56.94%) were the most common emm types. Two ST types were found, including ST28 (43.06%) and ST36 (56.94%). Additionally, emm1 was also found correlated to ST28, while emm12 was associated with ST36. Eight super-antigen genes were detected, including smeZ (100.00%), ssa (100.00%), speG (97.22%), speC (95.83%), speL (54.17%), speJ (41.67%), speA (38.89%) and speH (38.89%), while speK, speM, speL were not found (0%). Both speA and speJ genes were detected primarily in emm1 strains (all P < 0.05), while speH and speI genes were not detected in emm 1 strains (all P < 0.05). And emm12 strains were inclined to harbor speH and speL (all P < 0.05) but not speA or speJ (all P < 0.05). Twenty different genotypes were identified by PFGE.</p><p><b>CONCLUSION</b>All the emm types of GAS isolated from scarlet fever patients and asymptomatic carriers in Shandong province 2013 were mainly emm1 and emm12 and carrying speC, speG and smeZ, ssa. ST types mainly exsited in ST28 and ST36. In addition, there were correlations between emm types and super-antigen genes, ST types, PFGE types.</p>
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Niño , Humanos , Antígenos Bacterianos , Proteínas Bacterianas , Electroforesis en Gel de Campo Pulsado , Exotoxinas , Genotipo , Proteínas de la Membrana , Tipificación de Secuencias Multilocus , Escarlatina , Microbiología , Streptococcus pyogenes , GenéticaRESUMEN
Objective To study the effect of bisphenol A on the structure of the spleen and the expression of ER-? in F344 rats. Methods Fisher 344 rats were randomly divided into control,low-dose,moderate-dose and high-dose groups,10 in each and treated with bisphenol A through gavage at the doses of 4 mg/kg,40 mg/kg and 400 mg/kg respectively,once a day for 17 consecutive weeks. In the end of the experiment,the pathological examination of the spleen was done and the expression of ER-? was detected by western blotting. Results Compared with the control,the weight of high dose group decreased (P