Hepatitis B virus carriage among pregnant and lying-in womenin Cangnan County from 2011 to 2022 / 预防医学

Objective@#To investigate the prevalence of hepatitis B virus (HBV) carriage among pregnant and lying-in women in Cangnan County, Zhejiang Province from 2011 to 2022 and identify the influencing factors, so as to provide insights into the guidance of healthcare among HBV carriers during pregnancy.@*Methods@#A total of 34 403 women delivered in The Third People's Hospital of Cangnan County from January 2011 to July 2022 were enrolled, and their demographics, HBV carriage and pregnant outcomes were collected. The prevalence of HBV carriage was analyzed among pregnant and lying-in women, and factors affecting HBV carriage were identified using a multivariable logistic regression model.@*Results@#A total of 34 403 pregnant and lying-in women were enrolled, with a median age of 27.00 (interquartile range, 7.00) years, and including 8 118 floating populations (23.60%). The overall prevalence of HBV carriage was 3.44%, and the prevalence of HBV carriage was 1.59% from 2011 to 2014, 4.08% from 2015 to 2018 and 6.86% from 2019 to 2022, appearing a tendency towards a rise (P<0.05). Multivariable logistic regression analysis identified estimated age of delivery (20-24 years, OR=1.832, 95%CI: 1.037-3.235; 25-29 years, OR=2.404, 95%CI: 1.372-4.214; 30-34 years, OR=2.914, 95%CI: 1.656-5.129; 35-39 years, OR=3.116, 95%CI: 1.741-5.576; 40 years and older, OR=2.358, 95%CI: 1.145-4.858), floating population (OR=0.670, 95%CI: 0.574-0.782), scarred uterus after cesarean section (OR=1.228, 95%CI: 1.076-1.521) and year of delivery (from 2015 to 2018, OR=2.504, 95%CI: 2.143-2.926; from 2019 to 2022, OR=4.425, 95%CI: 3.779-5.182) as factors affecting HBV carriage among pregnant and lying-in women.@*Conclusions@#The prevalence of HBV carriage rate appeared a tendency towards a rise among pregnant and lying-in women in Cangnan County from 2011 to 2022. Estimated age of delivery, floating population, year of delivery and scarred uterus after cesarean section are factors affecting HBV carriage.

Interleukin 1 Receptor Antagonist(IL-1ra) Gene Polymorphism in Children with Henoch-Schonlein Purpura Nephritis

PURPOSE: Interleukin 1 receptor antagonist(IL-1ra) is an endogenous antiinflammatory agent that binds to IL-1 receptor and thus competitively inhibits the binding of IL-1alpha and IL-1beta. Allele 2 in association with various autoimmune diseases has been reported. In order to evaluate the influence of IL-1ra gene VNTR polymorphism on the susceptibility to HSP and its possible association with disease severity, manifested by severe renal involvement and renal sequelae, we studied the incidence of carriage rate and allele frequency of the 2 repeats of IL-1ra allele 2(IL1RN*2) of the IL-1ra gene in children with HSP with and without renal involvement. METHODS: The IL-1ra gene polymorphisms were determined in children with HSP with(n= 40) or without nephritis(n=34) who had been diagnosed at Busan Paik Hospital and the control groups(n=163). Gene polymorphism was identified by PCR amplification of the genomic DNA. RESULTS: The allelic frequency and carriage rate of IL1RN*1 were found most frequently in patients with HSP and in controls. The allelic frequency of IL1RN*2 was higher in patients with HSP compared to that of controls(4.7% vs. 2.5%, P=0.794). The carriage rate of IL1RN*2 was higher in patients with HSP compared to that of controls(8.1% vs. 6.8%, P= 0.916). The allelic frequency of IL1RN*2 was higher in patients with HSP nephritis compared to that of HSP(6.3% vs.2.9%, P=0.356). The carriage rate of IL1RN*2 was higher in patients with HSP nephritis compared to that of HSP(10.0% vs. 5.9%, P=0.523). Among 13 patients with heavy proteinuria(>1.0 g), 11 had IL1RN*1, 1 had IL1RN*2 and the others had IL1RN*4. At the time of last follow up 4 patients had sustained proteinuria and their genotype was IL1RN*1. CONCLUSION: The allelic frequency and carriage rate of IL1RN*1 were found most frequently in patients with HSP and in controls. Our study suggests that the carriage rate and allele frequency of the 2-repeats of IL-1ra allele 2(IL1RN*2) of the IL-1ra gene may not be associated with susceptibility and severity of renal involvement in children with HSP.

Epidemiological Study of Pneumococcal Nasal Carriage and Serotypes Among Korean Children / 소아과

PURPOSE: The aim of this study was to determine the prevalence of pneumococcal nasal carriage and confirm the distribution of pneumococcal capsular serotypes in Korean children below aged 5 years old. Another reason this study was performed was to identify the theoretical coverage by seven valent conjugate pneumococcal vaccine, and confirm the penicillin resistant rate. METHODS: This study included 213 children, who visited out patient clinic or were hospitalized in six hospitals between August 2001 and April 2002. Nasopharyngeal swabs and cultures for S. pneumoniae were performed. Serotyping of isolated samples was performed by the Quellung reaction at the Statens Seruminstitut in Copenhagen. Penicillin MICs were determined by the agar dilution method, and interpreted according to the NCCLS guide line. RESULTS: The prevalence of pneumococcal nasal carriage rate in this study was 34.3%. A total of 31 of 73 isolates(42.5%) had intermediate resistance to penicillin, and 29 of 73 isolates(39.7%) showed a high resistance to penicillin. The predominant serotype of the S. pneumoniae isolates was 23F(22%), and the percentages of vaccine serotypes(46.6%) and associated serotypes(37%) which belong to the seven-valent pneumococcal conjugate vaccine were 83.6%. The resistance pattern of pneumococcal isolates to penicillin was different among the serotypes. CONCLUSION: Pneumococcal isolates from nasal colonization of Korean children showed a high penicillin resistant rate. We assumed that newly developed seven-valent pneumococcal conjugate vaccine may offer a high theoretical coverage for the isolated strains.

Carriage and Antimicrobial Susceptibility of Haemophilus influenzae Isolated from Oropharynges of Children

PURPOSE: Haemophilus influenzae, one of the normal flora of the upper respiratory tract, can cause such infections as otitis, sinusitis, pneumonia, and meningitis in children. The oropharyngeal flora has therefore mainly been analyzed as a reservoir for pathogens. This study was performed to reveal the colonization rate of H. influenzae in the upper respiratory tract, their biotypes, their antimicrobial resistance and production of beta-lactamase in healthy children. METHODS: The specimens for H. influenzae were obtained through oropharyngeal swab from 209 healthy children, younger than 5 years of age in 4 day care centers from March 1998 to June 1998. These isolates of H. influenzae were tested for their biotypes, in vitro susceptibility to seven antimicrobial agents(ampicillin, ampicillin/sulbactam, aztreonam, chloramphenicol, cefotaxime, tetracycline and trimethoprim-sulfamedoxazole) by disc diffusion method and production of beta- lactamase. RESULTS: The carriage rate of H. influenzae in the day care center children was 13.4%(28/209). Of 24 isolates, 8 isolates(33%) were biotype II and 6 isolates(25%) were biotype I. The overall rates of resistance of 15 isolates are as follows; ampicillin 46.7%, tetracycline 28.6%, trimethop rim-sulfamedoxazole 14.3%, ampicillin/sulbactam 6.7%. The prevalence of beta-lactamase producing isolates was 65.2%. All beta-lactamase producing isolates were resistant to ampicillin. The resis tance rates of beta-lactamase producing isolates to tetracycline, trimethoprim-sulfamedoxazole, and ampicillin/sulbactam were 44.4%, 25.0%, and 11.1%, respectively. CONCLUSION: Children in day care centers in Seoul have high rates of H. influenzae carriage. The antimicrobial resistance of H. influenzae from the oropharyngeal specimens of healthy children was higher than expected.

Pharyngeal Colonization Rate of Penicillin-resistant Streptococcus pneumoniae among Day-care Center Children in Seoul, Korea / 감염

BACKGROUND: Antimicrobial resistance of Streptococcus pneumoniae presents a challenge to the clinicians in developing countries, particularly against the acute respiratory tract infections, including pneumonia. The present study was to evaluate the carriage rate and the antimicrobial resistance of S. pneumoniae isolated from children at a day-care center. METHODS: Oropharyngeal swabs were done every month for one year in 64 children at a day-care center in Seoul, Korea. Minimum inhibitory concentrations (MICs) of 9 antimicrobial agents (penicillin, ceftriaxone, cefuroxime, erythromycin, chloramphenicol, tetracycline, vancomycin, ciprofloxacin, cefpirome) were determined by agar-dilution method. RESULTS: The ages of the children ranged from 13 to 60 months (mean: 31 months). The overall carriage- rate of pneumococci was 26%, which was highest in December (46%) and lowest in July (3%). A total number of 105 strains of S. pneumoniae were isolated from 404 throat swabs and 68 strains among these were available for MIC tests. Only 8 (12%) strains were susceptible to penicillin, while 50 (73%) were intermediate and 10 (15%) were resistant. The isolates also exhibited high rates of resistance to other beta- lactams (53% and 21% were resistant to cefuroxime and ceftriaxone, respectively). The resistance rates to the other antimicrobial agents were also remarkable; 90% and 88% were resistant to erythromycin and tetracycline, respectively. However, 75% of isolates were susceptible to chloramphenicol and 100% were susceptible to vancomycin. CONCLUSION: There was a high rate of pharyngeal carriage of penicillin-resistant S. pneumoniae among children attending day-care center. Surveillance of pharyngeal cultures may provide useful information the treatment guideline of pneumococcal infections.