Distribution and drug resistance of pathogenic bacteria of biliary tract infection in patients subjected to hepatobiliary surgery / 中国基层医药

Objective:To study the distribution and drug resistance of pathogenic bacteria of biliary tract infection in patients with hepatobiliary surgery.Methods:A total of 103 patients with biliary tract infection who received treatment in the Department of Hepatobiliary Surgery, Lanxi People's Hospital from May 2020 to October 2022 were included in this study. Their bile was cultured to analyze the distribution and drug resistance of pathogenic bacteria. The data were processed using the WHONET5.5 software system.Results:Fifty-eight pathogenic bacteria-positive samples were cultured from the bile of 103 patients with biliary tract infection, with a pathogenic bacteria-positive rate of 56.31%. Among 58 strains of pathogenic bacteria, 38 strains (65.52%) were gram-negative bacteria, mainly Escherichia coli and Klebsiella pneumonia, and 5 strains (8.62%) were fungal strains. Escherichia coli and Klebsiella pneumoniae were highly resistant to sulfamethoxazole-trimethoprim, ciprofloxacin, and other antibacterial drugs, and were completely sensitive to imipenem and meropenem. Enterococcus faecalis was mainly resistant to ampicillin and penicillin G,and it was completely sensitive to vancomycin and teicoplanin. Staphylococcus aureus was resistant to vancomycin, ciprofloxacin, cefotaxime, and other drugs. A total of 13 strains of ultrabroad-spectrum beta-lactamase bacteria were isolated from 25 strains of Escherichia coli and 7 strains of Klebsiella pneumonia, with the positive detection rate of 40.63%. Conclusion:The main pathogenic bacteria of biliary tract infection are Gram-negative bacteria, which are widely distributed and have serious drug resistance. In clinical practice, antimicrobial drugs should be reasonably selected according to the results of bile drug sensitivity tests.

Advance in the application of recombinase polymerase amplification-lateral flow strips technology in the diagnosis of pathogenic microorganisms / 中华检验医学杂志

Recombinase polymerase amplification (RPA) is a newly developed isothermal amplification technology with high sensitivity and specificity. The combination of RPA and lateral flow strips (LFS) enables rapid identification of target genes. This technique has been widely used in medicine, food, botany, and other fields. This review generalizes the use of RPA-LFS technology for the diagnosing pathogenic microorganisms, providing a reference for point-of-care diagnosis of pathogenic microorganisms.

Genes involucrados con resistencia antimicrobiana en hospitales del Ecuador / Genes involved with antimicrobial resistance in Ecuadorian hospitals

INTRODUCCIÓN. La resistencia a los antimicrobianos es un problema de salud pública actual asociado con alta mortalidad, hospitalización prolongada, alternativas terapéuticas reducidas, mayores costos económicos y la posibilidad de brotes hospitalarios. OBJETIVO. Describir los principales genes involucrados con resistencia antimicrobiana en hospitales del Ecuador. MATERIALES Y MÉTODOS. Se realizó una descripción retrospectiva no experimental, de artículos indexados relacionados con resistencia antimicrobiana en hospitales del Ecuador, con evidencia desde el año 2009 al 2022. La revisión de bibliografías se llevó a cabo en bases de datos como Pubmed, Science Direct y Google Scholar. RESULTADOS. De un grupo original de 77 artículos, se seleccionaron 33 documentos. En Ecuador, varios estudios han descrito los mecanismos moleculares involucrados en la resistencia bacteriana. Sin embargo, en bacterias menos comunes, falta investigación sobre los genes asociados. CONCLUSIONES. Las principales bacterias multirresistentes descritas en Ecuador son Klebsiella pneumoniae, Escherichia coli y Acinetobacter baumanni, las cuales presentan genes involucrados en la producción de carbapenemasas (blaKPC, blaNDM, blaOXA-48). Estas bacterias presentan altos niveles de resistencia a los antibióticos y son objeto de vigilancia epidemiológica por parte del sistema nacional de salud. A nivel local, otras bacterias presentan mecanismos de resistencia a los carbapenémicos (Pseudomonas aeruginosa, Enterobacter sp., Serratia marcescens, Citrobacter sp.), pero no existen descripciones detalladas del genotipo, sus características microbiológicas o la clínica del paciente. El conocimiento de las tasas de resistencia a los antimicrobianos en los diferentes hospitales, la implementación de un plan de administración de antibióticos, el uso correcto de los equipos de protección personal, el aislamiento de las personas con infecciones multirresistentes, así como el trabajo colaborativo entre las diferentes áreas del hospital, son esenciales para reducir la propagación de estos patógenos.

INTRODUCTION. Antimicrobial resistance is a current public health problem associated with high mortality, prolonged hospitalization, reduced therapeutic alternatives, increased economic costs, and the potential for hospital outbreaks. OBJECTIVE. To describe the main genes involved with antimicrobial resistance in hospitals in Ecuador. MATERIALS AND METHODS. A retrospective non-experimental description of indexed articles related to antimicrobial resistance in hospitals in Ecuador was carried out, with evidence from 2009 to 2022. The review of bibliographies was carried out in databases such as Pubmed, Science Direct and Google Scholar. RESULTS. From an original group of 77 articles, 33 papers were selected. In Ecuador, several studies have described the molecular mechanisms involved in bacterial resistance. However, in less common bacteria, research on the associated genes is lacking. CONCLUSIONS. The main multidrug-resistant bacteria described in Ecuador are Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumanni, which present genes involved in the production of carbapenemases (blaKPC, blaNDM, blaOXA-48). These bacteria present high levels of antibiotic resistance and are subject to epidemiological surveillance by the national health system. Locally, other bacteria present mechanisms of resistance to carbapenemics (Pseudomonas aeruginosa, Enterobacter sp., Serratia marcescens, Citrobacter sp.), but there are no detailed descriptions of the genotype, their microbiological characteristics or the patient's clinic. Knowledge of antimicrobial resistance rates in different hospitals, the implementation of an antibiotic stewardship plan, the correct use of personal protective equipment, the isolation of individuals with multidrug-resistant infections, as well as collaborative work between different areas of the hospital, are essential to reduce the spread of these pathogens.

The scheme for validation of clinical metagenomics sequencing assay / 中华检验医学杂志

Clinical metagenomic next-generation sequencing (mNGS) entails unbiased shotgun sequencing of all microbial and host nucleic acids present in a clinical sample. By analyzing the microbiota diversity, taxonomic, and phylogenetic relationships of clinical specimens, metagenomics related analysis provides an opportunity to investigate substantial biological significance of different microbes. According to the published paper, most studies on mNGS mainly focused on the clinical impact evaluation. However, the studies focused on the analytical performance validation of mNGS before clinical application were rare. Here, a scheme, included intended use, method establishment, assay validation and standard operating protocol, for the laboratory validation of clinical metagenomics sequencing assay was provided by summarizing experiences of clinical laboratory department of Peking Union Medical College Hospital protocol and relevant research. In this scheme, we discussed important topics of mNGS laboratory validation as below: specimen type and pathogen list, bioinformatics pipeline setup, dry lab standard preparation and performance validation, mNGS workflow setup, background nucleotide acid evaluation, wet lab standard preparation and performance validation.

The role of pathogen infections in the development and progression of autoimmune liver diseases / 临床肝胆病杂志

The etiology and pathogenesis of autoimmune liver diseases has always been a hot area of research. Pathogen infections can elicit an autoimmune response and often become the key pathogenic factor of immune diseases. Based on the literature data and the author's clinical experience, this review will briefly introduce the role and influence of pathogen infections in the development and progression of autoimmune liver diseases from the aspects such as molecular mimicry mechanism, in order to further understand the pathogenesis of autoimmune liver diseases.

Etiological analysis of the immunosuppressed children with severe pneumonia by metagenomics next generation sequencing / 中国小儿急救医学

Objective:To explore the application of metagenomics next generation sequencing(mNGS)in the immunosuppressed children with severe pneumonia and to understand the distribution of pathogens in order to provide reference for early prevention and treatment.Methods:We performed a retrospective analysis of the immunosuppressed children with severe pneumonia who had mNGS reports admitted to PICU according with the enrollment condition from July 2019 to July 2020.The records included general clinical data, traditional detection method report and mNGS results.We evaluated the consistency of the mNGS with the clinical microbiology reports and clinical judgment.Results:Twenty-three patients were enrolled, 15 were male and 8 were female, aging from 28 days to 10 years old, with an average age of(3.67±3.20)years old.Seven cases were cured, 2 were improved, and 14 died.A total of 23 samples were obtained, including 21 blood specimens and 2 bronchoal-veolar lavage fluid specimens.Among the 23 cases, 5 were single infected and 15 were mixed infected.Fungi were detected in 15 cases(65.22%), including 12 cases of Pneumocystis jirovecii, 2 cases of Aspergillus fumigatus and 2 cases of Candida albicans.Virus were detected in 14 cases(60.87%), including cytomegalovirus(CMV) in 10 cases(8 cases with pneumocystis infection), Herpes virus in 3 cases and fine ring virus in 2 cases(1 case with herpes virus infection). Bacteria were detected in 10 cases, including 3 cases of Acinetobacter, 1 case of Klebsiella pneumoniae, 1 case of Stenotrophomonas maltophilia, 1 case of Pinocytogenes, 4 cases of Staphylococcus and 1 case of Bacillus licheniformis.There were Mycoplasma in 3 cases with mixed infection.The positive rate and coincidence rate of mNGS were significantly higher than that of the traditional test group( P<0.05). A total of 19 cases were treated with hormone or immunosuppressive agents, and 17 cases were treated for 1 to 6 months when severe pneumonia occurred. Conclusion:Most immunosuppressed children with severe pneumonia are mixed infection.The common pathogens are Pneumocystis jirovecii and CMV.The use of mNGS can significantly improve the pathogen detection rate, effectively guiding the treatment.

Distribution of pathogens and risk factors of bacterial infections around dental implants / 中国基层医药

Objective@#To investigate the distribution of pathogenic bacteria and the risk factors of bacterial infections around dental implants.@*Methods@#From January 2017 to December 2018, 427 patients with oral implantation in Xixi Hospital were selected inthe study.According to the occurrence of bacterial infections around oral implants, the patients were divided into infection group(46 patients) and the non-infection group(381 patients). Pathogenic bacteria were isolated and identified from the bottom of gingival sulcus of infected patients.The risk factors of bacterial infection around dental implants were analyzed by multivariate logistic regression analysis.@*Results@#A total of 59 pathogenic bacteria were isolated from 46 patients with bacterial infection around dental implants, including 38 anaerobic bacteria, 17 aerobic bacteria and 4 beneficial bacteria.Univariate analysis showed that there were no statistically significant differences in sex, age, BMI and hypertension between the two groups (χ2=0.003, 3.393, 0.744, 0.200, all P>0.05). The infection group complicated with diabetes mellitus (19.57%), chronic periodontitis (30.43%), smoking (58.70%), drinking (69.57%), periimplantal alveolar bone defects (50.00%) and overloading (30.43%) were higher than those without infection (5.77%, 6.82%, 29.40%, 34.91%, 23.12%, 11.29%), there werestatistically significant differences (χ2=9.636, 24.241, 16.048, 20.793, 16.655, 13.011, all P<0.05). The results of logistic regression analysis showed that diabetes mellitus, history of chronic periodontitis, smoking, alcohol consumption, poor alveolar bone around implants and overloading were risk factors for bacterial infection around implants.@*Conclusion@#Anaerobic bacteria are the main pathogens of bacterial infection around dental implants.Infection is affected by many factors, including diabetes mellitus, history of chronic periodontitis, smoking, alcohol consumption, poor alveolar bone around implants and excessive load.

La guerra biológica: un desafío para la humanidad / Biological warfare: a challenge for humanity

RESUMEN Fundamento: el control de enfermedades transmisibles contribuye al empleo ilegítimo de los agentes biológicos, de manera inicial con fines bélicos o criminales y en la actualidad con fines terroristas. Objetivo: describir la problemática del empleo de las armas biológicas, sus diferentes aristas y en su forma actual con fines terroristas y los aspectos que prohíben su uso según la normativa internacional vigente. Métodos: se realizó una revisión bibliográfica con el método de análisis bibliográfico con una búsqueda realizada entre los años 2000 al 2017, donde se consultaron bases de datos especializadas y se seleccionaron 31 publicaciones científicas sobre el tema. Desarrollo: se realizó un análisis del tema de la guerra biológica basado en los agentes utilizados y la amenaza que constituye su empleo, pues provocan enfermedades y causan la muerte al afectar la salud de los seres vivos y el medio ambiente. Son dañinas e incluyen conocimientos de ciencia, tecnología, ingeniería e involucran otras áreas, como la economía, el derecho, el marco jurídico que limita o no la obtención de materiales y los aspectos psicológicos ante tales ataques. Los avances tecnológicos en Biología e Ingeniería genética de las últimas décadas posibilitan modificar y crear nuevos microorganismos más resistentes al tratamiento y en particular en la búsqueda de inoculación de enfermedades como el cáncer. La biodefensa es el conjunto de medidas para la prevención y actuación frente a una alerta sanitaria donde está implicado el uso de los agentes biológicos con fines bélicos. Conclusiones: los agentes biológicos se utilizan como armas para ocasionar daños en circunstancias de guerra biológica y bioterrorismo, por ser de forma potencial el arma más destructiva conocida por la humanidad que implica aspectos políticos, económicos, científico-tecnológicos, jurídicos y psicológicos, por lo que la biodefensa protege a las personas y el medio ambiente con el uso de medidas sanitarias contra dichos agentes.

ABSTRACT Background: the control of transmittable diseases contributes to the illegitimate use of biological agents, initially for war or criminal purposes and currently for terrorist purposes. Objective: to describe the problem of the use of biological weapons, its different edges and in its current form for terrorist purposes and the aspects that prohibit its use according to current international regulations. Methods: a bibliographic review was made with the bibliographic analysis method with a search conducted between 2000 and 2017, where specialized databases were consulted and 31 scientific publications on the subject were selected. Development: an analysis on the issue of biological warfare was made based on the agents used and the threat that constitutes their use, since they cause diseases and cause death by affecting the health of living beings and the environment. They are harmful and include knowledge of science, technology, engineering and involve other areas, such as economics, law, the legal framework that limits or not the obtaining of materials and the psychological aspects of such attacks. The technological advances in Biology and Genetic engineering of recent decades make it possible to modify and create new microorganisms that are more resistant to treatment and in particular in the search for the inoculation of diseases such as cancer. The biodefense is the set of measures for the prevention and action facing a sanitary alert where the use of the biological agents with war aims is implied. Conclusions: biological agents are used as weapons to cause damage in circumstances of biological warfare and bioterrorism, as it is potentially the most destructive weapon known to humanity that involves political, economic, scientific-technological, legal and psychological aspects, which is why biodefense protects people and the environment with the use of sanitary measures against above-mentioned agents.

Quemaduras en edad pediátrica. Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus / Burns in pediatric age. Camilo Cienfuegos General Provincial Hospital of Sancti Spiritus

RESUMEN Fundamento: El niño quemado es por definición un paciente quirúrgico, traumatizado y extremadamente complejo por las repercusiones vitales, funcionales, estéticas y psicológicas que presenta. Objetivo: Describir el comportamiento de las quemaduras de los niños en el Servicio de Quemados del Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus para el manejo adecuado en la atención de urgencias. Metodología: Se realizó un estudio descriptivo, retrospectivo de corte transversal; la población de estudio fueron los 94 menores de 18 años atendidos en el servicio. Se tuvo en cuenta la edad, el sexo, el agente causal, el lugar de ocurrencia, la extensión y profundidad de las lesiones. Resultados: La edad que predominó fue de 0-4 años con incidencia superior en los varones. La mayor parte de las lesiones se produjeron en la casa y los agentes etiológicos fueron: los líquidos calientes o hirvientes y los metales calientes; siguió en frecuencia el indicador calle con el rozamiento y los accidentes por los rayos de bicicleta. Según su profundidad predominaron las quemaduras dérmicas A y AB y la extensión menor de 5 %. Conclusiones: La edad más frecuente en que se presentaron lesiones por quemaduras en la edad pediátrica fue de 0-4 años con mayor incidencia en los varones. Las quemaduras que predominaron fueron las dérmicas A y AB. La etiología más frecuente: las escaldaduras y los metales calientes y las lesiones de segundo grado. Es importante por ello el correcto manejo de urgencia del paciente quemado pediátrico, así como tener en cuenta medidas para la prevención de las quemaduras de los niños en la comunidad.

ABSTRACT Background: The burned child is by definition a surgical patient, traumatized and extremely complex due to the vital, functional, aesthetic and psychological repercussions that he presents. Objective: To describe the behavior of the burns of children in the Burns Service at Camilo Cienfuegos General Provincial Hospital of Sancti Spíritus for the adequate management of emergency care. Methodology: A descriptive, retrospective cross-sectional study was carried out; the population studied was 94 children under 18 years assisted in the service. Age, sex, causal agent, place of occurrence, extent and depth of injuries were taken into account. Results: The predominant age was 0-4 years with a higher incidence in males. Most of the injuries occurred in the house and the etiological agents were: hot or boiling liquids and hot metals; followed by the indicator referred to frictions and accidents by bicycle spokes in the street. According to their depth, the skin burns A and AB predominated and the extension was less than 5%. Conclusions: The most frequent age in which burns injuries occurred in the pediatric age was 0-4 years with the highest incidence in males. The prevailing burns were skin burns A and AB. The most frequent etiology: scalds and hot metals and second degree injuries. Therefore, the correct emergency management of the burned pediatric patient is important, as well as taking into account some measures for the prevention of burns of children in the community.

Preliminary application of next generation sequencing technique in pathogen identification of foodborne disease / 中华预防医学杂志

Objective@#To analyze genomic features of pathogens based on next generation sequencing technique in a food-borne disease event.@*Methods@#A total of 11 blood samples, stomach contents before gastric lavage from the death and patients' foods were collected. S. aureus, B. cereus and toxic substances were detected. B. cereus detected in foods were counted. The conserved region of 16 S rDNA gene and ces gene(cereulide) of B. cereus isolates were detected by real-time PCR. Next Generation Sequencing (NGS) technology was applied to acquire genome sequences of isolates. Different plasmids distribution and comparative genomics analysis with reference sequences in public databases were analyzed.@*Results@#Only B. cereus tested positive in all samples. The counts of B. cereus in Egg fried rice, one food samples, were 1.9×107 CFU/g, and the counts of B. cereus in dried and fried fish and brine pork head meat samples were 3.0×103 CFU/g both. Ten isolates were carrying hlyⅢ, nheA, nheB, inlA and inhA genes, and nine isolates carried the plcR gene and nine isolates carried the nheC gene. The PCR result of 16 S rDNA gene and ces gene of all isolates were positive. All carried the complete ces genes cluster sequence which were identical to the sequence of plasmid pCER270 (NC_01 0924.1) from strain AH187 in United Kingdom and pNCcld (NC_016792.1) from NC7401 in Japan. The alignment of plasmids turned out the sequence of the isolate differed from the pXO1 and pXO2 plasmids of B. anthracis, but carried the pNCcld plasmid containing the ces genes cluster. The phylogenetic tree based on genomic sequences of ten isolates showed high similarity (distances in phylogenetic tree from 2.0×10-6-9.0×10-6) to each other and to the B. cereus strains AH187 and NC7401 (MLST ST26 type, distances in phylogenetic tree from 3.8×10-5-4.5×10-5).@*Conclusion@#The foodborne disease event was caused by vomiting type Bacillus cereus without plasmid pXO1 and pXO2 contaminated egg fried rice. The vomiting-type food poisoning caused by B. Cereus globally is probably associated with ST26, ST164 and other strains harboring ces gene.

Etiological study of diarrhea in children under 5 years old in Dongcheng district of Beijing / 中华预防医学杂志

Objective@#To analyze the etiological characteristics of infectious diarrhea among people under 5 years old in Dongcheng District, Beijing.@*Methods@#The age, time of infection, clinical symptoms and laboratory test results of the cases who didn't used antibiotics within 3 days in the second maternal and child health care hospital were collected from 2012 to 2015, through the information management system of infectious disease monitoring technology platform. To compare the detection rate of virus and bacteria in children with different sex, time and age,and the difference of clinical characteristics between virus detection group and bacteria detection group by chi square test.@*Results@#1 977 cases of infectious diarrhea were collected, the median of the month age (P25, P75) was 14.19 (8.31, 23.15) months. The virus detection rate was 34.3% (679 cases); the bacterial detection rate was 14.6% (288 cases). The difference of virus detection rate in children with different months was statistically significant (χ2=72.38, P<0.001), the virus detection rate of 24-60 months (40.9% (188/460)) was the hightest, and the detection rate of 0-5 months (15.3% (48/314)) was the lowest. The difference of bacteria detection rate was also statistically significant (χ2=32.67, P<0.001), and the detection rate of 12-17 months (19.0% (81/426)) was the highest, the detection rate of 0-5 months (6.7% (21/314)) was the lowest. The proportion of vomit and water sample in the virus detection group was 22.2% (136 cases) and 73.3% (449 cases), respectively, which were higher than those in bacteria detection group (8.1% (18 cases) and 57.2% (127 cases)), the difference was statistically significant (χ2 values were 125.92 and 19.60; P values were both<0.001); the proportion of mucus stool and fever was 0.8% (5 cases) and 14.0% (86 cases), respectively, which were lower than those in bacterial detection group (4.1% (9 cases) and 18.5% (41 cases)), and the difference was statistically significant (χ2 values were 8.50 and 23.01; P values were 0.004 and <0.001).@*Conclusion@#The virus detection rate of infantile infective diarrhea is higher than that of bacteria in Dongcheng district of Beijing, and the clinical characteristics are significantly different.

Epidemiological characteristics and pathogenic analysis of bacillary dysentery in Zhengzhou city from 2004 to 2016 / 天津医药

Objective To understand the epidemic and etiological characteristics of bacillary dysentery and provide scientific evidence for the prevention strategies. Methods The surveillance data and serotyping of bacillary dysentery in Zhengzhou city from 2004 to 2016 were analyzed by descriptive epidemiological method.Results A total of 29 284 cases of bacillary dysentery were reported in Zhengzhou from 2004-2016.The average annual incidence was 31.28 per 100 000 and decreased annually(χ2=103.60,P<0.001).The peak season was from May to October.The incidence was higher in city than that of county,and male was higher than female.The majority of the bacillary dysentery cases was children under 3 years old, and scattered children were the main population at risk.A total of 385 Shigella strains were isolated and identified from 2004 to 2016, and 72.35% (280 strains) of strains were Shigella flexneri. F2a subtype was dominated, but the detective rate of Shigella sonnei was increased gradually. Conclusion Bacillary dysentery is still one of important infectious diseases in Zhengzhou,comprehensive measures should be taken to decrease the incidence including health education in targeted area and people in epidemic season.

The value of new 16S rRNA gene chip in pathogen detection of neonatal sepsis / 中国新生儿科杂志

Objective To study the value of new 16S rRNA gene chip in pathogen detection of neonatal sepsis.Method Newborns with suspected sepsis hospitalized in Peking University Shenzhen Hospital from January 2015 to December 2017 were chosen as the subjects.Blood culture and gene chip were both used to detect the pathogens of these infants.The positive rate,the detection time,and the blood volume needed for detection were compared between the two methods.Result A total of 306 cases of suspected neonatal sepsis were included in the study.Among them,34 (11.1％) were positive for blood culture and 54 (17.6％) were positive for gene chip.98 cases were diagnosed as neonatal sepsis,34 (34.7％) were positive for blood culture,and 52 (53.1％) were positive for gene chip.The positive rate of gene chip was higher than that of blood culture (P ＜ 0.05).For the 5 common pathogens of neonatal sepsis,the positive rate of gene chip was higher than that of blood culture.Time to positivity (TTP) and pathogen identification time of blood culture were (14.6 ± 5.5) h and (72.9 ± 19.0) h,respectively.TTP and pathogen identification time of gene chip were both 3 h.The detection time of gene chip was significantly less than that of blood culture (P ＜ 0.001).The blood volume needed for detection of blood culture and gene chip was 1 ～ 2 ml and 0.5 ml.Gene chip needs less blood volume than blood culture.Conclusion Compared with the traditional blood culture,gene chip can quickly detect the pathogens in the blood with higher positive rate and less blood volume.Gene chip is of great value in the diagnosis of neonatal sepsis.

Evaluation of Enterococcus faecalis, Staphylococcus warneri and Staphylococcus aureus species in adults with generalized chronic periodontitis / Avaliação das espécies Enterococcus faecalis, Staphylococcus warneri e Staphylococcus aureus em adultos com periodontite crônica generalizada

ABSTRACT Objective: To identify and quantify the levels of three bacterial species that have recently been identified as potential "new" periodontal pathogens (Enterococcus faecalis, Staphylococcus aureus and Staphylococcus warneri) in subjects with periodontal health and generalized chronic periodontitis. Methods: Thirty adults with generalized chronic periodontitis and 10 periodontally healthy were included in this study. Nine subgingival biofilm samples were collected per subject and individually analyzed by checkerboard DNA-DNA hybridization technique. Results: The mean levels of E. faecalis and S. warneri were higher in chronic periodontitis than in periodontal health (p<0.05). Furthermore, a higher percentage of subjects with periodontitis were colonized by the three species evaluated in comparison with healthy subjects (p<0.05). This represented a difference of 40 percentage points between the two groups, for E. faecalis (present in 90% of individuals with periodontitis and 50% of the healthy individuals) and S. warneri (100% and 60%, respectively), and 26 percentage points for S. aureus (86% and 60%, respectively). Conclusion: E. faecalis and S. warneri have the potential to be periodontal pathogens. The role of S. aureus was less evident, since this species was more prevalent and at relatively higher levels in health than the other two species. These data might guide future studies on the role of these microorganisms in the etiology of periodontitis and help to establish more effective treatments for these infections.

RESUMO Objetivo: Identificar e quantificar os níveis de três espécies bacterianas que foram recentemente apontadas como possíveis "novos" patógenos periodontais (Enterococcus faecalis, Staphylococcus warneri e Staphylococcus aureus), em indivíduos periodontalmente saudáveis e com periodontite crônica generalizada. Métodos: A amostra foi composta por 30 indivíduos adultos com periodontite crônica generalizada e 10 periodontalmente saudáveis. Nove amostras de biofilme subgengival foram coletadas por indivíduo e analisadas individualmente pela técnica de checkerboard DNA-DNA hybridization. Resultados: Os níveis médios de E. faecalis e S. warneri foram maiores no grupo com periodontite crônica do que no de saúde periodontal (p<0,05). Além disso, um maior percentual de indivíduos com periodontite estavam colonizados pelas três espécies avaliadas em comparação com os indivíduos saudáveis (p<0,05). Essa diferença entre os dois grupos foi de 40 pontos percentuais para E. faecalis (presente em 90% dos indivíduos com periodontite e 50% dos saudáveis) e S. warneri (100% e 60%, respectivamente), e de 26 pontos percentuais para S. aureus (86% e 60%, respectivamente). Conclusão: E. faecalis e S. warneri tem potencial para serem patógenos periodontais. O papel do S. aureus foi menos evidente, uma vez que esta espécie estava mais prevalente e em níveis relativamente mais altos do que as outras duas espécies em saúde. Estes dados podem guiar futuros estudos sobre o papel dessas espécies na etiologia das periodontites e ajudar a estabelecer tratamentos mais eficazes para essas infecções.

Candidatos vacunales contra Mycobacterium tuberculosis: una actualización del tema / Mycobacterium tuberculosis vaccine candidates: an update on the topic

Fundamento: la eficacia protectora de la actual vacuna contra la tuberculosis, sirve para contrarrestar las formas pulmonares de esta enfermedad, su reactivación resulta variable o poco eficiente, lo cual impone la búsqueda urgente de nuevas alternativas profilácticas contra la enfermedad. El avance en la obtención de vacunas y de nuevas drogas más efectivas, depende en gran medida del conocimiento de las características del microorganismo, así como la respuesta del sistema inmune en función del agente patógeno. Objetivo: realizar una revisión actualizada en bases de datos médicas sobre los candidatos vacunales contra Mycobacterium tuberculosis. Métodos: se realizó una revisión bibliográfica acerca del tema de un total de 60 artículos publicados en bases de datos médicas, se escogieron 38 artículos correspondientes a la última década para conformar la investigación. Se mostraron los temas más usados referentes al agente patógeno, Mycobacterium tuberculosis, candidato vacunal y los mecanismos de acción sobre el sistema inmune. Se profundizó sobre los tipos de vacunas y las potencialidades terapéuticas específicas para el Mycobacterium tuberculosis, además de evaluar la implicación inmunológica con relación al candidato vacunal. Conclusiones: la simulación de la infección y los eventos inmunes que le suceden en el establecimiento de la inmunidad natural sin causar la enfermedad, son condiciones esenciales de una vacuna clásica.

Background: The tuberculosis constitutes a serious sanitary problem. The vaccination is a powerful method to prevent the infections. The effectiveness protector of the current vaccine against the tuberculosis, to counteract the lung forms of this illness and its reactivation, is variable or not very efficient, that which imposes the urgent search of new alternative prophylaxes against this illness. The advance in the obtaining of bovine and of new more effective drugs, it depends in great measure of the knowledge of the characteristics of the microorganism as well as the answer of the immune system in the pathogen agent's function. Objectives: to carry out an up-to-date revision on the Candidates vaccinates them against Mycobacterium tuberculosis. Methods: you real it hoisted a bibliographical revision of a total of 60 published articles, of them 40 articles corresponding to the last decade were chosen to conform the investigation. The relating more used topics were shown to pathogen agent Mycobacterium tuberculosis candidate vacunal and the mechanisms of action on the immune system. It was deepened on the types of vaccine and the therapeutic potentialities, specific for the M. tuberculosis, besides, to evaluate the immunologic implication with relationship to the candidate vacunal. Conclusions: The simulation of the infection and the immune events that happen him in the establish ment of the natural immunity, without causing the illness are essential conditions of a classic vaccine.

The clinical characteristics of neonatal sepsis caused by different pathogens / 中国新生儿科杂志

Objective To study the characteristics of neonatal sepsis caused by gram positive (G +) bacteria,gram negative (G+) bacteria and fungi.Method Clinical data of 202 neonates with sepsis hospitalized from Jan.2012 to May.2015 were studied.According to the different pathogens,202 neonates were divided into gram positive bacteria group,gram negative bacteria group and fungi group.The general information,clinical manifestation,laboratory examination and treatment outcome of the three groups were analysed with Chi square analysis,LSD,Fisher exact probability tests.Result A total of 202 cases of neonatal sepsis were recruited.The detection rate of gram positive bacteria,gram negative bacteria and fungi was 35.2％ (71 cases),56.4％ (114 cases) and 8.4％ (17 cases),respectively.Comparing with gram negative group and fungi group,gram positive group had older gestational age (36.0 ± 3.8 w,compared with gram negative 33.0 ± 3.9 w,fungi group 31.2 ± 3.2 w,P ＜ 0.05),larger birth weight (2 620 ± 925 g compared with gram negative group 1 999 ± 849 g,fungi group 1 595 ± 666 g,P ＜ 0.05),lower nosocomial infection rate (29.6％ compared with gram negative group 70.2％,fungi group 94.1％,P ＜0.05),lower rate of shock,blood glucose disturbance and thrombocytopenia (P ＜ 0.05).There was no statistics difference between the gram negative group and fungi group.Comparing with the other two groups,fungi group was older [20.0 (11.5,39.5) d compared with gram positive group 7.0 (2.0,17.0) d,and gram negative 10.0 (6.0,18.2) d,P ＜ 0.05].The rate of deep venous catheterization in fungi group was higher than that in gram positive group and gram negative group (88.2％ compared with gram positive group 25.4％,gram negative group 40.4％,P ＜0.05).The treatment course of fungi group was longer than that of the gram positive group and gram negative group [22.0 (12.0,37.5) d compared with the gram positive group 14.0 (10.0,17.0) d,gram negative group 14.0 (11.0,18.0) d,P ＜0.05].The incidence of apnea in the gram negative group was higher than that in gram positive group and fungi group (P ＜ 0.05).The rate of leukocytosis,leukocytopenia and elevated CRP were higher in gram negative and gram positive group (P ＜ 0.05).Conclusion The clinical manifestations and laboratory examinations in neonatal sepsis caused by different pathogens were different,which can help to early identification of different pathogenic infections.However,there is no specific indicators to differentiate neonatal sepsis caused by different pathogens.Early identification of the pathogen needs clinical acumen.

Comparative study on the clinical features of purulent meningitis in preterm and term infants: a clinical analysis based on 10 years / 中国新生儿科杂志

Objective To study the differences of clinical manifestations,etiology and hospitalized outcomes of purulent meningitis in preterm and term infants.Method All preterm and term infants with purulent meningitis hospitalized in the Hospital from 2006 to 2015 were enrolled in this study.The data of neonate's condition,maternal condition,clinical manifestations,complications,etiology,treatment and outcomes of the preterm and term infants groups were compared.Result During the study period,44 preterm infants and 118 term infants were included.The time of onset for purulent meningitis of preterm infants group was statistically earlier than that of term infants group [11.2 (3.2,19.8) d vs.14.3 (5.6,23.9) d,P ＜ 0.05].The prognosis of preterm infants group was statistically worse than that of term infants group (P ＜ 0.05).Among them,the incidences of clinical manifestations in preterm infants group compared to term infants group were:fever (54.5％ vs.78.8％),seizure (11.4％ vs.26.3％),lethargy and poor response (59.1％ vs.38.1％),slow weight gain (9.1％ vs.0％),apnea (45.5％ vs.0.8％) and cyanosis (15.9％ vs.4.2％);all the differences between two groups were significant (P ＜ 0.05).The time of onset for purulent meningitis with complications was statistically earlier than those without complications [9.5 (4.1,20.5) d vs.13.8 (5.9,22.0) d,P＜0.05].The duration of treatment for purulent meningitis with complications was longer than that without complications [(42.2 ± 8.8) d vs.(28.7 ± 7.1) d,P ＜ 0.05],and the positive rate of pathogens was also statistically higher than those without complications (73.8％ vs.26.7％,P ＜0.05).Coagulase-negative staphylococcus was the main pathogen for both preterm and term infants group.Klebsiella pneumoniae was more common in preterm infants group than in term infants group (40.0％ vs.10.4％,P ＜0.05).Conclusion Preterm infants with purulent meningitis had early onset time,atypical clinical manifestations,and poor prognosis.The treatment course for purulent meningitis with complications is prolonged.The pathogens for neonatal purulent meningitis have already changed.The detection rate of conditional pathogens is increasing yearly,for which the clinicians should take note seriously.

Contaminación con bacterias patógenas de estetoscopios del personal médico en un hospital de nivel III en Lima, Perú / Contamination of medical stethoscopes with pathogenic bacteria in a level III hospital in Lima, Peru

Objetivos: Determinar el grado de contaminación bacteriana con bacterias patógenas de los estetoscopios del personal médico en un hospital general de Lima, Perú. Material y métodos: Estudio de tipo observacional,descriptivo y transversal, realizado en el Hospital Nacional Arzobispo Loayza, entre los meses de enero y juniodel 2013. Se estudiaron 124 muestras de estetoscopios del personal médico en las siguientes áreas: UCI 20; neonatología 13; quemados 3; medicina 52; emergencia 36. Se recolectaron las muestras con hisopos humedecidos,en condiciones estériles (En presencia de un mechero de vidrio para alcohol) y luego fueron introducidos en tuboscon preparado de caldo BHI (Infusión cerebro corazón) para ser incubados por 24 horas a 37°C; se cultivó en Agarsangre, Agar MacConkey, Agar manitol y Agar cetrimidepara su posterior determinación de bacterias patógenaspor procedimientos bioquímicos ,luego se identificó la susceptibilidad bacteriana con la técnica de Kirby- Bauer...

Objectives: To determine the degree of contamination with pathogenic bacteria by stethoscopes used for medical personnel in a general hospital in Lima, Peru. Methods: Cross sectional study carried-out at Hospital Nacional Arzobispo Loaya between January and June 2013. A total of 124 samples were evaluated from the following areas: 20 from the ICU, 13 from the neonatology service, 3 from the burn unit; 52 from medicine wards, and 36 from the emergency room. The samples were collected using a moist cotton swab in sterile conditions (using a alcohol bunser burner) and introduced in tubes containing brain-heart infusion to be incubated at 37C for 24 hours. The determination of pathogenic bacteria used MacConkey and manitol agar with specific biochemical methods. The Kirby-Bauer method was used to determine the antibiotic susceptibility pattern...

Diversidad de roedores, hantavirus y su relación con la salud pública / Diversity of rodents, hantavirus and its relationship to public health

El orden Rodentia comprende el grupo de mamíferos con la mayor diversidad de especies vivientes que son hospederos y reservorios naturales de hantavirus. Los hantavirus que causan síndrome cardiopulmonar en América utilizan como reservorio a la subfamilia Sigmodontinae. Cada hantavirus posee afinidad con un roedor hospedero específico. En 1976 en Corea se cultivó del pulmón del ratón Apodemus agrarius, el primer virus Hantaan. En 1978 se identificó el virus Seoul de Rattus norvegicus. En 1997 en Finlandia se aisló el hantavirus Puumala del pulmón de Myodes glareolus. En 1993 se aisló hantavirus Dobrava (Eslovenia) de Apodemus flavicolis y en 1982 fue aislado de Microtus pennsylvanicus el primer hantavirus no patógeno en las Américas: Prospect Hill. No obstante, en 1993 una misteriosa enfermedad pulmonar se expandió en Four Corners (USA); los pacientes repentinamente enfermaron y muchos murieron debido a shock y/o edema pulmonar; los síntomas no fueron asociados con hantavirus. Más tarde se aisló un nuevo hantavirus del roedor Peromyscus maniculatis, el cual era desconocido, y se lo denominó como Virus Sin Nombre y se asoció como la causa de este brote epidémico. En Suramérica se han reportado hantavirus en distintos hospederos naturales. En Colombia, entre 2004 y 2015 se han publicado diversos estudios realizados en el Caribe colombiano y en Urabá en los que se evidenció la presencia de hantavirus en humanos y en roedores. Recientemente se tuvo el primer reporte serológico de infección por hantavirus en humanos en la región de la Orinoquia colombiana. Sin embargo, la hantavirosis no es considerada una enfermedad de notificación obligatoria, y es probable que actualmente esté en silencio epidemiológico.

The order Rodentia comprises the group of mammals with the greatest diversity of living species that are natural hosts and reservoirs of hantavirus. Guests are natural reservoirs and hantavirus. All hantavirus that cause cardiopulmonary syndrome in the Americas are linked to the subfamily Sigmodontinae. Each hantavirus has affinity for a specific rodent host. In Korea the first Hantaan virus was isolated in 1976 from a lung culture of field mouse Apodemus agrarius. In 1978, the Seoul virus was identified from Rattus norvegicus. In Finland, the Puumala hantavirus from Myodes glareolus lung. In 1993, hantavirus Dobrava from Apodemus flavicolis was isolated in Slovenia and in 1982 the first hantavirus in the Americas called Prospect Hill isolated form Microtus pennsylvanicus, which resulted nonpathogenic and for this reason it was believed that the American hantavirus were nonpathogenic. However, in 1993 a mysterious lung disease began spreading in Four Corners (USA), the patients suddenly became ill and many died due to shock and/or lung edema; these early symptoms were not associated with hantavirus but a virus subsequently isolated from Peromyscus maniculatis was a new virus now known as hantavirus without name was cause of this outbreak. In South America hantavirus have been reported in different natural hosts. In Colombia between 2004 and 2006 the first serological studies in the Colombian Caribbean, where they reported the circulation of hantavirus in humans and rodents, were published. However, hantavirus is not considered a reportable disease and probably currently it is in epidemiological silence.

The pathogens analysis of pneumonia children with antibiotic-associated diarrhea / 中国医师进修杂志

Objective To investigate the intestinal pathogens in pneumonia children with antibioticassociated diarrhea (AAD).Methods The etiological data of 208 pneumonia children with AAD were analyzed retrospectively.Results The results dictated there were 46 A and/or B toxin-positive samples of Clostridium difficile(CD),and after culturing there were 122 Candida,107 Escherichia coli,42 Staphyloccocus aureus,28 Clostridiurn perfringens,21 Klebsiella oxytoca,18 Enterobacter cloacae,12 Klebsiella pneumoniae,8 Pseudomonas aeruginosa in the fecal specimens of 208 pneumonia children with AAD.Conclusions The pathogens are complicated in pneumonia children with AAD,the highest detection rate are Candida and Escherichia coli.The antibiotic use time of treatment of CD infection AAD and the hospital stay time are the longest,AAD treatment should be made according to different pathogens situation.