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Li GM, Gu WP, Hou M, Jia SQ, Wang YY, Bai LL, Yin JW, Zhou YM, Fu XQ, Lu JX, Wu Y. [Study on the features of Clostridioides difficile infection among diarrhea patients in Kunming from 2018 to 2020]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:624-628. [PMID: 37147836 DOI: 10.3760/cma.j.cn112338-20220712-00624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Objective: We analyze the characteristics of Clostridioides difficile (C. difficile) infection among diarrhea patients in Kunming from 2018 to 2020 and provide evidence for follow-up surveillance and prevention. Methods: A total of 388 fecal samples of diarrhea patients from four sentinel hospitals in Yunnan Province from 2018 to 2020 were collected. Real-time quantitative PCR was used to detect the fecal toxin genes of C. difficile. The positive fecal samples isolated the bacteria, and isolates were identified by mass spectrometry. The genomic DNA of the strains was extracted for multi-locus sequence typing (MLST). The fecal toxin, strain isolation, and clinical patient characteristics, including co-infection with other pathogens, were analyzed. Results: Among the 388 fecal samples, 47 samples with positive reference genes of C. difficile were positive, with a total positive rate of 12.11%. There were 4 (8.51%) non-toxigenic and 43 (91.49%) toxigenic ones. A total of 18 strains C. difficile were isolated from 47 positive specimens, and the isolation rate of positive specimens was 38.30%. Among them, 14 strains were positive for tcdA, tcdB, tcdC, tcdR, and tcdE. All 18 strains of C. difficile were negative for binary toxins. The MLST results showed 10 sequence types (ST), including 5 strains of ST37, accounting for 27.78%; 2 strains of ST129, ST3, ST54, and ST2, respectively; and 1 strain of ST35, ST532, ST48, ST27, and ST39, respectively. Fecal toxin gene positive (tcdB+) results were statistically associated with the patient's age group and with or without fever before the visit; positive isolates were only statistically associated with the patient's age group. In addition, some C. difficile patients have co-infection with other diarrhea-related viruses. Conclusions: The infection of C. difficile in diarrhea patients in Kunming is mostly toxigenic strains, and the high diversity of strains was identified using the MLST method. Therefore, the surveillance and prevention of C. difficile should be strengthened.
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Affiliation(s)
- G M Li
- Microbiology Testing Department, Kunming Center for Disease Control and Prevention, Kunming 650228, China
| | - W P Gu
- Division of Acute Infectious Diseases, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - M Hou
- Microbiology Testing Department, Kunming Center for Disease Control and Prevention, Kunming 650228, China
| | - S Q Jia
- Division of Acute Infectious Diseases, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - Y Y Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L L Bai
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J W Yin
- Division of Acute Infectious Diseases, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - Y M Zhou
- Division of Acute Infectious Diseases, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - X Q Fu
- Division of Acute Infectious Diseases, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - J X Lu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y Wu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Ma XW, Yin JW, Yang R, Yang S, Li J, Wang Y, Li R. [Clinical characteristics of severe late-onset ovarian hyperstimulation syndrome and its impact on the live birth outcome of IVF-ET]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:678-685. [PMID: 36177579 DOI: 10.3760/cma.j.cn112141-20220501-00287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the correlation between different clinical features and live birth in patients with severe late-onset ovarian hyperstimulation syndrome (OHSS) after in vitro fertilization-embryo transfer (IVF-ET). Methods: The clinical information of 330 patients who were pregnant after IVF-ET and referred to medical treatments diagnosed as late-onset severe OHSS in Peking University Third Hospital from January 2016 to December 2020 was retrospectively analyzed. The patients were divided into live birth achieved group (n=287) and non-live birth achieved group (n=43) according to pregnancy outcomes, and live birth achieved group was further divided into two subgroups, full-term birth group (n=222) and early-term birth group (n=65) according to gestational week at delivery for better analysis. Single factor and multi-factor analysis were utilized to clarify the influencing factors of both live birth and early-term birth. Results: Among all the patients who received IVF-ET, the incidence of severe OHSS was 0.67% (673/100 758). Among 330 severe late-onset OHSS patients, 42.4% (140/330) had pleural effusion, the incidence of abnormal liver function was 69.4% (229/330), and the live birth rate was 87.0% (287/330). Among the 287 patients who achieved live birth, 55.4% (159/287) had no pleural effusion, 18.5% (53/287) had a small amount of pleural effusion, and 26.1% (75/287) had medium or massive pleural effusion; in the non-live birth achieved group, there were more patients without pleural effusion and less patients with a small amount of pleural effusion; the difference was statistically significant (χ2=6.213, P=0.045). The rate of selective fetal reduction in live birth achieved group was 16.0% (46/287), which was significantly higher than that in the non-live birth achieved group, which was 2.3% (1/43; χ2=5.749, P=0.017). Multivariate logistic regression analysis revealed that moderately abnormal liver function was an independent risk factor for live birth (OR=3.15, 95%CI: 1.60-6.19), while selective fetal reduction was an independent protective factor for live birth (OR=0.13, 95%CI: 0.02-0.96). Additionally, subgroup analysis suggested that twin birth was an independent risk factor for preterm birth (OR=8.54, 95%CI: 4.31-16.91). Conclusions: Moderate hepatic dysfunction may be associated with adverse pregnancy outcomes in patients with severe late-onset OHSS. Selective fetal reduction and singleton pregnancy are recommended to ameliorate live birth rate, full-term delivery rate, also the maternal and neonatal prognosis for patients with multiple pregnancies.
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Affiliation(s)
- X W Ma
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
| | - J W Yin
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
| | - R Yang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
| | - S Yang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
| | - J Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
| | - Y Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
| | - R Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
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Xiong JJ, Hu HW, Xu CZ, Yin JW, Liu M, Zhang LZ, Duan Y, Huang YK. Developmental Patterns of Fecal Bile Acids in Healthy Neonates and Children. Med Sci Monit 2021; 27:e928214. [PMID: 33767128 PMCID: PMC8008968 DOI: 10.12659/msm.928214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Normal profiles of FBAs in healthy neonates and children in Kunming city and surrounding areas in China have not been previously determined. The objective of this study was to determine a developmental pattern of fecal bile acids (FBAs) in healthy neonates and children. Material/Methods A cross-sectional study was performed on 238 healthy neonates and children recruited in the First Affiliated Hospital of Kunming Medical University, China from October 2015 to September 2016. Secreted primary and secondary FBAs in fresh feces were quantitated by liquid chromatography mass spectrometry (LC-MS). Amounts of FBAs in feces were compared among various age groups. Results Trace amounts of cholic acid and chenodiol acid of primary FBAs were detectable at day 3 after birth, with a significant increase from day 3 to day 7. The primary FBAs gradually decreased from day 25 to the age of 6 years old. In contrast, a significant amount of glycochenodeoxycholic acid was detected on day 3 but decreased to a trace amount by day 7 and onwards. Primary FBAs appeared to maintain a high level, accounting for 98% of total FBAs, with no significant changes from day 7 to day 25 after birth. They gradually decreased from 90% to 10% from age 6 months to 6 years old. While the secondary FBAs were barely detected in neonates, only accounting for 2% of total FBAs, they were gradually elevated to 90% of total FBAs from age 6 months to 6 years old. Conclusions The liver can effectively synthesize primary bile acids 7 days after birth, and fecal primary bile acids tend to be stable after the neonate stage. Secondary bile acids continuously increase along with the maturation of intestinal flora, which reaches a relatively stable level at around 3 years old.
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Affiliation(s)
- Jing-Jing Xiong
- Department of Pediatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Hong-Wei Hu
- Department of Pediatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Chuan-Zhi Xu
- Department of Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Jian-Wen Yin
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China (mainland)
| | - Mei Liu
- Department of Pediatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Li-Zhi Zhang
- Department of Pediatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Yong Duan
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Yong-Kun Huang
- Department of Pediatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
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Luo C, Wang XQ, Chen LK, Yin JW, Chen SJ, Liu LG. [Association between plasma selenium and the risk of impaired glucose regulation]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:565-569. [PMID: 31177751 DOI: 10.3760/cma.j.issn.0253-9624.2019.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the association between plasma selenium exposure and the risk of impaired glucose regulation (IGR). Methods: A case-control study was conducted to select IGR patients who were admitted to the outpatient clinic of the Department of Endocrinology to perform oral glucose tolerance test(OGTT) at the Tongji Hospital affiliated to the Tongji Medical College from September 2004 to 2016 as a case group. Participants with normal glucose tolerance recruited from an unselected group of population undergoing routine health examinations in the same hospital were selected as a control group. The control group was matched according to the age (±5 years old) and sex of the case group. The inclusion criteria for subjects recruited were as follows: age ≥30 years, body mass index (BMI) <40 kg/m(2), no history of a diagnosis of IGR or type 2 diabetes, and no history of receiving pharmacological treatment for hyperlipidemia or hypertension. Patients with any clinically systemic disease such as neurological or endocrine disease, acute illness, chronic inflammatory disease or infectious disease were excluded from the study. A total of 1 957 subjects, 897 in the case group and 1 060 in the control group, were included. Questionnaires were used to collect information of all subjects, and peripheral venous blood was collected after fasting and OGTT, respectively. Plasma selenium, fasting blood glucose, blood lipid (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol) and 2 h OGTT plasma glucose concentration were detected, respectively. The subjects were divided into low, medium and high concentration groups according to the tertiles of plasma selenium concentration in the control group. The multivariate unconditional logistic regression analysis was performed to analyze the association between plasma selenium exposure and IGR. Results: The age (mean±SD) of the case and control group was (53.71±11.38) and (53.95±12.17) years old. The plasma selenium concentration [M (P(25), P(75))] in the case group was 92.81(77.07, 107.05) μg/L, which was significantly higher than the control group [88.73 (77.13, 100.88) μg/L] (P<0.05). The results of multivariate unconditional logistic regression analysis showed that after adjusting for age, sex, BMI, family history of diabetes and hypertension, the risk of IGR was higher in the high-concentration group and the low-concentration group compared with the middle-concentration group, the values of OR (95%CI) were 1.22 (95%CI: 0.94-1.59) and 1.81 (95%CI: 1.42-2.30), respectively. Conclusion: The study suggested a U-shaped association between plasma selenium and IGR.
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Affiliation(s)
- C Luo
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology/Hubei Key Laboratory of Food Nutrition and Safety, Wuhan 430030, China
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Wang X, Zhang C, Yin JW, Wang C, Huang JZ, Ma X, Wang CW, Wang X. Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination-External Rotation Type IV Ankle Fractures. Orthop Surg 2017; 9:42-48. [PMID: 28296225 DOI: 10.1111/os.12318] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/23/2016] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To investigate the effect of internal fixation on postoperative ankle function in patients with supination-external rotation type IV ankle fractures, including medial malleolus fractures and deltoid ligament injury. METHODS Between January 2012 and June 2014, patients with medial structure injuries were enrolled in this study and assigned to the medial malleolus fracture group or the deltoid ligament group. The surgical procedures for the two groups were documented. The follow-up endpoint was the time point when the steel plate or screw was removed from the lateral ankle. The Olerud-Molander ankle scoring system was used to assess ankle function. RESULTS A total of 84 patients with supination-external rotation type IV ankle fractures had complete medical records and were included in this study. The average age of the patients was 44.16 years (range, 15-75). The patient sample included 39 males and 45 females. Overall, 49 patients (19 males and 30 females) suffered a medial malleolus fracture. The average age of these patients was 40.20 years (range, 15-75). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 81.6% (40 patients) of these patients. Overall, 35 patients (20 males and 15 females) experienced a deltoid ligament injury. The average age of these patients was 44.21 years (range, 17-73). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 11.5% (four patients) of these patients. Open reduction was performed in patients with medial malleolus fractures, and two 4.0-mm cannulated screws were used to fixate the posterior malleolus and the medial malleolus. The suture-anchor technique was used to repair the ligaments in patients with deltoid ligament injuries. The follow-up endpoint was the time point when the steel plate and screws were removed from the lateral ankle in patients. The average follow-up period was 13.4 months (range, 11-17). The Olerud-Molander ankle scoring system was used to assess postoperative ankle function. The average score for the patients in the medial malleolus fracture group was 90.3 points (range, 85-95). The average score for the patients in the deltoid ligament injury group was 87.7 points (range, 80-95). No significant differences were found in the scores between the two groups. CONCLUSION Medial malleolus fracture and deltoid ligament injury are two different presentations of supination-external rotation type IV ankle fractures. Anatomic reduction of the articular surface concurrent with restoration of ankle stability can achieve favorable results for these two injuries.
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Affiliation(s)
- Xu Wang
- Department of Orthopaedic Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Chao Zhang
- Department of Orthopaedic Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Jian-Wen Yin
- Department of Orthopaedic Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Chen Wang
- Department of Orthopaedic Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Jia-Zhang Huang
- Department of Orthopaedic Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Xin Ma
- Department of Orthopaedic Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Cheng-Wei Wang
- Department of Orthopaedic Surgery, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xue Wang
- Department of Orthopaedic Surgery, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Zhang FR, Zhang RQ, He L, Yin JW, Yang MQ. Multidisciplinary management to decrease perioperative complications in senile patients with hypoxaemia in high altitudes during primary hip arthroplasty: data from our cohort study. Br J Anaesth 2016; 117:828-829. [PMID: 27956686 DOI: 10.1093/bja/aew369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhang SX, Li L, Yin JW, Jin M, Kong XY, Pang LL, Zhou YK, Tian LG, Chen JX, Zhou XN. Emergence of human caliciviruses among diarrhea cases in southwest China. BMC Infect Dis 2016; 16:511. [PMID: 27663519 PMCID: PMC5035476 DOI: 10.1186/s12879-016-1831-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 09/10/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Acute diarrhea is one of the most serious problems in global public health that causes considerable morbidity and mortality worldwide. Human caliciviruses (HuCV) including norovirus (NoV, genogroup GI and GII) and sapovirus (SaV), is a leading cause of acute sporadic diarrhea in individuals across all age groups. However, few studies had been conducted clarifying the characteristics of HuCV in diarrhea cases across all age groups in China. Our study was aimed at assessing the HuCV-related diarrhea burden and NoV genotypes distribution in southwest China. METHODS The study was conducted in four hospitals in Kunming city, Yunnan province, from June 2014 to July 2015. Stool specimens were collected from 1,121 diarrhea cases and 319 healthy controls in outpatient departments. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect NoV (GI, GII) and SaV. Sequencing was applied to confirm the three viral infections and phylogenetic analysis was performed to determine their genotypes. A structured questionnaire was used to record the demographic information and clinical symptoms of subjects. RESULTS HuCV was detected at an 11.0 % infection rate in 1,121 diarrhea cases and at 3.4 % rate in 319 non-diarrhea subjects (p < 0.0001, OR = 3.5, 95 % CI 1.8-6.5). The prevalence of the NoV genogroup GII and genotype GII.4 in diarrhea cases was significantly higher than that found in healthy controls (p < 0.0001, p = 0.018, respectively). NoV GII (n = 118, 10.5 %) was the most common HuCV subtype in diarrhea cases, followed by SaV (n = 3, 0.3 %) and NoV GI (n = 2, 0.2 %). Of 118 NoV GII strains isolated from diarrhea patients. GII.4 (n = 55, 46.6 %) was the predominant strain, followed by GII.3 (n = 28, 23.7 %), GII.12 (n = 25, 21.2 %), GII.17 (n = 8, 6.8 %), and GII.5 (n = 2, 1.7 %). Of the 55 GII.4 strains, the GII.4 Sydney 2012 variant had absolutely predominant prevalence (n = 52, 94.5 %), followed by the NoV GII.4-2006b variant (n = 3, 5.5 %). The GII.4 Orleans 2009 variant was not found in diarrhea cases of the study. CONCLUSIONS NoV GII was the major genogroup and GII.4 was the most predominant strain detected in diarrhea patients. The GII.17 is an emergent variant in sporadic diarrhea and might become the predominant strain in diarrhea cases in the near future. Rapid, accurate detection kits need to be developed to help us find and treat NoV-associated diarrhea in clinical settings in a timely manner.
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Affiliation(s)
- Shun-Xian Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Li Li
- The First People's Hospital of Yunnan Province, Kunming, 650000, People's Republic of China
| | - Jian-Wen Yin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, 650000, People's Republic of China
| | - Miao Jin
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Xiang-Yu Kong
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Li-Li Pang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Yong-Kang Zhou
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Li-Guang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Jia-Xu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China. .,Key Laboratory of Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China.
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Zhang SX, Zhou YM, Xu W, Tian LG, Chen JX, Chen SH, Dang ZS, Gu WP, Yin JW, Serrano E, Zhou XN. Impact of co-infections with enteric pathogens on children suffering from acute diarrhea in southwest China. Infect Dis Poverty 2016; 5:64. [PMID: 27349521 PMCID: PMC4922062 DOI: 10.1186/s40249-016-0157-2] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/20/2016] [Indexed: 12/15/2022] Open
Abstract
Background Acute diarrhea is a global health problem, resulting in high morbidity and mortality in children. It has been suggested that enteric pathogen co-infections play an important role in gastroenteritis, but most research efforts have only focused on a small range of species belonging to a few pathogen groups. This study aimed to assess the impact of co-infections with a broad range of enteric pathogens on children aged below five years who suffer from acute diarrhea in southwest China. Method A total of 1020 subjects (850 diarrhea cases and 170 healthy controls) were selected from four sentinel hospitals in Kunming, Yunnan province, southwest China, from June 2014 to July 2015. Stool specimens were collected to detect five virus (rotavirus group A, RVA; norovirus, NoV; Sapovirus, SaV; astrovirus, As; and adenovirus, Ad), seven bacterial (diarrheagenic Escherichia coli, DEC; non-typhoidal Salmonella, NTS; Shigella spp.; Vibrio cholera; Vibrio parahaemolyticus; Aeromonas spp.; and Plesiomonas spp.), and three protozoan (Cryptosporidium spp., Giardia lamblia, and Blastocystis hominis, B. hominis) species using standard microbiologic and molecular methods. Data were analyzed using the partial least square regression technique and chi-square test. Results At least one enteric pathogen was detected in 46.7 % (n = 397) of acute gastroenteritis cases and 13.5 % (n = 23) of healthy controls (χ2 = 64.4, P < 0.05). Single infection with RVA was associated with acute diarrhea (26.5 % vs. 5.8 %, P < 0.05). The prevalence of a single infection with B. hominis in diarrhea cases was higher than in healthy controls (3.1 % vs. 0.5 %, OR = 4.7, 95 % CI: 1.01–112.0). Single infection with NoV GII was not associated with diarrhea (4.4 % vs. 3.5 %, OR = 1.2, 95 % CI: 0.5–3.3). Single infections with bacterial species were not observed. The prevalence of co-infections with two enteric pathogens in diarrhea cases was higher than in asymptomatic children (20.1 % vs. 5.3 %, P < 0.05). RVA-NoV GII was the most common co-infection in symptomatic children (4.4 %), with it aggravating the severity of diarrhea. Conclusions Although it is clear that RVA has an overwhelming impact on diarrhea illnesses in children, co-infection with other enteric pathogens appears to also aggravate diarrhea severity. These findings should serve as evidence for public health services when planning and developing intervention programs. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0157-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shun-Xian Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Yong-Ming Zhou
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Wen Xu
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Li-Guang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Jia-Xu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Shao-Hong Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Zhi-Sheng Dang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Wen-Peng Gu
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Jian-Wen Yin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Emmanuel Serrano
- Centre for Environmental and Marine Studies, Departamento de Biología, Universidade de Aveiro, Aveiro, Portugal.,Servei d'Ecopatologia de Fauna Salvatge, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China. .,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China.
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Yin JW, Wang GJ, Xiao ZF. [Simultaneous determination of Cd2+, Pb2+, Cu2+ and Zn2+ by reversed-phase high performance liquid chromatography]. Se Pu 2000; 18:436-8. [PMID: 12541706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
HPLC was used in the investigation of the reaction behavior of Cd2+, Pb2+, Cu2+ and Zn2+ with mesotetrakis (4-hydroxy-phenyl)porphine (THPP) and chromatographic behavior of their complexes. The reaction and chromatographic separation parameters were optimized and a method for the simultaneous determination of Cd2+, Pb2+, Cu2+ and Zn2+ by reversed-phase high performance liquid chromatography with THPP as pre-column derivatization reagent was established. The metal-THPP complexes formed in 0.1 mol/L borate buffer (pH 10.5) by heating in 60 degrees C water bath for 20 min and were extracted into ethyl acetate-benzene mixture. The metal-THPP complexes and THPP were separated on a Prodigy ODS, 5 microns, 250 mm x 4.6 mm i.d. column with methanol-0.05 mol/L borate buffer(90:10, V/V) (pH 8.0) as eluent and detected at 437 nm (Cd2+ and Zn2+), 465 nm (Pb2+) and 416 nm (Cu2+). The detection limits of the four metal ions in 5 microL injection solution were Cd2+ 0.02 ng, Pb2+ 0.02 ng, Cu2+ 0.02 ng, and Zn2+ 0.12 ng, and the linear ranges were Cd2+ 8 ng-1.5 micrograms, Pb2+ 8 ng-3.0 micrograms, Cu2+ 8 ng-5.0 micrograms, and Zn2+ 50 ng-10 micrograms in 10 mL reaction solution. The intra-day repeatability (as RSDs) was in the range of 2.8%-4.8% and the inter-day reproducibility was in the range of 3.7%-9.7%.
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Affiliation(s)
- J W Yin
- School of Public Health, West China University of Medical Sciences, Chengdu 610041, China
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