Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections

Antibiotic-associated diarrhea(AAD) and Clostridum difficile infections(CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases Pub Med(June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications(required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar(discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.

Probiotics for antibiotic-associated diarrhea:Do we have a verdict?

Probiotics use has increased tremendously over the past ten years.This was coupled with a surge of data relating their importance in clinical practice.Antibioticassociated diarrhea,whose frequency has risen recently,was one of the earliest targets with data published more than ten years ago.Unfortunately,available trials suffer from severe discrepancies associated with variability and heterogeneity of several factors.Most published randomized controlled trials and subsequent meta-analyses suggest benefit for probiotics in the prevention of antibiotic-associated diarrhea.The same seems to also apply when the data is examined for Clostridium difficile-associated colitis.However,the largest randomized double-blind placebo-controlled trial to date examining the use of a certain preparation of probiotics in antibiotic-associated diarrhea showed disappointing results,but it was flawed with several drawbacks.The commonest species of probiotics studied across most trials is Lactobacillus;however,other types have also shown similar benefit.Probiotics have enjoyed an impeccable safety reputation.Despite a few reports of severe infections sometimes leading to septicemia,most of the available trials confirm their harmless behavior and show similaradverse events compared to placebo.Since a consensus dictating its use is still lacking,it would be advisable at this point to suggest prophylactic use of probiotics to certain patients at risk for antibiotic-associated diarrhea or to those who suffered previous episodes.

Preventing pediatric antibiotic-associated diarrhea and Clostridium difficile infections with probiotics: A metaanalysis

AIM： To assess the effcacy and safety of probiotics for preventing pediatric： （1） antibiotic associated diarrhea and （2） Clostridium diffcile （C. diffcile） infections.METHODS： On June 3, 2013, we searched PubMed （1960-2013）, EMBASE （1974-2013）, Cochrane Da-tabase of Systematic Reviews （1990-2013）, CINAHL （1981-2013）, AMED （1985-2013）, and ISI Web of Science （2000-2013）. Additionally, we conducted an extensive grey literature search including contact with National Institutes of Health Clinical Trials Registry, abstracts from annual infectious disease and gastroen-terology meetings, experts in the feld and correspondence with authors. The primary outcomes were the incidence of antibiotic-associated diarrhea （AAD） and C. difficile infections （CDI）. Dichotomous outcomes （e.g. , incidence of AAD or CDI） were pooled using a random-effects model to calculate the relative risk and corresponding 95% confidence interval （95%CI） and weighted on study quality. To explore possible explanations for heterogeneity, a priori subgroup analysis were conducted on probiotic strain type, daily dose, quality of study and safety of probiotics. The overall quality of the evidence supporting each outcome was assessed using the grading of recommendations, assessment, development and evaluation criteria.RESULTS： A total of 1329 studies were identifed with 22 trials （23 treatment arms and 4155 participants） meeting eligibility requirements for our review of prevention of AAD and 5 trials （1211 participants） for the prevention of CDI. Trials in adult populations, trials of uncertain antibiotic exposure or studies which did not provide incidence of AAD were excluded. We found 12 trials testing a single strain of probiotic and 10 trials testing a mixture of probiotic strains. Probiotics （all strains combined） signifcantly reduced the incidence of pediatric AAD （pooled RR = 0.42, 95%CI： 0.33-0.53） and significantly reduced pediatric CDI （pooled RR = 0.35, 95%CI： 0.13-0.92）. Of the two strains with multiple trials, both signifcantly reduced pediatric AAD： Sac-charomyces boulardii lyo （pooled RR = 0.43, 95%CI： 0.32-0.60） and Lactobacillus rhamnosus GG （pooled RR = 0.36, 95%CI： 0.19-0.69）. There was no significant effect by type of antibiotic, or by duration or dose of probiotic. No adverse events associated were found in the 22 controlled trials relating to the use of probiotics.CONCLUSION： This meta-analysis found that probiotics signifcantly prevented pediatric antibiotic associated diarrhea and pediatric CDI, but the effcacy varies signifcantly by the strain of the probiotic.

Efficacy of Xianglian pill for antibiotic-associated diarrhea: a protocol for systematic review and meta-analysis

Background:Antibiotic-associated diarrhea is a clinical common symptom of antibiotics overuse and occurs in 5%-70%of adults.Xianglian pill has been traditionally considered as an efficient treatment of diarrhea and gastrointestinal diseases for thousands of years.However,no systematic review and meta-analyses have focused on its positive effects.Hence,this protocol for systematic review and meta-analysis was developed to evaluate the effect and clinical safety of Xianglian pill on treating antibiotic-associated diarrhea.Methods:All randomized controlled trials published in Chinese and English and assessed use of Xianglian pill for antibiotic-associated diarrhea will be included.Databases of PubMed,EMBASE,Cochrane Library,China National Knowledge Infrastructure,Chinese Biomedical Literature,Wanfang,and Chinese Science and Technology Periodical Database will be searched for randomized controlled trials from their inception until November 16,2020.Primary outcomes will be the incidence of diarrhea and adverse events,and secondary outcomes will be bowel movements and microbiome characteristics.Two authors will extract data and assess the risk of bias independently.Risk ratio will be used to evaluate the results,and meta-analyses will be conducted using STATA 15.0 software.The review aims to demonstrate the effectiveness of Xianglian pill in the prevention and treatment of antibiotic-associated diarrhea.

Efficacy of a synbiotic chewable tablet in the prevention of antibiotic-associated diarrhea

Infection by Clostridium difficile, a complication of treatment with antibiotics, causes antibiotic- associated diarrhea (AAD) and can lead to colitis and pseudomembranous colitis. Incidence of C. difficile infection is increasing among the elderly undergoing antibiotics therapy confined to health care facilities, conditions that are expensive to treat, decrease the quality of life and are life threatening. Use of probiotics has been proposed as a method to decrease the incidence of AAD in health care facilities. To examine the efficacy of using probiotics, 120 nursing home residents undergoing antibiotic therapy were provided with a synbiotic tablet containing two probiotics, Saccharomyces boulardii and Bacillus coagulans, and a prebiotic, fructooligosaccharide. Residents were evaluated retrospectively for AAD and C. difficile infection. It was found that 95% of residents treated with antibiotics and taking the synbiotic tablet were free of AAD. More than 97% of the residents did not become infected with C. difficile. No adverse effects were reported. Minor side effects, gastrointestinal upset and nausea, were reported by less than 6% of the residents. The cause of the minor side effects was not known. Only 2.5% of the residents stopped taking the synbiotic tablet because of the gastrointestinal upset. These Results suggest that use of the synbiotic tablet prevents AAD and C. difficile infection in nursing home residents undergoing antibiotic therapy. It is concluded that this synbiotic tablet provides an easy to administer and safe approach to controlling AAD and C. difficile infection in residents in nursing homes.

Neonatal rhesus monkeys as an animal model for rotavirus infection

AIM To establish a rotavirus(RV)-induced diarrhea model using RV SA11 in neonatal rhesus monkeys for the study of the pathogenic and immune mechanisms of RV infection and evaluation of candidate vaccines.METHODS Neonatal rhesus monkeys with an average age of 15-20 d and an average weight of 500 g ± 150 g received intragastric administration of varying doses of SA11 RV( 107 PFUs/mL, 106 PFUs/mL, or 105 PFUs/mL, 10 mL/animal) to determine whether the SA11 strain can effectively infect these animals by observing their clinical symptoms, fecal shedding of virus antigen by ELISA, distribution of RV antigen in the organs by immunofluorescence, variations of viral RNA load in the organs by qRT-PCR, histopathological changes in the small intestine by HE staining, and apoptosis of small intestinal epithelial cells by TUNEL assay.RESULTS The RV monkey model showed typical clinical diarrhea symptoms in the 108 PFUs SA11 group, where we observed diarrhea 1-4 d post infection(dpi) and viral antigen shed in the feces from 1-7 dpi. RV was found in jejunal epithelial cells. We observed a viral load of approximately 5.85 × 103 copies per 100 mg in the jejunum at 2 dpi, which was increased to 1.09 × 105 copies per 100 mg at 3 dpi. A relatively high viral load was also seen in mesenteric lymph nodes at 2 dpi and 3 dpi. The following histopathological changes were observed in the small intestine following intragastric administration of SA11 RV: vacuolization, edema, and atrophy. Apoptosis in the jejunal villus epithelium was also detectable at 3 dpi.CONCLUSION Our results indicate that we have successfully established a RV SA11 strain diarrhea model in neonatal rhesus monkeys. Future studies will elucidate the mechanisms underlying the pathogenesis of RV infection, and we will use the model to evaluate the protective effect of candidate vaccines.

Effects of the viability of Lactobacillus rhamnosus GG on rotavirus infection in neonatal rats

AIM:To study the effects of live and dead Lactobacillus rhamnosus GG(GG) on rotavirus infection in a neonatal rat model.METHODS:At the age of 2 d,suckling Lewis rat pups were supplemented with either live or dead GG and the treatment was continued daily throughout the experi-ment.At the age of 5 and 6 d the pups received oral rotavirus(RV) SA-11 strain.The pups were sacrificed at the age of 7 or 8 d by decapitation.The gastrointestinal tract was removed and macroscopic observations were done.The consistency of feces in the colon was classified using a four-tier system.RV was detected from the plasma,small intestine,colon and feces by real-time quantitative polymerase chain reaction(PCR).RESULTS:In this neonatal rat model,RV induced a mild-to-moderate diarrhea in all except one pup of the RV-inoculated rats.RV moderately reduced body weight development from day 6 onwards.On day 7,after 2 d of RV infection,live and dead GG groups gained significantly more weight than the RV group without probiotics [36%(P = 0.001) and 28%(P = 0.031),respectively].In addition,when compared with the RV control group,both live and dead GG reduced the weight ratio of colon/animal body weight to the same level as in the healthy control group,with reductions of 22%(P = 0.002) and 28%(P < 0.001),respectively.Diarrhea increased moderately in both GG groups.However,the diarrhea incidence and severity in the GG groups were not statistically significantly different as compared with the RV control group.Moreover,observed diarrhea did not provoke weight loss or death.The RV control group had the largest amount of RV PCR-positive samples among the RV-infected groups,and the live GG group had the smallest amount.Rats receiving live GG had significantly less RV in the colon(P = 0.027) when compared with the RV control group.Live GG was also more effective over dead GG in reducing the quantity of RV from plasma(P = 0.047).CONCLUSION:Both live and dead GG have beneficial effects in RV infection.GG may increase RV clearance from the body and reduce colon swelling.

Gut health,stress,and immunity in neonatal dairy calves:the host side of host-pathogen interactions

The cumulative evidence that perinatal events have long-lasting ripple effects through the life of livestock animals should impact future nutritional and management recommendations at the farm level. The implications of fetal programming due to malnutrition, including neonatal survival and lower birth weights, have been characterized,particularly during early and mid-gestation, when placental and early fetal stages are being developed. The accelerated fetal growth during late pregnancy has been known for some time, while the impact of maternal stressors during this time on fetal development and by extent its postnatal repercussions on health and performance are still being defined.Maternal stressors during late pregnancy cannot only influence colostrogenesis but also compromise adequate intestinal development in the fetus, thus, that further limits the newborn's ability to absorb nutrients, bioactive compounds, and immunity(i.e., immunoglobulins, cytokines, and immune cells) from colostrum. These negative effects set the newborn calf to a challenging start in life by compromising passive immunity and intestinal maturation needed to establish a mature postnatal mucosal immune system while needing to digest and absorb nutrients in milk or milk replacer. Besides the dense-nutrient content and immunity in colostrum, it contains bioactive compounds such as growth factors, hormones, and cholesterol as well as molecular signals or instructions [e.g., microRNAs(miRNAs) and long non-coding RNAs(lncRNAs)] transferred from mother to offspring with the aim to influence postnatal gut maturation. The recent change in paradigm regarding prenatal materno-fetal microbiota inoculation and likely the presence of microbiota in the developing fetus intestine needs to be addressed in future research in ruminants. There still much to know on what prenatal or postnatal factors may predispose neonates to become susceptible to enteropathogens(e.g., enterotoxigenic Escherichia coli), causing diarrhea. From the host-side of this host-pathogen interaction, molecular data such as fecal RNA could, over time, help fill those gaps in knowledge. In addition, merging this novel fecal RNA approach with more established microbiome techniques can provide a more holistic picture of an enteropathogenesis and potentially uncover control points that can be addressed through management or nutrition at the farm level to minimize preweaning morbidity and mortality.

Effects of early postnatal gastric and colonic microbiota transplantation on piglet gut health

Background Diarrhea is a major cause of reduced growth and mortality in piglets during the suckling and weaning periods and poses a major threat to the global pig industry.Diarrhea and gut dysbiosis may in part be prevented via improved early postnatal microbial colonization of the gut.To secure better postnatal gut colonization,we hypothesized that transplantation of colonic or gastric content from healthy donors to newborn recipients would prevent diarrhea in the recipients in the post-weaning period.Our objective was to examine the impact of transplanting colonic or gastric content on health and growth parameters and paraclinical parameters in recipient single-housed piglets exposed to a weaning transition and challenged with enterotoxigenic Escherichia coli(ETEC).Methods Seventy-two 1-day-old piglets were randomized to four groups:colonic microbiota transplantation(CMT,n=18),colonic content filtrate transplantation(CcFT,n=18),gastric microbiota transplantation(GMT,n=18),or saline(CON,n=18).Inoculations were given on d 2 and 3 of life,and all piglets were milk-fed until weaning(d 20)and shortly after challenged with ETEC(d 24).We assessed growth,diarrhea prevalence,ETEC concentration,organ weight,blood parameters,small intestinal morphology and histology,gut mucosal function,and microbiota composition and diversity.Results Episodes of diarrhea were seen in all groups during both the milk-and the solid-feeding phase,possibly due to stress associated with single housing.However,CcFT showed lower diarrhea prevalence on d 27,28,and 29 compared to CON(all P<0.05).CcFT also showed a lower ETEC prevalence on d 27(P<0.05).CMT showed a higher alpha diversity and a difference in beta diversity compared to CON(P<0.05).Growth and other paraclinical endpoints were similar across groups.Conclusion In conclusion,only CcFT reduced ETEC-related post-weaning diarrhea.However,the protective effect was marginal,suggesting that higher doses,more effective modalities of administration,longer treatment periods,and better donor quality should be explored by future research to optimize the protective effects of transplantation.

以腹泻为主要症状的新生儿播散性马尔尼菲篮状菌感染1例

报道1例以腹泻为主要起病症状的新生儿播散性马尔尼菲篮状菌病。患儿,男,生后25 d,因“发热伴腹泻8 d”入院,血培养及痰培养均提示马尔尼菲篮状菌,外周血IgG水平明显降低,进一步对患儿、患儿父母及姐姐进行免疫缺陷病相关基因检测,提示患儿存在CD40LG基因突变所致X连锁高IgM综合征,患儿母亲及姐姐为该位点杂合变异,父亲正常。确诊后给予伏立康唑静滴治疗症状好转,复查血培养及痰培养阴性出院,出院后继续口服伏立康唑片巩固治疗,随访患儿未再发病。

新生儿肺炎继发腹泻发生风险调查及其预测模型的建立

目的调查新生儿肺炎继发腹泻发生风险,建立其预测模型并进行验证。方法选择2022年7月至2023年12月接诊的新生儿肺炎患儿432例进行研究。以7∶3比例将患儿随机分为模型组302例,验证组130例。收集可能影响新生儿肺炎患儿继发腹泻的相关因素,根据有无出现继发性腹泻将模型组患儿分为腹泻组与无腹泻组,比较2组患儿一般资料、疾病与治疗相关因素及实验室指标,以套索回归(least absolute shrinkage and selection operator,LASSO)筛选变量后行多因素Logisitic回归,以此建立列线图模型并进行验证。结果模型组302例新生儿肺炎患儿中共有81例(26.82%)出现腹泻,根据LASSO回归结果行多因素Logisitic回归分析结果显示,出生孕周、喂养方式、侵入性操作、抗生素联用、糖皮质激素使用情况、微生态制剂使用情况、住院时间为新生儿肺炎继发腹泻的独立性影响因素(P<0.05)。模型组接收者操作特性曲线(receiver operating characteristic curve,ROC)下面积为0.779,95%CI为0.719~0.838,灵敏度为79.0%,特异性为63.8%;验证组ROC曲线下面积为0.751,95%CI为0.689~0.813,灵敏度为85.2%,特异性为54.3%。模型组与验证组校准曲线斜率为1,截距为0.000,模型曲线与理想模型基本拟合成对角线。H-L拟合优度检验(P>0.05)。临床有效性分析结果显示,当预测概率阈值为0.15~0.75时使用本研究模型预测新生儿肺炎继发腹泻的净获益最高。结论新生儿肺炎患儿继发腹泻主要受出生孕周、喂养方式、侵入性操作等因素的影响,本研究建立的列线图模型用于预测新生儿肺炎继发腹泻发生风险具有较高的准确度与区分度。

猪轮状病毒OSU株对乳鼠的致病性

为建立猪轮状病毒(PoRV)OSU株感染乳鼠致腹泻模型,研究PoRV对乳鼠的致病性,本试验选用40只4日龄昆明乳鼠,将其随机分为3个攻毒组和1个空白对照组,攻毒组乳鼠经口灌胃不同剂量的PoRV培养液,分别为攻毒组1(50μL)、攻毒组2(100μL)和攻毒组3(150μL),病毒滴度为10~(5.2)TCID_(50)/100μL,空白对照组按同样的方法灌服细胞培养液。在感染后不同时间点观察乳鼠的临床症状、腹泻和死亡情况、解剖症状,采用苏木精-伊红(H.E.)染色进行肠道组织病理学检查,反转录聚合酶链式反应(RT-PCR)检测乳鼠肠内容物中PoRV含量。结果显示,乳鼠在接种PoRV后24 h出现明显腹泻症状,攻毒后3~4 d时发病最严重,4 d时乳鼠的腹泻率介于62.5%~100%,7 d时恢复正常,乳鼠的死亡率介于44.4%~90.0%。与空白对照组比,攻毒组小鼠在给予PoRV后,肠道出现明显的病理变化,主要表现为水肿和充血、肠上皮完整性破坏。RT-PCR检测结果显示,攻毒组部分乳鼠的肠内容物中检出PoRV。本试验利用PoRV OSU株成功建立了乳鼠腹泻模型,阐明了其致病特征。

Gastrointestinal symptoms as the first sign of chronic granulomatous disease in a neonate: A case report

BACKGROUND Chronic granulomatous disease(CGD)characterized by recurrent and severe bacterial and fungal infections is most common in childhood.CASE SUMMARY We reported a 24-d-old male infant who developed gastrointestinal symptoms as the first sign of CGD.CONCLUSION Gastrointestinal symptoms representing the first sign of CGD are very rare,and prompt diagnosis and treatment with broad-spectrum antibiotics were of crucial importance.

精细护理对新生儿腹泻的应用价值及对患儿睡眠的影响研究

目的:研究精细护理对新生儿腹泻的应用价值及对患儿睡眠的影响。方法:选取2021年1月至2021年12月厦门大学附属第一医院收治的腹泻患儿68例作为研究对象,按照随机数字表法分为对照组和观察组,每组34例。对照组给予常规护理,观察组给予精细护理,比较2组平均住院时间、住院期间每日睡眠(日间、夜间)时间、住院期间入睡后惊醒次数。结果:观察组平均住院时间短于对照组,差异有统计学意义(P<0.05);住院期间,观察组每天日间、夜间睡眠时间长于对照组,入睡后惊醒次数少于对照组,差异有统计学意义(P<0.05)。观察组患儿,显效人数更多,护理后治疗的有效率高于对照组患儿,观察组家属的满意率97.06%,明显高于对照组家属护理满意度85.29%,组间比较,差异有统计学意义(P<0.05)。结论:给予腹泻患儿精细护理有利于促进病情改善,缩短住院时间,提高患儿睡眠质量,患儿家属对护理的满意度更高,护理后治疗效果更好,护理效果显著,建议临床护理推广使用。

去乳糖奶粉喂养联合个体发育支持护理对新生儿抗生素相关性腹泻症状改善情况及生长发育的影响

目的探讨去乳糖奶粉喂养联合个体发育支持护理对新生儿抗生素相关性腹泻(AAD)症状改善情况及生长发育的影响。方法选取2021年6月至2023年5月收治的96例AAD新生儿为研究对象,按照护理方式的不同将其分为对照组与观察组,每组48例。对照组采用常规护理,观察组在常规护理的基础上采用去乳糖奶粉喂养联合个体发育支持护理。比较两组的护理效果。结果观察组的症状改善时间及住院时间均短于对照组(P<0.05)。观察组的并发症总发生率低于对照组(P<0.05)。护理后,观察组的每天哭闹次数少于对照组,每次哭闹持续时间短于对照组(P<0.05)。护理后,观察组的体重、身长及头围均明显优于对照组(P<0.05)。观察组患儿家属的满意度高于对照组(P<0.05)。结论去乳糖奶粉喂养联合个体发育支持护理在新生儿AAD中的应用效果显著,其可缩短患儿的症状改善时间及住院时间,减少并发症及哭闹情况,改善生长发育情况及家属满意度,值得临床推广应用。

新生小鼠轮状病毒腹泻模型建立及病理学致病机制研究

目的研究轮状病毒（RV）感染性腹泻的病理学机制。方法50只3d昆明鼠按接种RV与否随机分为实验组（40只）与对照组（10只），实验组经胃灌入0．2ml（2×10^8 PFU）含病毒（SA11株）培养液，对照组灌人0．2ml不含病毒的培养液，分别于接种后不同时间点观察腹泻情况，ELISA方法检测粪便RV抗原，并取其肠黏膜光镜观察形态学变化及电子显微镜下观察RV定植及细胞超微改变。结果实验组接种病毒后24h均出现腹泻，在接种后4d达高峰，第10天完全恢复正常，粪便ELISA检测RV抗原均为阳性。突出的病理改变为小肠上皮细胞广泛空泡样变性，炎症改变轻微。电镜下绒毛上皮细胞结构完整，紧密连接疏松、增宽，完整性受到破坏。结论猴SA11株可成功感染新生昆明鼠制备RV感染模型。RV腹泻的发生可能是通过破坏肠上皮细胞间连接关系，改变上皮细胞极化，从而影响水电解质平衡；与微绒毛损害、细胞凋亡脱落、绒毛萎缩及隐窝细胞取代关系不大。

一起新生儿病毒性腹泻病原学分析

目的查明引起新生儿病毒性腹泻疫情的病原并对其进行分子生物学特征分析。方法采用金标法检测轮状病毒抗原,采用乳胶凝集法检测腺病毒;通过聚丙烯酰胺凝胶电泳(PAGE)检测粪便样品中的轮状病毒核酸;利用逆转录-聚合酶链反应(RT-PCR)检测肠道病毒和扩增轮状病毒VP7基因并测序;利用DNAstar和Blast软件对测序结果进行分析。结果11份样品中,金标法检测到轮状病毒阳性样品9份,阳性率为81.82%;腺病毒和肠道病毒检测均为阴性;PAGE法检测到10份轮状病毒阳性样品,电泳带型为4-2-3-2的样品有8份,阳性率为72.73%,另2份阳性样品的电泳条带特殊;8份带型为4-2-3-2的阳性样品均能通过RT-PCR扩增出VP7基因,选择其中3份样品进行测序,测序结果经过比对发现这3个毒株的核苷酸的同源性为99.90%,氨基酸的同源性为100%,与G1型标准株Wa的核苷酸同源性分别为91.30%～91.50%,氨基酸同源性为94.80%;与泰国流行株Thai-2104亲缘关系最近,与中国以前的流行株处于不同的进化分支上。结论引起此次新生儿病毒性腹泻疫情的病原是A组轮状病毒,PAGE带型主要为4-2-3-2,其血清型为G1型。

新生儿肠道双歧杆菌与其婴儿期腹泻关系的研究

目的:研究新生儿肠道双歧杆菌与其婴儿期腹泻发生的相关性,为预防婴儿腹泻开辟新思路.方法:以120例新生儿为研究对象,生后5～7天均作大便双歧杆菌培养.据预实验结果分为双歧杆菌(LgN/g)相对不足者(＜7.0)和充足者(≥7.0)各60例.前者随机分为A和B两组(各30例),后者分为C和D两组(各30例),其中A组和C组使用外源性双歧杆菌干预.每例均严密随访至1岁,并准确记录发生腹泻情况.结果:新生儿肠道双歧杆菌相对充足者较不足者腹泻发生率(包括感染性腹泻)明显降低;使用外源性双歧杆菌早期干预能明显降低腹泻发生率.结论:新生儿肠道双歧杆菌是否充足与其婴儿期腹泻发生有明显的相关性;早期使用外源性双歧杆菌干预能明显减少婴儿腹泻的发生机会.

新生儿轮状病毒肠炎23例临床与流行病学分析

目的回顾性分析某院新生儿病区轮状病毒肠炎患儿的临床特征与流行规律,探讨预防与控制对策。方法查阅新生儿病区2006年初的23例轮状病毒肠炎患儿病历,对其临床资料与实验室结果进行分析。结果轮状病毒肠炎新生儿以腹泻入院者5例,支气管肺炎入院者17例,高胆红素血症1例。大便轮状病毒抗原检测均为阳性;轮状病毒核酸PAGE检测10例,其中5例阳性,证实为A组轮状病毒感染,分3个基因型。粪-口传播是本次感染的主要传播途径。结论在轮状病毒肠炎好发季节,除应对肠炎患儿进行隔离和大便轮状病毒检测外,对呼吸系统感染并腹泻患儿也要采取上述措施,并应加强环境消毒等,杜绝轮状病毒肠炎在病区内流行。

甘肃部分地区致羔羊腹泻大肠埃希菌的分离鉴定及耐药性分析

为调查甘肃地区大肠埃希菌对新生羔羊腹泻的致病性及其耐药性,从甘肃省8个养殖场采集新生腹泻羔羊粪便92份。采用16S rDNA扩增结合微生物鉴别培养技术对病料中的致病性大肠埃希菌进行鉴定,随机选取分离的6株菌株进行致病性试验,并采用Kirby-Bauer纸片琼脂扩散法对分离得到的菌株进行耐药性分析。结果表明,从92份病料中分离得到21株致病性大肠埃希菌,选取的6株菌均有一定的致病性,耐药性分析结果显示该地的大肠埃希菌对羊场常用的多种抗生素耐药。表明大肠埃希菌仍是引起甘肃地区新生羔羊腹泻的主要病原菌,而且耐药性严重。