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06 December 2011, Volume 26 Issue 12 Previous Issue    Next Issue

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Distribution and antibacterial resistance of pathogens in Pediatric Intensive Care Unit. HU Hai-yun，WANG Chun，QIAO Rong，ZHANG Hong，ZHANG Yu-cai 2011, 26(12): 920.  Abstract ( )   Abstract：Objective　To investigate the tendency of bacterial distribution and drug resistance of pathgens in Pediatric Intensive Care Unit，then instruct clinical application of antibiotics reasonably. Methods　The bacteria isolated from patients in PICU from Jan 2009 to Dec 2010 were identified by vitek 2 compact instrument and antibiotic susceptibility was determined by K-B disk diffusion method. Results　A total of 657 pathogens strains were isolated，Gram-negative bacilli，Gram-postive cocci and fungi accounted for 69.9%，23.4%，6.7%，respectively. The most common pathogens of them were Pseudomonas aeruginosa （21.3%），then in series Acinetobacter baumannii （19.2%）； the rate of the ESBL -producing strains of Klebsiella pneumoniae and Escherichia coli was more than 70%，the ceftazidime and cefotaxime resisitant rates of ESBL- positive strains are more than 80%，the cefepime resisitant rate of ESBL-positive strains is more than 40%；the ceftazidime、cefepime、 imipenem、meropenem resisitant rate of Acinetobacter baumannii are more than 75%； Staphylococcus aureus account for 5.0%，29% strains of Staphylococcus aureus were Methicillin resistant S.aureus. The most common strains of fungi were Candida albicans （6.0%）. All of them were sensitive to fluconazole，ketoconazole and amphotericin b. Conclusion　The multi-drug resistance of pathogens are serious in PICU. It is important and urgent to carry out surveillance of bacterial resistance for appropriately using antibiotics.

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Seroepidemiological study of Epstein-Barr virus infection in hospitalized children. WANG Yang，XU Hong-mei. 2011, 26(12): 924.  Abstract ( )   Abstract：Objective　To understand the prevalence of Epstein-Barr virus in hospitalized children. Methods　All results of anti-VCA-IgM and anti-VCA-IgG to Epstein-Barr virus detected by ELISA in Chongqing Children’s Hospital from January to December in 2009 were collected. The data was counted using statistical analysis of Chi-Square Test by gender， age group and season. Results　The total infection rate of Epstein-Barr virus for hoapitalized children under 18 years old was 35.27% in 2009 and the recent infection rate was 12.66%.The accumulation infection rate gradually increased with ages， and nearly half of children had been infected by Epstein-Barr virus in pre-school age group. The period from 3 to 5 years old was the peak age of infection. The accumulation rate among 0～3 months， 3～6 months， 6～12 months， 1～2 years， 3～5 years， 6～12 years and 13～18 years old was 27.70%， 10.48%， 14.13%， 27.69%， 44.61%， 51.99% and 57.34%， respectively. And the recent infection rate was 1.15%， 1.25%， 2.52%， 12.55%， 22.21%， 18.55% and 20.3%， respectively. The recent infection rates in March， September and October were higher than those of others in 2009， and the difference was statistically significant （P < 0.05）. Except the 1～2 years group （P < 0.05）， there was no difference in other age groups about the cumulative and the recent infection rate by gender （P > 0.05）. Conclusion　1. The infection rate of Epstein-Barr virus for childen is lower than that reported before in China. Nearly half of children have been infected by Epstein-Barr virus in pre-school age group， the peak period of infection being 3～5 years old.2. There is no gender difference of cumulative and recent infection rate in Chongqing in 2009， the infection rate in March and September-October were higher than those of others.

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Clinical analysis of 121 cases of hand-foot-mouth disease caused by enterovirus 71 infection. LU Hai-yan*，SUN Bao-chang，ZHAO Qian-lei，CHEN Wang-qiang，YANG Zu-qin，ZHOU Zhu-yin 2011, 26(12): 928.  Abstract ( )   Abstract：Objective　To study the clinical features of hand-foot-mouth disease （HFMD） caused by enterovirus 71 （EV71） infection. Methods Clinical data of hospitalized children with hand-foot-mouth disease caused by EV71 infection from May 2010 to August 2010 were analyzed retrospectively. The difference of clinical manifestation and results of auxiliary examination between intensive HFMD group and serious HFMD group were compared. Results　High fever and nontypical skin rash showed significant difference between intensive group and serious group（P = 0.002，P = 0.000，respectively）； 120 EV71-positived HFMD cases （99.17%） showed neurological impairments. The major neurological features included fatigue （84.30%），frequent vomiting （65.30%），limb tremble （60.33%） and sleep disorders （53.72%）. The rate of abnormal knee reflex was 52.07% in physical examination. The incidence of vomiting（P = 0.001），unconsciousness （P = 0.000），abnormal muscular tension（P = 0.000），abnormal heart rate （P = 0.000），dysarteriotony （P = 0.000），capillary refill time being more than 3 seconds （CRT > 3 s） （P = 0.000），tachypnea or dyspnea （P = 0.000） and pulmonary exudative lesion in chest X-ray （P = 0.000） was morefrequent in serious group compared with intensive group，There were 51 cases （42.15% ） with a peripheral blood WBC count of more than 12 × 109/L or less than 4×109/L，52 cases （42.98% ） with blood glucose level of more than 6 mmol/L and cardiac troponin I elevated in 22 cases （18.18%）. The above three indexes were significantly different between two groups （P < 0.000，respectively）. Conclusion　HFMD caused by EV71 infection often shows neurological impairments. High fever，nontypical skin rash，frequent vomiting，unconsciousness，abnormal muscular tension，abnormal heart rate，dysarteriotony，CRT > 3s，tachypnea or dyspnea，and pulmonary exudative lesion are risk factors of serious HFMD. Early identification and correct treatment are the key to the rescue of serious HFMD.

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Observation on the result of 7 years of implementation of mother-to-child AIDS transmission blocking project. WEN Yong，LU Kuan，YAO Na，REN Xiu-qin. 2011, 26(12): 933.  Abstract ( )   Abstract：Objective　Explore the epidemiological characteristics of check-ups and maternal HIV infections people and implementation of mother-to-child transmission blocking，and reduce the rate of AIDS mother-to-child transmission.  Methods　Take maternal and marriage registration as subjects. Establish AIDS mother-to-child transmission block network. Block HIV positive anti-body maternal，put in different period implement different drug blocking plan. Results　In the past seven years in the city of 30823 people to go，and accept the voluntary consultant 27736 people with HIV，consulting rate 90.0%，accept HIV antibody test at 20652 people，the detection rate 74.5%，confirmed that 342 people infected with HIV cases，infection rates by 1.7%. In the past seven years in the city of 57096 people，the number of pregnant women care to accept the consultants of 52907 people，92.7% rate，accept consulting HIV antibody test at 50633 people，the detection rate 95.7%，confirmed that 340 people infected with HIV infection rate 0.7%，among them，foreign maternal accounted for 31.6%. In 340 HIV infections in pregnant women，168 cases of voluntary requirements，ccounting for termination of pregnancy； 49.4% of pregnant women with HIV infection The natural birth in 148，accounting for 43.5%. Childbirth and continue to have 172 pregnancies，according to different pregnancy， all the implemen-tation different drugs block. Of the 148 people，has delivery voluntary requirements of cesarean section in 116 cases， accounting for 78.4%，the natural birth 32 cases，accounting for 21.6%. HIV infection in the life the maternal infant 150 people，including twins in 2 cases. Lie birth interim foreign visitors and lost 7 cases. 143 baby implement the drugs and artificial feed. Block Already full 18 months of 97 people，including the baby 87 babies HIV testing，rate was 89.7%，the total detected by HIV antibodies in 2 cases，accounting for 2.3% of the number of client. Conclusion　Implemented a maternity and child care centers as the core，establish health care，disease control，medical institutions of trinity regional AIDS mother-to-child transmission network，to go through the block，pregnancy consulting detection，inpatient delivery of the three aspects of comprehensive intervention，to different gestational age at different drugs block pregnant women implementation method，is AIDS mother-to-child transmission of blocking an effective model.

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Study on variation of circulating levels of inflammatory markers in fetal growth restriction fetuses and neonates. LIU Xiao-mei，GU Hui，XING Yan-lin，YUAN Zheng-wei. 2011, 26(12): 937.  Abstract ( )   Abstract：Objective　To investigate alterations of circulating levels of the inflammatory markers— reflecting brain and adipose tissue inflammation—in the fetal growth restriction（FGR）fetuses and newborns，and explore its possible relation ship with adverse intrauterine development. Methods　Sixty parturients，hospitalized in Shengjing hospital of China Medical University，giving consecutively birth either to 30 appropriate for gestational-age（AGA） singleton infants （AGA group ） or 30 FGR full-term singleton infants （FGR group），were recruited.Plasm hs-CRP，PAI-1，S100B and leptin levels were determined by enzyme link immune assay（ELISA）in the umbilical cords blood （UC ） and venous blood from neonates on postnatal day 1 （D1） and day 4（D4）. Results　The birth weight，body length and the body mass index （BMI） of the FGR neonates were significantly lower compared with those of AGA group （P < 0.05）.The leptin levels of UC in the FGR neonates were lower than that in the AGA groups（P < 0.05），and correlated positively with the birth weights and the BMI（P < 0.05）.Plasma hs-CRP levels did not differ significantly at all time points between AGA and FGR groups（P > 0.05）.hs-CRP levels in Umbilical cords blood were significantly decreased when compared with D1 hs-CRP in both AGA and FGR groups （P < 0.05），and D1 hs-CRP was significantly increasedwhen compared with respective D4 hs-CRP（P < 0.05）.Plasma PAI-1 and S100B levels did not differ significantly at all time points between AGA and FGR groups（P > 0.05），and did not correlated with the birth weights and the BMI. Conclusion　Despite the lower birth weight，BMI and leptin levels in FGRs， there was no difference for the levels of inflammatory markers hs-CRP and PAI-1 between IUGR and AGA fetuses/neonates.The CRP level in both studied groups fluctuated from fetus to neonate stage might attribute to parturition stress and adaptation recovery.