不孕妇女解脲支原体和人型支原体感染及耐药分析

[目的]了解女性不孕症患者支原体感染状况及对抗生素的耐药情况,指导临床合理用药.[方法]选择柳州地区不孕妇女332例,其中原发不孕138例,继发不孕194例,并选择120例正常生育妇女做对照,取宫颈分泌物做Uu、Mh检测,并对阳性者做药敏试验.[结果]不孕症患者支原体阳性率45.2%,与对照组比较差异有统计学意义(P＜0.05);继发不孕组与原发不孕组相比,支原体阳性率无差异(P＞0.05);支原体感染以Uu为主,Uu+Mh次之;Uu对美满霉素、强力霉素、交沙霉素、环脂红霉素较敏感,Uu+Mh对美满霉素、强力霉素较敏感,它们可用于支原体感染的治疗;Uu+Mh感染的耐药率升高,多重耐药现象严重;Uu对4种抗生素耐药所占比例最高(26.2%),Uu+Mh对10种抗生素耐药所占比例最高(50%),Uu、Uu+Mh对抗生素的耐药种效不一致.[结论]柳州地区不孕症患者支原体感染率高,且多重耐药,但对强力霉素、美满霉素较敏感.     

女性生殖道支原体感染及药敏分析

目的:了解女性生殖道支原体感染和药物敏感情况,为临床合理用药提供参考依据。方法:对2006年11月～2008年11月长兴县妇幼保健院妇科门诊的876例阴道炎患者进行支原体培养,并对阳性标本进行抗生素药敏试验,采用支原体培养、鉴定及药敏一体化试剂盒进行检测。结果:876例患者中检测出支原体阳性412例,阳性率为48.06%,其中解脲支原体(Uu)308例,占35.16%,人型支原体(Mh)8例,占0.91%,Uu+Mh混合感染96例,占10.96%;支原体对不同抗生素的敏感性不同,对甲砜霉素敏感性最强,对红霉素耐药性最高。结论:女性生殖道支原体感染以Uu感染为主,支原体对常规抗生素已产生较高的耐药性,支原体培养及药敏试验有助于指导临床医生合理用药。     

解脲支原体和人型支原体培养及药敏分析 FREE

目的方法结果结论了解某地区泌尿生殖道感染与不孕症患者的支原体感染及药敏情况,为临床诊断及治疗提供实验数据。采用支原体鉴定、药敏试剂盒对683例患者的标本进行检测,并用WHONET5.4软件作统计分析。683份标本中共检出支原体阳性353份,阳性率51.68%。其中,解脲支原体(Uu)阳性率38.07%,人型支原体(Mh)阳性率1.17%,Uu与Mh共同感染的阳性率为12.45%;男性标本的阳性率为24.53%,女性标本的阳性率为63.91%,后者明显高于前者(χ2=90.78,P<0.005)。在药敏结果中,Uu对强力霉素、交沙霉素、美满霉素的敏感率较高,分别为91.15%、90.38%、90.38%;而Uu与Mh混合感染对上述3种抗菌药物的敏感率分别为68.24%、56.47%、65.88%。提示在生殖道支原体感染中,女性明显高于男性;支原体中Uu单项感染率高,单项Uu感染对抗菌药物的敏感性比Uu+Mh混合感染高。     

女性泌尿生殖道炎症患者支原体感染现状及其对抗生素的敏感性研究

目的了解女性泌尿生殖道炎症患者支原体的感染现状及其对抗生素的敏感性。方法回顾性分析清苑县妇幼保健院2010年1月-2011年8月收治的女性泌尿生殖道炎症患者560例的临床资料,支原体感染254例,对该254例泌尿生殖道炎症患者做体外支原体培养鉴定及药物敏感试验。结果支原体感染阳性率为45.4%。单纯解脲脲原体(Uu)感染率为63.8%(162/254),明显高于单纯人型支原体(Mh)及Uu+Mh混合感染率9.5%(24/254)、26.8%(68/254),组间差异有统计学意义(P<0.05)。单纯Uu感染对克拉霉素、交沙霉素敏感,Uu与Mh混合感染者对强力霉素敏感,单纯Mh感染对强力霉素敏感。结论本院女性泌尿生殖道炎症患者支原体的感染以单纯Uu感染为主,不同生物型支原体感染对抗生素敏感率不同,临床医师应根据支原体的感染现状及其对抗生素的敏感性选用合适的抗生素。     

不孕不育患者支原体感染状况及药物敏感结果分析

目的:探讨不孕不育患者支原体感染状况及对12种抗生素的药敏情况,为临床合理治疗提供参考。方法:对本中心620例不孕不育患者的生殖道分泌物进行支原体培养及体外药敏试验,计算男性及女性患者支原体感染总阳性率、解脲支原体(Uu)及人型支原体(Mh)阳性率,采用卡方检验进行统计学分析。结果:支原体感染总阳性率为18.4%(114/620),男性和女性阳性率分别为13.6%(32/236)、21.4%(82/384)。男性和女性Uu阳性率分别为3.4%(8/236)、16.7%(64/384);Mh阳性率分别为6.8%(16/236)、2.1%(8/384),Uu和Mh合并感染阳性率分别为3.4%(8/236)、2.6%(10/384)。女性患者与男性患者支原体感染阳性率、Uu感染率、Mh感染率以及女性患者的Uu与Mh感染率间差异有统计学意义(P均<0.05)。Uu感染对美满霉素的敏感性最高(100.0%),对环丙沙星的耐药性最强(41.6%);Mh感染对美满霉素的敏感性最高(100.0%),对红霉素、环酯红霉素和克拉霉素的耐药性均达到50.0%;Uu和Mh混合感染对美满霉素的敏感性最高(77.8%),对12种抗生素均有不同程度的耐药性,其中对红霉素的耐药性最强(77.8%)。结论:男性和女性患者支原体感染状况不同,治疗时建议根据药敏结果合理用药。     

女性生殖道支原体的致病性及其与不孕关系的探讨

目的:探讨不孕女性生殖道支原体感染与致病情况。方法:对60例已经排除其他导致不孕原因的女性可疑支原体感染患者的生殖道分泌物进行支原体培养及药敏鉴定试验。结果:对于培养阳性且计数>104cfu/ml的结果进行统计分析,不孕症组Uu、Mh阳性率及Uu+Mh感染率分别为53.33%、11.67%和3.33%,Uu、Mh明显高于对照组妇女,差异有统计学意义(P<0.05)。结论:女性患者生殖道的支原体感染已成为不孕的重要原因之一,建议对于女性不孕就诊患者常规支原体筛查,对于阳性结果应按相应药敏结果进行治疗。     

生殖道感染就诊妇女与健康体检妇女中支原体感染状况的调查

目的了解解脲脲原体(Uu)、人型支原体(Mh)在生殖道感染妇女和健康体检妇女中的感染状况。方法采集2005年11月至2006年4月南京市某三甲医院就诊的生殖道感染女性184例和健康体检女性199名的生殖道分泌物样本,同时采用培养法和聚合酶链反应法进行Uu、Mh的检测,在培养的同时采用倍比稀释法进行颜色变化单位(CCU)浓度检测,并结合调查表资料,对两组人群的支原体感染状况进行分析。结果生殖道感染人群支原体阳性率76.1%,显著高于健康女性人群42.2%(X~2=45.1862,P<0.0001)。健康女性以单纯Uu和单纯Mh感染为主,生殖道感染者以Uu和Mh的混合感染为主(单纯Uu、Uu Mh:X~2=39.5956,P<0.0001;单纯Mh、Uu Mh:X~2= 13.2935,P=0.0003)。支原体CCU浓度检测结果显示,生殖道感染女性人群体内Uu、Mh浓度显著高于健康体检人群(Uu:秩和检验Z=7.1058.P<0.0001,Mh:秩和检验Z=8.7201,P<0.0001)。支原体在各年龄段普遍易感。结论两种支原体均为条件致病菌,两者并存具有一定的协同致病作用,当支原体感染量较高时易导致临床症状的出现。     

不孕不育患者支原体感染状况及药敏分析

目的:总结分析门诊中不孕不育患者支原体感染及对12种抗生素药物的敏感性情况,为临床诊疗提供参考。方法:对来本中心1615例不孕不育患者进行泌尿生殖道分泌物支原体培养及抗生素药敏试验。计算患者解脲支原体(Uu)和人型支原体(Mh)阳性率,并进行统计学分析。结果:不孕不育患者中女性患者Uu感染高于Mh和混合感染,男性患者Mh感染高于Uu和混合感染,且女性患者Uu感染和Mh感染均高于男性患者。而不同年龄支原体阳性患者的支原体感染类型无统计学差异。药敏结果显示,Uu对环酯红霉素(94.51%)、强力霉素(93.41%)、交沙霉素(96.70%)、美满霉素(91.21%)高度敏感;Mh对甲砜霉素(86.36%)的敏感性最强;Uu和Mh合并感染对强力霉素(81.82%)敏感性最强。结论:本研究组中不同性别患者支原体感染状况不同,而不同年龄患者支原体感染状况无明显差异,治疗时建议根据药敏试验结果合理用药。     

性病高危人群泌尿生殖道支原体、衣原体感染研究

目的 了解性病高危人群泌尿生殖道支原体、衣原体感染状况.方法 对932例性病高危人群的泌尿生殖道标本进行支原体培养和衣原体抗原检测.结果 932例标本中支原体、衣原体感染率为34.3%,男性感染率为31.9%,女性感染率为38.1%;其中沙眼衣原体(Ct)、解脲脲支原体(Uu)、人支原体(Mh)感染阳性例数及阳性率分别为77例8.3%、122例1,3.1%、70例7.5%,Uu+Mh、Uu+Ct、Ct+Mh、Ct+Uu+Mh混合感染的阳性例数及阳性率分别为7例0.8%、14例1.5%、3例0.3%、1例0.1%;与健康人群感染率8.7%比较,差异有统计学意义(P<0.05).结论 性病高危人群泌尿生殖道支原体、衣原体感染率高、流行广,在性病的防治与监测工作中应重视对这些人群的常规检测.     

不孕症妇女感染沙眼衣原体、解脲支原体的临床分析

目的:探讨沙眼衣原体、解脲支原体感染与女性不孕症的关系。方法:采用聚合酶链反应(PCR)技术对116例不孕症妇女(不孕症组)及100例正常生育妇女(对照组)行宫颈分泌物沙眼衣原体和解脲支原体检测。结果:116例不孕症妇女宫颈分泌物标本中沙眼衣原体阳性率为36.21%(42/116),解脲支原体阳性率为52.59%(61/116);正常生育妇女组沙眼衣原体、解脲支原体阳性率分别为12.00%(12/100)和19.00%(19/100),不孕症组沙眼衣原体、解脲支原体混合感染率15.52%(18/116),对照组混合感染率6.00%(6/100),两组差异有统计学意义P<0.05。结论:沙眼衣原体和解脲支原体感染与女性不孕症发生有密切关系。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.