Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.

ObjectiveTo evaluate the safety and effectiveness of high power focused-beam microwave for deep region/whole body heating.MethodsTen 20 cm?20 cm?2 cm Jiang Han-bao prescribtion muscle phantoms were counterpoised exactly to 37 ℃,then piled up under microwave applicator. Nine thermocouples were placed between the phantoms in the center to monitor the temperature during heating. The phantoms were heated with a series of different source-skin distances and powers with the temperature measured every 1-2 min. After heating,the thermal distributive images for the phantoms were attained by liquid crystal plate (LCP) with the temperature of 40-45 ℃. Five swines with 60-75 kg weight were heated 8 times (1-3 times for each swine ) for 120 min each session,with a heating power of 600-800 W. Serum and tissues including liver,kidney,colon-rectum,intestine,muscle,fat and lung were collected for pathologic examination before and after heating. ResultsThe temperature images of 2-10 cm depth attained immediately after heating by LCP showed that the aim temperature (equal or over 40 ℃) was achieved and exhibited uniform thermal distribution in these areas. The tissues of the swines showed no serious damage by either microscopic or electron-microscopic examination. Some serum enzymatic parameters temporarily increased after heating,then reduced to normal level after a short interval (about one week) ConclusionHigh power focused-beam microwave is effective and safe for deep region/whole body heating by either phantoms or animal tests.

Objective: To investigate the antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of S.paratyphi A strains in Zhengzhou city isolated from sentinel hospitals in 2013-2015. Methods: According to Salmonella molecular typing and K-B drug susceptibility testing method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI2015), we analyzed drug sensitivity and PFGE molecular characteristics of 67 S.paratyphi A strains(11 strains in 2013, 7 strains in 2014, 49 strains in 2015) isolated from blood and stool samples in two sentinel hospitals of fever with rash syndrome surveillance system established in Zhengzhou city in 2013-2015. Results: The results showed 67 strains of S.paratyphi A had different levels of resistance to 13 kinds of antibiotics, 65 strains were multi-drug resistant strains (97.0%), 5 isolates were resistant to 2-3 kinds of antibiotics (7.5%), 41 isolates were resistant to 5-8 kinds of antibiotics (61.2%),11 isolates were resistant to 9-10 kinds of antibiotics(16.4%),8 isolates were resistant to 11-12 kinds of antibiotics(11.9%). 67 strains of S.paratyphi A were divided into 10 molecular patterns(PTYA1-PTYA10) by digestion with XbaⅠ restriction endonuclease and pulsed field gel electrophoresis, each pattern contains 1-48 strains with similarity ranged from 94.31%-100%. PTYA3 contained 48 strains, which was predominant band type; PTYA1, 9 contained 6 strains; PTYA 2, 4, 5, 6, 7, 8, 10 contained 1 strains among them. Conclusion The status of drug resistance of clinical isolates of S.paratyphi A in Zhengzhou city was rather serious, PFGE patterns showed diversity and dominant characteristics. The PFGE patterns of partial strains and its corresponding anti-drug spectrum have certain relevance and cluster relationship.

Objective: To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China. Methods: In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR. Epidemiological information (including demographic information such as age, sex and clinical symptoms) was also collected from the patients and analyzed. Results: Group A rotavirus was detected in 30.9% (785/2 541) of diarrhea samples from children. The detection rate was higher in October (54.8%, 345/629) and lower in July (5%, 5/101) each year from 2008 to 2015. The group A rotavirus infection rate was higher in boys (30.6%, 451/1 476) than in girls (31.4%, 334/1 065) (χ²=0.18, P=0.664). Infection mainly occurred in 4-12 months old patients (61.3%, 481/785) (χ²=196.69, P<0.001), and the infection rate was lower in cities (26%, 258/992) compared with rural areas (34.0%, 527/1 549) (χ²=18.19, P<0.001). G typing of 785 strains of group A rotavirus revealed the following types: G1 (13.5%, 106 strains), G2 (11.1%, 87 strains), G3 (29.7%, 233 strains), and G9 (57.5%, 451 strains); P typing revealed the predominance of P[4] (11.3%, 89 strains) and P[8] (84.7%, 665 strains); gene type combinations comprised mainly G9P[8], G2P[4], G3P[8], G1P[8], respectively accounted for 52.9% (415), 9.7% (76), 17.3% (136), 11.3% (89). Gene type combinations G1 [8] and G3P[8] have been decreasing in prevalence since 2008 and G9P[8] has become the dominant gene type of group A rotavirus in Henan province. Among the group A rotavirus infection samples, the male:female infection ratio was 1.4∶1 (451/334), with no significant difference in the infection rate (χ²=0.18, P=0.664); the infection rate was higher in 4- 12 months old patients (61.3%, 481/785), with a significant difference detected between age groups (χ²=196.69, P<0.001). The rate of detection was lower in cities (26.0%, 258/992) than in rural areas (34.0%, 527/1 549) (χ²=18.19, P<0.001). Clinical analysis revealed a body temperature of below 37 degrees in 75.7% of positive cases (594 patients), 37.0- 37.5 degrees in 17.2% of cases (135 patients), 37.6-38.0 degrees in 2.0% of cases (16 patients), and above 38 degrees in 5.1% of cases (40 patients), with most cases showing no fever or a mild fever. The frequency of episodes of diarrhea among the patients was 0- 3 times (21.1%, 166 cases), 4- 6 times (65.6%, 515 cases), 7- 9 times (8.0%, 63 cases), or 10- 15 times (5.2%, 41 cases), mainly showing mild and moderate diarrhea. Vomiting also varied in frequency among the patients from no vomiting (86.9%, 682 cases), 1-2 times (11.8%, 92 cases), 3 times (6.0%, 47 cases), and more than 3 times (0.4%, 3 cases). The occurrence of dehydration varied from no dehydration (86.9%, 682 cases), mild dehydration of 1%- 5% (12.1%, 95 cases), to severe dehydration of ≥5% (1.0%, 8 cases). Conclusion A higher infection rate of group A rotavirus was detected in children younger than five years of age with acute diarrhea in sentinel hospitals in Henan province, including part-mixed infection cases. A predominance of cases was detected in the autumn, and secondly the spring of each year. Gene type G9P[8] was most frequently isolated. The majority of patients displayed no fever, vomiting or dehydration. The cases with clinical symptoms of fever, diarrhea, vomiting and dehydration often showed mild disease.

Objective To investigate the drug tolerance and PFGE patterns of Salrnonella (S.) paratyphi A strains isolated from sentinel hospitals in Dengfeng,Henan province,during 2009-2015.Methods Venous blood samples were collected from paratyphoid patients and cultured in double phase blood culture bottle.Suspicious strains were identified and used for Salomonella.O antigen and H1/2 phase flagellum-induced serum agglutination test with API20E biochemical systems and SSI Salmonella typing sera.According to Salmonella molecular typing and K-B drug susceptibility testing method published by PulseNet China bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute,we analyzed the drug susceptibility and PFGE molecule characteristics of S.paratyphiA strains isolated from the patients.Results A total of126 strains of S.paratyphi A were isolated from 248 blood samples,the antigen modes of them were 1,2,12:a:-.The resistance rate of 126 strains of S.paratyphi A was 83.3％ to ampicillin;29.4％ to ceftazidime,31.2％ to cefotaxime,17.5％ to cefepime;62.6％ to nalidixic acid;19.3％ to ciprofloxacin,26.4％ to norfloxacin;22.8％ to gentamicin,47.9％ to streptomycin;19.2％ to chloramphenicol,24.2％ to methicillin benzyl ammonium,58.6％ to compound sulfamethoxazole and 46.7％ to tetracycline.The 126 strains of S.paratyphi A had different levels of resistance to 8 kinds of antibiotics,109 strains were multidrug resistant (86.5％),9 strains were resistant to 2-3 kinds of antibiotics (7.1％),76 strains were resistant to 5-8 kinds of antibiotics (60.3％),17 strains were resistant to 9-10 kinds of antibiotics (13.5％),7 strains were resistant to 11-12 kinds of antibiotics (5.6％).The 126 strains of S.paratyphi A were divided into 14 molecular patterns by digestion with Xba I and pulsed field gel electrophoresis.The antibiotics resistance to third generation cephalosporin (CAZ,CTX),one generation and three generation of quinolones (NAL,CIP,NOR) and aminoglycosides antibiotics (STR) showed an upward trend.Each pattem contained 1-98 strains with similarity ranged from 64.10％ to 100.00％.PTYA 1,6,9 and 10 were the main PFGE belt types.Conclusion The drug resistance of clinical isolates ofS.paratyphi A was serious in Dengfeng,Henan province,PFGE pattems showed a diversity,but predominant patterns could also be found.The PFGE patterns of some strains had clustering and were related with their antidrug spectrums.

OBJECTIVETo investigate the antimicrobial resistance status and pulsed field gel electrophoresis (PFGE) patterns of Salmonella Enteritidis (S.Enteritidis) strains in Henan province.

METHODSS. Enteritidis strains were isolated from seven sentinel hospitals from March 2011 to December 2013. According to molecular typing and Salmonella (Kirby-Bauer, K-B) drug susceptibility testing method published by the international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI), we analyzed drug sensitivity of 8 kinds antibiotics and PFGE molecule characteristics of 120 S. Enteritidis isolates from seven sentinel hospitals.

RESULTSAmong 120 strains of S. Enteritidis, 77 were isolated from male patients, 43 from female patients. A total of 78 strains S. Enteritidis were isolated from young children ranged from 0 to 5 years old (65.0%), including 57 strains isolated from 6 months to 2 years old (47.5%). The isolated time mainly centralized on May to October of the year, 11 strains isolated in March-April (9.2%), 48 were in May-July (40.0%),54 in August-October (45.0%), 7 in other months, with a typical summer seasonal characteristics. The resistance rate of 120 strains S. Enteritidis to ampicillin was 50.0% (n=60); to ceftazidime was 14.2% (n=17), to cefotaxime was 18.3% (n=22); to cefepime was 5.8% (n=7); to nalidixic acid was 61.7% (n=74); to ciprofloxacin was 8.3% (n=10), to norfloxacin was 5.8% (n=7); to gentamicin was 42.5% (n=51); to streptomycin was 21.7% (n=26); to chloramphenicol was 30.0% (n=36); resistance to methicillin benzyl ammonium was 11.7% (n=14), compound sulfamethoxazole resistance rate was 71.7% (n=86); the tetracycline resistant rate was 47.5% (n=57). All 120 strains of S. Enteritidis had different levels of resistance to 8 kinds of antibiotics, all strains were multidrug resistant strains, 28 isolates were resistant to 3-4 kinds of antibiotics (23.3%), 38 isolates were resistant to 5-6 kinds of antibiotics (31.7%), 39 isolates were resistant to 7-8 kinds of antibiotics (32.5%). All 120 strains of S. Enteritidis were divided into 44 molecular patterns by digestion with XbaI and pulsed field gel electrophoresis. each pattern contained 1-35 strains with similarity ranged from 54.3%-100%. EN14 and EN19 were the main PFGE types, including 35 and 29 strains respectively.

CONCLUSIONThe status of drug resistance of clinical isolates of Salmonella in Henan province was rather serious, PFGE patterns showed advantages and partial strain's corresponding resistant spectrum have certain relevance and the same aggregation relationship.

Anti-Bacterial Agents ; pharmacology ; Child, Preschool ; China ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Microbial Sensitivity Tests ; Molecular Typing ; Salmonella Infections ; microbiology ; Salmonella enteritidis ; classification ; drug effects

Objective To analyze the serotypes and antibiotic resistance phenotypes of non-typhi Salmonella strains in Henan province from 2011 to 2015.Methods The stool samples were collected from diarrhea patients,and enriched with SBG enrichment broth and the pathogen isolation was conducted with CHROMAgar selective culture medium at 37 ℃ for 18-24 hours using KIA/MIU biochemical action and API20E biochemical system slab to identify Salmonella strains.The serotypes of all the positive strains were detected with SSI Salmonella typing sera.According to K-B drug susceptibility testing method published by USA clinical and Laboratory Standards Institute (CLSI),the antibiotics resistant phenotype of the positive strains were analyzed.Results A total of 1 351 strains of non-typhi Salmonella were isolated,in which 811 were from males,540 were from females.The ratio of men to women was 1.5 ∶ 1.Children and young adults were mainly affected.The pathogen isolation was mainly in May-October during a year.The 1 351 strains of non-typhi Salmonlla were divided into 58 serotypes.S.enteritidis,S.typhimurium,S.agona,S.derby,S.indiana,S.senfienberg and S.thompson ranked 1st-7th.The drug-resistance rate of the 1 351 strains was 46.1％ to synthetic broad-spectrum penicillin ampicillin (AMP),19.5％ and 21.2％ to the three generation cephalosporin ceftazidime (CAZ) and cefotaxime (CTX),8.8％ to the four generation cephalosporins cefepime (FEP),58.7％ to the one generation of quinolones nalidixic acid (NAL),14.7％ to the three generation fluoroquinolone ciprofloxacin (CIP) and norfloxacin (NOR),25.0％ and 35.6％ to aminoglycoside antibiotic gentamicin (GEN) and streptomycin (STR),35.4％ to amphenicols (CHL),31.7％ to sulfonamide trimethoprim (TMP) and 37.8％ to tetracycline (TET).Totally 879 strains were multidrug resistant (65.1％):350 strains were resistant to 3-4 kinds of antibiotics (25.9％),309 strains were resistant to 5-7 kinds of antibiotics (22.9％),174 strains were resistant to 8-10 kinds of antibiotics (12.9％) and 48 strains were resistant to 11-12 kinds of antibiotics (3.6％).Conclusion The serotypes of non-typhi Salmonella strains isolated from Henan province varied,some strains were resistant to 12 kinds of antibiotics commonly used in clinical treatment and the multidrug resistance has become serious.

Objective To investigate the infection status of human rotavirus,calicivirus,astrovirus and enteric adenovirus in children aged ＜5 years in disease surveillance areas in Henan province from 2013 to 2015.Methods A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR,while rotavirus (group B,C),calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR.The epidemiological data of positive cases were statistically analyzed.Results A total of 594 positive samples were detected,including 24 mixed infection samples,370 rotavirus positive samples (42.0％);162 calicivirus positive samples (18.4％);69 astrovirus positive samples (7.8％) and 17 enteric adenovirus positive samples (1.9％).The overall positive rate of four viruses was significantly higher in urban area than in rural area,but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group.G9P [8] was the major genotype of group A rotavirus,there were two seasonal infection peaks in autumn and spring.Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring.Viral diarrhea cases were distributed in different age groups,mainly in age groups 0-12 months (rotavirus) and 3-5 years (calicivirus).The main clinical symptoms included fever,diarrhea and vomiting.The etiological characteristics differed with gender and area.Conclusions The infection rate of diarrheal viruses was higher in young children ＜5 years old in disease surveillance areas.The epidemiological and clinical features varied with the type of pathogen.

Objective To understand the distribution of Salmonella in external environment in Henan province,and explore the distribution of different serotypes of the Salmonella and their homology.Methods A total of 4 488 samples were collected form animal dung,meat products and kitchen utensils,and identified by biochemical tests and serotyped by serum agglutination reaction.The predominant serotypes were further typed by PFGE.Results A total of 324 Salmonella strains were detected in these samples,the detection rate was 7.21％.The 324 Salmonella isolates belonged to 39 serotypes,S.enteritidis (24.07％,78/324) and S.derby (20.37％,66/324) were predominant.Forty six strains ofS.enteritidis and 30 strains of S.derby were divided into 12 and 17 molecular patterns by digestion with Xba Ⅰ,while chicken and swine were the predominant animal hosts.Conclusions Serotyping of external environment Salmonella were phenotypically diverse and the serotype of Salmonella from different sources were different.The same clone was prevalent in same area.It is necessary to strengthen supervision and surveillance to ensure food safety.

Objective:To explore the serotype distribution and drug resistance of Shigella in stool samples of children under five years old with diarrhea from 2008 to 2017 in Sui County, Henan Province. Methods:A total of 4 721 stool samples of children under five years old with diarrhea were collected from Doufuyuan Clinic of Sui County during 2008 to 2017, and Shigella strains were isolated through bacterial culture. The slide agglutination test was used for serotyping of Shigella strains. Two hundred of seventy-one Shigella strains were selected in proportion, and multiple gradient polymerase chain reaction was used to detect virulence genes and Kirby-Bauer agar method was used for drug sensitivity. Trend chi square test was used to analyze the annual trend of drug resistance. Results:The detection rate of Shigella strains in 4 721 fecal samples was 20.69% (977/4 721). A total of 977 Shigella strains were divided into 13 serotypes in two groups, including 77.79%(760/977) Shigella flexneri strains and 22.21%(217/977) Shigella sonnei strains.The top three serotypes detected alternately every year.The dominant gene pattern of Shigella flexneri was Shigella enterotoxin ( shET)-1+ , shET-2+ , invasion plasmid antigen H ( ipaH)+ , invasion-associated locus ( ial)+ , accounted for 84.04%(179/213) and that of Shigella sonnei was shET-1-, shET-2+ , ipaH+ , ial+ , accounted for 46.55%(27/58). The drug resistance rates of 271 Shigella strains to ampicillin, nalidixic acid and tetracycline were more than 90% and the strains were more sensitive to cefepime and ceftazidime.The drug resistance rates to cefotaxime, cefepime, ciprofloxacin, chloramphenicol and sulfamethoxazole/trimethoprim increased year by year, and all had statistically significant differences ( χ2=24.027, 7.232, 6.039, 4.764 and 6.809, respectively, all P< 0.05). There were 98.52%(267/271) strains resistant to more than three kinds of drugs. The resistance rates of Shigella flexneri to ciprofloxacin, norfloxacin, and chloramphenicol were higher than those of Shigella sonnei, and the resistance rates to gentamicin and sulfamethoxazole/trimethoprim were lower than those of Shigella sonnei. The differences were statistically significant ( χ2=31.866, 14.868, 83.036, 68.534 and 14.738, respectively, all P<0.01). Conclusions:The major serotypes of Shigella in children under five years old in Sui County are constantly changing from 2008 to 2017. The dominant gene patterns of different serotypes are different. Most isolated strains have multiple drug resistances, and different serotypes have different resistance profiles.