Chronic granulomatous disease(CGD)is a rare primary immunodeficiency disease with X-linked or autosomal pattern of inheritance, which belongs to monogenic disorders, mainly manifested in repeated infection, granuloma formation caused by inflammatory response disorder and other inflammatory diseases.Detection of neutrophil respiratory burst function can screen the disease, and gene sequence analysis can identify the pathogenic genes.Now, the latest research on gene therapy was updated, and the clinical manifestations, diagnosis, routine treatment and hemato-poietic stem cell transplantation(HSCT)were summarized in order to strengthen the clinicians′ understanding of CGD.

Objective:To explore the epidemiological characteristics of Streptococcus pyogenes, namely β-hemolytic Group A Streptococcus (GAS) in children in Shenzhen. Methods:Multilocus sequence typing (MLST) data on the epidemic clonal population of GAS infection in children in Shenzhen Children′s Hospital from January 2016 to December 2018 were retrospectively analyzed.In the present study, 32 GAS strains belonging to 7 different emm types were from 32 children′s with impetigo, cellulitis, scarlet fever, sepsis, pneumonia, obstructive sleep apnea hypopnea syndrome, bronchitis, allergy with rhinitis, buttock abscess, allergic purpura or pharyngeal tonsillitis, which were isolated from 23 throat swabs, 5 sputum samples, 3 pus and 1 blood.Using polymerase chain reaction technology, 7 pairs of allelic housekeeping genes ( gki, gtr, murI, mutS, recP, xpt and yqiL) of 32 GAS isolates were analyzed, and the target gene products were subjected to sequencing.Then the obtained gene sequences of each allele were submitted to the MLST database to obtain the allele profile.Finally, the allele profiles were introduced in the MLST database again to confirm the sequence typing (ST). Results:The GAS clone groups of emm 1.00 and its subtypes, emm 4.00, emm 12.00 and its subtypes, emm 22.00, emm 28.00, emm 75.00, and emm 89.00 belonged to the sequence typing ST28, ST39, ST36, ST46, ST52, ST49, and ST921, respectively. Conclusions:From 2016 to 2018, the MLST clone populations of GAS isolates causing infections in children in Shenzhen are classified as ST28, ST39, ST36, ST46, ST52, ST49 and ST921.

BACKGROUND: Hospital emergency department (ED) use by patients from residential aged care facilities (RACFs) is not always appropriate, and this calls for interventions to avoid some unnecessary uses. This study aims to compare patterns of ED use by RACF patients with and without a Hospital in the Nursing Home (HiNH) program. METHODS: RACF patients presenting to EDs of a hospital with and a hospital without this program during pre- and post-intervention periods were included. Data on patient demographics and ED presentation characteristics were obtained from the Emergency Department Information System database, and were analysed by descriptive and comparative statistics. RESULTS: In both hospitals, most RACF residents presenting to EDs were aged between 75–94 years, female, triaged at scale 3 to 5, and transferred on weekdays and during working hours. Almost half of them were subsequently admitted to hospitals. In accordance with the ICD-10-AM diagnostic coding system, diagnoses that consistently ranked among the top three reasons for visiting the two hospitals before and after intervention included Chapter XIX: injury and poisoning and Chapter X: respiratory diseases. Associated with the intervention, significant decreases in the numbers of presentations per 1000 RACF beds were identified among patients diagnosed with Chapter XI: digestive diseases [rate ratio (95％CI): 0.09 (0.04, 0.22);P<0.0001] and Chapter XXI: factors influencing health status and contact with health services [rate ratio (95％CI): 0.22 (0.07, 0.66);P=0.007]. CONCLUSION: The HiNH program may reduce the incidence of RACF residents visiting EDs for diagnoses of Chapter XI and Chapter XXI.

Group A Streptococcus (GAS) is a very important pathogenic organism, especially for children.Chinese experts′consensus statement on diagnosis, treatment, and prevention of Group A Streptococcus infection related diseases in children was developed in November 2022 by pediatric experts in the fields of respiration, infection, immunology, testing, cardiovascular, kidney, critical care and prevention in China, aiming to further standardize the prevention and treatment of diseases associated with GAS infections and to promote and maintain the health of children.Its main contents are now explained, including disease burden, prevention, diagnosis, antimicrobial resistance and therapy.

As a pathogen of public health significance, group A Streptococcus (GAS) infects 18.1 million people and leads to 500 000 deaths all over the world every year.GAS is often transmitted through respiratory droplets and contact with damaged skin.Children, the elderly and immunocompromised people are highly susceptible to GAS infection.Schools, kindergartens, hospitals, nursing homes and other densely populated areas are high-risk areas for GAS transmission.Prevention and control measures should highlight the improvement of living conditions and hand hygiene.Adherence to infection prevention and control measures should be emphasized in high-risk environments.In this paper, the risk factors, prevention and control strategies of GAS infection and transmission were summarized, so as to provide basis for the prevention and control of GAS.

Objective:To identify the epidemic types of Group A Streptococcus (GAS)causing scarlet fever, to compare the gene structure and variability of GAS with different emm types, and to elucidate the epidemiological pattern of scarlet fever pathogens in Shenzhen. Methods:Pharyngeal swab samples were collected and analyzed retrospectively from children diagnosed with scarlet fever in Shenzhen Children′s Hospital from January 1, 2016 to May 31, 2018.The GAS strains were preserved for emm genotyping analysis.The strains of representative emm types were selected for whole-genome sequencing.The genomic polymorphism of GAS strains was described by comparative genomic analysis.Moreover, a phylogenetic tree was constructed based on the whole genome core-gene single nucleotide polymorphisms(SNPs) to clarify the evolutionary relationship between strains.Data between groups were compared by Rank sum test. Results:Among 176 GAS isolates that caused scarlet fever in children, 8 emm types were detected.The most common genotype was emm12.0 and its subtype(108/176 strains, 61.4%), followed by emm1.0 and its subtype(53/176 strains, 30.1%). These two genotypes accounted for 91.5% of all isolates collected.Comparative genome analysis was made taking GCA-900984775 as a reference sequence, and the results showed that the genomes of GAS strains had high levels of SNP and insertion or deletion (InDel) polymorphisms.There were more SNPs in emm12.0 strains[183(163, 213)] than those in emm1.0 strains[63 (54, 75)], and the difference was statistically significant ( P<0.05). As for InDel, more insertions and deletions [4(3, 6), 8(6, 10)] were observed in emm12.0 strains than those [1(0, 2), 5(3, 7)] in emm1.0 strains.According to the phylogenetic tree built by taking MGAS5005 as the reference sequence based on the whole genome core-gene SNPs, 18 strains and reference strains formed two clades. Conclusions:The emm12.0 and emm1.0 types are the most common GAS strains leading to scarlet fever in children.There are differences in the genome composition of different GAS strains.The emm12.0 strains have higher genetic diversity.

Group A Streptococcus (GAS) is one of the most important pathogens leading to children deaths all over the world.Bacterial typing is the commonest approach to analyzing the epidemiological characteristics of pathogenic microorganisms.The emm typing is frequently adopted to study GAS.The emm cluster typing is a recently proposed typing method based on the amino acid sequence homology of M proteins and the ability to bind to the host serum protein.This typing system has been extensively used for epidemiological investigation, strain selection and vaccine deve-lopment in foreign countries.However, it has not been applied in China yet. emm typing is based on a small variable region of emm genes, while the emm cluster typing system defines GAS types according to nearly intact sequences of emm genes.Besides, the emm cluster grouping system is acquired directly by emm typing comparison, so it is simple and feasible.Furthermore, the emm cluster typing can provide more information regarding the functional and structural properties of M proteins in different emm types of GAS.In this review, the methods, principles and applications of the emm cluster typing system in GAS research were summarized, in order to promote its application in China.

Since 2022, there has been an increasing trend in the incidence of scarlet fever and deaths due to Group A Streptococcus (GAS) in the UK and some European countries, with the paediatric population particularly affected, a phenomenon that has attracted widespread international attention.The author believes that GAS has not received sufficient attention and that there are significant national differences in early surveillance, treatment strategies, management and control.Here, author present professional insights on the unresolved scientific issues related to GAS infections, with a view to attracting the attention of domestic colleagues and jointly promoting GAS-related research, prevention and control.

Group A Streptococcus(GAS), also known as Streptococcus pyogenes, is one of the top 10 infectious disease pathogens responsible for childhood deaths worldwide.The most common infectious disease is GAS pharyngitis, which is highly prevalent in school age and can lead to complications.Rheumatic fever, a complication of GAS pharyngitis, and its sequelae, rheumatic heart disease, remain a public health challenge in developing and low-income countries and require urgent attention.The purpose of this review is to summarize the domestic and international guidelines and related literature on GAS pharyngitis for the reference of domestic clinicians, in the hope that more attention will be paid to the diagnosis and treatment of GAS pharyngitis, and the diagnosis and treatment of GAS pharyngitis will be improved.

Group A Streptococcus (GAS) are important human pathogens.In recent years, the M1 UK strain has attracted widespread attention in the United Kingdom and other countries because it has been associated with a surge in scarlet fever and an increase in invasive GAS infections.Author conducted a whole-genome sequencing study of 42 GAS strains from 2016 to 2018 in Shenzhen, and found that a GAS strain isolated from a child with scarlet fever in Shenzhen area in 2018 was homologous to M1 UK, which is the first strain of M1 UK confirmed in the mainland of China.For this reason, hereby publish it with a view to attracting the attention of our domestic counterparts and safeguarding public health safety.