There were many reports of longitudinal changes in the causative organisms of neonatal sepsis in Western countries but few in Asia. We aimed to study longitudinal trends in the epidemiology of neonatal sepsis at Seoul National University Children's Hospital (SNUCH), a tertiary center in Korea, and compared the results to previous studies of Western countries. The medical records of all of the neonates who were hospitalized at SNUCH from 1996 to 2005 with positive blood cultures were reviewed. We also compared the findings to previous 16-yr (1980-1995). One hundred and forty-nine organisms were identified in 147 episodes from 134 infants. In comparison with the previous 16-yr studies, there was a decrease in the number of Escherichia coli infections (16.2% vs 8.7%: odds ratio [OR] 0.495; 95% confidence interval [CI], 0.255-0.962; P = 0.035), but an increase in Staphylococcus aureus (16.6% vs 25.5%: OR 1.720; 95% CI, 1.043-2.839; P = 0.033) and fungal infections (3.3% vs 18.7%: OR 6.740; 95% CI, 2.981-15.239; P < 0.001), predominantly caused by Candida species. In conclusion, the incidence of sepsis caused by E. coli decreases, but S. aureus and fungal sepsis increases significantly. Compared with Western studies, the incidence of sepsis caused by S. aureus and fungus has remarkably increased.
*Hospitals ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases/*epidemiology/microbiology ; Intensive Care Units, Neonatal ; Longitudinal Studies ; Mycoses/epidemiology ; Republic of Korea/epidemiology ; Sepsis/*epidemiology/microbiology ; Staphylococcal Infections/epidemiology

OBJECTIVETo identify epidemic status of murine typhus in Hongta areas of Yuxi city and to provide evidence for control and prevention of the disease.

METHODSSerologic survey was conducted among residents and rodents. Isolation of Rickettsia moseri was performed.

RESULTSThe overall infection rate among general population was 28.92% (96/332) with geometric meantiter (GMT) as 10.83 and there was no difference between males and females (26.71%, 43/161 vs. 30.99%, 53/171, P > 0.05). Significant differences were found between age groups (P < 0.05) with positive rates of 29.63% (8/27), 18.06% (13/72), 39.62% (42/106), 27.50% (22/80) and 23.40% (11/47) among age groups 0-6, 7-18, 19-39, 40-59 and over 60, respectively. The overall rate of infection in mouse was 44.95% (89/198) with GMT as 30.30. Five isolates of R. moseri from mouse specimen, three from fleas plus one case of murine typhus were diagnosed. Rattus norvegicus and Rattus flavipectus were the predominant species of rodent animals (99.49%, 197/198) and Xenopsylla cheopis was the major species of vector (74.26%, 303/408). Flea index and mouse density were 2.06 and 11.13% respectively.

CONCLUSIONHigh infection rates on R. moseri were demonstrated in rodents and residents as well as high risk of murine typhus outbreak might occur in these areas.

Adolescent ; Adult ; Animals ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mice ; Middle Aged ; Rats ; Rodent Diseases ; epidemiology ; microbiology ; transmission ; Siphonaptera ; microbiology ; Typhus, Endemic Flea-Borne ; epidemiology ; microbiology ; transmission ; Young Adult

OBJECTIVETo study neonatal Streptococcus agalactiae (GBS) infection in The Children's Hospital of Gansu Province through Polymerase Chain Reaction(PCR) Array.

METHODAfter obtaining the informed consent from parents or guardians, blood samples of 286 neonates were collected and studied in The Children's Hospital of Gansu Province from June 2011 to January 2012. DNA of the selected samples was extracted through the method of 5% Chelex-100 + 0.5% NP40 solution. Twenty-five genes were ultimately selected and then 25 pairs of primers were designed respectively through primer-BLAST tool of NCBI database.For every primer, PCR conditions were optimized through the identified GBS, and 25 pairs of primers were arrayed as to be used to study neonatal GBS infection.

RESULTThe results of PCR Array showed that the 14 samples were detected positive, accounting for 4.90% of all the selected specimens. As for neonatal GBS infection, the positive rate was 4.55% within 7 days after birth and 5.19% in those older than 7 days. The positive rate of 53 preterm infants was 5.66%. The follow-up survey showed that none of the cases died.

CONCLUSIONIn the Children's Hospital of Gansu Province neonatal GBS infection rate was 4.90%, which is similar to the previous domestic reports, but is lower than the reports from Europe and the United States.Studies have shown that the gene expression related to immune evasion has a higher frequency. The present study suggests that the strategy of GBS immune adaptation may play an important role in neonatal GBS infection.

Bacterial Proteins ; genetics ; China ; epidemiology ; DNA Primers ; DNA, Bacterial ; genetics ; Female ; Gene Amplification ; Hospitals, Pediatric ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; epidemiology ; microbiology ; Male ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Streptococcal Infections ; diagnosis ; epidemiology ; microbiology ; Streptococcus agalactiae ; genetics ; isolation & purification

OBJECTIVETo analyze the high-risk factors of premature rupture of membranes (PROM) with neonatal infection and explore their clinical significance.

METHODSForty-two cases of PROM with neonatal infections were retrospectively analyzed for the risk factors with another 42 PROM cases matched for gestational age without neonatal infections as the control group. The relations of gestational age, time from membrane rupture to delivery, mode of delivery, placental pathology, maternal serum C-reactive protein concentration, leukocyte and neutrophil values to neonatal infections were analyzed.

RESULTSThe time from membrane rupture to delivery was significantly longer and the incidence of chorioamnionitis significantly higher in the study group (P<0.05). Meningitis and neonatal sepsis occurred at a significantly higher incidence in preterm PROM group (P<0.05).

CONCLUSIONAn appropriate extension of the gestation weeks and timely termination of pregnancy after dynamic monitoring of the biochemical changes and identification of the signs of infection are important to reduce the incidence of neonatal infection.

Adult ; Case-Control Studies ; Female ; Fetal Membranes, Premature Rupture ; epidemiology ; microbiology ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; epidemiology ; microbiology ; Infection ; complications ; epidemiology ; Pregnancy ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo investigate the incidence of nosocomial infections of extremely premature infants and to explore the risk factors and strategies for infection control.

METHODThere were 118 extremely premature infants who were confirmed to have nosocomial infection in neonatal intensive care unit of the authors' hospital from January 2008 to December 2012. Their data of the infection rate, risk factors and clinical characteristics were retrospectively analyzed.

RESULTDuring the study, nosocomial infection occurred in 78 extremely premature infants 129 times. The nosocomial infection rate was 66.10%. The rate of ventilator-associated pneumonia (VAP) was 1.43% (35/2 452). The catheter related blood stream infection (CRBSI) rate was 0.35% (16/4 613). There were 74 (57.36%) cases of pneumonia, which was the most common nosocomial infection of extremely premature infants. There were 35 cases of VAP, which accounted for 47.30% of pneumonia. The next was sepsis, 48 cases. Seventy-four (74/90, 82.22%) strains of isolates were Gram-negative bacteria, which accounted for the highest proportion, followed by Gram-positive (12 strains), fungus (4 strains); Klebsiella pneumonia is the most common pathogens of nosocomial infection in extremely premature infants. The isolation rates of Klebsiella pneumonia with positive extended-spectrum beta-lactamases (ESBL) were 90.91% (20/22) , universally resistant to cephalosporins. Single-factor analysis showed that the body weight, mechanical ventilation, umbilical vein catheterization, central venous catheter, parenteral nutrition and hospitalization time were risk factors for nosocomial infections in extremely preterm infants. Logistic regression analysis showed that length of hospitalization (OR = 1.024, P = 0.043) and central venous catheterization (OR = 6.170, P = 0.041) were independent risk factors of nosocomial infection.

CONCLUSIONExtremely preterm infants were at higher risk of nosocomial infection. It is important to identify the high risk factors for nosocomial infections in extremely premature infants. To shorten time for mechanical ventilation, central venous catheterization and hospitalization days would be conducive to reducing the morbidity of nosocomial infection.

Birth Weight ; Catheterization, Central Venous ; adverse effects ; Cross Infection ; epidemiology ; microbiology ; Female ; Gram-Negative Bacteria ; isolation & purification ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Incidence ; Infant, Extremely Premature ; Infant, Newborn ; Infant, Premature, Diseases ; epidemiology ; microbiology ; Intensive Care Units, Neonatal ; Logistic Models ; Male ; Pneumonia, Ventilator-Associated ; epidemiology ; microbiology ; Respiration, Artificial ; adverse effects ; Retrospective Studies ; Risk Factors ; Sepsis ; epidemiology ; microbiology

OBJECTIVETo investigate the prevalence of viral infections and putative association of viral infection with illness severity in young children with severe lower respiratory tract infection (LRTI) in Chongqing.

METHODRespiratory secretion specimens were collected from 119 hospitalized patients with severe pneumonia from December 2006 to March 2008.After being processed, the samples were detected for respiratory viruses including respiratory syncytial virus (RSV), adenovirus (ADV), human metapneumovirus (hMPV), human bocavirus (HBoV), parainfluenza virus 1, 2, 3 (PIV 1, 2, 3), influenza virus A and B (IVA and IVB) either by PCR or RT-PCR. Clinical data were analyzed along with virological data by using appropriate statistical methods.

RESULTViral pathogens were identified in specimens of 86 (72.3%) cases, among which RSV was detected in 49 (41.2%) patients. More than one virus was detected in 23 individual (26.7%) samples, of which 19 were dual positive for RSV and another virus. Bacterial cultures were performed for 69 patients. Both bacterial and viral pathogens were identified in 53 (76.8%) patients. Bacterial and viral coinfection was demonstrated in samples from 41 (59.4%) cases.

CONCLUSIONViral pathogens are the main etiology of severe pneumonia in young children in Chongqing area during the study period. RSV was the most frequent viral pathogens, followed by ADV and hMPV. Coinfection with respiratory common viruses was relatively common, though co-infection with viruses did not appear to aggravate the patients' condition.

Adenoviridae ; isolation & purification ; Child, Preschool ; China ; epidemiology ; Human bocavirus ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; Influenza A virus ; isolation & purification ; Metapneumovirus ; isolation & purification ; Pneumonia, Bacterial ; microbiology ; virology ; Pneumonia, Viral ; microbiology ; virology ; Respiratory Syncytial Viruses ; isolation & purification ; Virus Diseases ; virology

INTRODUCTIONWe carried out an epidemiological review of cholera in Singapore to determine its trends and the factors contributing to its occurrence.

MATERIALS AND METHODSEpidemiological data of all notified cases of cholera maintained by the Communicable Diseases Division, Ministry of Health, for the period 1992 to 2007 were collated and analysed. Case-control studies were carried out in outbreaks to determine the source of infection and mode of transmission. Linear patterns in age and ethnic distribution of cholera cases were assessed using chi2 test for trend.

RESULTSThere were a total of 210 cholera cases reported between 1992 and 2007. The incidence of cholera declined from 17 cases in 1992 to 7 cases in 2007. About a quarter of the cases were imported from endemic countries in the region. Between 76% and 95% of the reported cases were local residents. Four elderly patients with comorbidities and who sought medical treatment late died, giving a case-fatality rate of 1.9%. Vibrio cholerae 01, biotype El Tor, serotype Ogawa, accounted for 83.8% of the cases. The vehicles of transmission identified in outbreaks included raw fi sh, undercooked seafood and iced drinks cross-contaminated with raw seafood.

CONCLUSIONWith the high standard of environmental hygiene and sanitation, a comprehensive epidemiological surveillance system and licensing and control of food establishments, cholera could not gain a foothold in Singapore despite it being situated in an endemic region. However, health education of the public on the importance of personal and food hygiene is of paramount importance in preventing foodborne outbreaks. Physicians should also maintain a high level of suspicion of cholera in patients presenting with severe gastroenteritis, especially those with a recent travel history to endemic countries.

Adolescent ; Child ; Child, Preschool ; Cholera ; microbiology ; mortality ; Disease Outbreaks ; statistics & numerical data ; Female ; Foodborne Diseases ; epidemiology ; prevention & control ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Population Surveillance ; Singapore ; epidemiology ; Vibrio cholerae O1 ; isolation & purification ; Young Adult