Primary immunodeficiency diseases (PID)are a heterogeneous group of congenital and genetically determined conditions caused by one or more defects of innate and/or adaptive immunity,which are a common retarding factor of vaccines immunization.The infections,however,play a major role in the final prognosis of most PID.The immune response after the vaccine injection may be impaired in some PID cases,even no protection is evoked.Moreover,some disease caused by the live vaccine virus or bacteria strains could occur after immunization.The contents of this paper is to introduce the consensus of the vaccine immunization based on the category of PID,immunization of the contacts and other concerns.

Pertussis toxin(PTx), an important toxin that produced by Bordetella pertussis, is an important pathogenic factor in the pathogenesis of whooping cough.The previous studies have showed that PTx interacting proteins vary distinctly in size, ranging from the 43 kD surface protein of human lymphocyte to the 200 kD surface protein of insulin secreting cells.PTx has been shown to interact with N-linked oligosaccharides on the surface of host cells, sialoglycoprotein-like factors, glycoproteins such as haptoglobin, fetuin, G D1a glycolipids.Especially, the interaction of PTx with its receptor Gi protein can result in increased intracellular cAMP level, which will lead to multiple physiological responses.However, the current limited understanding of other PTx modified substrates and interacting proteins in cells has seriously hindered our understanding on the mechanism that PTx regulates other signaling pathways and physiological functions of the host.

Objective To study the differences of clinical characteristics in the children patients with pneumonia under differ‐ent body mass indexes(BMI) to provide the basis for its clinical research .Methods 160 children patients with pneumonia in the Shandong Armed Police Corps Hospital were selected and divided into the normal BMI group (15 .00

Objective To investigate the clinical manifestations and pathogen distribution of the neonatal sepsis, and to analyze the antibiotic resistance of the pathogens. Methods Review the Medical records of 38 sepsis cases of full-term and premature neonates in our hospital from October 2011 to February 2014 were col-lected and analyzed. Results Ten cases were caused by Gram-positive bacteria among the 18 full-term neonates with sepsis. Eight of ten of the isolates were resistant to oxcillin. Nine of ten of the cases were belonged to late onset infection, and the cases with no nosocomial infection were found. In the other eight full-term neonatal cases caused by Gram-negative bacteria , six cases were nosocomial infection. Among the 20 premature neonates with sepsis , 17 cases were infected Gram-negative bacteria , in which Escherichia coli , Klebsiella pneumonia and En-terobacter cloacae were the most common agents (16/17). Early onset type and nosocomial infection were identi-fied for 11 (11/20) and 9 (9/20) cases in the premature neonates, respectively. The penicillin G, methicillin resistant rates of the Gram-positive bacteria were close to or over 70%. All the Gram-positive bacteria were sensi-tive to vancomycin. All the Gram-negative bacteria were resistant to amoxicillin , but over 60% of them were sen-sitive to piperacillin-tazobactam and other compounds containing enzyme inhibitor , and 100% of them were sensi-tive to carbapenems and aminoglycoside. Conclusion The full-term neonatal sepsis admitted into our hospital were mainly caused by Gram-positive bacteria , which were usually resistant to oxcillin. The premature sepsis were mainly caused by Gram-negative bacteria , which were always sensitive to carbapenems and aminoglycoside.

Objective To indicate the restriction profiles of pbps in Streptococcus pneumoniae(S.pneumoniae), and relationship between pbps profiles and the penicillin MIC.Methods The E-test MIC method was used to determinate penicillin susceptibility of 132 S.pneumoniae strains consisting of 69 penicillin susceptible S.pneumoniae (PSSP) strains and 63 nonsusceptible S.pneumoniae (PNSP) strains. Furthermore, we compared these strains by detecting restriction fragment length polymorphism (RFLP) of the PBPs genes pbp1a, pbp2b and pbp2x.Results The RFLP results showed that 9 genotypes were founded for pbp1a, in which 2 were detected from PSSP and some PNSP strains. The other 7 ones were founded mainly in the PNSP with penicillin MIC≥0.25 ?g/ml. Ten genotypes were founded for pbp2b, in which 3 were detected from PSSP and some PNSP strains. The other 7 ones, similar with pbp1a, were founded mainly in the PNSP with penicillin MIC≥0.25 ?g/ml. Thirty-one restrictive patterns were founded for pbp2x. Seventeen patternss from them were detected in PSSP, and 13 ones were founded only in PSSP. The other 14 patterns all were covered PNSP strains. A total of 47 patterns were found according to the three pbps types. Twenty-three patterns from them were detected in PSSP, and 17 ones were founded only in PSSP. The other 24 patterns all were detected in PNSP.Conclusions Results of the study are consistent with the concept that mutations in PBP1a, PBP2b and PBP2x play an important role in the development of resistance to ?-lactam antibiotics by S.pneumoniae. In the meantime, the profiles of pbps can predict penicillin susceptibility.

Objective To explore clinical features and antimicrobial resistance of Klebsiella pneumoniae (K.pneumoniae) lower respiratory tract infection(LRTI) in children.Methods Clinical data of 107 children with K.pneumoniae LRTI confirmed by sputum culture from January to December 2015 were analyzed retrospectively.Results 62.62% of children with LRTI were aged less than 6 months and 64.49% episodes occurred in autumn and winter.All cases had cough and 39 had fever, the main complications were type I respiratory failure, type Ⅱ respiratory failure, cardiac insufficiency, and electrolyte disturbance, 39 cases(36.45%) had complications involving two systems, 5 cases(4.67%)had complications involving three systems,47 cases (43.93%) met the diagnostic criteria of severe pneumonia.43 cases (40.19%) had primary underlying diseases, the major were congenital heart disease, preterm and low birth weight, and malnutrition.Children with imipenem-resistant bacteria infection were more prone to develop extrapulmonary complications than those with non-resistant pathogenic infection.The resistance rate of K.pneumoniae to amikacin was the lowest(9.35%).90 cases were recovered and markedly effective, 11 cases were effective, 4 cases were not healed and voluntarily discharged from hospital, and 2 cases died.Conclusion Children aged less than 6 months and with underlying diseases are prone to develop LRTI, and complications are more.

Objective To investigate the distribution of the emm types and superantigens of group A streptococcal ( GAS) isolated from Chinese children. Methods Totally 222 GAS isolates collected from five Children's Hospitals of China during 2005～2006 were studied, emm types were performed by PCR and sequencing. The eight superan-tigen (SAg) genes (speA, speC, speH, speI, speG, speJ, ssa and SMEZ) were checked by PCR. Results Nine emm types were identified, of which emml2 (55. 86% ) and emml (39. 64% ) were the most prevalent types. The GAS isolates carried six or more SAg genes take 78. 39% of all the isolates in this study. The SAg gene profiles were closely associated with the emm type. Conclusion The emm type of S. pyogenes isolated from Chinese chil-dren was quite wide-spreading and SAg genes appeared to be associated with the emm type so its expression is po-tential in vaccine development.

Objective To investigate the clinical features of invasive pneumococcal disease(IPD) in pediatric intensive care unit(PICU) and to analyze outcomes,so as to provide evidence for early and reasonable diagnosis and treatment as well as to improvement of prognosis.Methods A retrospective study was conducted at a research center for IPD in PICU in Beijing Children's Hospital from January 2013 to April 2016.Clinical data of children with IPD were collected and analyzed.All specimens were for bacteria culture,isolation,strain identification and drug sensitivity test.At the same time,the quellung test was used to identify serotypes of the streptococcus pneumoniae.Results A total of 30 children meeting inclusion criteria were included,19 male and 11 female.The median age was 1.5 years (range 3 months to 7.5 years).The Pediatric Critical Illness Scores (PCIS) were 72 (64,82) scores.There were 13 cases whose Glasgow Coma Scores (GCS) were below 15 scores.The 28-day mortality rate was 36.7％ (11/30 cases).Among death cases,there were 7 cases of purulent meningitis,3 cases of septicemia and 1 case of purulent pleurisy.The onset age,peripheral blood leucocytes count,PCIS and GCS of death group were significantly lower than those of survival group (all P ＜ 0.05).The mortality rate of children complicated with septic shock was significantly higher than that of children without septic shock [75.0％ (6/8 cases) vs 22.7 ％ (5/22 cases),P ＜ 0.05].The most common serotypes were 19F and 19A.The coverage rate of pneumococcal conjugate vaccine 13 was 96.7％.The percentage of penicillin nonsusceptible streptococcus pneumoniae was 73.3％,and the percentage of penicillin resistant streptococcus pneumoniae was 53.3％,and multi-drug resistant was 90％.Conclusions The mortality rate of IPD in PICU is high,and the main serotypes were 19F and 19A.Most patients of death group were less than 2 years old.Peripheral blood white blood cell count,PCIS and GCS were significantly reduced,and more complicated with septic shock.Vaccination of pneumococcal conjugate vaccine 13 for children less than 2 years old may reduce the incidence of IPD.

Objective To evaluate the application of partial cpsA-cpsB serotype prediction system as a serotyping method for streptococcus pneumonia.Methods Ninety-four isolates in this study were provided by Microorganism Research Room of Beijing Pediatric Research Institution,Beijing Children's Hospital Affiliated to Capital Medical University.The quelling test was applied to determine gold standard of serotypes of isolates.Polymerase chain reaction (PCR),sequencing,sequence data management and alignment were implemented previously.Results Eighty-three out of all 94 isolates were serotyped by quelling reaction,and 11 isolates were non-serotype isolates.Among the 83 isolates,67 (80.72％) isolates got positive PCR results and 60 (89.55％)isolates got results consistent with gold standard or containing gold standard.Among 12 isolates belonging to 19F,10 isolates were correctly predicted,and 2 isolates were predicted to be 6A,23F/10A.Among 19 isolates belonging to serotype 19A,1 isolate was predicted to be 35 F/47F,and the other 18 isolates were correctly predicted.Among 10 isolates belonging to serotype 14,9 isolates got results consistent with gold standard,and 1 isolate was predicted to be 19A.All 7 isolates belonging to serotype 6B were predicted to be 6A/6B and 4 isolates belonging to 23F were predicted to be 23F/10A.3 of 11 (27.27％) non-serotype isolates got positive PCR results and were predicted to be 6A/6C,6A/6B,19A.Conclusions Partial cpsA-cpsB sequencing system is a useful method for detecting streptococcus pneumoniae serotypes.

Objective To analyze the molecular biological characteristics of Streptococcus pyogenes (GAS) causing children tonsillitis in Yangfangdian community Haidian district,Beijing between 2011 and 2013.Methods From Apr.2011 to Apr.2013,there were 94 children with tonsillitis treated in outpatient of Beijing Shijitan Hospital Affiliated to Capital Medical University,and 17 strains GAS were isolated from these pediatrician outpatients.Their encoding mature M protein gene (emm gene),7 pairs of alleles housekeeping gene (gki,gtr,murI,mutS,recP,xpt and yqiL),superantigen speA and speC genes,macrolide-resistance genes ermB,mefA and ermRT were amplified by polymerase chain reaction (PCR).The PCR amplified products of emm gene and 7 pairs of alleles housekeeping gene were sequenced.The emm gene sequences were stored in the Centers for Disease Control and Prevention database.The emm types of GAS were identified.The 7 pairs of alleles housekeeping gene sequences of GAS were sent to the multilocus sequence typing (MLST) website for their iso-allelic sequences to identify their sequence types (ST).The PCR amplified products of superantigen gene speA and speC,macrolide-resistance genes ermB,mefA and ermRT were performed with agar gel electrophoresis.The corresponding qualitative results were obtained.Results Five emm-types were discovered:emm12.0 (76.4％),emm1.0 (5.9％),emm89.0 (5.9％),emm75.0 (5.9％) and emm22.0 (5.9％) ;emm12.0 and its subtype strains had the same allelic profiles which belonged to ST36 type; emm1.0 strain belonged to ST28 ; emm89.0 strain belonged to ST101 ; emm75.0 strain belonged to ST49 ; emm22.0 strain belonged to ST46 ; 94.1％ (16/17) strains carried macrolide-resistance gene ermB.None carried macrolide-resistance genes mefA and ermRT.None carried superantigen speA gene.100.0％ (17/17 cases) carried superantigen speC gene.Conclusions emm12.0 (ST36) strain was the most common type of GAS causing the children tonsillitis in Yangfangdian community Haidian District,Beijing between 2011 and 2013.These strains mainly carry macrolide-resistance ermB and superantigen speC gene.