目的:分析北京市昌平区 2018-2019 年 6 起副溶血性弧菌食源性疾病聚集事件分离株的血清型、耐药性、毒力基因和分子特征.方法:对 6 起事件中的 23 株副溶血性弧菌进行血清学分型、毒力基因检测、微量肉汤稀释药敏实验和脉冲场凝胶电泳.结果:21株人源分离株鉴定为3种血清型(O3:K6、O4:K8和O4:KUT),主要为O3:K6 型,毒力基因均为tlh+、tdh+、trh-;2 株食品分离株血清型为O8:K20,毒力基因为tlh+、tdh-、trh-.药敏结果显示,对头孢唑啉 12 株菌敏感,5 株耐药,6 株中介;对氨苄西林 1 株菌中介,其余菌株敏感;对其他15 种抗生素 23 株菌均敏感.PFGE聚类分析显示,23 株副溶血性弧菌分为8 种PFGE带型,5 起事件的人源分离株属于优势PFGE带型PT06.结论:6 起事件中的副溶血性弧菌血清型主要为O3:K6,多数菌株属于优势带型PT06,无多重耐药菌出现,人源分离株均携带毒力基因tlh和tdh.

目的 了解北京市昌平区健康人与腹泻患者粪便标本中金黄色葡萄球菌(SA)检出情况,及其肠毒素分布、耐药类型和PFGE型别.方法 对2018年549份健康人和704份腹泻患者的粪便标本进行SA菌检测,并对菌株进行肠毒素(SEs)/类肠毒素(SEls)、耐药和PFGE分型检测.结果 SA菌检出率健康人为17.12％,腹泻患者为11.93％,差异有统计学意义(x2=6.82,P＜0.01).腹泻患者来源SA菌SEs/SEls基因总检出率为70.24％,健康人为53.19％,差异有统计学意义(x2=5.43,P=0.02);腹泻患者来源SA菌中sea、seg、sei、seln、selx、sely等基因检出率均高于健康人(P值均＜0.05).健康人来源和腹泻患者来源SA菌均对青霉素耐药率最高,其次为红霉素和克林霉素.腹泻患者检出10株MRSA菌,检出率11.90％,健康人检出12株,检出率12.77％,差异无统计学意义(x2=0.03,P=0.86).PFGE分析显示,两种来源SA菌的PFGE带型散在分布,呈多样性.结论 北京市昌平区健康人/腹泻患者来源SA菌携带多种肠毒素基因,存在不同程度的耐药性和多重耐药现象,且出现MRSA菌株,PFGE带型多样.

目的 了解北京市昌平区腹泻患者弯曲菌感染现状及其分子流行特征,为该地区弯曲菌腹泻病的预防控制提供科学依据.方法 收集2019年北京市昌平区某哨点医院腹泻患者粪便样本382份,进行弯曲菌、沙门菌、致泻大肠埃希菌、副溶血性弧菌检测,并对分离到的空肠弯曲菌进行脉冲场凝胶电泳分型(PFGE)分析.结果 382份样本中,弯曲菌(58株,15.18％)检出率高于致泻大肠埃希菌(37株,9.69％)、沙门菌(24株,6.28％)和副溶血性弧菌(21株,5.50％),差异有统计学意义(χ2=26.735,P=0.000).季节分析显示:弯曲菌春季(14.71％)、夏季(18.33％)、秋季(15.00％)、冬季(10.00％)四季均有检出,但其差异无统计学意义(χ2=2.197,P=0.533).PFGE分析显示:30株空肠弯曲菌具有26种PFGE带型,相似系数为31.00％ ～100.00％,其PFGE带型具有多样性.结论 弯曲菌检出率居于首位,四季检出,提示昌平区弯曲菌感染较严重,应引起重视,并制定相应的方针政策,防止由弯曲菌感染引起的疫情发生.

目的 了解2013-2019年北京市昌平区霍乱弧菌表型及其分子特征.方法 采用常规培养方法对2013-2019年北京市昌平区疑似霍乱标本进行检测.对分离鉴定的O1群小川型霍乱弧菌,用Not Ⅰ和SfiⅠ两种内切酶进行脉冲场凝胶电泳(PFGE)、用荧光PCR和普通PCR进行9种毒力基因检测,用微量肉汤稀释法进行21种药物敏感试验.结果 2013-2019年北京市昌平区共分离到29株O1群小川型霍乱弧菌,其中散发病例中分离到10株,一起聚集性疫情中分离到19株.29株菌经Not Ⅰ和Sfi Ⅰ双酶切后可分成3种PFGE谱型(CP-01～03),3种PFGE谱型间的相似系数为78.50％～100.00％,以CP-02为主(27/29,93.10％).所有菌株均不携带ctxAB基因,携带toxR和hlyA基因,其他毒力基因ompU、tcpA、tcpI、rtxC、zot和ace的携带率分别为89.66％、82.76％、82.76％、44.83％、6.90％和6.90％.29株菌药敏结果,除头孢唑啉(0.00％)和链霉素(3.45％)敏感率极低外,对其他19种抗菌素为敏感(82.76％～100.00％).结论 2013-2019年北京市昌平区的O1群小川型霍乱弧菌为非产毒株,以PFGE谱型CP-02为主,毒力基因toxR和hlyA携带率高,对多数抗生素敏感,提示在防控工作中应关注此类菌株并制定相应的方针政策,减少疫情的发生.

Pseudomonas aeruginosa (P. aeruginosa) is a major opportunistic pathogen in hospital-acquired infections. Thus, early diagnosis is the best strategy for fighting against these infections. In this report, we incorporated multiple cross displacement amplification (MCDA) combined with the malachite green (MG) for rapid, sensitive, specific and visual detection of P. aeruginosa by targeting the oprl gene. The MCDA-MG assay was conducted at 67°C for only 40 min during the amplification stage, and then products were directly detected by using colorimetric indicators (MG), eliminating the use of an electrophoresis instrument or amplicon analysis equipment. The entire process, including specimen processing (35 min), amplification (40 min) and detection (5 min), can be finished within 80 min. All 30 non-P. aeruginosa strains tested negative, indicating the high specificity of the MCDA primers. The analytical sensitivity of the MCDA-MG assay was 100 fg of genomic templates per reaction in pure culture, which was in complete accordance with MCDA by gel electrophoresis and real-time turbidity. The assay was also successfully applied to detecting P. aeruginosa in stool samples. Therefore, the rapidity, simplicity, and nearly equipment-free platform of the MCDA-MG technique make it possible for clinical diagnosis, and more.

目的 了解北京某区近年托幼机构消毒质量,为进一步做好消毒防病工作,保护幼儿健康提供参考.方法 对某区2014年-2017年70所托幼机构消毒质量检测资料进行回顾性分析.结果 采集空气、餐饮具及工作人员手等样品3 768件,合格为3 222件,合格率为85.51％.2014年-2017年样品合格率依次为94.93％、94.15％、78.69％和85.89％.其中工作人员手合格率最低(52.38％),物体表面、餐饮具和空气合格率依次为95.73％、85.52％和78.17％,样品大肠菌群合格率(99.88％)高于细菌菌落总数合格率(97.32％),第一季度样品合格率最高(92.19％).结论 近年某区托幼机构消毒质量有逐年下降趋势,其中尤以工作人员手污染问题最严重,餐饮具、物体表面及空气消毒质量也有待提高.建议加强消毒知识培训,检查及监测,以提高消毒工作质量,保证幼儿身体健康.

目的 增强实验室对突发发热疫情的快速诊断能力,完善、优化聚集性发热的病原检测方法.方法 采用多重巢式PCR扩增法,对1起聚集性发热疫情样本进行病原筛查,同时对扩增产物测序,进行BLAST比对,进行血清型分型,比较不同引物的扩增效果.结果 采集7份病例咽拭子标本,以呼吸道病毒核酸多重联检试剂盒进行14种病毒筛查,其中4份为腺病毒阳性,阳性率为57.1%.采用3组巢式引物进行扩增,腺病毒阳性样本6份,均为腺病毒3型;测序成功的5株核苷酸、蛋白质序列同源性均为100.0%.第3组巢式引物扩增、分析效果较好,阳性率为71.4%.结论 成品试剂盒可进行不明原因发热疫情的病原筛查;多重巢式PCR扩增法可增加病毒检出率,对病毒分型和序列分析.

目的 了解2016年北京市昌平区健康人群中脑膜炎奈瑟菌的携带率和血清群分布,以及对抗生素的敏感性.方法 参照《流行性脑脑膜炎奈瑟菌诊断标准》WS 295-2008进行菌株分离及鉴定,用PCR法对菌株进行血清分群,用K-B纸片法对菌株进行抗生素药物敏感性实验,对分离的其他口腔细菌进行16S rRNA测序鉴定.结果 收集2016年昌平区2016年9-10月健康人群咽拭子共计252份,分离得到11株(4.37%)脑膜炎奈瑟菌(Nm):属于4个血清群,依次为B群(6株),W135群(3株),C群(1株),X群(1株);抗生素药敏试验结果表明,对头孢噻肟,头孢曲松,美罗培南,利福平完全敏感(100.00%),对环丙沙星,复方新诺明完全耐药(100.00%);27.27%的菌株对四环素耐药,54.55%的菌株对头孢西丁耐药,36.36%的菌株对阿奇霉素不敏感.结论 昌平区健康人群携带脑膜炎奈瑟菌以B群为主,对头孢类,碳青霉烯类,安莎霉素类药物敏感,对氟喹诺酮类,磺胺类耐药,并出现对大环内酯类药物不敏感菌株.

Objective To understand the contamination by Listeria monocytogenes in commercial food in Changping District, Beijing City and then provide technical support for effective supervision of governmental departments. Methods Totally, 368 foods of 12 categories were sampled from farmers' markets, supermarkets/convenience stores and restaurants for Listeria monocytogenes test from 2010 to 2015. Results Sixteen strains of Listeria monocytogenes were detected in the 368 food samples. The total detection rate was 4.35％, with the highest detection rate (25.71％) in raw poultry, followed by those in raw livestock meat (11.11％) and in frozen aquatic products (6.67％). The samples colleceted in the third quarter of the year had the highest detection rate (7.41％), followed by those in the second quarter (4.11％). No Listeria monocytogenes were detected in the samples collected in the first and fourth quarters. The detection rates in the farmers' markets, supermarkets/convenience stores and restraints were 4.85％, 4.11％ and 4.20％ respectively. Conclusions There was contamination by Listeria monocytogenes in raw poultry, raw livestock meat and frozen aquatic products in Changping District of Beijing in 2010-2015. It was particularly prominent in the third quarter.

目的 了解北京市昌平区食源性单增李斯特菌(Lm)的毒力基因携带情况、抗生素敏感性及分子特征.方法 对2010-2016年12类食品中分离的22株Lm进行血清型、毒力基因、抗生素敏感性、多位点序列分型(MLST)和脉冲场凝胶电泳(PFGE)分析.结果 22株Lm分为5种血清型(以1/2c、3a血清型为主);19种毒力基因携带谱(T1～ T19),毒力基因阳性数为6～12个;对氨苄西林、青霉素、美罗培南、复方新诺明、万古霉素和环丙沙星敏感,出现对四环素、红霉素耐药菌株;分为8个序列型(ST)(包括7个新型STA1～STA7),STA3为主要型别;分为17种PFGE带型,其相似系数为63.5％～ 100.0％,PTI为主要PFGE带型.结论 昌平区食源性Lm以1/2c、3a血清型为主,STA3为主要型别,PTI为主要PFGE带型,其毒力基因的携带具有差异性,出现对四环素、红霉素耐药株,为食源性Lm的研究提供了参考.

Objective To investigate the contamination of drinking water and the distribution of microorganisms in rural area of Changping district of Beijing,provide evidence for the revision and perfection of National Standards for Drinking Water Quality,and ensure the safety of drinking water in rural area.Methods A total of 105 samples of terminal tap water and finished water were collected from self-water supply system of 75 natural villages in Changping from May to August in 2016 for the detection of total colony count,total coliforms,thermotolerant coliforms,Escherichia coli,mold and yeast,Pseudomonas aeruginosa,Cronobacter spp.,Streptocoocus faecium,Aeromonas hydrophila and diarrheogenic Escherichia coli.Results The pass rate of total colony count,total coliforms,thermotolerant coliforms and Escherichia coli detections were 96.19％ (101/105),70.48％ (74/105),87.62％ (92/105)and 89.52％ (94/105),respectively.The overall qualified rate was 68.57％ (72/105).The detection rate of other microorganisms was 67.62％ (71/105),Pseudomonas aeruginosa was predominant (35.24％,37/105).Conclusion Microbial contamination of drinking water was found in the detection of water samples from self-water supply system in rural area of Changping.Except the microorganisms specified in the National Standards for Drinking Water Quality,the contaminations of Pseudomonas aeruginosa,Aeromonas hydrophila and Acinetobacter were detected too.It is necessary to strengthen the control of other pathogenic microorganisms,which are not specified in the National Standards for Drinking Water Quality,to reduce the outbreak of waterborne communicable diseases.

Objective To understand the antibiotic resistance,virulence genes and molecular characteristics of 36 Pseudomonas aeruginosa strains isolated from rural drinking water in Changping district,Beijing.Methods The strains were isolated and identified according to GB/T 8538-2008,and related antibiotic susceptibility test,virulence gene detection,and pulsed-field gel electrophoresis (PFGE) were conducted.Results Among the 36 P.aeruginosa strains isolated,27 were isolated from finished water samples.All the strains were completely sensitive to 12 antibiotics,i.e.piperacillin,piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,imipenem,meropenem,Amikacin,gentamicin,tobramycin,ciprofloxacin and levofloxacin.In 36 P.aeruginosa strains,4 virulence gene profiles (T1-T4) were found,T1 (lasI/lasR/rhlI/rhlR/toxA/plcH/rhlAB/lasB) was the major gene profile,and 11 PFGE patterns were found,0003 and 0010 were predominant.Conclusion P.aeruginosa strains,which were antibiotic sensitive,were mainly isolated from the finished water,0003 and 0010 were the predominant PFGE patterns,and T1 was the predominant gene profile in Changping.

Objective To understand the microbioal contamination of drinking water in Changping District,so as to provide reference for the prevention of outbreak and prevalence of waterborne infectious diseases.Methods According to GB/T 5750.12-2006,water samples were collected and tested,and according to GB/T 5749-2006 microbiological indicators results were determined.Results From 2014 to 2016,2 423 water samples were monitored,with the overall qualified rate of 80.48％,and the qualified rate of total coliforms was the lowest(82.34％).There was statistical significance on the difference in the qualified rate of water samples during 2014-2016 (x2 =10.00,P ＜ 0.05).The qualified rate of secondary water supply was the highest (95.39 ％),and the qualified rate of rural water was the lowest (68.31％).There was statistical significance on the difference in the qualified rate of domestic water supplied by different ways(x2 =174.99,P ＜ 0.05).The qualified rate of dringking water in wet period(70.38％) was lower than the dry period(84.46％),and the differences of water qualified rate were statistically significant (x2 =44.46,P ＜ 0.05).There was no statistical significance on the difference of water qualified rate between the outgoing water(71.68％) and the end water(70.80％) (P ＞ 0.05).Conclusion The main unqualified index is total coliforms in Changping Distract of Beijing.In order to reduce outbreak and epidemic of waterborne infectious diseases,the relevant departments should strengthen supervision and monitoring to ensure the safety of drinking water.

目的 为客观反映实验室的检测能力和检测技术水平,保证实验室检验结果的准确性和可比性,及时发现和纠正自身存在的问题,达到实验室检测工作持续改进的目的.方法 依据国家标准GB/T 4789.6-2003、GB/T 4789.11-2003、GB/T 4789.14-2003、GB/T 4789.9-2008、GB/T 4789.36-2008、GB 4789.2-2010、GB 4789.3-2010、GB 4789.4-2010、GB 4789.10-2010、GB4789.15-2010、GB4789.30-2010、GB4789.40-2010、GB 4789.7-2013和能力验证说明书进行样品处理和检验.结果 2014年本实验室共参加14次能力验证活动,能力验证满意率为92.86％ (13/14),其中定性检测项目满意率为100.0％ (8/8),定量检测项目满意率为83.33％(5/6).结论 本实验室2014年能力验证中定性检测项目取得满意结果,定量检测项目能力验证结果虽然能够满足食品资质认证的要求,但有待进一步提高.

目的 研究北京市昌平区2011年-2014年分离获得的80株食源性金黄色葡萄球菌药物敏感性和耐药性,为该地区金黄色葡萄球菌引起的食源性疾病预防及治疗提供参考.方法 依据GB 4789.10-2010进行菌株分离和鉴定,用VITEK 2 Compact进行药敏试验,应用检测试剂盒进行β-内酰胺酶检测.结果 金黄色葡萄球菌对莫西沙星、喹努普汀、利奈唑胺、万古霉素、替加环素和呋喃妥因的敏感率为100.0％,对青霉素耐药率最高(86.2％),其中多重耐药率为53.7％,检出2株耐苯唑西林(MRSA)金黄色葡萄球菌.68株β-内酰胺酶阳性株除青霉素100.0％耐药外,红霉素耐药率最高,为47.1％,其中多重耐药率为57.4％,12株β-内酰胺酶阴性株,多重耐药率为33.3％,所有菌株对青霉素敏感.结论 昌平区食源性金黄色葡萄球菌存在耐药和多重耐药现象,应根据药物敏感性试验结果有针对性选择抗菌药物,减少耐药菌株的产生.

目的 对北京市昌平区2011-2014年分离获得的74株食源性金黄色葡萄球菌耐药谱、毒力因子编码基因携带情况和分子流行病学特征进行研究分析,为金黄色葡萄球菌食源性疾病的预防控制提供参考.方法 依据GB 4789.10-2010进行菌株分离和鉴定,用全自动微生物鉴定及药敏分析系统VITEK2 Compact进行16种药物敏感性试验,并使用检测试剂盒进行β-内酰胺酶的检测;利用PCR方法检测分离菌株肠毒素,杀白细胞素和耐热磷酸酶等毒力因子编码基因;脉冲场凝胶电泳(PFGE)方法对分离株进行分子分型.结果 74株金黄色葡萄球菌中68株(91.89％)有不同程度的耐药,其中对青霉素耐药率(87.84％)最高,其次为红霉素(44.59％)和克林霉素(39.19％).毒力因子检测结果显示肠毒素阳性率64.86％(48/74),产2种以上肠毒素菌株占72.92％ (35/48).耐热磷酸酶阳性率89.19％,杀白细胞素编码基因lukF阳性率77.03％.PFGE分型结果显示除9株菌不可分型外,其余65株菌分为40个不同型别,无优势型别.结论 昌平区2011-2014年分离的食源性金黄色葡萄球菌具有较强的耐药性、分子多态性和毒力因子携带率较高的特征,说明这些菌株可以导致潜在的食品安全问题.

Brucellosis is one of the w idespread zoonotic diseases in the w orld. It is now considered as a reemerging priority infectious disease in China due to the increased incidence. The paper summarizes the progress in research of drug susceptibility,drug resistant gens and drug resistant mechanism of Brucella in the w orld.

目的 结合基层医疗机构的特点,探讨如何做好基层医疗机构的消毒隔离管理工作.方法 压力蒸汽灭菌器监测依据GB 15981-1995《消毒与灭菌的效果评价方法与标准》进行;室内空气、物体表面、医护人员手等项目监测依据GB 15982-1995《医院消毒卫生标准》进行;医院污水监测依据GB 18466-2005《医疗机构水污染物排放标准》进行.结果 2009年-2014年对全区各级医疗机构采样监测7 150件,检验合格6 807件,平均合格率为95.20％,其中以室内空气合格率最低为83.48％,其余项目的合格率由低至高依次为:医护人员手(93.94％)、物体表面(98.17％)、压力灭菌器(98.52％)、污水(98.90％)、使用中的消毒剂(100.00％);近年来社区卫生服务中心消毒隔离工作进步明显.结论 依法管理,规范工作,因地制宜地开展消毒隔离管理工作,可有效提高基层医疗机构消毒隔离的工作质量.

[Objective]To analyze the prevalence rate of hypertension among residents over 18 years old in Changping District of Beijing in 2002,2005,2008 and 2010,as well as monitoring results of related risk factors,evaluate the effect of prevention and control,and explore the community health management model of hypertension. [Methods]By using the proportional multistage stratified cluster random sampling,the questionnaire survey,physical measurement and blood biochemical detection were conducted among 912,2 991,1 724 and 8 084 people in each year respectively.[Results]The prevalence rate of hypertension was respectively 30. 04%,44. 37%,34. 74% and 36. 31%,and the detection rate of overweight was respectively 36. 29%,43. 10%,34. 28% and 36. 49%,which showed a decreasing trend since 2008( hypertensionχ2= 92. 33,P 0. 01; overweightχ2= 51. 46, P 0. 01). The rates of blood lipid abnormality and smoking showed an increasing trend( blood lipid abnormalityχ2= 404. 23, P 0. 01; smokingχ2= 69. 37,P 0. 01). [Conclusion]Under the situation of aging of population and rapid growth of medical expense,the chronic disease management model based on the community health service,especially the health management of hypertension,can improve the health level of residents.

Objective:To investigate the poliomyelitis antibody level in health people in Changping district of Beijing.Methods: Ten age groups were sampled in 10 villages in Changping,and 220 sera samples were detected for polio neutralization antibodies by ELISA.Results: The neutralized antibody-positive rate for polioⅠ,Ⅱ,Ⅲ were 96.36%,96.36%and 92.27% respectively,the geometric mean titers(GMT) were 1∶ 55.02,1∶ 52.66 and 1∶ 42.40 respectively.There were no significant differences in antibody levels between different residents,genders,ages and immune histories.Conclusion: The polio antibody of health people in Changping stay at high levels,forming a stable immunization barrier.