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2016 Vol.11 No.5
Published 2016-10-25

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Invited paper
Original Article
Case Analysis
Review
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Invited paper
258 WEN Yumei
Precision medicine and microbial infection—Discussion on application of precision infectious diseases

In March of 2015, President Xi assigned the Ministry of Science and Technology to organize the first expert meeting regarding precision medicine. Based on the contribution of Chinese scientists in the field of pathogenic microbiology, immunology, vaccinology and infectious diseases, a proposal on developing precision infectious diseases is presented in this article. While the etiology of infectious diseases is clear, host responses vary markedly, especially in fatal cases. It is proposed that genomic analysis of host immune system together with analysis of environmental factors and life styles may further benefit people for combating infectious diseases, which is of global implication.

2016 Vol. 11 (5): 258-261 [Abstract] ( 373 ) [HTML 1KB] [PDF 461KB] ( 924 )
262 HOU Dongni, TONG Lin, SONG Yuanlin
Role of lung microbiome in chronic respiratory diseases

The lungs of healthy individuals are previously considered to be sterile. However, modern microbiological techniques using DNA sequencing reveal the existence of a complex and dynamic microbiome in the normal respiratory tract. There is growing evidence that the respiratory microbiome has an important effect on the development and progression of chronic respiratory diseases and the features of respiratory microbe are associated with clinical phenotypes and prognosis. Comparison of respiratory samples of patients between stable and exacerbation phases leads to new hypothesis for exacerbation of these diseases. Future studies of lung microbe, with progresses in sequencing data analysis and study design focused on clinical problems, will provide a potential therapeutic target for chronic respiratory diseases.

2016 Vol. 11 (5): 262-267 [Abstract] ( 288 ) [HTML 1KB] [PDF 553KB] ( 935 )
 
Original Article
268 WANG Quzhi1, JIANG Yuan2, SHEN Sufang1, SHEN Xin2, ZHAO Hongjin1, TANG Wenhong1, XU Feng1, YANG Xianchao1, LIU Peihong
Isolation and identification of Mycobacterium from cows with delayed type hypersensitivity response to bovine purified protein derivative

To evaluate the specificity of single intradermal cervical tuberculin (SICT) of bovine purified protein derivative (PPD) in bovine tuberculosis detection, a total of 118 tissue specimens from 54 cows with positive reaction were collected and subjected to the detection of Mycobacterium. Acid-fast bacteria strains were isolated from 14 cows and Mycobacterium strains were isolated from 10 cows. Mycobacterium bovis (M. bovis) was isolated from one cow. Sixteen acid-fast bacteria strains were isolated from 118 tissue samples and 12 strains were identified as Mycobacterium. The isolation rate of Mycobacterium was 10.2% (12/118). One strain was identified as M. bovis and the others were nontuberculous Mycobacteria (NTM), such as M. avium and M. terrace. M. bovis accounted for 8.3% (1/12) and NTM accounted for 91.7% (11/12) of all Mycobacteria respectively. The results of pathogen detection indicated a low isolation rate of M. bovis by SICT method. To ensure the accuracy of SICT, it is necessary to use more than one method to verify the results. The culture and species identification by using rapid detection techniques are recommended to be introduced into the program for tuberculosis elimination, which could improve the specificity of tuberculosis detection.

2016 Vol. 11 (5): 268-272 [Abstract] ( 201 ) [HTML 1KB] [PDF 561KB] ( 903 )
273 QIU Jin, JU Zhiying, LI Jun, WANG Jian, MENG Chengyan
Screening of pulmonary tuberculosis in entry applicants in Shanghai port during 2014-2015

In order to prevent the cross-border transmission of tuberculosis (TB),tuberculosis screening was performed on each entry applicant older than 14 years in Shanghai port during 2014-2015. Suspected tuberculosis patients were selected by history enquiry, physical examination and chest X-ray scanning. Thereafter, sputum smear and culture, T-SPOT.TB assay and Xpert MTB/RIF test were applied in the suspected tuberculosis patients. In total, 215 persons were suspected of tuberculosis in Shanghai port during 2014-2015, with the detection rate of 229.76/100 000. Among them, 33 were confirmed as pulmonary tuberculosis, with confirmation rate of 15.3%. In all suspected patients,95 (44.2%) and 78 (36.3%) cases were subjected to T-SPOT.TB assay and Xpert MTB/RIF test respectively. The sensitivity and specificity of T-SPOT.TB assay were 100% and 49.4% compared with sputum culture results as the standard of diagnosis. The sensitivity and specificity of Xpert MTB/RIF test were 87.5% and 96.8% comparatively. Among 33 confirmed tuberculosis patients, 25 (75.8%) left Shanghai, 15 (45.5%) accepted anti-tuberculosis treatment for 2 weeks before leaving, and 8 (24.2%) cases were lost. The results suggest that the confirmation rate of tuberculosis in Shanghai port is relatively low in suspected cases. T-SPOT.TB assay with higher sensitivity and Xpert MTB/RIF test with higher specificity can be complementary and performed simultaneously in suspected cases to improve the detection rate of tuberculosis. All the confirmed and suspected tuberculosis cases should be managed and followed up in the future during the applicant’s stay in China.

2016 Vol. 11 (5): 273-277 [Abstract] ( 198 ) [HTML 1KB] [PDF 525KB] ( 643 )
278 SHEN Zhongliang1,2,*, RAO Yuliang3,*, WANG Wei2, MA Zhangmei2, LIU Jing1,2, PAN Shaokun2,4, XIE Youhua1,2
Impact of topological regions of small hepatitis B virus surface antigen on its expression and secretion

The small hepatitis B virus surface antigen (SHB) is expressed on the endoplasmic reticulum (ER) and is secreted along the cellular secretory pathway. To analyze the impact of SHB domains on its expression and secretion, SHB proteins of eight HBV genotypes (A-H) plus a clinical strain C8 were subjected to a domain analysis. All the SHBs have four transmembrane motifs (Tmhelix1-4), three regions in the ER lumen (Inside1-3), and two regions outside of the ER (Outside1-2). The topological regions of SHBs in C8 and genotypes A, B, C, D, E and G were identical, while four topological regions of SHBs in genotypes F and H were slightly different from that in C8. Deletion analysis of SHB topological regions in C8 indicated that Inside1 region was not required for SHB expression and secretion; Outside1, Tmhelix2 and Inside2 regions were required for both SHB expression and secretion; Tmhelix1 and Outside2 regions were dispensable for SHB expression but needed for SHB secretion; Tmhelix3 and Tmhelix4 regions were important for SHB expression and necessary for SHB secretion. Finer deletion (6 amino acids) mapping in Outside1 and Outside2 regions showed that amino acids 55-78 of Outside1 and Outside2 were required for SHB secretion. This is the first systematic analysis of the impact of SHB topological regions on SHB expression and secretion, which has provided valuable clues for future study of the structure-function relationship of SHB.

2016 Vol. 11 (5): 278-286 [Abstract] ( 262 ) [HTML 1KB] [PDF 1139KB] ( 745 )
287 WANG Yuee,WEN Xiao,CHEN Peidong,FAN Qingqi,WANG Ting,JIA Wen,BAO Ying,WANG Jiaying
Assessment of probable biomarkers predicting relapse of chronic hepatitis B after withdrawal of nucleos(t)ide analogs

To evaluate the probable predicting factors and biomarkers associated with the relapse of chronic hepatitis B after withdrawal of nucleos(t)ide analogs, a clinical assessment of patients with chronic hepatitis B, either hepatitis B virus e antigen (HBeAg)-positive or -negative, who had received the treatment of nucleos(t)ide analogs and met the requirement for withdrawal was made. Then the clinical data were collected including sex, age, treatment course, HBeAg level, baseline alanine aminotransferase (ALT) and HBV DNA levels, liver stillness, HBV surface antigen (HBsAg) level, interleukin 21 (IL-21) level and frequency of peripheral blood CD4 IL-21 T cells at the time of withdrawal. Forty seven patients met the requirement for withdrawal. Among them, 26 patients were HBeAg-positive and 21 patients were HBeAg-negative. The mean age was (42.45±14.08) years. The mean treatment course was (4.60±1.61) years. The mean baseline ALT level was (174.38±200.84) U/L. The mean baseline HBV DNA level was (5.87±1.06) log copies/mL. The mean HBsAg level was (1 104.82±1 328.11) IU/mL. The mean IL-21 level was (729.82±427.39) pg/mL. The mean frequency of peripheral blood CD4 IL-21 T cells was (0.79±0.49)%. The liver stillness measurement at the time of withdrawal was F1 in 27 patients, F2 in 16 patients, and F3 in 4 patients. Twenty seven (57.45%) patients relapsed in one year. Single-factor logistic regression analysis showed that the relapse of chronic hepatitis B after withdrawal of nucleos(t)ide analogs was associated with treatment course, IL-21 level, frequency of peripheral blood CD4IL-21 T cells, and HBsAg level. Multi-factor logistic regression analysis showed that HBsAg level and IL-21 level could predict the relapse of chronic hepatitis B after withdrawal of nucleos(t)ide analogs.

2016 Vol. 11 (5): 287-292 [Abstract] ( 241 ) [HTML 1KB] [PDF 1065KB] ( 784 )
 
Case Analysis
293 SHEN Yinfang1,CHEN Mingliang2,3,CHEN Min2,WANG Jianshe1,ZHANG Xi2
One case of scarlet fever caused by Streptococcus pyogenes with ICE-emm12 and ΦHKU.vir

Epidemics of scarlet fever started in China in 2011. Most of the cases were represented by the classic type, while the surgical type was rarely reported. It is unclear whether ICE-emm12 and ΦHKU.vir, the two mobile genetic elements firstly discovered in the strains leading to scarlet fever outbreak in Hong Kong, were carried by the strains in Mainland China. Here we reported a scarlet fever case in Zhejiang which was caused by Streptococcus pyogenes. Strains isolated from the pharynx and skin wound all carried ICE-emm12 and ΦHKU.vir. The result suggests a screening of the two mobile genetic elements in Mainland China for genetic surveillance of scarlet fever.

2016 Vol. 11 (5): 293-296 [Abstract] ( 238 ) [HTML 1KB] [PDF 1021KB] ( 860 )
 
Review
297 WANG Peng, XI Min, YU Yongsheng, ZANG Guoqing, TANG Zhenghao
Research advance in efflux-mediated antibiotic resistance of Acinetobacter baumannii

The overexpression of efflux pump is one of the most important multidrug-resistant mechanisms in Acinetobacter baumannii (A. baumannii). The understanding of their complicated mechanisms will help to find out efficient coping strategy. So far four prominent families of efflux transporters in A. baumannii have been reported, including resistance-nodulation-cell division (RND) superfamily, major facilitator superfamily (MFS), multidrug and toxic compound extrusion (MATE) superfamily, and small multidrug resistance (SMR) superfamily. They can be divided into chromosomally encoded efflux system and acquired efflux system. The substrates are also distinguished among different efflux transporters. In this review, the classification, function and regulation of efflux pumps in A. baumannii are described.

2016 Vol. 11 (5): 297-301 [Abstract] ( 227 ) [HTML 1KB] [PDF 472KB] ( 817 )
302 WU Zheng, LI Wenjing, LI Aimei, FU Yingmei, ZHANG Fengmin
Regulatory role of small RNA in intracellular bacterial growth, virulence and iron level

Small RNA (sRNA) is a class of non-coding RNA of 50-500 bases with a regulatory function on transcription, translation and mRNA stability. Bacterial sRNAs have been implicated in gene expression, cellular proliferation, virulence and adaptation to environmental conditions. The role of sRNAs in intracellular infection (such as Salmonella, Listeria, Legionella pneumophia, etc.), including the regulation on growth, virulence and host iron levels is reviewed in this paper.

2016 Vol. 11 (5): 302-306 [Abstract] ( 265 ) [HTML 1KB] [PDF 440KB] ( 737 )
307 WU Yueming*,ZHU Naiwei*,ZHU Yongzhe
Applications and limitations of animal models in enterovirus 71 infection

Enterovirus 71 (EV71) is a major pathogen of hand, foot and mouth disease which is known as a neglected tropical infectious disease. EV71 is responsible for several outbreaks in the Asia-Pacific Region over the past 15 years. Since the effective control of poliovirus, EV71 has been regarded as the most important neurotropic enterovirus and its severe neurological complications threaten the children’s health. Appropriate animal models of EV71 infection are essential to understand the neuropathology and to facilitate the development of effective vaccines and drugs. In this paper, we review the characteristics, applications and limitations of three major kinds of established animal models, including non-human primate models, mouse-adaptation models and transgenic mouse models.

2016 Vol. 11 (5): 307-311 [Abstract] ( 320 ) [HTML 1KB] [PDF 414KB] ( 577 )
312 XUE Aijuan, HUANG Ying
Role of probiotics in inflammatory bowel disease

Inflammatory bowel disease (IBD) mainly consists of Crohn’s disease (CD) and ulcerative colitis (UC). Rapid progress has been made to understand the interaction between the gut microbiota and IBD, which provides the rationale for administering probiotic agents in the medical treatments of IBD. It is now widely accepted that probiotic therapy is a helpful option for UC and pouchitis, but stays controversial for CD. Probiotics help to alter the gut dysbiosis, improve the function of mucosal barrier, stimulate the development of innate and adaptive immunity and modulate bacterial metabolites. Although probiotics have shown promise in the treatment of IBD, further controlled studies, enrolling larger numbers of patients, are needed to identify the therapeutic role of probiotics.

2016 Vol. 11 (5): 312-316 [Abstract] ( 246 ) [HTML 1KB] [PDF 497KB] ( 1081 )
317 ZHANG Yuchao1,2, HAO Ruidong2, XU Jianqing1,2
The application of CRISPR/Cas9 technology in infectious diseases

The clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated protein 9 (Cas9)(CRISPR/Cas9) technology is a new gene editing technique. Compared with the previous gene editing techniques, such as homing endonuclease technology, zinc finger nuclease technology and transcription activator-like effector nuclease technology, it has greater advantages in target specificity, operation simplicity, treatment completeness and broad applications. Hepatitis B, acquired immunodeficiency syndrome (AIDS), malaria and other infectious diseases have been the major problems in clinic. Scientists are trying to use CRISPR/Cas9 technology to solve these medical problems. This article mainly summarizes the progress on CRISPR/Cas9 technology applied in infectious diseases.

2016 Vol. 11 (5): 317-320 [Abstract] ( 375 ) [HTML 1KB] [PDF 395KB] ( 871 )
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