5 Infectious Disease

2015152 Value of shock index in the prognosis of early severe sepsis and septic shock in the emergency department.ZHANG Zhizhong（張志忠），et al.Emerg Dept，Beijing Friendship Hosp，Capital Med Univ，Beijing 100050.Chin J Emerg Med 2015；24（2）：147-150.

Objective To explore the significance of shock index in the early assessment of patients with severe sepsis and septic shock.Methods A retrospective study of 100 patients with severe sepsis and septic shock admitted in the Emergency Department of the Beijing Friendship Hospital from September 2011 to August 2013 was carried out.According to the 28-day outcome，all patients were divided into survival group（n=48）and death group（n=52）.Shock index of patients was calculated at admission（SI1）and 2 hours after resuscitation（SI2）. Results（1）The SI1 and SI2（1.5±0.05），（1.2± 0.04）in the death group were significantly higher than those（1.3±0.08），（0.9±0.05），in the survival group（P＜0.01）；（2）AUC of SI1 and SI2 of death group were 0.707 5 and 0.889 4，respectively.The SI2 showed higher sensitivity（80.3%）andspecificity （78.4%）compared to SI1.The optimal cut-off point for SI2 was≥1.Conclusion SI2 may potentially be utilized as a reliable predictor for death in patients with septic shock and severe sepsis in an emergency department.

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2015153 Analysis of epidemiology characteristics of norovirus among diarrheal outpatients in 27 provinces in China，2009-2013.YU Jianxing（徐建興），et al.Div Infect Dis，Key Lab，Chin Dis Contr Prev Center，Beijing 102206.Chin J Epidemiol 2015；36 （3）：199-204.

Objective To investigate the epidemiology characteristics of norovirus among diarrheal outpatients in China.Methods Diarrhea cases were monitored at emergency/outpatient departments at 173 hospitals in 27 provinces of China，with clinical and epidemiological data，and fecal specimens collected and sent to 58 network-laboratories to detect norovirus by RT-PCR method，and to analyze the positive rate of norovirus in various regions，population and time during 2009-2013.Results 11.6%of the 34 031 diarrheal cases under surveillance were found with norovirus.Age group of 6-23 month-old children and that of people over 45 years old were found with the highest positive percentage，13.7%and 12.4% respectively.Positive percentage of norovirus peaked in autumn and winter in a year；it peaked in mid-temperate zones（10.7%）and warm-temperate zones（11.6%）in winter.It peaked in sub-tropical zones in autumn （14.3%）.The most prevalent genogroups detected were norovirus GⅡ，accounting for 89.9%of identified strains.Conclusion Norovirus affects all ages and is the most prevalent in children and the elderly among diarrhea outpatients.Norovirus'positive percentage shows strong seasonal pattern，and peaks at different times of a year in different climate zones of China.Since no effective preventive measures exist，further study on norovirus epidemiology and intervention strategies should be conducted in future.

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2015154 The infection and molecular characteristics of Vibrio parahaemolyticus isolated from intestinal outpatient in two sentinel hospitals in Shanghai，2010-2012.CHEN Haili（陳海麗），et al.Shanghai Public Health Clin Center，Key Lab Med Molec Virol，Pathogen Diag&Biosafety Dept，Shanghai 200000.Chin J Prev Med 2015；49（3）：233-236.

Objective To analyze virulence genes and molecular characteristics of Vibrio parahaemolyticus isolated from sporadic cases with diarrhea in two sentinel hospitals of Shanghai，2010-2013.Methods A total of 2 729 stool samples were collected from two surveillance sentinel hospitals in Shanghai 2010-2012.Vibrio parahaemolyticus strains were isolated and identified from diarrhea out patients using TCBS agar plates and biochemical reactions.Thermostable direct hemolysin gene（tdh），thermostable-related hemolysin gene（trh），hemolysin gene （tlh）were detected by multiplex PCR method.Isolates were analyzed by PFGE and MLST.The PFGE profiles were analyzed using BioNumerics software.Results A total of 30 clinical Vibrio parahaemolyticus strains isolated from 2 729 stool samples.The anually Vibrio parahaemolyticus isolation rate during 2010 to 2012 were 1.1% （11/973），1.0%（11/1 120）and 1.3%（8/636）respectively.The PCR positive rates of virulence genes tlh，tdh and trh were 100%，97%and 0 respectively. The Vibrio parahaemolyticus strains were divided into 13 PFGE types（P1-P13）and 3 ST types（ST-189，ST-799，ST-3）.Among 13 PFGE types，P4 was the main PFGE type，accounting for 30% （9/30）.P9，P10 accounting for 12%（4/30）respectively，P1，P2，P12，P13 accounting for 7%（2/30）respectively，the others types were 3%（1/30）respectively.MLST analysis results showed there are three ST types，ST3 was 84% （25/30），ST189 and ST799 were accounting for 13% （4/30）and 3%（1/30）respectively.Conclusion The infection rate of Vibrio parahaemolyticus was not very high from 2010-2012 in Shanghai，all strains were positive for tlh and negative for trh.ST3 was the major type of Vibrio parahaemolyticus.

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2015155 Clinical characteristics of hospitalized cases of severe acute respiratory infection with laboratory-confirmed influenza and the risk factors analysis of influenza infection for children under 15 years old in ten provinces in China during 2009-2014.PENG Zhibin（彭質(zhì)斌），et al.Div Infect Dis，Chin Dis Contr Prev Center，Beijing 102206.Chin J Epidemiol 2015；36（3）：210-215.

Objective To identify clinical characteristics of hospitalized laboratory-confirmed influenza cases of children under 15 years old，and their risk factors of influenza infection.Methods The reports of hospitalized laboratoryconfirmed influenza cases of children under 15 years old who were detected by the sentinel surveillance systems in 10 provinces from December 2009 to June 2014 were analyzed.Such data as their demographic，medical history，clinical symptoms and signs，treatment and outcome were collected using questionnaire，with their clinical characteristics and their risk factors of influenza infection described.Results Of the 2 937 severe acute respiratory infection inpatients，190（6.5%）were laboratory-confirmed influenza cases.123（64.7%）of such confirmed cases were male，and 139（73.2%）were children under 5 years old，with age median of 3.0 years（IQR：1.0-5.0 years）.20（10.5%）of them had at least one chronic medical condition，mostly chronic cardiovascular disease（3.2%），immunosuppressive disease（3.2%），and cancer/tumor（2.6%）.Most common clinical symptoms of the cases were fever（92.6%）and cough（88.8%），of which abnormal pulmonary auscultation（51.1%）and abnormal chest X-ray performance（36.1%）were the most common clinical signs.29 cases（15.8%）had complications，of which pneumonia（15.3%）was most common.16 cases（8.6%）used antiviral drugs，and 4 cases（2.2%）were admitted into ICU.Risk factor analysis suggested that age＜6 months（OR=0.406，95% CI：0.203-0.815）was a protective factor against influenza infection；and age 5-9 years old（OR=2.535，95%CI：1.059-6.066）was a risk factor for influenza infection.Conclusion Hospitalized laboratory-confirmed influenza cases were found mostly in children under 5 years old.Risk exposure for influenza infection varied among age groups.

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