摘要
目的探讨非食源性腹泻患者中分离的产气荚膜梭菌毒力型分布特征。方法选取2020年1月1日至12月31日清华大学附属北京清华长庚医院收治的非食源性腹泻住院患者粪便样本分离的86株产气荚膜梭菌,其中59株分离于抗生素相关性腹泻(antibiotic-associated diarrhea,AAD)患者,27株分离于非AAD患者。采用实时荧光聚合酶链反应(polymerase chain reaction,PCR)检测菌株的6种毒素基因,即产气荚膜梭菌alpha毒素(cpa)、beta毒素(cpb)、epsilon毒素(etx)、iota毒素(ι-iap)、肠毒素(cpe)和坏死性肠炎B毒素(netB),依据毒素类型将菌株分为A~G 7种毒力型,分析毒力型分布以及AAD组和非AAD组间毒力型的差异。结果86株产气荚膜梭菌中,毒素基因cpa、cpb、etx、ι-iap、cpe和netB的检出率分别为100.0%、5.8%、0.0%、0.0%、18.6%和2.3%;A~G毒力型分别占74.4%、0.0%、5.8%、0.0%、0.0%、17.4%和2.3%。A毒力型在AAD组和非AAD组的检出率分别为74.6%和74.1%,占比最高,其次是F毒力型,分别为13.6%和25.9%。AAD组与非AAD组A型、C型、F型和G型4种毒力型的检出率比较,差异无统计学意义(P=0.185)。结论非食源性腹泻患者感染的产气荚膜梭菌主要以A毒力型和F毒力型为主,在AAD中没有特征性毒力型,应同时检测alpha毒素和肠毒素,以避免漏诊。
Objective To investigate the characteristics of toxinotypes of Clostridium perfringens isolated from patients with non-foodborne diarrhea.Methods Eighty-six strains of C.perfringens which were isolated from feces of inpatients with non-foodborne diarrhea in Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University throughout the year of 2020 were selected.Fifty-nine and 27 of strains were recovered from patients with antibiotic-associated diarrhea(AAD)and non-AAD,respectively.Six toxin genes,includingα-toxin(cpa),β-toxin(cpb),ε-toxin(etx),ι-toxin(ι-iap),C.perfringens enterotoxin(cpe),and necrotizing enteritis B toxin(netB)were detected by real-time PCR.C.perfringens strains were divided into seven toxinotypes,namely A to G.Distribution and differences of toxinotypes were analyzed between AAD group and non-AAD group.Results Of the 86 C.perfringens strains,the detection rate of cpa,cpb,etx,ι-iap,cpe and netB was 100.0%,5.8%,0.0%,0.0%,18.6% and 2.3%,respectively.The seven toxinotypes of A-G accounted for 74.4%,0.0%,5.8%,0.0%,17.4% and 2.3%,respectively.Type A accounted for the highest proportion of toxinotypes in the AAD group and non-AAD group(74.6% and 74.1%,respectively),followed by Type F(13.6% and 25.9%,respectively).There was no significant difference in the distribution of Type A,Type C,Type F and Type G(P=0.185)between AAD group and non-AAD group.Conclusions Type A and F is mainly responsible for patients with C.perfringens-mediated non-foodborne diarrhea,and no specific toxinotype accounts for AAD.Theα-toxin and enterotoxin should be detected simultaneously to avoid misdiagnosis.
作者
王利君
肖楠
唐杰
赵秀英
Wang Lijun;Xiao Nan;Tang Jie;Zhao Xiuying(Department of Clinical Laboratory,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)
出处
《北京医学》
CAS
2022年第6期490-493,共4页
Beijing Medical Journal
关键词
产气荚膜梭菌
毒素
抗生素相关性腹泻
非食源性腹泻
Clostridium perfringens
toxin
antibiotic-associated diarrhea(AAD)
non-foodborne diarrhea
