目的调查海南地区类鼻疽伯克霍尔德菌的分子流行病学特征,为该地区类鼻疽监测防控提供参考。方法采集可疑患者的临床样本进行类鼻疽的分离培养,采用形态特征观察和染色镜检对临床分离的类鼻疽进行鉴定。采用HGDI分析菌株的遗传多态性特...目的调查海南地区类鼻疽伯克霍尔德菌的分子流行病学特征,为该地区类鼻疽监测防控提供参考。方法采集可疑患者的临床样本进行类鼻疽的分离培养,采用形态特征观察和染色镜检对临床分离的类鼻疽进行鉴定。采用HGDI分析菌株的遗传多态性特征,用MLVA_4方法调查类鼻疽伯克霍尔德菌的分子流行病学关联,并构建MST(最小生成树)揭示菌株的起源进化特征。同时,对患者的年龄、性别、职业分布、临床特征及治疗结果进行分析。结果在164株类鼻疽伯克霍尔德菌中,有66%(109/164)的菌株分布于海南省的三亚、东方和乐东等西南沿海地区。MLVA_4方法对菌株具有极高的分辨力,HGDI为0.9887。4个分型位点的多态性指数由高到低依次为0.9130(L933),0.8322(L2341),0.8237(L1788)和0.8096(L389)。164株类鼻疽聚为97个MLVA_4基因型(GT1~97),其中33个为共享基因型表明该类基因型的菌株间可能有潜在的流行病学关联。另外64个为单一基因型且每株菌代表一个独特的基因型,表明该地区多于39%的类鼻疽具有零星或散发的流行特征。在33个共享基因型中,14个共享基因型(GT6、16、18、22、33、39、41、49、50、51、58、61、85和92)由来自相同地区分离的菌株构成,证实了该地区类鼻疽呈现由多个共同传染源引发的多点流行的特征;另外,有28个共享基因型(除GT6、41、58、61和92外其他所有共享基因型)分别由2-5个不同地区分离的菌株构成,揭示了该地区类鼻疽可能存在由多个共同传染源引发的多地交叉感染,33个共享基因型包括100株类鼻疽伯克霍尔德菌,菌株聚类率为61.0%(100/164),所有共享基因型的菌株都来自2-5个不同地区,提示类鼻疽在海南省多个地区均有流行。基于MLVA_4数据的最小生成树(Minimum spanning tree MST)分析结果表明164株类鼻疽伯克霍尔德菌可分为2个地理集群,定安县的菌株是海南省类鼻疽的潜在祖先�展开更多
BACKGROUND Melioidosis,an infectious disease caused by Burkholderia pseudomallei(B.pseudomallei),occurs endemically in Southeast Asia and Northern Australia and is a serious opportunistic infection associated with a h...BACKGROUND Melioidosis,an infectious disease caused by Burkholderia pseudomallei(B.pseudomallei),occurs endemically in Southeast Asia and Northern Australia and is a serious opportunistic infection associated with a high mortality rate.CASE SUMMARY A 58-year-old woman presented with scattered erythema on the skin of her limbs,followed by fever and seizures.B.pseudomallei was isolated successively from the patient’s urine,blood,and pus.Magnetic resonance imaging showed abscess formation involving the right forehead and the right frontal region.Subsequently,abscess resection and drainage were performed.The patient showed no signs of relapse after 4 months of follow-up visits post-treatment.CONCLUSION We present here a unique case of multi-systemic melioidosis that occurs in nonendemic regions in a patient who had no recent travel history.Hence,it is critical to enhance awareness of melioidosis in non-endemic regions.展开更多
文摘目的调查海南地区类鼻疽伯克霍尔德菌的分子流行病学特征,为该地区类鼻疽监测防控提供参考。方法采集可疑患者的临床样本进行类鼻疽的分离培养,采用形态特征观察和染色镜检对临床分离的类鼻疽进行鉴定。采用HGDI分析菌株的遗传多态性特征,用MLVA_4方法调查类鼻疽伯克霍尔德菌的分子流行病学关联,并构建MST(最小生成树)揭示菌株的起源进化特征。同时,对患者的年龄、性别、职业分布、临床特征及治疗结果进行分析。结果在164株类鼻疽伯克霍尔德菌中,有66%(109/164)的菌株分布于海南省的三亚、东方和乐东等西南沿海地区。MLVA_4方法对菌株具有极高的分辨力,HGDI为0.9887。4个分型位点的多态性指数由高到低依次为0.9130(L933),0.8322(L2341),0.8237(L1788)和0.8096(L389)。164株类鼻疽聚为97个MLVA_4基因型(GT1~97),其中33个为共享基因型表明该类基因型的菌株间可能有潜在的流行病学关联。另外64个为单一基因型且每株菌代表一个独特的基因型,表明该地区多于39%的类鼻疽具有零星或散发的流行特征。在33个共享基因型中,14个共享基因型(GT6、16、18、22、33、39、41、49、50、51、58、61、85和92)由来自相同地区分离的菌株构成,证实了该地区类鼻疽呈现由多个共同传染源引发的多点流行的特征;另外,有28个共享基因型(除GT6、41、58、61和92外其他所有共享基因型)分别由2-5个不同地区分离的菌株构成,揭示了该地区类鼻疽可能存在由多个共同传染源引发的多地交叉感染,33个共享基因型包括100株类鼻疽伯克霍尔德菌,菌株聚类率为61.0%(100/164),所有共享基因型的菌株都来自2-5个不同地区,提示类鼻疽在海南省多个地区均有流行。基于MLVA_4数据的最小生成树(Minimum spanning tree MST)分析结果表明164株类鼻疽伯克霍尔德菌可分为2个地理集群,定安县的菌株是海南省类鼻疽的潜在祖先�
文摘BACKGROUND Melioidosis,an infectious disease caused by Burkholderia pseudomallei(B.pseudomallei),occurs endemically in Southeast Asia and Northern Australia and is a serious opportunistic infection associated with a high mortality rate.CASE SUMMARY A 58-year-old woman presented with scattered erythema on the skin of her limbs,followed by fever and seizures.B.pseudomallei was isolated successively from the patient’s urine,blood,and pus.Magnetic resonance imaging showed abscess formation involving the right forehead and the right frontal region.Subsequently,abscess resection and drainage were performed.The patient showed no signs of relapse after 4 months of follow-up visits post-treatment.CONCLUSION We present here a unique case of multi-systemic melioidosis that occurs in nonendemic regions in a patient who had no recent travel history.Hence,it is critical to enhance awareness of melioidosis in non-endemic regions.
