23起疑似霍乱疫情的快速诊断和分子流行病学分析  

A quick method for retrieving the specimens of cholera epidemic and analysis of molecular epidemiology

作　　者：郭惠[1] 杨晋川[1] 王路梅 许静静[1] 张雷[1] 景怀琦[2] 

机构地区：[1]江苏省徐州市疾病预防控制中心,221006 [2]江苏省徐州市疾病预防控制中心传染病研究所,221006

出　　处：《中华全科医学》2015年第9期1393-1395,共3页Chinese Journal of General Practice

基　　金：国家科技重大专项项目(2009ZX10004-201);江苏省预防医学科研课题(Y200722)

摘　　要：目的应用建立的4种快速检测技术检测霍乱疫情标本,根据霍乱病例诊断结论,优化快速诊断方案来鉴定和识别霍乱疫情。方法应用免疫胶体金(IMG)、免疫磁珠富集(IMS)、实时荧光PCR(Rt-PCR)、显色培养基(Ch)四种快速检测技术优化组合,建立了IMG,IMS-PCR,IMS-Chr,Rt-PCR四种方法,用于腹泻疫情样品中霍乱弧菌(O1、O139)的快速检测。通过对23起疑似霍乱疫情的123份标本,239份霍乱流行期外环境样品的实际检测,评价4种方法的灵敏度,特异度,尤登指数。选择最佳组合方案用于霍乱疫情诊断。结果 IMS-PCR用于检测腹泻粪便和外环境样品中的霍乱弧菌,尤登指数>90%,较一般的快速筛选方法具有更高的准确性,适用于快速确认检测。Realtime-PCR法的灵敏度最高,适于快速筛选。结论通过IMS-PCR和Realtime-PCR法的联合诊断,效果最佳。优化的快速检测方案,能够对霍乱疫情实现有效及时的监控。Objective To establish rapid detection technology for Vibrio cholera, and optimize the Rapid diagnostic schemes to identify and distinguish the cholera epidemic. Methods By the optimal combination with immune colloidal gold （ IMG）, immunomagnetic enrichment （ IMS）, real-time PCR （qRT-PCR） and chromogenic media （ Ch）, we established IMG, IMS-PCR, IMS-Chr and RT-PCR detective system for the quick test of Vibrio cholerae （ O1, O139） in the diarrhea epidemic samples. Through detection of 123 suspected cholera outbreak specimens and 239 environmental samples outside the cholera epidemic periods, the sensitivity, specificity, superior index of these four kinds of methods were evaluated. The best combination were choosen to use for the the diagnosis of cholera. Results The superior index of IMS-PCR for the detection of Vibrio cholera in the diarrheal stool and external environmental samples is more than 90%, which is with higher accuracy when compared with other rapid screening method. The sensitivity of realtime-PCR was highest and suit- able for the rapid screening. Conclusion Combining IMS-PCR with reahime PCR can achieve a best diagnosis re- suits. The optimized rapid detection scheme can realtime monitor the cholera epidemicing.

关 键 词：霍乱弧菌 免疫磁珠捕获 实时荧光PCR 酶底物显色培养基 

分 类 号：R516.5[医药卫生—内科学] R378.3[医药卫生—临床医学]