住院非腹泻儿童艰难梭菌的定植及相关特征  

The colonization and characteristics of Clostridium difficile in non-diarrhea children

作　　者：温海楠[1,2] 杨靖 赵建宏[1,2] 强翠欣 李志荣 宋文杰[1] 李继红[1] 时东彦[1] 魏宏莲[1] 孙倩[1] 王向红 郭玉梅 

机构地区：[1]河北医科大学第二医院,河北石家庄050000 [2]河北省临床检验中心,河北石家庄050000 [3]石家庄市妇幼保健医院,河北石家庄050000 [4]石家庄市疾病控制与预防中心,河北石家庄050000

出　　处：《中国微生态学杂志》2015年第8期895-899,903,共6页Chinese Journal of Microecology

基　　金：河北省自然科学基金(2013206450);河北省科技厅基础条件平台建设项目(河北省医学微生物菌种资源标准平台建设10966142D);科技部国家科技基础条件平台工作重点项目(2005DKA21202-6);河北医科大学第二医院科研基金(2H0201011)

摘　　要：目的了解石家庄地区住院非腹泻儿童艰难梭菌的定植率、毒素产生及核糖体分型特征,并与本地区成人艰难梭菌感染（Clostridium difficile infection,CDI）患者中分离的菌株进行同源性分析。方法采用改良快速肉汤孵育法对2011年10月至2012年6月石家庄三所医院的601份粪便标本进行厌氧培养,筛选出艰难梭菌;应用PCR方法检测A、B毒素基因并进行核糖体分型,Ntsys PC 2.0软件进行同源性分析。结果 601份住院非腹泻儿童粪便标本的艰难梭菌定植率为25.3%（152/601）,其中产毒株定植率为18.3%（110/601）;2岁以下婴儿与2~18岁儿童定植率分别为20.6%（81/394）、34.3%（71/207）。PCR核糖体分型共分有23个型别,其中6种主要型别的菌株占82.2%（125/152）。与该地区成人CDI患者来源菌株的12个型别相比,有10个型别相同。结论石家庄地区住院非腹泻儿童艰难梭菌的定植率不同年龄段有差异,产毒株的定植率较高,且与引起成人CDI的菌株有同源性。提示艰难梭菌可能在儿童与成人间相互传播,尤其是无症状儿童作为艰难梭菌的储存库可能会污染医院环境,成为医院感染的潜在因素。Objectives To investigate the colonization rate of Clostridium difficile in non-diarrhea children and the ribotyping in Shijiazhuang region.Methods Six-hundred and one stool specimens were collected from three hospitals in Shijiazhuang from October 2011 to June 2012.The specimens were screened for Clostridium difficile by a modified rapid broth incubation method.The toxin A and B genes and ribotyping of the strains were analyzed by PCR and the homology was analyzed using Ntsys PC 2.0.Results One hundred and fifty-two strains（25.3%）were isolated,among which the isolating rate of toxigenic strains was18.3%（110/601）.The isolating rates of Clostridium difficile in infants under 2years of age and children between 2to 18 years were 20.6%（81/394）and 34.3%（71/207）respectively.Twenty three PR types were identified from all the strains;6main PR types were found in 82.2%（125/152）of the strains.Twelve types of strains from adult CDI patients were all found in these specimens except SⅩ and SⅪ.ConclusionThe isolating rate of Clostridium difficile in non-diarrhea children in Shijiazhuang region is similar to that in foreign countries,but the rate of toxigenic strains is higher.The similar homology found in the toxigenic strains between children and adults with CDI suggests that Clostridium difficile can disseminate between children and adults in hospital.Asymptomatic children may be a repository of Clostridium difficile who might contaminate hospital environment and become a threat to susceptible patients.

关 键 词：艰难梭菌 产毒株 非腹泻 儿童 定植 核糖体分型 

分 类 号：R515[医药卫生—内科学]