中国部分城市艰难梭菌携带毒素基因特征分析  

Characteristics of Clostridium difficile harboring toxin genes in some Chinese cities

作　　者：金慧[1] 高晓东[2] 陈琳 干铁儿[4] 任淑华[5] 李福琴[6] 姜亦虹 韦凌娅[1] 沈林海[1] 徐虹[1] 倪晓平[1] 胡必杰[2] 

机构地区：[1]杭州市疾病预防控制中心消媒所,浙江杭州310021 [2]复旦大学附属中山医院医院感染管理科,上海200032 [3]宁波市第二人民医院医院感染管理科,浙江宁波315010 [4]浙江省中医院医院感染管理科,浙江杭州310006 [5]杭州市第一人民医院医院感染管理科,浙江杭州310006 [6]郑州大学第一附属医院医院感染管理科,河南郑州450052 [7]南京鼓楼医院医院感染管理科,江苏南京210008

出　　处：《中华医院感染学杂志》2016年第11期2418-2420,2424,共4页Chinese Journal of Nosocomiology

基　　金：浙江省重点科技创新团队基金资助项目(2011R50021);杭州市科技发展计划基金资助项目(20130733Q32)

摘　　要：目的了解中国5个城市艰难梭菌携带毒素基因特征,为中国艰难梭菌感染诊治提供试验依据。方法收集2013年6月-2015年6月中国上海、杭州、宁波、郑州和南京5个城市分离自住院患者和环境表面的艰难梭菌,采用多重PCR的试验方法,对所有菌株进行tcdA/tcdB/cdtA/cdtB4个毒素基因检测,分析所携带的毒素基因特征。结果中国5个城市共成功复苏出艰难梭菌408株,371株来自患者的艰难梭菌经多重PCR检测,tcdA+,tcdB+基因阳性299株,阳性率为80.59%,tcdA-、tcdB-阳性44株,阳性率为11.86%;37株来自环境的艰难梭菌经多重PCR检测,tcdA-、tcdB-阳性15株,阳性率40.54%;tcdA-、tcdB+阳性9株,阳性率24.32%;中国部分城市的艰难梭菌携带毒素基因以A+B+毒素基因为主,产双性毒素基因占1.08%。结论研究所揭示的艰难梭菌毒素基因特征应引起临床医师高度关注,尤其是在选择以检测毒素为主的诊断技术时,应考虑不同方法检测毒素基因的能力。OBJECTIVE To investigate the characteristics of Clostridium difficile strains harboring toxin genes that were isolated from 5Chinese cities so as to provide experimental basis for diagnosis and treatment of C.difficileinfection.METHODS From Jun 2013 to Jun 2015,the C.difficilestrains were isolated from hospitalized patients and environmental surfaces in 5Chinese cities,including Shanghai,Hangzhou,Ningbo,Zhengzhou,and Nanjing.The multiple PCR was employed to detect 4toxin genes such as tcdA,tcdB,cdtA,and cdtB.The characteristics of the harbored toxin genes were analyzed.RESULTS A total of 408 strains of C.difficile were successfully recovered from the 5Chinese cities.The result of the multiple PCR showed that of 371 strains of C.difficile isolated from the hospitalized patients,299 were tested positive for tcdA＋,tcdB＋ genes,with the positive rate80.59%;44were tested positive for tcdA-,tcdB- genes,with the positive rate 11.86%.The result of the multiple PCR indicated that of 37 strains of C.difficileisolated from the environmental surfaces,15 were tested positive for tcdA-,tcdB- genes,with the positive rate 40.54%;9were tested positive for tcdA-,tcdB＋ genes,with the positive rate 24.32%.The A＋B＋toxin genes were dominant among the toxin genes harbored in the C.difficile strains isolated from the Chinese cities,and the double toxin genes accounted for 1.08%.CONCLUSION The clinicians should pay great attention to the characteristics of toxin genes in the C.difficilestrains;it is necessary to consider the ability of different methods in detection of toxin genes especially when the detection of toxin is chosen as the diagnostic technique.

关 键 词：艰难梭菌 毒素基因 特征 分析 

分 类 号：R378.8[医药卫生—病原生物学]