B型婴儿肉毒中毒的实验室诊断  

Laboratory-based confirmation of type B infant botulism

作　　者：董银苹[1] 李颖[2] 徐进[1] 王伟 江涛[1] 韩春卉[1] 闫韶飞[1] 张迪[2] 李凤琴[1] 

机构地区：[1]国家食品安全风险评估中心卫生部食品安全风险评估重点实验室,北京100021 [2]首都儿科研究所附属儿童医院,北京100020

出　　处：《中国食品卫生杂志》2016年第5期576-580,共5页Chinese Journal of Food Hygiene

基　　金：国家自然科学基金青年基金项目(81402684)

摘　　要：目的对1例疑似肉毒毒素中毒的婴儿病例灌肠液样品进行实验室检测并确证。方法对患儿的灌肠液样品进行肉毒梭状芽胞杆菌分离及肉毒毒素检测。结果患儿灌肠液样品TPGY培养物腹腔注射小鼠后可致小鼠出现类似肉毒毒素中毒表现(竖毛、呼吸困难并出现典型的蜂腰、四肢麻痹)继而死亡。培养物经胰酶处理后小鼠仍出现中毒并死亡,但培养物经100℃加热处理后再次染毒动物,小鼠不出现中毒和死亡。A、B、C、D、E、F六种混合型肉毒毒素诊断血清及B型单价肉毒毒素诊断血清可对小鼠起到保护作用。患儿灌肠液样品中分离到梭状芽胞杆菌,该菌经表型、生化、PCR肉毒毒素产毒基因鉴定,结果为产B型肉毒毒素的肉毒梭状芽胞杆菌。结论患儿疾病与B型肉毒毒素中毒相关。Objective Laboratory-based confirmation was performed on an enema sample from a suspected case of infant botulism. Methods Clostridium botulinum isolation and toxicity determination by mouse assay were carried out. Results Mice injected with the enema TPGY culture supernatant showed the typical signs of botulism including irritable,dyspnea,bellows breathing and quadriplegia before death. Mice injected with a trypsinilzed culture died,but those injected with the culture heated at 100 ℃ survived. The polyvalent botulinum neurotoxins（ BoNTs） antitoxin and the monovalent Bo NT type B antitoxin could protect mice from death. Also,Clostridium was isolated from the enema sample and further characterized by morphological characteristics,gram＇s stain,microscopic,biochemical test and detection of gene producing Bo NT toxin by PCR. The result showed that Clostridium isolated from enema sample was C. botulinum that harbors gene producing type B Bo NT. Conclusion The patient was associated with type B botulinum toxin poisoning.

关 键 词：肉毒毒素 肉毒梭状芽胞杆菌 婴儿肉毒中毒 食源性致病菌 食源性疾病 食物中毒 基因检测 毒素分型 诊断 

分 类 号：R725.9[医药卫生—儿科]