婴儿艰难梭菌携带状况及菌株特征研究  

Clostridium difficile carriage in infants and the characteristics of isolates

作　　者：周天祥[1] 束振华 肖克林[3] 王中兴[1] 麦光兴[3] 夏勇[3] 黄震 范回生 古聪慧 

机构地区：[1]深圳市宝安区妇幼保健院检验科,广东深圳518133 [2]深圳市龙岗区中心医院检验科,广东深圳518116 [3]深圳市宝安区妇幼保健院中心实验室,广东深圳518133 [4]深圳市龙岗区第五人民医院体检科,广东深圳518100 [5]深圳市罗湖区人民医院产科,广东深圳518001

出　　处：《国际检验医学杂志》2017年第13期1735-1737,共3页International Journal of Laboratory Medicine

基　　金：广东省科技计划项目公益研究与能力建设专项资金(2014A020212703);广东省医学科研基金项目(A2015142);深圳市宝安区科技计划项目(2014083);深圳市龙岗区科技发展资金医疗卫生(扶持类)项目(20160606173802570)

摘　　要：目的调查婴儿艰难梭菌的携带状况及菌株特征。方法收集2015年8-11月在该院住院或门诊治疗的1岁内婴儿粪便标本238份,利用免疫层析法快速初筛艰难梭菌,阳性标本再利用CDIF平板进行厌氧培养以获得菌株,利用PCR方法检测艰难梭菌毒素A、B的编码基因tcdA、tcdB和二元毒素编码基因cdtA、cdtB,运用slpA测序分型(slpA ST)方法对菌株进行基因分型。结果 238份粪便标本共分离出50株艰难梭菌,<3月、3~<6月和6月至1岁三组婴儿艰难梭菌的分离率分别为9.3%,17.6%和27.3%,三组见比较差异有统计学意义(χ~2=6.940,P=0.031<0.05)。52.0%(26/50)的菌株为产毒株,其中69.2%(18/26)的菌株产毒模式为tcdA+tcdB+cdtA-cdtB-。50株艰难梭菌可分为11种slpA ST型,产毒株最常见的基因型为slpA ST fr-02和kr-02,而非产毒株则为xr-03。结论 1岁内婴儿艰难梭菌携带率较高,且过半为产毒株,大多同时产毒素A和B。产毒株与非产毒株的基因型存在差别。Objective To investigate the carrying status and characteristics of Clostridium difficile isolated from infants.Methods Two hundred and thirty-eight stool specimens were collected from infant younger than 1 year old,that were hospitalized or outpatient from August to November 2015.Immunochromatography targeted GDH and toxin A&B of C.difficile was used for C.difficile screening,and those positive specimens were inoculated in CDIF and anaerobic culture.C.difficile isolates were genotyped by using slpA sequence typing(slpA ST),and tcdA,tcdB,cdtA and cdtB of C.difficileisolates were detected by PCR.ResultsFifty C.difficile strains were isolated from 238 stool samples,and the isolated rates of C.difficilefrom <3 months,3 months to <6 months,and 6 months to 1 years old groups were 9.3%,17.6% and 27.3%(χ~2=6.940,P=0.031<0.05),respectively.52.0%(26/50) of the C.difficileisolates were toxigenic,and 69.2%(18/26)toxigenic isolates harbored tcdA+tcdB+cdtA-cdtB-.Fifty C.difficileisolates were genotyped as 11 slpA STs,slpA ST fr-02 and kr-02 were the commonest genotypes in toxigenic C.difficileisolates;however,that was slpA ST xr-03 in non-toxigenic isolates.Conclusion High C.difficile carriage is found in infants younger than 1 year old,and more than half of C.difficileisolates are toxigenic.Most of toxigenic isolates harbored toxin A and B.The genotype of C.difficileisolates is different between toxigenic isolates and non-toxigenic isolates.

关 键 词：艰难梭菌 婴儿 slpA测序分型 毒素编码基因 

分 类 号：R446.5[医药卫生—诊断学]