2016-2018年陕西省炭疽监测及基因溯源分析  

Surveillance and gene tracing of anthrax in Shaanxi,2016-2018

作　　者：刘东立[1] 石一[1] 马琳[1] 周体操[1] 曹磊[1] 张璐[1] 李雪梅[1] 张义[1] LIU Dong-li;SHI Yi;MA Lin;ZHOU Ti-cao;CAO Lei;ZHANG Lu;LI Xue-mei;ZHANG Yi(Shaanxi Center for Disease Control and Prevention,Xi′an,Shaanxi 710054,China)

机构地区：[1]陕西省疾病预防控制中心

出　　处：《现代预防医学》2019年第11期1927-1932,共6页Modern Preventive Medicine

基　　金：陕西省卫生计生科研基金项目(No.2016D094);陕西省科技资源共享平台项目(2016FWPT-12)

摘　　要：目的调查了解2016-2018年陕西省炭疽流行情况、病原学特征及分子流行病学特征。方法对2016-2018年报告炭疽病例开展个案调查,进行流行病学三间分布分析;采集病例生物样本及环境样本,进行炭疽杆菌分离培养、炭疽ELISA抗体检测及荧光定量PCR检测,对分离到的阳性标本以canSNP及MLVA15的方法进行分子分型,与陕西省历史菌株及国内部分省份菌株基因型进行聚类分析。结果 2016-2018年陕西省共炭疽病例14例,发病到诊断平均9天,地理分布以关中及陕北地区为主,8月份发病较多,人群分布性别比为6∶1(12/2),26~59岁占85.7%(12/14),农民占71.4%(10/14)。人体标本病原培养17份,分离到炭疽杆菌1株,阳性5.9%,环境标本培养77份均为阴性,ELISA检测阳性率83.3%(10/12),荧光定量PCR阳性率21.4%(3/14);陕西省炭疽菌株canSNP基因型为A.Br.001/002型,2015年、2018年及1953年菌株MLVA分型分别为MLVA15-38、31、CHN17基因型。结论 2016-2018年陕西省炭疽疫情属较低散发水平,主要分布在关中及陕北地区,8月为发病高峰,人群以青壮年男性农民为主。炭疽杆菌canSNP基因型为A.Br.001/002,与国内主要流行株相同。存在3种不同的MLVA15基因型。陕北地区MLVA15-38型,与北部内蒙古相近;关中地区MLVA15-31型,与甘肃省及新疆类似;历史上还曾有MLVA15-CHN17型。Objective To investigate the epidemic situation,etiological characteristics and molecular epidemiological characteristics of anthrax in Shaanxi Province from 2016 to 2018.Methods We used case investigation of anthrax cases reported in 2016-2018 and epidemiological analysis of spatial,temporal and population distribution.Biological samples and environmental samples were collected for B.anthracis isolation culture,anthrax ELISA antibody detection and real-time PCR detection.The positive samples were molecularly typed by canSNP and MLVA15,and clustered with the historical strains of Shaanxi Province and the genotypes of some domestic provinces.Results A total of 14 cases were reported from 2016 to 2018 in Shaanxi Province.The average time from onset to diagnosis was 9 days.The geographical distribution was mainly in Guanzhong and Northern Shaanxi.There were more cases in August.The sex ratio of population distribution was 6:1(12/2).85.7%(12/14)were 26-59 years old,and 71.4%(10/14)were peasants.One strain of Bacillus anthracis was isolated from 17 human specimens,and the positive rate was 5.9%.77 environmental specimens were negative.The positive rate of ELISA was 83.3%(10/12).The positive rate of fluorescence quantitative PCR was 21.4%(3/14).CanSNP genotype of anthrax strain in Shaanxi Province was A.Br.001/002.MLVA genotypes of strains isolated in Shaanxi Province in 2015,2018 and 1953 were MLVA15-38,31 and CHN17 genotypes,respectively.Conclusion The anthrax epidemic in Shaanxi Province in 2016-2018 is at a low emission level.The cases are mainly distributed in Guanzhong and Northern Shaanxi.August is the peak incidence.The distribution of the population is dominated by young male farmers.The canSNP genotype A.Br.001/002 of Bacillus anthracis in Shaanxi Province is the same as that of the main domestic strains,and there are three different MLVA15 genotypes.MLVA15-38 in Northern Shaanxi is similar to Inner Mongolia.MLVA15-31 in Guanzhong is similar to Gansu Province and Xinjiang Province.There have also been MLVA15-

关 键 词：炭疽 流行病学 canSNP MLVA 

分 类 号：R181.23[医药卫生—流行病学]