海南省类鼻疽伯克霍尔德菌的分子流行病学特征分析  

Investigation of molecular epidemiological characteristics of Burkholderia pseudomallei in Hainan Province,China

作　　者：朱雄 陈海 李沙 王立程 吴多荣[3] 王旭明[4] 陈如寿[5] 郑霄[2] 刘志国 ZHU Xiong;CHEN Hai;LI Sha;WANG Li-cheng;WU Duo-rong;WANG Xu-ming;CHEN Ru-shou;ZHENG Xiao;LIU Zhi-guo(Sanya People’s Hospital,Sanya 572000,China;State Key Laboratory for Infectious Disease Prevention and Control,National Institute for Communicable Disease Control and Prevention,China Center for Disease Control and Prevention,Beijing 102206,China;Haikou People’s Hospital,Haikou 570311,China;Hainan Provincial Peoples’s Hospital,Haikou 570311,China;The third People’s Hospital of Haikou,Haikou 571100,China)

机构地区：[1]三亚市人民医院,三亚572000 [2]中国疾病预防控制中心传染病预防控制所,传染病预防控制国家重点实验室,北京102206 [3]海口市人民医院,海口570208 [4]海南省人民医院,海口570311 [5]海南省第三人民医院,三亚572000

出　　处：《中国人兽共患病学报》2020年第2期110-117,共8页Chinese Journal of Zoonoses

基　　金：海南省重点研发计划项目课题基金项目(No.ZDYF2019149);国家自然科学基金项目(No.81573208);海南省自然科学基金项目(No.817398和817319);三亚市医疗卫生科技创新项目(No.2019YW20)联合资助。

摘　　要：目的调查海南地区类鼻疽伯克霍尔德菌的分子流行病学特征,为该地区类鼻疽监测防控提供参考。方法采集可疑患者的临床样本进行类鼻疽的分离培养,采用形态特征观察和染色镜检对临床分离的类鼻疽进行鉴定。采用HGDI分析菌株的遗传多态性特征,用MLVA_4方法调查类鼻疽伯克霍尔德菌的分子流行病学关联,并构建MST(最小生成树)揭示菌株的起源进化特征。同时,对患者的年龄、性别、职业分布、临床特征及治疗结果进行分析。结果在164株类鼻疽伯克霍尔德菌中,有66%(109/164)的菌株分布于海南省的三亚、东方和乐东等西南沿海地区。MLVA_4方法对菌株具有极高的分辨力,HGDI为0.9887。4个分型位点的多态性指数由高到低依次为0.9130(L933),0.8322(L2341),0.8237(L1788)和0.8096(L389)。164株类鼻疽聚为97个MLVA_4基因型(GT1~97),其中33个为共享基因型表明该类基因型的菌株间可能有潜在的流行病学关联。另外64个为单一基因型且每株菌代表一个独特的基因型,表明该地区多于39%的类鼻疽具有零星或散发的流行特征。在33个共享基因型中,14个共享基因型(GT6、16、18、22、33、39、41、49、50、51、58、61、85和92)由来自相同地区分离的菌株构成,证实了该地区类鼻疽呈现由多个共同传染源引发的多点流行的特征;另外,有28个共享基因型(除GT6、41、58、61和92外其他所有共享基因型)分别由2-5个不同地区分离的菌株构成,揭示了该地区类鼻疽可能存在由多个共同传染源引发的多地交叉感染,33个共享基因型包括100株类鼻疽伯克霍尔德菌,菌株聚类率为61.0%(100/164),所有共享基因型的菌株都来自2-5个不同地区,提示类鼻疽在海南省多个地区均有流行。基于MLVA_4数据的最小生成树(Minimum spanning tree MST)分析结果表明164株类鼻疽伯克霍尔德菌可分为2个地理集群,定安县的菌株是海南省类鼻疽的潜在祖先�To investigate the molecular epidemiological characteristics of Burkholderia pseudomallei isolated from Hainan province,provide reference for surveillance and control of Melioidosis in this area.Samples from suspect patients were collected to isolate B.pseudomallei,both morphological characteristics observation and Gram staining were applied to identify isolated strains.HGDI was used for analysis on genetic diversity of strains,and molecular epidemiological relation among strains were investigated by MLVA_4 approach,then constructed MST based on MLVA_4 data to expound origin and evolution characteristics of isolated strains.Meanwhile,age feature,gender,occupation distribution,clinical manifestation and therapy outcome of patients were analyzed.A total of 164 strains were isolated and identified in this study,66%(109/164)of them were distributed in southwest coastal regions,including Sanya,Dongfang and Ledong areas.MLVA_4 genotype method was shown in great high resolution to strains with HGDI of 0.9887.The order of diversity index from high to low of 4 typing loci were 0.9130(L933),0.8322(L2341),0.8237(L1788)and 0.8096(L389).164 B.pseudomallei were sorted into 97 MLVA_4 genotypes(GT1~97)in this study,33 of them were shared in genotypes,which showed that there was a potential epidemical relations among strains from these genotypes.Others 64 were single genotypes and each one strain representing unique genotype,which indicated that more than 39%Melioidosis cases exhibited epidemiologically unrelated or sporadic characteristics.Among 33 shared genotypes,14 shared genotypes were consisted with strains from identical regions,which confirmed that epidemic of Melioidosis in this area is characterized by multiple-point epidemics caused by multiple common sources of infectious,moreover,28 shared genotypes were consisted with strains from two to five different regions,which suggest that there may be multiple regions cross-infection caused by multiple common sources of infectious in this area,33 shared genotypes including 10

关 键 词：类鼻疽 分子流行病学 临床特征 

分 类 号：R378.6[医药卫生—病原生物学]