艰难梭菌毒素基因检测及分子流行病学分析  

Detection of Clostridium difficile toxin gene and molecular epidemiology

作　　者：李洋 姚立琼[1] 刘志武[1] 梁帅龙 韦小宝 刘旭升 颉晓玲[2] LI Yang;YAO Liqiong;LIU Zhiwu;LIANG Shuailong;WEI Xiaobao;LIU Xusheng;XIE Xiaoling(Department of Laboratory Medicine,the First Hospital of Lanzhou University,Lanzhou 730000;Department of Central Laboratory,the First Hospital of Lanzhou University,Lanzhou 730000;the First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,Gansu,China)

机构地区：[1]兰州大学第一医院检验科,兰州730000 [2]兰州大学第一医院中心实验室,兰州730000 [3]兰州大学第一临床医学院,兰州730000

出　　处：《临床检验杂志》2020年第6期431-433,共3页Chinese Journal of Clinical Laboratory Science

基　　金：甘肃省卫生行业科研计划项目(GSWSKY2018-42)。

摘　　要：目的了解腹泻患者艰难梭菌感染现状,并分析分离菌株的核糖体分型情况。方法收集161例住院腹泻患者粪便标本进行艰难梭菌毒素基因PCR检测,同时进行产毒培养法,并比较2种方法的一致性;对分离的艰难梭菌进行核糖体分型。结果艰难梭菌产毒培养法阳性率为9.94%(16/161),粪便艰难梭菌毒素基因阳性率为9.94%(16/161),2种方法结果差异无统计学(P>0.05),一致性较好(Kappa>0.75)。培养所得18株艰难梭菌中A、B毒素基因均阴性的2株(11.11%),tcdA+tcdB+产毒株15株(83.33%),tcdA-tcdB+1株(5.56%)。18株艰难梭菌核糖体分型分为16种型别(GS1~GS16),未发现核糖体分型027型菌株。结论艰难梭菌粪便毒素基因PCR检测可用于临床诊断,未发现本院艰难梭菌暴发流行。Objective To understand the infectious status of Clostridium difficile(C.difficile)in the patients with diarrhea,and study the ribosome typing of the isolated strains.Methods Feces samples of 161 hospitalized patients with diarrhea were collected for PCR detection of C.difficile toxin gene and the results were compared with the standard method of toxigenic culture.The confirmed C.difficile strains was isolated and tested for toxin gene and PCR-ribotyping.Results The positive rate of C.difficile toxin culture was 9.94%(16/161),and the positive rate of toxin gene detection in feces samples was also 9.94%(16/161).There was no statistical difference between the two methods(P>0.05)with fine consistency(Kappa>0.75).Both tcdA and tcdB genes were negative in 2 of the 18 cultured isolates(11.11%)and both tcdA and tcdB genes were positive in 15(83.33%)isolates.Only 1(5.56%)isolate was tcdA-negative and tcdB-positive.The 18 strains of C.difficile were divided into 16 ribotypes(GS1 to GS16).No isolate was found to be ribotype 027.Conclusion The PCR for Clostridium difficile toxin gene in fecal samples could be used for clinical diagnosis independently.No outbreak of C.difficile was found in our hospital.

关 键 词：艰难梭菌 毒素基因 核糖体分型 

分 类 号：R446.5[医药卫生—诊断学]