海南省一例糖尿病患者足趾感染非产毒白喉棒状杆菌的鉴定与溯源分析  

Analysis on identification and traceability of one non-toxigenic Corynebacterium diphtheriae from a patient with diabetic foot in Hainan province

作　　者：周晓君[1] 陈存仁[2] 王旭明[1] 吴华[1] 黄涛[1] 王少玲[3] 牛莉娜[4] Zhou Xiaojun;Chen Cunren;Wang Xuming;Wu Hua;Huang Tao;Wang Shaoling;Niu Lina(Clinical Laboratory Department,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Haikou 570311,China;Endocrinology Department,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Haikou 570311,China;Hainan Center for Disease Control&Prevention,Haikou 570203,China;Key Laboratory of Translational Medicine for Tropical Diseases,Hainan Medical University,Haikou 571199,China)

机构地区：[1]海南省人民医院检验科,海南医学院附属海南医院,海口570311 [2]海南省人民医院内分泌科,海南医学院附属海南医院,海口570311 [3]海南省疾病预防控制中心,海口570203 [4]海南医学院热带病转化医学重点实验室,海口571199

出　　处：《中华预防医学杂志》2022年第8期1107-1111,共5页Chinese Journal of Preventive Medicine

基　　金：海南省卫生健康行业科研项目(21A200216);国家自然科学基金(82060377);海南省自然科学青年基金项目(822QN457);海南省临床医学中心建设项目资助。

摘　　要：为探讨糖尿病患者足趾感染的病因,采用微生物形态学结合分子生物学方法对2021年9月海南省人民医院的1例老年糖尿病患者足趾伤口分泌物培养分离出的白喉棒状杆菌溯源分析,为临床感染诊断提供参考。通过革兰染色、Albert法染色镜检、VITEK 2 Compat鉴定仪和MALDI-TOF MS质谱仪鉴定结合16S rRNA基因序列溯源分析,同时开展tox毒力基因检测。结果显示分离菌株镜检为革兰阳性杆菌,有异染颗粒,可发酵大多数糖类,符合白喉棒状杆菌生物学特性;16S rRNA序列与白喉棒状杆菌标准菌株Corynebacterium diphtheriae NCTC 11397T(GenBank登记号:MW682323.1)同源性为100%;tox毒力基因阴性。本研究结果为临床微生物实验室准确鉴定非产毒白喉棒状杆菌奠定了基础,同时为临床认识非产毒白喉棒状杆菌的感染风险提供依据。There is a rare case of an elderly diabetic with diabetic foot infection at Hainan General Hospital in September 2021,which was diagnosed as Corynebacterium diphtheriae infection incidentally on routine culture with conventional methods and molecular biological approaches,to aid in diagnosis in clinical practice.Owing to smear staining,Albert staining and VITEK 2 system,automated identification systems viz matrix-assisted laser desorption ionization-time of flight(MALDI-TOF)confirmed combing with 16S ribosomal RNA(16S rRNA)gene has been used for the taxonomic classification of bacteria.Otherwise,toxin gene tox was done for diphtheria toxin synthesis.The isolate was Gram-stain-positive,rod-like arrangement with irregular thickness,with characteristic metachromatic granules,ferment most sugars and homology of 16S rRNA analyses with C.diphtheriae NCTC11397T(MW682323.1)was greater than a 100%possibility,toxin gene tox was negative.The findings lay the foundation to clinical identify and trace of non-toxigenic C.diphtheriae.Moreover,this work provides insights into the non-toxigenic C.diphtheriae that contribute to recognized risk of non-toxigenic C.diphtheriae infections.

关 键 词：白喉棒状杆菌 基质辅助激光解吸电离 糖尿病足 

分 类 号：R587.2[医药卫生—内分泌]