郴州市住院腹泻患者艰难梭菌感染状况及其基因特征  

Prevalence of Clostridium difficile infection in hospitalized diarrhea patients of Chenzhou City and genetic characteristics

作　　者：谢群 李军 吴媛[2] 贺莉萍 毛煜铭 聂言清 尹爱思 XIE Qun;LI Jun;WU Yuan;HE Li-ping;MAO Yu-ming;NIE Yan-qing;YIN Ai-si(School of Pubic Health Xiangnan University,Chenzhou,Hunan 423000,China;不详)

机构地区：[1]湘南学院公共卫生学院,湖南郴州423000 [2]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《中华医院感染学杂志》2022年第9期1303-1306,共4页Chinese Journal of Nosocomiology

基　　金：国家科技重大专项资助项目(2018ZX10733402);国家重点实验室自主研究开放课题资助项目(2021SKLID302);湖南省教育厅基金资助项目(18A457)。

摘　　要：目的 通过对住院腹泻患者粪便中艰难梭菌的分离培养和毒力基因检测及分型,了解郴州市住院腹泻患者艰难梭菌感染状况。方法 收集2020年10-12月湘南学院附属医院、郴州市第一人民医院和郴州市第三人民医院住院腹泻患者粪便标本306例,厌氧培养法分离艰难梭菌菌株,采用荧光聚合酶链反应(RT-PCR)检测A、B毒素基因tcdA、tcdB及二元毒素基因cdtA、cdtB,并对分离的艰难梭菌菌株进行多位点序列分型(MLST)。结果 郴州市住院腹泻患者产毒艰难梭菌核酸阳性率为8.17%(25/306),>60岁患者感染风险更高(χ^(2)=5.499,P=0.019),306份标本中分离出17株艰难梭菌,粪便标本荧光PCR检测有25份阳性,二者比较有统计学差异(P=0.008),毒力基因检测均为tcdA^(+)tcdB^(+),未检出二元毒素;选取7株艰难梭菌进行MLST分型,分出5个ST型,ST54型(3株)、ST129型(1株)、ST98型(1株)、ST53(1株)和ST631(1株)。结论 郴州市住院腹泻患者艰难梭菌感染率较低,感染毒素类型为tcdA^(+)tcdB^(+),呈多种ST流行。OBJECTIVE To detect the genotypes of virulence genes in Clostridium difficile isolated from stool specimens of hospitalized diarrhea patients so as to understand the prevalence of C.difficile infection among the hospitalized diarrhea patients of Chenzhou city.METHODS A total of 306 stool specimens were collected from the patients who were hospitalized in the Affiliated Hospital of Xiangnan University,the First People′s Hospital of Chenzhou City and the Third People′s Hospital of Chenzhou City between Oct 2020 and Dec 2020.The C.difficile strains were isolated by anaerobic culture method,the A,B virulence genes tcdA,tcdB and binary virulencd gene cdtA,cdtB were detected by fluorescent polymerase chain reaction,multilocus sequence typing(MLST)was carried out for the isolated C.difficile strains.RESULTS The positive rate of nucleic acid of toxigenic C.difficile was 8.17%(25/306)among the hospitalized diarrhea patients in Chenzhou City,the patients with more than 60 years of age were at higher risk of the infection(χ^(2)=5.499,P=0.019).Totally 17 strains of C.difficile were isolated from the 306 specimens,and the fluorescent PCR showed that 25 stool specimens were tested positive,there was significant difference(P=0.008).All of the virulence genes were detected as tcdA^(+)tcdB^(+),and no binary toxins were detected.MLST was carried out for 7 strains of C.difficile,and 5 ST types were determined,including ST54(3 strains),ST129(1 strain),ST98(1 strain),ST53(1 strain)and ST631(1 strain).CONCLUSION The incidence rate of C.difficile infection is low among the hospitalized diarrhea patients in Chenzhou City,the strains carrying with tcdA^(+)tcdB^(+)toxin gene cause the infection and show the prevalence of multiple ST types.

关 键 词：艰难梭菌 腹泻 感染 毒素基因 多位点序列分型 

分 类 号：R574.62[医药卫生—消化系统]