2021年贵州省一起人间钩端螺旋体病疫情的分子流行病学调查分析  

Molecular epidemiological analysis of an epidemic of human leptospirosis in Guizhou Province in 2021

作　　者：营夏 刘英[2] 姚光海[2] 王铭 胡灿[2] 周敬祝[2] 王丹[2] 杨幸贵 谭勤琴 胡勇[1] 李世军[1,2] YING Xia;LIU Ying;YAO Guang-hai;WANG Ming;HU Can;ZHOU Jing-zhu;WANG Dan;YANG Xing-gui;TAN Qin-qin;HU Yong;LI Shi-jun(School of Public Health,the Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guizhou Medical University,Guiyang 550025,China;Guizhou Center for Disease Control and Prevention,Guiyang 550004,China)

机构地区：[1]贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵阳550025 [2]贵州省疾病预防控制中心,贵阳550004

出　　处：《中国人兽共患病学报》2023年第2期192-199,共8页Chinese Journal of Zoonoses

基　　金：国家自然科学基金项目(No.81960622);贵州省传染病人才培养基地建设项目子项目(No.RCJD2102)。

摘　　要：目的对2021年贵州省一起疑似钩端螺旋体病(钩体病)疫情开展病原学调查和分子流行病学分析,为病例的确诊和疫情防控提供科学依据。方法对收集的疑似钩体病例全血样本进行分离培养和致病性钩体特异性PCR检测,同时采用显微镜凝集试验(MAT)对病例血清进行钩体抗体检测。采用“夹夜法”捕捉疫区鼠类宿主动物,取肾脏进行钩体分离培养,采用致病性钩体特异性PCR进行检测,进一步采用血清群特异PCR进行鉴定。应用多位点序列分析(MLST)对本起疫情菌株进行基因分型,构建聚类分析图谱,分析其与国内菌株间的遗传和进化关系。结果3份疑似钩体病例样本经分离培养均为阴性,MAT试验分别为黄疸出血群、秋季群和爪哇群抗体阳性,经致病性钩体特异性PCR检出1例阳性。从鼠类宿主动物样本中分离出6株疑似钩体菌株,经鉴定分别为黄疸出血群(5/6)和秋季群菌株(1/6)。MLST分析显示,鼠类宿主动物携带的5株钩体为ST1型(83.33%),另1株为ST129型(16.67%)。聚类分析显示,鼠类宿主动物携带钩体与四川省、湖南省、江西省和贵州省往年菌株存在同一ST型。结论本起疫情是由致病性钩体感染引起,优势血清群和ST型与本省和周边省份往年分离株一致。秋季群菌株为贵州省近年来首次发现的钩体血清群,当地应加强监测以更好地预防和控制钩体病。To provide a scientific reference for the diagnosis and prevention of leptospirosis,we analyzed an epidemic of suspected leptospirosis in Guizhou Province in 2021,on the basis of etiology and molecular epidemiology.Three whole blood samples collected from suspected leptospirosis cases were identified by microscopic agglutination tests to belong to three serogroups,Icterohaemorrhagiae,Autumnalis and Javanica,one of which tested positive in a pathogenic Leptospira-specific PCR assay.A total of 120 rats were caught by trapping at night in a leptospirosis epidemic area.Whole blood and rodent kidney samples were subjected to culture and biotechnical analysis,and the serotypes of the isolates were identified.All samples were typed with multiple locus sequence typing(MLST).All whole blood samples were identified as negative in culture and biotechnical analysis,serogroup-specific PCR and MLST.Six suspected strains of Leptospira isolated from 120 samples of rats were identified as pathogenic Leptospira through pathogenic Leptospira-specific PCR assays;their serogroups were Icterohaemorrhagiae(5/6)and Autumnalis(1/6).MLST showed that five isolates were ST1 type(83.33%),and one isolate was ST129 type(16.67%).Cluster analysis indicated that the rat isolates had the same ST type as the strains from Sichuan,Hunan,Jiangxi and Guizhou Provinces.The epidemic was caused by pathogenic Leptospira strains.The predominant serogroups and ST types of Leptospira in this outbreak were consistent with strains isolated from this province and neighboring provinces in previous years.The Autumnalis serogroup in this epidemic was first discovered in Guizhou Province in recent years.Thus,surveillance of this epidemic area should be strengthened to better prevent and control leptospirosis.

关 键 词：钩端螺旋体病 钩端螺旋体 显微镜凝集试验 聚合酶链式反应 多位点序列分析 

分 类 号：R446[医药卫生—诊断学]