2022年天津市1例非产毒白喉棒状杆菌携带者流行病学调查  

Epidemiological investigation of a non-toxic corynebacterium diphtheriae carrier in Tianjin in 2022

作　　者：郭玉婷 张颖[1] 李闻[1] 丁亚兴[1] 于爽 刘莹 张维[1] 曲江文[1] Guo Yuting;Zhang Ying;Li Wen;Ding Yaxing;Yu Shuang;Liu Ying;Zhang Wei;Qu Jiangwen(Tianjin Center for Disease Control and Prevention,Tianjin 300011,China;Heping District Center for Disease Control and Prevention,Tianjin 300070,China)

机构地区：[1]天津市疾病预防控制中心,天津300011 [2]天津市和平区疾病预防控制中心,天津300070

出　　处：《中国疫苗和免疫》2023年第1期31-34,共4页Chinese Journal of Vaccines and Immunization

摘　　要：目的对天津市2022年1例报告疑似白喉病例进行鉴定。方法采集该病例咽拭子、全血和肺泡灌洗液标本,进行白喉棒状杆菌(Corynebacterium diphtheriae,Cd)核酸检测、细菌分离培养、生化鉴定和毒力基因检测。结果该病例为女性,29岁,无国外旅居史;2022年7月25日出现咳嗽等症状并住院治疗,无白喉样症状,咽拭子和肺泡灌洗液标本Cd核酸均阳性,分离培养和生化鉴定检出Cd,Cd毒力基因检测阴性,2022年8月8日治愈出院。结论该病例为非产毒Cd携带者,排除白喉诊断;需加强疑似白喉的及时发现、报告和规范处置。Objective To make a definitive diagnosis in a suspected diphtheria patient reported in Tianjin in 2022.Methods We collected pharyngeal swabs,whole blood samples,and bronchoalveolar lavage fluid samples from the patient and tested for Corynebacterium diphtheriae(Cd)nucleic acid,attempted bacterial isolation and culture,conducted biochemical tests,and tested for presence of a virulenceassociated gene.Results The patient was a 29-year-old female with no history of traveling abroad who developed a cough on July 25,2022 and was hospitalized for evaluation and treatment.She had no signs or symptoms of diphtheria.Pharyngeal swab and bronchoalveolar lavage fluid samples were positive for Cd nucleic acid.Cd was detected by bacterial culture and biochemical tests,but samples were negative for Cd virulence gene.The patient recovered and was discharged from the hospital on August 8,2022.Conclusions The patient was a carrier of non-toxic Cd and was not diagnosed with diphtheria.We need to strengthen timely detection,reporting,and standardized response to suspected diphtheria cases.

关 键 词：白喉 白喉棒状杆菌 毒力基因 带菌者 

分 类 号：R183.3[医药卫生—流行病学] R184.6[医药卫生—公共卫生与预防医学]