2013—2021年深圳市急性腹泻人群副溶血性弧菌基因组流行病学特征分析  

Genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021

作　　者：谢丽 杨超 江敏[3] 邱亚群[3] 蔡锐 胡璐璐 姜伊祥 王磊 陈琼城[3] 吴双[3] 石晓路[3] 扈庆华 李迎慧[3] Xie Li;Yang Chao;Jiang Min;Qiu Yaqun;Cai Rui;Hu Lulu;Jiang Yixiang;Wang Lei;Chen Qiongcheng;Wu Shuang;Shi Xiaolu;Hu Qinghua;Li Yinghui(School of Public Health,University of South China,Hengyang 421001,China;Institut Pasteur of Shanghai,Chinese Academy of Sciences,Shanghai 200031,China;Institute of Pathogenic Microbiology,Shenzhen Center for Disease Control and Prevention,Shenzhen 518055,China;Shenzhen Center for Disease Control and Prevention,Shenzhen 518055,China)

机构地区：[1]南华大学公共卫生学院,衡阳421001 [2]中国科学院上海巴斯德研究所,上海200031 [3]深圳市疾病预防控制中心病原微生物检测所,深圳518055 [4]深圳市疾病预防控制中心,深圳518055

出　　处：《中华预防医学杂志》2023年第3期386-392,共7页Chinese Journal of Preventive Medicine

基　　金：广东省自然科学基金项目(2019A1515011523);深圳市引进高层次医学团队项目“三名工程”(SZSM201811071);深圳市医学重点学科(SZXK064);中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2020-PT330-006);国家自然科学基金(32000008)。

摘　　要：目的了解2013—2021年深圳市急性腹泻人群副溶血性弧菌的感染状况及基因组流行病学特征。方法对深圳市感染性腹泻监测系统主动监测的急性腹泻病例进行流行病学数据收集和统计,对分离到的副溶血性弧菌菌株进行全基因组测序,划分克隆群并分析血清型,毒力基因及多位点序列型别,采用单核苷酸多态性变异位点差异分析2019—2021年腹泻监测人群的暴发簇。结果2013—2021年深圳市15家哨点医院共监测急性腹泻病例48623例,分离到副溶血性弧菌1135株,阳性分离率为2.3%。全基因组测序共获得852株菌的基因组数据,序列分析获得29种血清型、21种已知ST型和5种新ST型,tdh+trh-菌株占比达93.2%;种群结构包含8个全基因组克隆群(CG),以CG3占绝对优势,其次为CG189。CG3以O3:K6血清型和ST3序列型为主;CG189以O4:KUT、O4:K8血清型和ST189a、ST189序列型为主。2019—2021年共发现13个基因簇,包含154个病例,以及发现30个暴发簇,其中29个暴发簇均由CG3菌株引起。结论副溶血性弧菌是深圳市急性感染性腹泻的主要病原菌,CG3和CG189长期流行并占主导地位,存在被忽略的散在暴发及持续的共同污染来源;针对流行克隆群进行溯源和采取精准防控措施,有望大幅减轻副溶血性弧菌感染引起的腹泻疾病负担。Objective To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021.Methods Based on the Shenzhen Infectious Diarrhea Surveillance System,acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021.Whole-genome sequencing(WGS)of Vibrio parahaemolyticus isolates was performed,and the genomic population structure,serotypes,virulence genes and multilocus sequence typing were analyzed.Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis.Results A total of 48623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021,and 1135 Vibrio parahaemolyticus strains were isolated,with a positive isolation rate of 2.3%.Qualified whole-genome sequencing data of 852 isolates were obtained.Eighty-nine serotypes,21 known ST types and 5 new ST types were identified by sequence analysis,and 93.2%of strains were detected with toxin profile of tdh+trh-.8 clonal groups(CGs)were captured,with CG3 as the absolute predominance,followed by CG189.The CG3 group was dominated by O3:K6 serotype and ST3 sequence type,while CG189 group was mainly O4:KUT,O4:K8 serotypes and ST189a and ST189 type.A total of 13 clusters were identified,containing 154 cases.About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021.Conclusion Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City,with diverse population structures.CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time.Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis.Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.

关 键 词：副溶血性弧菌 全基因组测序 多位点序列分型 毒力基因 种群结构 横断面研究 

分 类 号：R574.62[医药卫生—消化系统] R446.5[医药卫生—内科学]