武汉市输入性恶性疟原虫kelch13基因C580Y位点突变监测分析  

Monitoring and analysis of kelch13 C580Y mutation in imported Plasmodium falciparum in Wuhan,China

作　　者：贾西帅 周水茂[1] 罗华堂[1] 杨燕[1] JIA Xishuai;ZHOU Shuimao;LUO Huatang;YANG Yan(Wuhan Center for Disease Control and Prevention,Wuhan,Hubei 430015,China)

机构地区：[1]武汉市疾病预防控制中心,湖北武汉430015

出　　处：《中国热带医学》2023年第9期998-1001,共4页China Tropical Medicine

基　　金：武汉市卫生计生委医学科研项目(No.WG17B04,No.WG18Q05);武汉市卫生健康委第七批中青年医学骨干人才培养工程。

摘　　要：目的 了解武汉市输入性恶性疟原虫kelch13基因C580Y位点突变情况,为输入性恶性疟防治提供参考依据。方法 2009—2015年,采集武汉市从非洲和东南亚等疟疾流行区回国人员中确诊为恶性疟的患者血样。提取患者血样中的疟原虫DNA,利用环介导等温扩增(loop-mediated isothermal amplification, LAMP)法扩增kelch13基因,了解C580Y位点突变分布情况。结果 LAMP检测恶性疟患者血样208份,检出C580Y位点突变16份。其中2009—2012年69例非洲输入性恶性疟病例未检出突变,2013—2015年114例非洲输入性恶性疟病例检出C580Y位点突变13份,突变率为11.4%,其中南非、西非和中非的突变率分别为12.5%,9.6%和19.0%,北非和东非未检出突变病例。2009—2013年25例东南亚地区恶性疟,共检出3例,全部来自缅甸,缅甸的突变率为14.3%(3/21),东南亚地区的突变率为12.0%(3/25),和非洲地区2013—2015年的突变率差异无统计学意义(P>0.05)。结论 武汉市输入性恶性疟原虫kelch13基因C580Y位点存在不同程度突变,应该加强相关抗性基因的监测和评估。Objective To investigate the prevalence of C580Y mutation of kelch13 gene in the imported P.falciparum cases in Wuhan City,China,and to provide a reference basis for the prevention and treatment of imported falciparum malaria.Methods From 2009 to 2015,blood samples were collected from returnees who infected with P.falciparum in endemic areas of Africa and Southeast Asia in Wuhan City.The P.falciparum DNA was extracted from the blood samples,and kelch13 gene was amplified by loop-mediated isothermal amplification(LAMP),and the distribution of C580Y mutation was analyzed.Results C580Y mutation was detected in 16 of the 208 cases tested by LAMP.No mutations were detected in 69 cases of imported falciparum malaria from Africa during 2009-2012,while 13 cases of the C580Y mutation were detected in 114 cases from 2013 to 2015,with a mutation rate of 11.4%.The mutation rate in South Africa,West Africa,and Central Africa was 12.5%,9.6%,and 19.0%,respectively,with no mutations detected in cases from North Africa and East Africa.Among the 25 cases of falciparum malaria from Southeast Asia between 2009 and 2013,three cases were positive for the C580Y mutation,all from Myanmar,with a mutation rate of 14.3%(3/21)in Myanmar and 12.0%(3/25)in Southeast Asia.There was no significant difference in the mutation rate between Africa and Southeast Asia after 2013(P>0.05).Conclusions Our findings highlight the varying degrees of C580Y mutations of kelch13 gene in imported P.falciparum cases in Wuhan and suggest the need for enhanced monitoring and evaluation of related resistance genes.

关 键 词：恶性疟原虫 环介导等温扩增 kelch13基因 位点突变 

分 类 号：R382.31[医药卫生—医学寄生虫学]