福建省3例输入性白喉棒状杆菌感染病例流行病学和病原学分析  

Epidemiological and pathogenic analyses of three cases of imported Corynebacterium diphtheriae infection in Fujian Province

作　　者：李曲文[1,2] 梁雪晨 高亚东 翁顺太 高源[4] 邵祝军[4] LI Qu-wen;LIANG Xue-chen;GAO Ya-dong;WENG Shun-tai;GAO Yuan;SHAO Zhu-jun(Fujian Provincial Center for Disease Control and Prevention,Fujian Provincial Key Laboratory of Zoonosis Research,Fuzhou 350012,China;Professional teaching practice base of School of Public Health,Fujian Medical University,Fuzhou 350012,China;School of Public Health,Fujian Medical University,Fuzhou 350122,China;Institute for Infectious Disease Control and Prevention,China Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]福建省疾病预防控制中心(福建省人兽共患病研究重点实验室),福州350012 [2]福建医科大学公共卫生学院专业教学实习基地,福州350012 [3]福建医科大学公共卫生学院,福州350122 [4]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《中国人兽共患病学报》2024年第6期590-594,598,共6页Chinese Journal of Zoonoses

基　　金：福建省卫生健康科技计划项目(No.2021GGA036);福建省科技创新平台建设项目(No.2019Y2001)联合资助。

摘　　要：目的对福建省发现的3例输入性白喉病例进行流行病学和病原学分析。方法对3例疑似皮肤白喉患者进行流行病学调查,采集患者皮肤破损的分泌物样品,进行白喉棒状杆菌分离培养。对纯培养的疑似白喉棒状杆菌进行生化鉴定和质谱分析,检测白喉棒状杆菌(Diphtheria toxin repressor,dtxR)、(Toxin A,toxA)、(Toxin B,toxB)等毒力相关基因,进行MLST序列分型。结果3例病例有典型的皮肤白喉临床表现,皮肤破损部位均分离到白喉棒状杆菌。2例病例分离到的2株白喉棒状杆菌毒力基因检测结果为dtxR(+)、toxA(-)、toxB(-),MLST型别均为ST-703;1例病例分离的白喉棒状杆菌菌株毒力基因检测结果为dtxR(+)、toxA(+)、toxB(+),MLST型别为ST-248。结论福建省存在白喉输入性风险,非毒原菌亦可引起皮肤白喉。The epidemiology and etiology of three suspected cases of imported skin diphtheria infection in Fujian Province were investigated.Secretion samples of patients with skin damage were collected for isolation and culture of Corynebacterium diphtheriae.Biochemical identification and mass spectrum analysis of pure cultures of suspected C.diphtheriae were conducted,the virulence-related genes,including diphtheria toxin reporter(dtxR),toxin A(toxA),and toxin B(toxB)were detected,and multilocus sequence typing(MLST)was performed.All three cases had typical clinical manifestations of cutaneous diphtheria,and C.diphtheriae was isolated from the damaged skin.The virulence genes of two C.diphtheriae strains isolated from two cases were identified as dtxR(+),toxA(-),and toxB(-),and the MLST type was ST-703.The virulence genes of C.diphtheriae isolated from one case were identified as dtxR(+),toxA(+),toxB(+),and the MLST type was ST-248.There is an increased risk of diphtheria in Fujian Province.C.diphtheriae without diphtheria toxin genes can also cause skin diphtheria.

关 键 词：白喉棒状杆菌 毒力基因 皮肤白喉 

分 类 号：R379[医药卫生—病原生物学]