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目的了解中国5个城市艰难梭菌携带毒素基因特征,为中国艰难梭菌感染诊治提供试验依据。方法收集2013年6月-2015年6月中国上海、杭州、宁波、郑州和南京5个城市分离自住院患者和环境表面的艰难梭菌,采用多重PCR的试验方法,对所有菌株进行tcdA/tcdB/cdtA/cdtB4个毒素基因检测,分析所携带的毒素基因特征。结果中国5个城市共成功复苏出艰难梭菌408株,371株来自患者的艰难梭菌经多重PCR检测,tcdA+,tcdB+基因阳性299株,阳性率为80.59%,tcdA-、tcdB-阳性44株,阳性率为11.86%;37株来自环境的艰难梭菌经多重PCR检测,tcdA-、tcdB-阳性15株,阳性率40.54%;tcdA-、tcdB+阳性9株,阳性率24.32%;中国部分城市的艰难梭菌携带毒素基因以A+B+毒素基因为主,产双性毒素基因占1.08%。结论研究所揭示的艰难梭菌毒素基因特征应引起临床医师高度关注,尤其是在选择以检测毒素为主的诊断技术时,应考虑不同方法检测毒素基因的能力。
Objective To understand the characteristics of the toxins carried by C. difficile in five Chinese cities and provide experimental evidence for the diagnosis and treatment of C. difficile infection in China. Methods From June 2013 to June 2015, C. difficile isolated from inpatients and environmental surfaces in 5 cities of Shanghai, Hangzhou, Ningbo, Zhengzhou and Nanjing, China were collected. TCDA / tcdB / cdtA / cdtB toxin genes to detect and analyze the toxin gene characteristics. Results A total of 408 strains of Clostridium difficile were successfully recovered in 5 Chinese cities. 371 strains of Clostridium difficile were detected by multiplex PCR. The positive rate of tcdA + and tcdB + genes was 299.5%, and the positive rate was 80.59%. There were 44 tcdA- and tcdB- , The positive rate was 11.86%; 37 strains of Clostridium difficile from the environment were detected by multiplex PCR, tcdA-, tcdB-positive 15, the positive rate of 40.54%; tcdA-, tcdB + positive 9, the positive rate of 24.32% Of the C. difficile carrying toxin genes are A + B + toxin genes, producing about 1.08% of the toxin genes. Conclusions The Clostridium difficile toxin gene characteristic revealed by the study should be of great concern to clinicians. In particular, in the selection of toxin-based diagnostic techniques, different methods of detecting toxin genes should be considered.