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目的了解广州地区腹泻患者中艰难梭菌(CD)的分布、毒素类型和基因型。方法 PCR直接检测粪便中CD tpi基因、毒素基因tcd A、tcd B和cdt A/cdt B。对tpi阳性的标本富集芽孢后,进行厌氧分离培养CD及分子鉴定,同时对菌株进行MLST分型。结果 467份标本的tpi基因阳性率为6.2%(29/467);29份tpi阳性标本的CD培养阳性率为75.9%(22/29);22株CD可分成9种不同的ST型,其中ST54、ST3为相对优势型别,未检测到高产毒株ST1和ST11。结论目前广州地区腹泻患者中CD感染发病率不高,感染多为散发,未发现CD高产毒菌株和暴发流行。对于腹泻患者粪便标本,先采用PCR检测CD种特异性tpi,再富集芽孢厌氧培养和鉴定CD的方法,是一种经济、实用的实验室检测方法。
Objective To understand the distribution of C. difficile (CD), toxin types and genotypes in patients with diarrhea in Guangzhou. Methods Direct detection of CD tpi gene, toxin genes tcd A, tcd B and cdt A / cdt B in feces by PCR. Tpi-positive specimens were collected spores, CD and molecular identification of anaerobic culture, MLST genotyping strains at the same time. Results The positive rate of tpi gene in 467 specimens was 6.2% (29/467). The positive rate of CD culture in 29 specimens with tpi was 75.9% (22/29). The 22 strains of CD were divided into 9 different ST types, ST54, ST3 is the relative dominant type, no high-yielding strains ST1 and ST11 were detected. Conclusions The prevalence of CD infection in patients with diarrhea in Guangzhou is not high at present. Most of the infections are emancipation, and no strains of CD high-yielding viruses and outbreaks are found. For diarrhea patients with stool specimens, PCR-specific detection of CD-specific tpi, then enrichment of spores anaerobic culture and identification of CD, is an economical and practical laboratory test.