梅毒螺旋体分子流行病学研究进展

基于arp／tpr两个基因的梅毒螺旋体基因分型方法正被广泛应用，不同血液成分及脑脊液标本都可用于梅毒螺旋体检测及基因分型，结合tp0548基因加强分型，发现中国梅毒螺旋体菌株主要为梅毒螺旋体14d／f型，而脑脊液中常检测到梅毒螺旋体19d／e型。23SrRNA基因A2058G突变是梅毒螺旋体耐14、15元环大环内酯类抗菌素的原因，对16元环大环内酯类抗菌素同时耐药的A2059G突变菌株在国外已经出现。梅毒螺旋体分子流行病学研究有助于了解其基因型别与梅毒类型之间的相关性，通过监测梅毒螺旋体携带抗菌素耐药基因的情况，为临床选用抗菌素治疗梅毒提供依据。

Molecular epidemiology of Treponema pallidum

The acidic repeat protein （arp） gene- and Treponema pallidum （TP） repeat （tpr） gene- based subtyping system is widely applied in the genotyping of TP. Multiple blood component and cerebrospinal fluid （CSF） samples can be used for the detection and genotyping of TP. The enhanced molecular typing with the tp0548 gene has demonstrated that 14d/f is the most predominant type of TP in China, and the type 19d/c is more readily detected in CSF. The A2058G mutation in the 23S rRNA gene is considered to be responsible for the resistance to 14- and 15-membered lactone ring macrolides in TP. A novel point mutation,A2059G, which has been recently found abroad, is reported to be associated with the resistance to 14-, 15- and 16- membered lactone ring maerolides. Molecular epidemiological studies of TP may facilitate understanding of the relationship between genotypes of TP and clinical types of syphilis,and provide evidences for antibiotic selection in the treatment of syphilis by surveillance of antibiotic resistance-associated genes.