多重PCR同时检测病原菌及其耐药基因

目的建立一种多重PCR方法,在同一扩增体系内同时检测病原菌及其β-内酰胺类耐药基因,探讨采用多重PCR同时鉴定病原菌及其耐药基因的可行性。方法根据细菌基因序列和对β-内酰胺类抗生素耐药特点,设计一对细菌鉴定通用引物和三对β-内酰胺类耐药基因引物,并在同一扩增体系内行PCR扩增。结果 MRSA和大肠埃希菌及肺炎克雷伯菌的产酶标准菌株的bla mecA、blaTEM、blaSHV和16S-23S rRNA基因间隔区（ISR）多重扩增均为阳性,对本实验室内保存的50株多重耐药的葡萄球菌（包括40株表型筛查为MRS菌株及10株非MRS菌株）及30株ESBLs阳性的大肠埃希菌及30株肺炎克雷伯菌的多重PCR结果显示：MRS阳性菌株均同时扩增出了葡萄球菌特有的多态性及blamecA指纹图谱,而多重耐药的非MRS菌株也都扩增出了blamecA,ESBLs表型阳性的大肠埃希菌多以blaTEM为主,而肺炎克雷伯菌多以blaSHV为主。结论多重PCR与传统的培养及药敏试验相比敏感、特异、迅速,对于解决难培养或不能培养的微生物的鉴定和药敏试验,是一种很有前景的方法。     

PCR-反向线点杂交技术鉴定慢生长分枝杆菌的方法学研究

目的建立和评价以16S-23S rDNA间隔序列（ITS）为靶基因的PCR-反向线点杂交技术（RLB）快速鉴定慢生长分枝杆菌（SGM）的方法。方法PCR—RLB检测70株分枝杆菌参考菌株、4株诺卡菌参考菌株、5株红球菌参考菌株、1株棒状杆菌参考菌株，来源于中国生物制品和药品鉴定所和悉尼大学感染性疾病和微生物中心；358株分枝杆菌临床分离株来源于深圳、广州和澳大利亚。结果所有分枝杆菌参考菌株均可扩增出200～250bp DNA片段，分枝杆菌引物可扩增4种诺卡菌和5种红球菌，但不与分枝杆菌属探针和种探针杂交。21个探针可鉴定分枝杆菌、结核分枝杆菌复合群、溃疡／海分枝杆菌、堪萨斯分枝杆菌a／b和堪萨斯分枝杆菌c亚种及其他16种SGM。结论该方法能快速、简便和准确地鉴定SGM。     

基于16S rDNA数据库的细菌在线分类鉴定平台的构建

目的 利用且兼并简化现有16S rDNA基础数据库,建立可用于传染病预防控制及感染性疾病的临床诊疗的细菌快速分类的核糖体基因数据库,构建快速鉴定在线分析平台。 方法 收集整理已有的包括RDP、GenBank、SILVA、HOMD等国际公认、公开的16S rDNA数据库,进行整理、筛选和去冗余,重新构建16S rDNA数据库。利用生物信息学构建自动化分析流程,并利用先进的web 2.0、JAVAEE等技术开发设计数据库系统及网站,构建了自动化的在线细菌分类鉴定平台。 结果 通过核酸序列比较,将已公布的1 450 265条16S rDNA序列简化为具有代表性的96 138条序列,并构建了序列数据库。结合序列比较、序列聚类等生物信息方法,建立了基于web的快速检索系统(http://ssu.bioinfo-icdc.org)。 结论 通过构建基于16S rDNA序列的细菌分类鉴定在线分析平台,具有快速、简单、明确的特征,能够对病原菌进行快速、准确的分类学鉴定,有效提高传染病预防控制和感染性疾病临床诊疗中的病原菌鉴定和疫情溯源的速度,为及时实施有效治疗和控制措施赢得时间。     

MALDI-TOF MS在临床常见菌快速鉴定中的应用研究

目的 评价MALDI-TOF MS在临床常见细菌快速鉴定中的应用.方法 选择浙江大学医学院附属第二医院2008年12月至2009年8月分离自血液、痰液、分泌物和尿液的临床常见细菌和浙江省疾病预防与控制中心收集的沙门菌共426株.包括革兰阳性球菌76株和革兰阴性杆菌350株.采用Vitek系统将细菌鉴定到种,血清凝集试验对沙门菌和志贺菌进行血清分型.PCR扩增91株细菌的16S rDNA基因并测序,所得核苷酸序列与GenBank中的数据库进行比对,确定细菌种类.用MALDI-TOF MS对所有细菌进行快速鉴定,比较不同鉴定方法 之间的符合情况.结果 除沙门菌和志贺菌外的所有革兰阳性球菌和革兰阴性杆菌的Vitek和MALDI-TOF MS两者的鉴定结果 完全符合.23株沙门菌中只有2株肠炎沙门菌鼠伤寒血清型的3种鉴定方法 结果 相符,另有1株伤寒沙门菌、3株甲型副伤寒沙门菌、1株乙型副伤寒沙门菌、1株肠炎沙门菌和1株肠炎沙门菌病牛血清型的血清凝集结果 与16s rDNA基因测序结果 相符.Vitek及血清凝集试验鉴定为福氏志贺菌的4株菌16s rDNA基因测序和MALDI-TOF MS的鉴定结果 均为大肠埃希菌.结论 MALDI-TOF MS可快速、准确地对细菌进行鉴定,具有良好的重复性,但对沙门菌和志贺菌效果不佳.     

MALDI-TOF MS在临床常见菌快速鉴定中的应用研究

目的 评价MALDI-TOF MS在临床常见细菌快速鉴定中的应用.方法 选择浙江大学医学院附属第二医院2008年12月至2009年8月分离自血液、痰液、分泌物和尿液的临床常见细菌和浙江省疾病预防与控制中心收集的沙门菌共426株.包括革兰阳性球菌76株和革兰阴性杆菌350株.采用Vitek系统将细菌鉴定到种,血清凝集试验对沙门菌和志贺菌进行血清分型.PCR扩增91株细菌的16S rDNA基因并测序,所得核苷酸序列与GenBank中的数据库进行比对,确定细菌种类.用MALDI-TOF MS对所有细菌进行快速鉴定,比较不同鉴定方法 之间的符合情况.结果 除沙门菌和志贺菌外的所有革兰阳性球菌和革兰阴性杆菌的Vitek和MALDI-TOF MS两者的鉴定结果 完全符合.23株沙门菌中只有2株肠炎沙门菌鼠伤寒血清型的3种鉴定方法 结果 相符,另有1株伤寒沙门菌、3株甲型副伤寒沙门菌、1株乙型副伤寒沙门菌、1株肠炎沙门菌和1株肠炎沙门菌病牛血清型的血清凝集结果 与16s rDNA基因测序结果 相符.Vitek及血清凝集试验鉴定为福氏志贺菌的4株菌16s rDNA基因测序和MALDI-TOF MS的鉴定结果 均为大肠埃希菌.结论 MALDI-TOF MS可快速、准确地对细菌进行鉴定,具有良好的重复性,但对沙门菌和志贺菌效果不佳.     

MALDI-TOF MS在临床常见菌快速鉴定中的应用研究

目的 评价MALDI-TOF MS在临床常见细菌快速鉴定中的应用.方法 选择浙江大学医学院附属第二医院2008年12月至2009年8月分离自血液、痰液、分泌物和尿液的临床常见细菌和浙江省疾病预防与控制中心收集的沙门菌共426株.包括革兰阳性球菌76株和革兰阴性杆菌350株.采用Vitek系统将细菌鉴定到种,血清凝集试验对沙门菌和志贺菌进行血清分型.PCR扩增91株细菌的16S rDNA基因并测序,所得核苷酸序列与GenBank中的数据库进行比对,确定细菌种类.用MALDI-TOF MS对所有细菌进行快速鉴定,比较不同鉴定方法 之间的符合情况.结果 除沙门菌和志贺菌外的所有革兰阳性球菌和革兰阴性杆菌的Vitek和MALDI-TOF MS两者的鉴定结果 完全符合.23株沙门菌中只有2株肠炎沙门菌鼠伤寒血清型的3种鉴定方法 结果 相符,另有1株伤寒沙门菌、3株甲型副伤寒沙门菌、1株乙型副伤寒沙门菌、1株肠炎沙门菌和1株肠炎沙门菌病牛血清型的血清凝集结果 与16s rDNA基因测序结果 相符.Vitek及血清凝集试验鉴定为福氏志贺菌的4株菌16s rDNA基因测序和MALDI-TOF MS的鉴定结果 均为大肠埃希菌.结论 MALDI-TOF MS可快速、准确地对细菌进行鉴定,具有良好的重复性,但对沙门菌和志贺菌效果不佳.     

小儿常见感染菌16S—23S rRNA基因区间的分子生物学研究

目的：探讨聚合酶链反应（PCR）加限制性内切酶片段长度多态性（RFLP）分析在细菌rDNA区间检测中的应用。方法：以16S－23S RNA基因区间为靶序列,设计引物,选择合适的内切酶,采用PCR法加RFLP法检测标准菌株及临床菌株的rDNA区间。结果：26株不同的标准菌株经PCR扩增后,分别出现一条带,两条带,三条带及多条带的不同DNA图谱,敏感性试验可检出2．5CFU的细菌,与人类基因组DNA,真菌及病毒无交叉反应,其中14种菌经一步PCR扩增即可区分,另12种菌除肺炎克雷伯氏菌与坚韧肠球菌经Hinf I或Alu I酶切后仍不能区分外,其余经其中一内切酶酶切后均能区分,32例血培养阳性标本均扩增出与相应标准菌株相一致的图谱。结论：16S－22S rRNA区间基因PCR．扩增加RFLP技术检测细菌rDNA区间,具有特异,敏感,快速,准确的特点,为细菌感染的病原诊断提供新的科学依据。     

16SrRNA、16S-23SrRNA基因测序分析检测主要血流感染病原菌比较

目的比较细菌16SrRNA、16S-23SrRNA基因测序分析在血流感染病原菌检测中的作用。方法提取临床上血流感染常见的金黄色葡萄菌、表皮葡萄球菌、大肠埃希菌、粪肠球菌、肺炎链球菌、铜绿假单胞菌、阴沟肠杆菌、鲍曼不动杆菌、洛菲不动杆菌、肺炎克雷伯杆菌、化脓性链球菌、奇异变形杆菌、潘尼变形杆菌、屎肠球菌、粘质沙雷菌、宋内志贺菌、产气肠杆菌、小肠结肠炎耶尔森菌、腐生葡萄球菌基因组DNA,运用16SrRNA、16S-23SrRNA基因进行PCR扩增。扩增产物经测序后在美国国家生物技术中心（NCBI）上进行比对分析,确定菌种。结果在所分析的19种临床血流感染常见细菌中,16SrRNA基因测序分析可将除粘质沙雷菌外的细菌鉴定到种的水平,但无法完全区分近缘种属;16S-23SrRNA成功鉴定17种细菌,除大肠埃希菌、宋内志贺菌外所有细菌均成功鉴定到单一种的水平。结论16S-23SrRNA基因可作为血流感染细菌检测较好的分子靶标。     

急性淋巴细胞白血病患者血液中草螺菌的鉴定

目的 分离鉴定源于急性淋巴细胞白血病（ALL）患者血液中的未知细菌.方法 采用常规及VITEK32微生物GNI鉴定卡鉴定细菌,K-B法进行药敏试验,PCR法扩增细菌的16S rRNA基因,通过测序并与GenBank中相关序列进行比对.结果 常规生化反应和微生物自动化鉴定系统不能鉴定.16S rRNA PCR扩增产物经测序与GenBank中序列比对,发现与草螺菌属有99%同源性.结论 来源于ALL患者血液中的未知细菌是草螺菌.     

23S rRNA基因在临床常见致病菌检测中的应用

目的 根据临床常见致病菌23S rRNA基因序列的差异，建立可初步鉴别革兰阴性菌和革兰阳性菌的分子生物学方法。方法 分析常见细菌的23S rRNA基因序列，设计相应引物。采用多重PCR扩增标准菌株及临床分离株23S rRNA基因，并根据电泳结果作出初步分类。结果 革兰阴性菌株均出现1条DNA电泳条带(约为350bp)，而革兰阳性菌株则出现2条电泳条带(约为250和400bp)。60株临床分离菌经PCR扩增、电泳后，电泳分析结果与常规鉴定结果符合率达100％。结论 23S rRNA基因检测用于细菌初步分类鉴定，具有快速、灵敏、准确的特点，可为细菌感染的实验室诊断提供客观依据。     

High-throughput screening of bacterial pathogens in clinical specimens using 16S rDNA qPCR and fragment analysis

Molecular-based detection of bacterial pathogens directly from clinical specimens permits rapid initiation of effective antimicrobial treatment and adequate patient management. Broad-range polymerase chain reaction (PCR) amplification of the 16S rRNA gene (16S rDNA qPCR) is used in many diagnostic laboratories as a complement to cultural identification of bacterial pathogens. However, efforts for automation of 16S rDNA PCR workflows are needed in order to reduce turnaround times and to enhance reproducibility and standardization of the technique. In this retrospective method evaluation study, clinical specimens (N?=?499) from patients with suspected bacterial infections were used to evaluate 2 diagnostic semiautomated workflows for rapid bacterial pathogen detection. The workflows included automated DNA extraction (QIASymphony), 16S rDNA qPCR, fragment or melting curve analysis, and amplicon sequencing. Our results support the use of the 16S rDNA qPCR and fragment analysis workflow as it enabled rapid and accurate identification of bacterial pathogens in clinical specimens.     

Genetic diversity of Flavobacterium columnare examined by restriction fragment length polymorphism and sequencing of the 16S ribosomal RNA gene and the 16S-23S rDNA spacer

Genetic variability among strains of Flavobacterium columnare, isolated in the United States, was characterized by restriction fragment length polymorphism (RFLP) and phylogenetic analysis based on the sequence of the 16S rRNA gene. Twenty-seven isolates of F. columnare were differentiated into three genotypes. The isolates within the genotypes were further grouped based on RFLP of the 16S-23S rDNA spacer. The first genotype had five strains that were further divided into group A (4 strains) and B (1 strain) while the second genotype had 10 strains that were also further divided into group A (4 strains) and B (6 stains). The third genotype had 12 isolates with no differences in the RFLP patterns of the 16S-23S rDNA spacers. The 16S rRNA gene sequences representing the three identified genotypes were compared to the different published sequences by phylogenetic analysis and the results showed the American genotypes 1, 2 and 3 corresponding to genomovar 1, 2, and 3, respectively, reported by Triyanto and Wakabayashi [Triyanto, Wakabayashi H. Genotyping of strains of Flavobacterium columnare from diseased fishes. Fish Pathol 1999; 34: 65-71]. The study demonstrates a method for RFLP and sequencing of the 16S rRNA gene and the 16-23S rDNA spacer as a useful tool in epidemiological studies of F. columnare.     

Comparison of VITEK2, MALDI-TOF MS,and 16S rDNA sequencing for identification of Myroides odoratus and Myroides odoratimimus

The genus Myroides comprises the 2 medically relevant species Myroides odoratus and Myroides odoratimimus that are rare opportunistic pathogens and cause infections in immunocompromised patients. A fast identification of Myroides is of importance because these bacterial strains show multiple resistance against antibiotics and therefore limit treatment options. They are associated, for instance, with urinary tract infections, sepsis, meningitis, pneumonia, and infectious cellulitis. Since more and more Myroides spp. are being described, additional potentially pathogenic bacteria may be identified in the future demanding the need for fast and reliable identification methods at species level. However, to date, only molecular approaches meet these demands. In this study, we, therefore, attempt to define an appropriate method other than DNA fingerprinting that will permit a comparable efficacy and, possibly, a more economical strain identification. For this purpose, we compared 2 widely used automated diagnostic systems (VITEK 2 [bioMérieux, Nürtingen, Germany] and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) [Bruker Daltonics, Bremen, Germany]) and correlated the results to 16S rDNA sequencing data. In total, we analyzed 22 strains collected in the course of routine diagnostics. In this study, we demonstrate that VITEK 2 reliably identifies the genus Myroides but cannot differentiate between M. odoratimimus and M. odoratus. In contrast to this, both MALDI-TOF MS and 16S rDNA sequencing efficiently distinguish between the 2 species.     

16S rDNA检测在临床细菌检验中的应用

目的根据细菌16S rDNA的高度保守性,设计合成所有细菌的通用引物,建立快速检测细菌的方法。方法应用PCR方法检测细菌16S rDNA基因。同时对白假丝酵母菌、人白细胞DNA和HBV-DNA阳性病人血清同法检测。结果所有检测细菌均出现特异性条带,而白假丝酵母菌、人白细胞DNA和HBV-DNA阳性病人血清阴性。结论该法快速、特异、敏感。一个样品中能同时检测多种细菌,可为实验室初步判断是否存在细菌感染提供客观依据。     

Comparison of pulsed-field gel electrophoresis (PFGE) and two different polymerase chain reactions (PCRs) for species identification of Borrelia burgdorferi sensu lato strains

The purpose of the present study was to compare the findings of three different molecular-biological methods for Borrelia burgdorferi sensu lato species identification: (i) large DNA fragments pattern obtained with Mlul restriction endonuclease and separated with pulsed-field gel electrophoresis (PFGE); (ii) polymerase chain reaction (PCR), the region inside the 16S rRNA gene multiplied with species-specific primers; and (iii) PCR, the interspace region between the 5S and 23S rRNA genes amplified, the PCR product restricted with Msel restriction endonuclease and fragments separated in polyacrylamide gel. Forty-eight Borrelia strains isolated from diverse clinical materials and two tick strains were analyzed. Each of the 50 isolates analyzed by PFGE was found to be a single species: 30 B. afzelii, 14 B. garinii, and 6 B. burgdorferi sensu stricto. PCR amplification of 16S rRNA with species-specific primers revealed a single species in 41/50 samples and in nine samples two species were detected. PCR of the 5S-23S interspace region restricted with MseI restriction endonuclease detected a single species in 48/50 samples and a mixture of two species was found in 2/50 samples. In all cases where a single species was identified using PCR the species was in accordance with the PFGE result, and in all cases where a mixture of two species was identified by PCR one of the species was the same as that detected by PFGE. Using a criterion of complete concordance of the results a significant difference in species identification was found when PFGE and the 16S rRNA PCR were compared (p = 0.0026), but not between 5S-23S interspace PCR and PFGE (p = 0.4949) or between 16S rRNA and 5S-23S interspace PCRs (p = 0.0552). PCR assays were faster and easier to perform than PFGE for Borrelia species identification, however PFGE remains a standard procedure for analyzing isolates and demonstrating heterogeneity within species.     

复发性外阴阴道念珠菌病菌种的26S rDNA序列分析

目的探讨基于核糖体基因26SrDNA D1/D2区序列分析法在临床酵母菌菌种鉴定中的应用。方法收集来源于复发性外阴阴道念珠菌病分泌物标本93株,PCR扩增其26SrDNA D1/D2区,对扩增产物进行序列测定和分析,并与基因库中的基因序列进行同源性比对。结果所有菌株均鉴定到种,同源性达99%和100%,同属于真菌双核亚界、子囊菌门、酵母菌科的3个属,89株为candida,3株为Kodamaea,1株为Pichia。其中candida中有7个种,38株candida glabrata,23株candida albicans,16株candida parapsolisis,9株candida metapdilosis,1株candida orthop-silisis,1株candida tropicalis,1株candida nivariensis;3株Kodamaea ohmeri;1株Pichia kudriavzevii。结论复发性外阴阴道念珠菌病的病原体主要为candida属的candida glabrata、candida albicans和candida parapsolisis,非candidaalbicans占75.27%是其特征;26SrDNA D1/D2区序列分析为临床酵母菌的分子水平鉴定提供了一种准确、可行的方法。     

Identification of bacteria from a non-healing diabetic foot wound by 16 S rDNA sequencing

Approximately 10-20% of diabetic foot wounds fail initial antibiotic treatment. It is generally believed that several bacterial species may be present in these types of wounds. Because some of these organisms cannot be easily cultured, proper identification is problematic and thus, appropriate treatment modalities cannot be applied. This report examined the bacterial flora present in a chronic diabetic foot wound that failed antibiotic treatment. A tissue sample was collected from the base of the wound and used for standard microbiological culturing. DNA from the sample was used to amplify bacterial 16 S rDNA gene sequences and a library of these sequences was made. The clones were placed into two major groups on the basis of their melting temperatures. Representatives of these groups were sequenced, and information was used to identify the bacteria present in the wound. The culture-based method identified a single anaerobic species, Bacteroides fragilis. The method employing rDNA sequencing identified B. fragilis as a dominant organism and Pseudomonas (Janthinobacterium) mephitica as a minor component. The results indicate that rDNA sequencing approach can be an important tool in the identification of bacteria from wounds.     

16S rDNA基因芯片检测临床常见感染性细菌

目的 提高细菌和临床微生物检测的速度和准确性，建立含有20种细菌探针在内的感染性细菌检测用基因芯片模型。方法 使用16S rDNA克隆探针和合成的寡核苷酸探针两种，利用点样仪制成基因芯片。细菌DNA经过16S rDNA通用引物扩增后与芯片上的探针杂交，然后用荧光扫描仪检测信号。结果 基因芯片能够用于细菌检测，克服探针具有广泛和灵敏的特点，但是交叉反应明显；寡核苷酸探针具有较高的特异性，但是灵敏度稍差。结论 cDNA探针和寡核苷酸探针结合或设计几个不同的探针来指向同一株细菌很可能是将来基因芯片的检测方向。