O1/O139群霍乱弧菌检出率与珠江河口水体理化因素的相关性研究

目的:探讨珠江水中O1/O139群霍乱弧菌检出率与珠江水体中理化因素之间的相关性,为霍乱的防控工作提供参考。方法:2010年每月在珠江河沿岸24个采样点采集珠江河口水体,参照卫生部疾病控制司1999年版《霍乱防治手册》进行霍乱弧菌的分离培养和菌型鉴定,用7500a电感耦合等离子体质谱仪进行水样各离子浓度的检测。结果:共采集水样576份,检出51株O1/O139群霍乱弧菌,检出率为8.85%。夏天检出O1/O139群霍乱弧菌数占30%以上。Al、Mn及Ni与O1/O139群霍乱弧菌检出率之间有一定的线性关系。市内、外珠江水中Mg2+、K+、Ca2+、Mn2+、Ni2+、Se4+、Sb3+含量和PH值存在显著或极显著差异。结论:珠江河口水中检出O1/O139群霍乱弧菌与珠江河口水体理化因素Al、Mn及Ni有一定相关性。     

珠江河口水体霍乱弧菌监测及菌株毒力基因分布特征

目的 了解珠江河口水体中O1群和O139群霍乱弧菌的分布状况,分析菌株的分子特征和毒力基因特征.方法 对2009年1月至2010年12月从珠江河口水体中分离的59株O1群和10株O139群霍乱弧菌,采用聚合酶链反应(PCR)方法体外检测ctxA、tcpA、ace、zot、tcpl,hlyA、toxR和ompU等毒力相关基因,并进行毒力相关基因分型分析,对限制性内切酶Not Ⅰ消化后的基因组DNA进行脉冲场凝胶电泳(PFGE)分析,采用BioNumerics软件分析图谱,得到菌株带型相似性的聚类分析树状图.结果 2009-2010年共采集1 152份水体标本,分离得到O1/O139群霍乱弧菌69株,其中O1群埃尔托霍乱弧菌59株(小川型18株,稻叶型41株),O139群霍乱弧菌10株.PCR检测69株菌ctxA全部阴性,hlyA和toxR全部阳性,基因分型可分成9个型.稻叶型菌株中,34.15％(14/41)为hlyA+ toxR+ ompU+ ace+ zot+ tcpⅠ+型;小川型菌株中,66.67％(12/18)为hlyA+toxR+型;O139群菌株中,70％(7/10)为hlyA+ toxR+型.PFGE分型发现,O139群菌株PFGE相似度为69.9％～ 95.5％;O1群菌株相似度为72.8％～ 100.0％,可分成3个聚类.结论 在霍乱流行间歇期,该地区外环境水体中O1群和O139群霍乱弧菌非产毒株广泛存在,基因型别多样.     

四川省2005年霍乱分子流行病学特征

目的：分析四川省2005年霍乱弧菌分子特征,以及霍乱暴发疫情分离的菌株与菌株之间,疫情分离的菌株与海、水产品监测分离的霍乱弧菌之间的遗传相关性,查找霍乱传染来源,为预测疫情和制定防治措施提供依据.方法：利用聚合酶链反应（PCR）检测O139群霍乱弧菌特异性编码脂多糖基因（LPS）和霍乱毒力基因（ctxAB）;脉冲场凝胶电泳对菌株进行分子分型,所得结果以BioNumerics V4.0软件UPGMA方法进行聚类分析.结果：所试16株霍乱弧菌14株LPS阳性,为O139群霍乱弧菌;另2株为O1群稻叶型霍乱弧菌.2株稻叶型霍乱弧菌和1株O139群霍乱弧菌ctxAB阴性,其余13株菌均具有ctxAB,为产毒株.对16株菌以NotⅠ酶切后PFGE可分为5个型别.O139群霍乱弧菌优势流行株与从甲鱼分离的O139群霍乱弧菌PFGE型别一致,且同为产毒株.结论：甲鱼等海、水产品被O139群霍乱弧菌污染情况严重,甲鱼中分离的O139群霍乱弧菌与霍乱疫情分离菌株之间高度同源,被污染的甲鱼可能是本年度食源性霍乱暴发的主要传染来源之一,海、水产品的监测是近期霍乱防控的重点.     

2010年湖南省霍乱弧菌病原学特征及溯源分析

目的分析2010年湖南省霍乱弧菌分离株的病原学特征,比较霍乱疫情分离株与常规监测分离株之间的克隆相关性,追溯传染源。方法对疫情与监测分离到的42株霍乱弧菌进行常规生物分型和PCR检测毒力基因,对23株代表株进行药敏试验,对18株代表株通过脉冲场凝胶电泳(PFGE)获得电泳图谱,利用BioNumerics软件对图谱进行聚类分析,探讨菌株间的相关性。结果 2010年从湖南省霍乱疫情中分离10株霍乱弧菌均为O139群,ctxA阳性率100%。常规监测分离霍乱弧菌32株,其中O1群15株,全部为ctxA阴性株;O139群17株,ctxA阳性率94.11%。23株霍乱弧菌耐药结果显示强力霉素、复方新诺明的耐药率分别为47.83%、56.52%,发现1株对诺氟沙星、环丙沙星耐药。PFGE方法显示有5种脉冲场凝胶电泳图谱,相似率在82%~100%之间,甲鱼中分离的O139群霍乱弧菌与霍乱疫情分离菌株之间高度同源。结论湖南省霍乱弧菌存在紧密相关的流行克隆群;被O139群霍乱弧菌污染的甲鱼很可能是湖南省霍乱疫情发生的主要传染来源,海、水产品的监测是霍乱防控的重点;要密切关注对诺氟沙星、环丙沙星的耐药变化。     

脉冲场凝胶电泳分型技术在追溯O139霍乱传染来源中的应用

目的分析四川省2004年7起因聚餐暴发霍乱疫情的分离菌株之间,及其与常规监测中从外环境、水产品中分离的霍乱弧菌之间的分子分型特征和遗传相关性,查找霍乱传染来源.方法利用聚合酶链反应检测霍乱毒力基因（ctxAB）,用脉冲场凝胶电泳（PFGE）对菌株进行分子分型,所得结果以BioNumerics V4.0软件UPGMA方法进行聚类分析.结果所试72株O139群霍乱弧菌中所有4株从河水分离的菌株ctxAB阴性,其余均具有ctxAB,为产毒株.对其中的67株菌以Not I酶切后PFGE可分为16个型别.从甲鱼分离的O139群霍乱弧菌与同期流行的O139群霍乱弧菌优势PFGE型别一致,并且也为产毒株.7起暴发中分离的菌株型别各不相同.结论2004年四川省O139霍乱暴发感染来源复杂,提示并非因为菌株在该地持续存在而引起,但甲鱼可能是2004年度霍乱聚餐暴发的主要传染来源之一.     

湖南省2005年-2010年霍乱疫情分离株的毒力基因PCR及PFGE分型分析

目的:了解2005年-2010年湖南省霍乱疫情分离到的O139群霍乱弧菌菌株的病原学特征,研究疫情分离株之间的克隆相关性。方法:采用K-B法进行药敏试验;聚合酶链反应(PCR)检测ctxAB毒力基因;脉冲场凝胶电泳对疫情分离代表株进行PFGE分型分析。结果:33株霍乱弧菌对强力霉素、复方新诺明的耐药率较高,分别为39.39%和75.76%,对环丙沙星、诺氟沙星以及丁胺卡那100%敏感;毒力基因的PCR结果显示为所有疫情分离的O139霍乱弧菌均为产毒株,即霍乱肠毒素基因ctxAB阳性;24株分离自2005年和2010年的7起疫情里的O139霍乱弧菌进行PFGE分型及聚类分析后,共分为3个PFGE带型,所有菌株的带型相似率在83%～100%之间。结论:湖南省2005年-2010年霍乱疫情以O139群为主,引起疫情的全部为产毒株,不同年份不同地区之间霍乱疫情的分离菌株之间存在着紧密相关的流行克隆群,对分离菌株进行耐药性监测和进一步的分子分型分析,有助于霍乱的主动监测和传染来源的追踪。     

广东省2011—2013年腹泻病例非O1/O139群霍乱弧菌耐药性及分子特征

目的分析2011—2013年广东省腹泻病例非O1/O139群霍乱弧菌的耐药性及分子特征,为霍乱防控提供依据。方法选取2011—2013年广东省腹泻病例非O1/O139群霍乱弧菌分离株20株,以及同时期海水产品分离株4株,采用抗菌药物敏感试验、毒力基因PCR检测和脉冲场凝胶电泳(PFGE)分子分型方法,分析其耐药性及分子特征。结果抗菌药物敏感性试验结果显示,分离株对复方新诺明、萘啶酸和四环素的耐药率分别为70.8%(17/24),37.5%(9/24)和20.8%(5/24);对头孢曲松和阿米卡星则完全敏感。毒力基因PCR检测结果显示,所有的菌株均携带hly A和toxR基因,而所有菌株均未检出ctxA、tcp A、ace、zot、st等5种毒力基因。菌株经NotⅠ酶切后的PFGE型别表现出明显的多样性,病例菌株与海水产品分离株的带型差别较大。结论广东省非O1/O139群霍乱弧菌毒力基因和遗传特征复杂多样,菌株对多种抗菌药物高度耐药,耐药率较高,需加强腹泻病例中非O1/O139群霍乱弧菌的菌株型别变异及耐药监测。     

广东省外环境O1/O139群霍乱弧菌毒力基因分型

目的 分析广东省外环境来源O1/O139群霍乱弧菌毒力基因的携带及基因分型特征,为霍乱防控提供依据.方法 选取2008 -2009年广东省O1/O139群霍乱弧菌水体分离株69株,水产品分离株16株和同期病例分离株5株,应用多重聚合酶链反应对ctxA、ace、zot、tcpA、tcpl、hlyA、ompU、toxR等8种毒力基因进行检测和分型分析.结果 90株O1/O139群霍乱弧菌均携带hlyA和toxR基因;5株病例菌株中有3株携带8种毒力基因,另外2株小川型菌株为非产毒株,基因型为hlyA+ toxR+ ompU+ zot+ tcpA+ tcpl+型和hlyA+ toxR+ tcpA+型;水体菌株中,稻叶型菌株以hlyA+ toxR+ ompU+ ace+ zot+ tcpl+型(34.15％)为主,小川型(66.67％)和O139群(70％)以hlyA+ toxR+型为主;水产品菌株中,稻叶型菌株以hlyA+ toxR+ ompU+ tcpl+型(75.00％)为主,小川型菌株各种基因型别均有分布,无明显优势基因型别.结论 广东省外环境来源O1/O139群霍乱弧菌以非产毒株广泛存在,毒力基因型别多样.     

脉冲场凝胶电泳分型方法追溯霍乱传染源

目的　了解四川省 2 0 0 4年霍乱疫情分离菌株与常规监测的外环境和水产品中霍乱弧菌分离株之间的遗传相关性 ,追溯传染源 ,为预测疫情和制定防治措施提供依据。方法　O139群霍乱弧菌编码脂多糖 (LPS)特异性基因引物聚合酶链反应 (PCR)复核菌株 ,霍乱毒素 (CT)基因引物PCR检测霍乱毒力基因 ,脉冲场凝胶电泳 (PFGE)进行菌株的分子分型。结果　 2 5株受试菌株LPS基因 2对引物PCR结果均为阳性。所有 6株河水中分离的菌株均为CT基因阴性 ,其余均具有CT基因。 2 4株菌PFGE可分为 13个型。结论　LPS基因PCR检测结果从分子水平证实受试菌株均为O139群霍乱弧菌。河水中分离的 6株菌是非产毒株 ,其余菌株均具有致病性。环境水分离的O139群非产毒株之间以及产毒株与非产毒株之间遗传相关性较远。产毒株之间具有较高的同源性。四川省从甲鱼分离的O139群霍乱弧菌与同期流行的O139群霍乱弧菌分型的带型一致 ,在国内首次以分子流行病学分析提示甲鱼可能是四川省近年霍乱疫情主要传染来源之一。     

7株产色素非O1群霍乱弧菌的生物学性状及毒素原性检测

目的：了解佛山市产色素非O1群霍乱弧菌的生物学性状、血清学分型和致病性。方法：1998－2000年在珠江水系佛山段沿岸的25个采水点每月采样1次，采用水样吸附沉淀集菌法分离非O1群霍乱弧菌。使用PCR检测待测菌是否带有霍乱肠毒素（CT）基因；用ELISA法检测耐热肠毒素（ST）和不耐热肠毒素（LT）。结果：3年共检测1644份水样，共分离到478株非O1群霍乱弧菌，其中分离到7株分属7个不同血清型的产褐色色素的非O1群霍乱弧菌，并发现其中3株带有毒素。结论：首次在佛山市外环境水体中分离出产色素非O1群霍乱弧菌，通过检测发现部分菌株具有一定的致病性，提示在感染性腹泻和霍乱的监测工作中，应注意对产色素非O1群霍乱弧菌的观察和研究。     

表型和分子分型技术在霍乱弧菌研究中的应用

目的分析1999～2005年广州地区O1群和O139群霍乱弧菌代表菌株的致病基因型和PFGE型别,确定霍乱菌株的分子流行病学特征和同源性,研究本地霍乱弧菌的分子特性。方法采用多重PCR方法检测霍乱弧菌的4种致病相关基因,采用限制性内切酶Not I,以脉冲场凝胶电泳技术(PFGE)对菌株进行分子分型,采用分型处理软件BioNumerics Version对PFGE图谱做聚类分析。结果本地霍乱弧菌代表株中存在3种致病基因型(A、B、C型),病例分离的霍乱弧菌多为A型基因,而环境分离的霍乱弧菌则多为C型和B型。总共96株霍乱弧菌分为60个不同的PFGE型,带型范围:8 kb-650 kb。相同或相近的PFGE型(相差1～3条带)存在于多次霍乱暴发疫情分离株中、环境分离霍乱与临床株之间、输入病例与本地病例分离霍乱弧菌间,不同的PFGE克隆型(4～6带及以上)的流行病学联系也较远。结论将致病基因分型、PFGE型与流行病学资料结合,揭示了本地霍乱菌株从受污染的珠江水及水产品传递给人并引起霍乱暴发、散发的特征,提示开展霍乱菌株PFGE分子分型监测及加强地区间合作的必要性和急迫性。     

Comparison of amplified fragment length polymorphism and pulsed-field gel electrophoresis for subtyping of Vibrio cholerae serogroups O1 and O139

Molecular typing of Vibrio cholerae strains is a powerful tool for the surveillance of cholera. Amplified fragment length polymorphism (AFLP) is considered to be a powerful subtyping technique to distinguish bacterial strains at the genetic level. Optimization and standardization of AFLP protocol is required to allow data comparisons across different laboratories in a surveillance network. Here, we performed AFLP using different restriction enzymes and primer pairs for subtyping of V. cholerae serogroups O1 and O139 and compared the optimized AFLP protocol with pulsed-field gel electrophoresis (PFGE) to evaluate the applicability of AFLP for conducting epidemiological surveillance of cholera. The discriminatory index (D-value) of PFGE for serogroup O1 strains was similar when digested with NotI and SfiI, whereas that for O139 strains was higher for NotI digestion than for SfiI. EcoRI-G/MseI-T was the restriction enzyme and primer combination with highest discriminatory index used in the AFLP analysis. Capillary electrophoresis-based AFLP showed higher discriminatory power than that of polyacrylamide gel electrophoresis-based AFLP. When the two methods were compared using 72 epidemiologically unrelated serogroup O1 El Tor isolates, AFLP had a lower D-value than PFGE with NotI and SfiI digestions, respectively. For 54 epidemiologically unrelated serogroup O139 isolates, NotI PFGE had the highest discriminatory power, and SfiI PFGE and AFLP yielded almost the same but lower discriminatory power. We conclude that NotI and SfiI are both suitable for the PFGE of V. cholerae serogroup O1, whereas NotI should be defined as the primary enzyme for serogroup O139. The applicability of AFLP in V. cholerae subtyping and outbreak investigations is limited.     

Comparison of pulsed-field gel electrophoresis and ribotyping for subtyping of Vibrio cholerae O139 isolated in Thailand.

Pulsed-field gel electrophoresis (PFGE) of Cpo I-digested genomic DNA and ribotyping (Bgl I) were applied to 60 Vibrio cholerae strains including 48 V. cholerae O139 from Thailand to compare their value in differentiating strains of the present V. cholerae O139 epidemic. PFGE patterns were divided into groups A and B representing five and four subtypes, respectively, while ribotyping showed four different patterns. PFGE group B subtypes were only presented among O139 isolates from Thailand, whereas four O139 strains from Bangladesh and India showed identical PFGE group A subtypes observed in O139 isolates from Thailand. Two nontoxigenic O139 isolates from Thailand showed different and unique PFGE types as did five V. cholerae non-O139 isolates containing a gene virulence complex found in V. cholerae O139. These results indicate that PFGE (Cpo I) can resolve recent evolutionary divergence within V. cholerae O139 and offers a useful supplementary tool for following the progressing V. cholerae O139 epidemic.     

Molecular typing of Vibrio cholerae O1 isolates from Thailand by pulsed-field gel electrophoresis

The aim of the present study was to genotypically characterize Vibrio cholerae strains isolated from cholera patients in various provinces of Thailand. Two hundred and forty V. cholerae O1 strains, isolated from patients with cholera during two outbreaks, i.e. March 1999-April 2000 and December 2001-February 2002, in Thailand, were genotypically characterized by NotI digestion and pulsed-field gel electrophoresis (PFGE). In total, 17 PFGE banding patterns were found and grouped into four Dice-coefficient clusters (PF-I to PF-IV). The patterns of V. cholerae O1, El Tor reference strains from Australia, Peru, Romania, and the United States were different from the patterns of reference isolates from Asian countries, such as Bangladesh, India, and Thailand, indicating a close genetic relationship or clonal origin of the isolates in the same geographical region. The Asian reference strains, regardless of their biotypes and serogroups (classical O1, El Tor O1, O139, or O151), showed a genetic resemblance, but had different patterns from the strains collected during the two outbreaks in Thailand. Of 200 Ogawa strains collected during the first outbreak in Thailand, two patterns (clones)--PF-I and PF-II--predominated, while other isolates caused sporadic cases and were grouped together as pattern PF-III. PF-II also predominated during the second outbreak, but none of the 40 isolates (39 Inaba and 1 Ogawa) of the second outbreak had the pattern PF-I; a minority showed a new pattern--PF-IV, and others caused single cases, but were not groupable. In summary, this study documented the sustained appearance of the pathogenic V. cholerae O1 clone PF-II, the disappearance of clones PF-I and PF-III, and the emergence of new pathogenic clones during the two outbreaks of cholera. Data of the study on molecular characteristics of indigenous V. cholerae clinical isolates have public-health implications, not only for epidemic tracing of existing strains but also for the recognition of strains with new genotypes that may emerge in the future.     

广西首次分离 O139群霍乱弧菌的病原学特征

目的 了解O139群霍乱弧菌的病原学特征。方法 采用经典的微生物学、噬菌体-生物分型方法进行生化、药敏和流行菌株的分型,并用家兔肠段结扎方法进行霍乱肠毒素检测。结果 4株菌与O139群霍乱诊断血清发生强凝集反应。与O1群多价血清不凝集;在庆大琼脂平板上菌落较O1群霍乱弧菌混浊、隆起。霍乱肠毒素检测均为中等毒力,对氟哌酸、丁胺卡那霉素敏感,对9种抗菌药物耐药。结论 霍乱肠毒素检测为中等毒力,具备引起流行的能力,为流行株。因此加强监测,及时做好防治措施十分必要。     

实时聚合酶链反应检测O1群和O139群霍乱弧菌方法的建立及应用

目的建立检测O1群和O139群霍乱弧菌的实时荧光聚合酶链反应（RT—PCR）方法并进行水体标本的检测评价。方法根据O1群和O139群霍乱弧菌O抗原编码基因rfb序列设计引物，利用SYBRGreen染料，建立同时检测霍乱弧菌O1群和O139群的RT—PCR方法，对所建立的方法分别进行实验室内的灵敏度、特异性及重复性评价。采集河口水标本增菌后进行RT—PCR检测，与分离培养方法比较评价实际应用价值。结果建立了检测O1群和O139群霍乱弧菌的双重RT—PCR方法，根据扩增产物的溶解温度能有效区分O1群和O139群霍乱弧菌两种目标片段的扩增；对其他10种弧菌染色体DNA没有扩增；RT—PCR检测524份河口水体标本的增菌液，与常规分离方法相比显示了明显的灵敏性，并且所有常规分离方法阳性标本其荧光PCR检测亦为阳性。结论以O1群和O139群rfb基因为目标检测片段建立的霍乱弧菌RT—PCR方法可用于环境水体样本中霍乱弧菌常规分离前的快速筛查。     

Emergence of classical ctxB genotype 1 and tetracycline resistant strains of Vibrio cholerae O1 El Tor in Assam, India

Cholera epidemics with moderately high case fatality rates in Assam, northeast India were investigated in 2007, 2008 and 2010. Based on mismatch amplification mutation assay PCR for detection of ctxB allele, 40 isolates of Vibrio cholerae O1 El Tor collected from the epidemics were found to harbour the classical ctxB gene allele of cholera toxin (CT). DNA sequencing of ctxB gene confirmed the isolates to be genotype 1 of ctxB. Antimicrobial susceptibility tests reveal that 100% of the isolates were resistant to trimethoprim and 40% were resistant to tetracycline. The recent V. cholerae O1 strains circulating in Assam, India are due to the El Tor variant carrying classical type CT. Emergence of tetracycline and trimethoprim resistant strains necessitates the review of antibiotic use for severe cholera.     

Preferential association of the heat-stable enterotoxin gene (stn) with environmental strains of Vibrio cholerae belonging to the O14 serogroup

Toxigenic Vibrio cholerae O1 and O139 serogroups have the capacity of causing epidemic and pandemic cholera but are infrequently found in the environment. The other serogroups are abundant in aquatic environments but do not possess the virulence genes necessary for causing the disease. Of the 559 environmental strains of V. cholerae, collected during different periods from environmental samples in Calcutta, 9 (1.6%) harboured the heat-stable enterotoxin gene (stn). Six of the 9 strains belonged to the O14 serogroup. Thus, V. cholerae strains carrying the stn gene revealed preferential association with the O14 serogroup. Three of the six strains harboured the tcpA gene of the E1 Tor type, which is an unusual feature among environmental V. cholerae strains. A strain that possessed the E1 Tor type tcpA also had the CTX prophage. Pulsed field gel electrophoresis (PFGE) revealed that the stn gene positive O14 strains of V. cholerae were not clonal.