细菌16S-23S rRNA 基因特异DNA图谱的分子诊断

目的　应用聚合酶链反应 (PCR)、限制性内切酶片段长度多态性分析 (RFLP)及测序技术 ,建立检测不同属种细菌的 16S 2 3SrRNA基因区间的特异图谱。方法　对临床上常见的细菌进行PCR扩增、RFLP、分子克隆及序列分析 ,同时对临床标本进行培养与PCR RFLP比较。结果　 2 7株不同细菌行PCR扩增后 ,得到不同DNA图谱。其中 15种细菌经PCR扩增即可区分 ,另 10种经HinfI或AluI酶切后才能区分。肺炎克雷伯菌与坚韧肠球菌的差异只在第 779位碱基上不同 ,XmaIII酶能区别。 42例临床诊断为新生儿败血症者 ,15例培养阳性 ,阳性率 3 5 7% ;而PCR阳性者则为 2 7例 ,阳性率为 64 2 9% ,明显高于血培养 (P <0 0 1)。 6例脑脊液标本中 ,1例PCR及培养均阳性 (表皮葡萄球菌 ) ;2例培养阴性标本 ,其PCR也阳性 ;经图谱分析为葡萄球菌 ,1例培养为新型隐球菌的脑脊液标本PCR检测为阴性。另 2例PCR及培养均阴性。结论　建立了PCR RFLP技术快速检测细菌 16S 2 3SrRNA基因区间的方法 ,具有特异、敏感、快速、准确的特点 ,为临床细菌感染的病原诊断提供新的科学依据。

Molecular diagnosis of the specific DNA patterns of 16S-23S rRNA gene of bacteria

OBJECTIVE: To establish the specific 16S-23S rRNA gene spacer regions pattern in different bacteria using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), DNA cloning and sequences analysis. METHODS: A pair of primers were selected from highly conserved sequences adjacent to the 16S-23S rRNA spacer region. Bacterial DNA of sixty-one strains of standard bacteria and corresponding clinical isolates representative of 20 genera and 27 species was amplified by PCR, and further studied by RFLP, DNA cloning and sequences analysis. Meanwhile, all specimens were examined by bacterial culturing and PCR-RFLP analysis. RESULTS: The 27 different standard strains showed one, two, three or more than three bands. The sensitivity of PCR reached 2.5 colony-forming unit (CFU), and there was no cross reaction to the human, fungal or viral genomic DNAs. Fifteen species could be distinguished immediately by PCR, while another 10 species were further identified by Hinf I or Alu I digestion. Klebsiella pneumoniae (Kp) and Enterococcus durans (Ed) could not be differentiated from each other by Alu I or Hinf I digestion. The spacer sequences of the Kp and Ed were 908 bp and 909 bp, respectively, and they differed only at the site of the 779th nucleotide. The former was G, and the latter was A. The 760 - 790 bp sequence of Kp was as follows: CGACTGCACCGCCTCCTAC / GGCCGCGTATTC. The 760 - 790 bp sequence of Ed was as follows: CGACTGCAC CGCCTCCTAC / AGCCGCGTATTC. Only one enzyme XmaIII, could discriminate the two. The cleaving site of XmaIII is C downward arrow GGCCG. Kp DNA was cleaved into 778 bp and 130 bp fragments, while E. durans was not. Of 42 specimens with suspected septicemia, 15 were positive (35.7%) on blood culture, and 27 on PCR (64.29%). The positive rate of PCR was significantly higher than that of blood culture (P < 0.01). Of the six CSF specimens, one was positive for Staphylococcus epidermidis (Se) on culture as well as by PCR, while two specimens which were negative on cultures were positive by PCR and were diagnosed as Se according to its DNA pattern. One specimen was culture-positive for Cryptococcus neoformans (Cn) but was negative by PCR. The other two specimens were negative by both PCR and culture. Fifteen blood samples from healthy children were negative by both blood culture and PCR. CONCLUSIONS: The method of detecting bacterial 16S-23S rRNA spacer regions using PCR-RFLP techniques was specific, sensitive, rapid and accurate in detecting pathogens in clinical bacterial infections.