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刘东立, 陈雅丽, 张振才, 丁全明, 张铮, 李斌, 白洋, 马琳, 石一. 2022年陕西省一起霍乱疫情调查及全基组溯源分析[J]. 疾病监测. DOI: 10.3784/jbjc.202304140166
引用本文: 刘东立, 陈雅丽, 张振才, 丁全明, 张铮, 李斌, 白洋, 马琳, 石一. 2022年陕西省一起霍乱疫情调查及全基组溯源分析[J]. 疾病监测. DOI: 10.3784/jbjc.202304140166
shu
Liu Dongli, Chen Yali, Zhang Zhencai, Ding Quanming, Zhang Zheng, Li Bin, Bai Yang, Ma Lin, Shi Yi. Investigation and whole genome sequencing analysis of a cholera epidemic in Shaanxi, 2022[J]. Disease Surveillance. DOI: 10.3784/jbjc.202304140166
Citation: Liu Dongli, Chen Yali, Zhang Zhencai, Ding Quanming, Zhang Zheng, Li Bin, Bai Yang, Ma Lin, Shi Yi. Investigation and whole genome sequencing analysis of a cholera epidemic in Shaanxi, 2022[J]. Disease Surveillance. DOI: 10.3784/jbjc.202304140166
shu

2022年陕西省一起霍乱疫情调查及全基组溯源分析

Investigation and whole genome sequencing analysis of a cholera epidemic in Shaanxi, 2022

    摘要
  • 摘要:
    目的 对2022年陕西省城固县1起霍乱疫情调查溯源。
    方法 对病例进行个案调查，对现场环境进行卫生学调查，收集当地气温及降水资料。 采集病例、同餐人员及同期腹泻患者粪便或肛拭子样本，采集剩余食品、环境水体、水产品样本，进行霍乱弧菌核酸检测及分离培养。 对分离到的霍乱弧菌进行血清学和质谱鉴定，利用国家致病菌识别网药物敏感试验指南进行药敏试验，提取菌株DNA进行毒力基因检测，利用二代测序平台进行全基因组测序，用测序拼接数据进行毒力基因及耐药基因预测，与既往分离的霍乱弧菌、pubMLST下载的国内外霍乱弧菌基因组序列进行核心基因组多位点序列分析（cgMLST）及核心基因组单核苷酸多态性分析（cgSNP)。
    结果 本起疫情从1例霍乱病例和1例带菌者中各分离到1株霍乱弧菌，均为O139群，携带ctxAB毒力基因，对磺胺类、碳青霉烯类、三代头孢菌素类、喹诺酮类、β-内酰胺类药物均敏感，而对氯霉素、多粘菌素类、四环素类、氨基糖苷类有抗药性； cgMLST分析结果显示，菌株为大流行菌克隆株序列型（ST）69型，与陕西省既往霍乱菌株无关联。 同餐人员及同期腹泻病例共106人均未检出霍乱弧菌。 水体样本96份，鱼类样本35份，环境样本7份，畜禽粪便样本7份。 经霍乱弧菌核酸检测阳性2份，分别为文川河某处采集的鱼类样本2份中检出霍乱弧菌hlyA、O139群基因核酸阳性，ctxAB毒力基因阴性。
    结论 本起疫情为霍乱弧菌O139群引起的散发疫情，其病原为国内的大流行菌株，感染来源可能与水产品污染有关，高温、干旱等因素是霍乱发生的原因之一。

     

    Abstract:
    Objective To investigate the source of a cholera epidemic in Chenggu county, Shaanxi province in 2022.
    Methods Case investigation and field hygienic survey were conducted, and local temperature and precipitation data were collected. Stool samples or anal swabs from the cases, dining companions and other diarrhea patients and samples of residual food, environmental water and aquatic products were collected for nucleic acid detection of V. cholerae and isolation and culture of V. cholerae. Serological test and mass spectrometry were conducted for the identification of isolated V. cholerae strains. Drug susceptibility testing was performed according to the guideline from national pathogenic bacterium identification network, virulence gene was detected by using the DNA extracted from the strains, The strains were sequenced using a second-generation sequencing platform, Virulence gene and drug resistance gene were predicted by using sequencing data, The sequencing data of previously isolated V. cholerae and domestic V. cholerae genome sequencing data from pubMLST were used for the analyses on core-genome multilocus sequence typing (cgMLST) and core-genome single nucleotide polymorphism (cgSNP).
    Results Two strains of V. cholerae were isolated from 1 case and 1 carrier, both were V. cholerae O139, carrying ctxAB virulence genes, showing sensitivity to sulfonamides, carbapenems, three-generation cephalosporins, quinolones and β-lactaides and resistance to chloramphenicol, polymyxin, tetracycline and aminoglycoside. The cgMLST analysis after gene sequencing showed that the strains belonged to pandemic strain ST69, which had no association with previous cholera strains in Shaanxi. V. cholerae was not detected in 106 samples from the dining companions and other cases of diarrhea. In 96 water samples, 35 fish samples, 7 environmental samples and 7 livestock manure samples, 2 fish samples from Wenchuan River were positive for nucleic acid of V. cholerae hlyA and O139.The detection result of ctxAB virulence gene was negative.
    Conclusion This epidemic was caused by V. cholerae O139 group, a pandemic strain, and the infection source might be the contamination of aquatic products, and high temperature, drought and others might be the associated factors.

     

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