郑霄, 王鲁茜, 朱雄, 陈海, 吴华, 麦文慧, 李伟, 夏连续. 强台风后类鼻疽发病情况及临床菌株分子特征的初步分析[J]. 疾病监测, 2016, 31(8): 628-632. DOI: 10.3784/j.issn.1003-9961.2016.08.004
引用本文: 郑霄, 王鲁茜, 朱雄, 陈海, 吴华, 麦文慧, 李伟, 夏连续. 强台风后类鼻疽发病情况及临床菌株分子特征的初步分析[J]. 疾病监测, 2016, 31(8): 628-632. DOI: 10.3784/j.issn.1003-9961.2016.08.004
ZHENG Xiao, WANG Lu-xi, ZHU Xiong, CHEN Hai, WU Hua, MAI Wen-hui, LI Wei, XIA Lian-xu. Preliminary study on incidence of melioidosis and molecular characteristics of clinical strains of Burkholderia pseudomallei after Typhoon Rammasun attack[J]. Disease Surveillance, 2016, 31(8): 628-632. DOI: 10.3784/j.issn.1003-9961.2016.08.004
Citation: ZHENG Xiao, WANG Lu-xi, ZHU Xiong, CHEN Hai, WU Hua, MAI Wen-hui, LI Wei, XIA Lian-xu. Preliminary study on incidence of melioidosis and molecular characteristics of clinical strains of Burkholderia pseudomallei after Typhoon Rammasun attack[J]. Disease Surveillance, 2016, 31(8): 628-632. DOI: 10.3784/j.issn.1003-9961.2016.08.004

强台风后类鼻疽发病情况及临床菌株分子特征的初步分析

Preliminary study on incidence of melioidosis and molecular characteristics of clinical strains of Burkholderia pseudomallei after Typhoon Rammasun attack

  • 摘要: 目的 了解强台风袭击海南省后灾区类鼻疽病的发病情况及其临床菌株的分子特征。方法 2014年7月威马逊台风袭击海南省后,于3所大型医疗机构开展类鼻疽新发病例主动监测工作。对收集的病例绘制分布地图,并对发病情况及临床表现等进行描述性流行病学分析,采用多位点序列分型(MLST)、脉冲场凝胶电泳(PFGE)、多位点可变数目串联重复序列多态性分析(MLVA)等方法对病例临床分离株进行分子溯源及同源性比较。结果 调查期间共发现类鼻疽确诊病例16例,高于2013年同期病例数(7人),其中12例(75.0%)于灾后4周内发病,其余4例于5~8周出现。病例均来自受灾严重的海南省北部地区,其中9例集中分布于台风中心途经的文昌-海口带状区域。临床表现以类鼻疽肺炎(75.0%)、类鼻疽败血症(68.8%)为主;病死率达50.0%。分子分型显示16株类鼻疽伯克霍尔德菌区分为12个序列型(ST)、13种PFGE带型及15个MLVA型别,除两株ST1325型菌株外来源均不相同。结论 威马逊台风过后2个月内海南省灾区出现聚集性类鼻疽病例;相关类鼻疽伯克霍尔德菌对应多个ST型,呈高度多态性,能够排除生物恐怖袭击的可能性。出现聚集性类鼻疽病例的原因及其与台风的关系尚需进一步调查。

     

    Abstract: Objective To understand the incidence of melioidosis and to study the molecular characteristics of Burkholderia pseudomallei clinical strains after Typhoon Rammasun attack in Hainan island. Methods A 2-month surveillance for melioidosis was carried out in three general hospitals in Hainan after typhoon attack on July 18,2014. General and clinical information of melioidosis cases were collected and analyzed with the methods of descriptive epidemiology and geographic informatics. Clinical isolates of B. pseudomallei were characterized by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and 4-locus multilocus variable number tandem repeat analysis (MLVA-4) to analyze their relationships and the homology. Results During the investigation, a total of 16 confirmed cases of melioidosis were found, higher than that during the same period in 2013 (7 cases). Among these cases, 12 (75.0%) occurred within 4 weeks after the disaster, and the other 4 occurred within 5-8 weeks. All the cases were from northern Hainan, an area seriously affected by this typhoon. Nine cases were distributed in a zonal area of Wenchang and Haikou, where the eye of the typhoon passed. The common symptoms of the cases included pneumonia (75.0%) and sepsis (68.8%). Eight cases were fatal (50.0%). Molecular typing divided the 16 clinical isolates into 12 sequence types (STs), 13 PFGE patterns and 15 MLVA genotypes, indicating high genetic polymorphism of the strains. Conclusion The clustering of melioidosis cases was observed after Typhoon Rammasun attack in Hainan. Related clinical isolates of B. pseudomallei were genetically diverse, excluding the possibility of bioterrorism attack. Further investigations are needed to clarify the infection cause and its relationship with the activity of typhoon.

     

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