目的 对福建省发现的3例输入性白喉病例进行流行病学和病原学分析.方法 对3例疑似皮肤白喉患者进行流行病学调查,采集患者皮肤破损的分泌物样品,进行白喉棒状杆菌分离培养.对纯培养的疑似白喉棒状杆菌进行生化鉴定和质谱分析,检测白喉棒状杆菌(Diphtheria toxin repressor,dtxR)、(Toxin A,toxA)、(Toxin B,toxB)等毒力相关基因,进行MLST序列分型.结果 3例病例有典型的皮肤白喉临床表现,皮肤破损部位均分离到白喉棒状杆菌.2例病例分离到的2株白喉棒状杆菌毒力基因检测结果为dtxR(+)、toxA(-)、toxB(-),MLST型别均为ST-703;1例病例分离的白喉棒状杆菌菌株毒力基因检测结果为dtxR(+)、toxA(+)、toxB(+),MLST型别为ST-248.结论 福建省存在白喉输入性风险,非毒原菌亦可引起皮肤白喉.
The epidemiology and etiology of three suspected cases of imported skin diphtheria infection in Fujian Province were investigated.Secretion samples of patients with skin damage were collected for isolation and culture of Corynebacterium diphtheriae.Biochemical identification and mass spectrum analysis of pure cultures of suspected C.diphtheriae were conduc-ted,the virulence-related genes,including diphtheria toxin reporter(dtxR),toxin A(toxA),and toxin B(toxB)were detec-ted,and multilocus sequence typing(MLST)was performed.All three cases had typical clinical manifestations of cutaneous diphtheria,and C.diphtheriae was isolated from the damaged skin.The virulence genes of two C.diphtheriae strains isolated from two cases were identified as dtxR(+),toxA(-),and toxB(-),and the MLST type was ST-703.The virulence genes of C.diphtheriae isolated from one case were identified as dtxR(+),toxA(+),toxB(+),and the MLST type was ST-248.There is an increased risk of diphtheria in Fujian Province.C.diphtheriae without diphtheria toxin genes can also cause skin diphtheria.
李曲文;梁雪晨;高亚东;翁顺太;高源;邵祝军
福建省疾病预防控制中心(福建省人兽共患病研究重点实验室),福州 350012||福建医科大学公共卫生学院专业教学实习基地,福州 350012福建医科大学公共卫生学院,福州 350122福建省疾病预防控制中心(福建省人兽共患病研究重点实验室),福州 350012中国疾病预防控制中心传染病预防控制所,北京 102206
基础医学
白喉棒状杆菌;毒力基因;皮肤白喉
Corynebacterium diphtheriae;virulence gene;cutaneous diphtheria
《中国人兽共患病学报》 2024 (006)
590-594,598 / 6
福建省卫生健康科技计划项目(No.2021GGA036)和福建省科技创新平台建设项目(No.2019Y2001)联合资助 Supported by the Fujian Provincial Health Science and Tech-nology Plan Project support(No.2021GGA036),and the Fujian Provincial Science and Technology Innovation Platform construction project(No.2019Y2001).
10.3969/j.issn.1002-2694.2024.00.081
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