广东省2009－2013 年霍乱弧菌病原学特征分析

李柏生; 谭海玲; 王多春; 柯碧霞; 陈经雕; 何冬梅; 刘美真; 柯昌文; 张永慧

Abstract

李柏生,谭海玲,王多春,柯碧霞,陈经雕,何冬梅,刘美真,柯昌文,张永慧.广东省2009－2013 年霍乱弧菌病原学特征分析[J].Chinese journal of Epidemiology,2014,35(7):825-831

广东省2009－2013 年霍乱弧菌病原学特征分析

Etiologic characteristics of Vibrio cholerae in Guangdong province in 2009-2013

Received:February 27, 2014

DOI：10.3760/cma.j.issn.0254-6450.2014.07.016

KeyWord: 霍乱弧菌抗菌药物敏感性试验毒力基因脉冲场凝胶电泳

English Key Word: Vibrio cholerae Antibiotic susceptibility test Toxic gene Pulsed field gel electrophoresis

FundProject:广州市医药卫生重点项目（2008-Zda-06）；广东省医学科学研究基金（B2011026）

Author Name	Affiliation	E-mail
Li Baisheng	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China School of Public Health and Tropic Medicine, South Medical University
Tan Hailing	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China
Wang Duochun	National Institute of Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention
Ke Bixia	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China
Chen Jingdiao	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China
He Dongmei	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China
Liu Meizhen	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China
Ke Changwen	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China
Zhang Yonghui	Center for Disease Control and Prevention of Guangdong Province, Guangzhou 511430, China School of Public Health and Tropic Medicine, South Medical University	zyh@cdcp.org.cn

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Abstract:

目的分析广东省2009－2013 年霍乱病例及环境来源O1/O139 群霍乱弧菌病原学特征。方法选取2009－2013 年广东省霍乱病例来源、环境（水体和海水产品）来源的O1/O139群霍乱弧菌。采用血清分型、抗菌药物敏感性试验、毒力基因PCR 检测和脉冲场凝胶电泳（PFGE）分子分型方法 , 研究不同来源的霍乱弧菌血清型、抗菌药物敏感性、毒力基因携带以及分子分型方面的异同。结果 2009－2013 年广东省共分离得到各类来源O1/O139 群霍乱弧菌190株（病例16 株, 外环境174 株）。病例来源菌株分为O1 群稻叶型（3 株）、小川型（7 株）和O139 群（6株）3 种菌型；其中10 株ctxA 基因阳性, 2 株小川型菌株携带不完整CTXΦ噬菌体；5 株菌对11 种抗菌药物完全敏感, 3 株对4 种抗菌药物表现出耐受。外环境来源菌株中53 株稻叶型, 22 株小川型和2 株O139 群菌株携带不完整CTXΦ噬菌体；2 株O139 菌株检出ctxA 基因阳性；25 株对≥4 种抗菌药物耐受, 其中有2 株同时对11 种抗菌药物中的7 种耐受, 以水产品中的稻叶型菌株为主（13株）。PFGE分子分型结果显示, 菌株经NotⅠ酶切后的PFGE型别表现出明显的多样性。稻叶型和O139 群病例菌株的带型聚集在同一个聚类中, 小川型病例菌株带型分散在不同的聚类中, 病例来源菌株与环境来源菌株的带型差别较大。结论广东省O1/O139 群霍乱弧菌毒力基因和遗传特征复杂多样, 菌株多重耐药形势严峻, 需要加强菌株型别变异及耐药监测。

English Abstract:

Objective To analyze the etiologic characteristics of O1/O139 Vibrio cholerae in Guangdong province in 2009-2013. Methods Isolates from cholera cases and from the environment surveillance points were investigated by serological typing, antibiotic susceptibility testings, toxic genes detection and molecular typing to analyze the similarities and differences of the identified species. Results Totally, 190 isolations of O1/O139 V. cholerae were obtained from cholera cases（16 strains）and environmental samples（174 strains）in Guangdong province in 2009-2013. The sero-types would include Inaba（3 isolates）, Ogawa（7 isolates）and O139（6 isolates）in all the isolates from the cholera cases. Ten strains from the ctxA positive cases were detected by PCR. Two Ogawa strains carried incomplete CTXΦ phage. Results from the antibiotic susceptibility test indicated that 5 strains were absolutely sensitive to 11 antibiotic discs in vitro, while another 3 strains were simultaneously resistant to 4 antibiotic discs. Except for 2 stains, all the O139 strains from the environment were ctxA negative, detected by PCR. Incomplete CTXΦ phage was found in the Inaba （53 isolates）, Ogawa（22 isolates）and O139（2 isolates）, respectively. Results from the antibiotic susceptibility test exhibited that 25 strains were resistant simultaneously to 4 and/or more antibiotic discs, especially the Inaba strains from the seafoods（13 isolates）. 2 Inaba strains from seafood were simultaneously resistant to 7 antibiotic discs. Results from PFGE molecular typing indicated that the PFGE types digested by NotⅠexpressed significant diversity. Inaba and O139 strains from cases were gathered in the same clusters, while the Ogawa strains from cases scattered in different clusters but no significant correlation smong these strains were found. Our results suggested that a distant genetic relationship might exist between these two different sources strains. Conclusion Complex and diverse as the virulence genes and genetic characteristics and with the grim situation of multi-drug resistant strains, all seemed important to strengthen the surveillance programs on the variation of strain types and antibiotics resistance of O1/O139 V. cholerae in Guangdong province.

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