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目的调查婴儿艰难梭菌的携带状况及菌株特征。方法收集2015年8-11月在该院住院或门诊治疗的1岁内婴儿粪便标本238份,利用免疫层析法快速初筛艰难梭菌,阳性标本再利用CDIF平板进行厌氧培养以获得菌株,利用PCR方法检测艰难梭菌毒素A、B的编码基因tcdA、tcdB和二元毒素编码基因cdtA、cdtB,运用slpA测序分型(slpA ST)方法对菌株进行基因分型。结果 238份粪便标本共分离出50株艰难梭菌,<3月、3~<6月和6月至1岁三组婴儿艰难梭菌的分离率分别为9.3%,17.6%和27.3%,三组见比较差异有统计学意义(χ~2=6.940,P=0.031<0.05)。52.0%(26/50)的菌株为产毒株,其中69.2%(18/26)的菌株产毒模式为tcdA+tcdB+cdtA-cdtB-。50株艰难梭菌可分为11种slpA ST型,产毒株最常见的基因型为slpA ST fr-02和kr-02,而非产毒株则为xr-03。结论 1岁内婴儿艰难梭菌携带率较高,且过半为产毒株,大多同时产毒素A和B。产毒株与非产毒株的基因型存在差别。
Objective To investigate the carriage status and strain characteristics of C. difficile in infants. Methods A total of 238 1-year-old infant stool samples were collected from hospitalized or outpatient clinics from August to November in 2015. Clostridium difficile was rapidly screened by immunochromatography. Positive samples were then anaerobically cultured using CDIF plates to obtain strains The coding genes tcdA, tcdB and binary coding genes cdtA and cdtB of C. difficile toxin A and B were detected by PCR. The strains were genotyped by slpA ST. Results A total of 50 Clostridium difficile isolates were isolated from 238 stool specimens. The rates of Clostridium difficile isolates from the three groups were 9.3%, 17.6% and 27.3% respectively in March, June, June and June, The difference between the two groups was statistically significant (χ ~ 2 = 6.940, P = 0.031 <0.05). 52.0% (26/50) of the strains were toxin-producing strains, among which 69.2% (18/26) of the strains were given tcdA + tcdB + cdtA-cdtB-. Fifty Clostridium difficile strains were divided into 11 types of slpA ST. The most common genotypes of toxigenic strains were slpA ST fr-02 and kr-02, while non-virulent strains were xr-03. Conclusions The prevalence of C. difficile in infants during 1 year old is high, and more than half of them are toxigenic strains, most of which produce toxins A and B at the same time. There is a difference in genotypes between toxigenic and non-toxigenic strains.