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目的分析海南省2009年-2011年不明原因发热病人中立克次体的感染状况及基因型别,探讨其防制对策。方法利用巢氏PCR方法,检测海南省不明原因发热病人血液标本立克次体gro EL基因的特异性片段,并对阳性结果进行序列测定及聚类分析。结果 236份病人标本中27份gro EL阳性,阳性率为11.4%。阳性PCR产物测序并聚类分析结果显示,恙虫病东方体序列与R.tsutsugamushi(M31887)恙虫病东方体同源性高;斑点热群立克次体和Rickettsia sibirica(AY059014)等11株斑点热群立克次体同源性较接近,而与2007年在澄迈县1例病人血标本中分离到Rickettsia sp Hainan 1(gb|EU402925)斑点热立克次体比较同源性较低;斑疹伤寒群立克次体和Rickettsia typhi str.B9991CWPP(CP003398)斑疹伤寒群立克次体共处于同一分支,同源性为100%。结论海南省不明原因发热病人中持续存在斑点热、斑疹伤寒和恙虫病感染的现象,应加强立克次体病的疾病监测和实验室检测能力。
Objective To analyze the infection status and genotypes of Rickettsia in Hainan Province from 2009 to 2011 with unexplained fever and to explore its control strategy. Methods The nested PCR method was used to detect the specific fragment of gro-gene of rickettsia in blood samples of patients with unexplained fever in Hainan Province. The positive results were sequenced and clustered. Results A total of 27 gro EL samples from 236 patients were positive, with a positive rate of 11.4%. The positive PCR products were sequenced and cluster analysis showed that the oriental sequence of tsutsugamushi was highly homologous to the R. tsutsugamushi (M31887) Orientia tsutsugamushi, and the 11 spot fever of Rickettsia sibirica (AY059014) The homology of Rickettsia sp Hainan 1 (gb | EU402925) was lower than that of Rickettsia sp Hainan 1 (gb | EU402925) in blood samples from one patient in Chengmai County in 2007. Rickets typhus Rickettsia and Rickettsia typhi str.B9991CWPP (CP003398) typhus Rickettsia co-located in the same branch, homology was 100%. Conclusion The persistence of spot fever, typhus and scrub typhus infection in patients with unexplained fever in Hainan Province should strengthen the disease monitoring and laboratory testing ability of rickettsial disease.