海南岛立克次体血清学和病原学调查报告

INVESTIGATION OF SEROLOGY AND ETIOLOGY OF RICKTTSTTSIA ON HAINAN ISLAND

目的:调查海南岛立克次体的群别及其分布。方法:应用微量免疫荧光检测法(mIFA)对人群血清进行恙虫病、斑疹伤寒和斑点热3种立克次体IgM、IgC抗体检测。应用L929单层细胞进行立克次体分离培养。立克次体用特异性抗体进行mIFA鉴定。结果:恙虫病、斑疹伤寒和斑点热3种立克次体ISC抗体阳性率分别是13.55％(76/561),18.77％(101/538),30.83％(164/532)。其中IgM和IgC抗体均≥1:80者,斑疹伤寒为32.08％,斑点热为46.30％。立克次体分离培养结果,20份不明原因发热或疑似立克次体病患者血液标本分离出12株立克次体,免疫血清mIFA鉴定及聚合酶链反应(PCR)技术检测立克次体特异性DNA等方法鉴定出3株恙虫病立克次体、2株斑疹伤寒立克次体和7株斑点热群立克次体。结论:海南岛确有恙虫病、斑疹伤寒、斑点热病存在,该岛的中、西部感染率较高,南、北部较低。

Objective: To Investigation the gruops and distribution of Rickettstsia in Hainan Island. Method: The indirect microimmunofluorescence(mIFA)test was using for determination of Rickettstia tsutsugamushi,Rickettsia typhus and Rickettsia spoted fever group IgG,IgM antibody.Isolation of Rickettstia with L929 cell culturation. Identification of Rickettstia by mIFA using specific antibody,and determination of Rickettstia specific DNA by PCR. Results: Among 561 serum specimens were collected from outpatients at hospital in eastern,southern,western,northern and center of the island,the positive number (positive rate)contained IgG antibody reacted with Rickettstia tsutsugamushi,Rickettsia typhus and Rickettsia spoted fever group 13.55 %(76/561), 18.77 %(101/538),30.83 %(164/532)re-spectively. the positive number (positive rate) contained high liter (≥1 : 80) antibody IgG and IgM. reacted with Rickettsia typhus and Rickettsia spoted fever respectively 32.08%,and 46.30%.Among 20 blood specimens were collected from patient with fever unknown organism (FUO). 12 atrans of Rick-ettstiae were isolated from bloods of fever of unknown organism patients, and 3 strans Rickettstia tsutsugamushi, 2 strans Rickettsia typhus and 7 strans Rickettsia spoted fever group were Identificated by mIFA using specific antibody,and determination of Rickettstia specific DNA by PCR. Conclusion; we confirm the exist of scrub fever,typhus and spotted fever in Hainan Island The infective rate is higher in western and center of the island thanthat in southern and northern.