一起青年学员急性传染性肺炎暴发的病因学探究

Etiological investigation of an outbreak of acute infectious pneumonia in young students

目的从血清学和基因水平探究一起青年学员急性传染性肺炎暴发的病因。方法采用ELISA法检测常见呼吸道病原体抗体;提取血清DNA/RNA,采用PCR法检测病原体核酸;采用非选择性高通量扩增测序法直接查找病原体核酸,对扩增产物通过Solexa分析系统直接测序分析。结果在71例患者的急性期和恢复期血清中检测到抗肺炎支原体IgM和/或IgG阳性,能诊断肺炎支原体感染者16例(22.5%);特异性检测甲、乙型流感病毒和支原体核酸均阴性;在非选择性扩增出的582750条带中,未见特征病毒序列出现;与限定物种数据库比对,不存在人流感病毒A型、肺炎支原体和鼻病毒等呼吸道相关病原体的基因片段。结论利用血清学和分子生物学手段未能明确本次疫情的病因,与在疫情早期未能收集到呼吸道分泌物标本有一定的关系。

Objective To confirm at biomolecular and serological level the cause of an outbreak of acute infectious pneumonia. Methods Seventy-one sera of patients at acute stage and recovery stage of illness were obtained respectively and were detected by ELISA. Abstracting DNA and RNA from the serum, then thepolymerase-chain-reaction with specific primer to human influenza virus A and B, and myeoplasma pneumoniae, meanwhile detected by unbiased high-throughput sequencing, which was finished by Solesa system, to identify microbial sequences. Results The specific detection of 71 acute stage serum showed that sixteen（22% ）were anti-MP IgM and/or anti-MP IgG positive. And our specific detection with specific primers showed the negative results;In 582750 reads amplified by unbiased high - throughput sequencing, all reads were nonspecifie for viral sequences. The further analysis as compared in Solexa system still revealed the negative findings of human influenza virus A, Mycoplasma pneumoniae and human rhinovirus. Conclusions Sixteen patients ware diagnosis as Mycoplasma pneumonia, the morbidity is 22% （ 16/71 ）. The cause of this outbreak of acute infectious pneumonia in a trainning camp can not be identified by serological and biomolecular methods. Unbiased high-throughput sequencing ware negative, as we know that obtaining appropriate specimens in times is significant for etiological study, so it maybe the most likely reason for the negative genetic testing.