淋病奈瑟菌opa基因分型方法的流行病学应用

Application of opa-typing of Neisseria gonorrhoeae strains

目的调查我国4个不同城市淋病奈瑟菌opa基因型的分布状况,并考察实验结果与临床资料之间的一致性,从而了解淋病的传播路线及传播方式。方法研究于2006年在我国沿海地区4个不同城市共收集330株淋病奈瑟菌,其中中国医学科学院皮肤病研究所(南京)采集86株,山东省皮防所(济南)采集80株,福建省皮防所(福州)采集94株,广西壮族自治区皮防所(南宁)采集70株。对330株淋球菌进行opa基因分型,并应用GelCompar分型软件对各菌株opa基因扩增片段的酶切产物条带进行聚类分析。研究还收集了这些菌株相应的临床和流行病学资料,其中包括淋病患者的性接触信息。结果 330株淋球菌opa基因经过TaqI与HpaII两种限制性内切酶酶切后共产生了309个opa型,其中292个opa型各包含一株淋球菌,14个opa型各包括两株淋球菌,2个opa型各包括3株淋球菌,1个opa型包括4株淋球菌。在292个各包括一株淋球菌的opa型中,有18个opa型(18株淋球菌)两两之间形成9个opa型相似对。在这4个城市中,只包括一株菌的opa型占各自城市opa型总数的比率分别为:南京90.7%,济南77.5%,福州89.4%,南宁97.1%。流行病学资料显示19例淋病患者存在明显的性接触史:包括8对两两之间存在性接触的淋病患者及一个三人组淋病患者。其中有8组(七对与一个三人组)淋病患者间的性接触信息通过opa基因分型研究中的8个opa簇证实,而余下的一对淋病患者性接触信息则通过研究中的一个opa型相似对所印证。结论 Opa分型是一种效率极高的淋球菌基因分型方法,能够很好地应用于淋球菌感染的流行病学调查研究中。用这种技术所得到的实验结果比患者提供的性接触信息更贴近实际情况,并能让我们更好地了解淋球菌的传播状况。

Objective To investigate the distribution of opa-types in patients attending at STDs clinics in China and to evaluate the concordance between epidemiologic data and opa-typing results.Methods 330 gonorrhea patients were recruited at four cities in 2006：STD Clinic affiliated with the National Center for STD Control in Nanjing（86 cases）,STD Clinic of Shandong Provincial Institute of Dermatology in Jinan（80 cases）,STD Clinic of Fujian Provincial Institute of Dermatology in Fuzhou（94 cases）,and STD Clinic of Guangxi Provincial Institute of Dermatology in Nanning（70 cases）.Opa-typing was conducted for 330 Neisseria gonorrhoeae strains：the amplified opa genes were digested overnight with restriction enzyme TaqⅠ and HpaⅡ respectively.Image of band patterns produced by TaqⅠ and HpaⅡ were saved in TIFF format and the pattern profiles were analyzed using the GelCompar program.The epidemiologic data of the 330 strains was collected as well.Results Opa-typing with two restriction enzymes TaqI and HpaII identified 309 opa-types among 330 isolates.292 unique opa-types were each linked to one isolate,14 opa-types each consisted of 2 isolates,2 opa-types each consisted of 3 isolates,and one opa-type consisted of 4 isolates.Among the 292 isolates with unique opa-types,18 isolates formed 9 similar pairs.The proportions of strains with unique opa-type in the four cities are：Nanjing,90.7%;Jinan,77.5%;Fuzhou,89.4%;and Nanning,97.1%.Patients＇ epidemiologic data revealed 9（8 pairs and 1 triplet） sexual links among 19 patients from their known sexual contacts.8 sexual links were confirmed with opa-typing with eight opa clusters,and the remaining sexual link was confirmed by one similar pair.Conclusions Opa-typing is a discriminatory tool which can be used in epidemiologic studies on gonococcal infections.This technique is more powerful than epidemiologic data to identify sexual links and improve our understanding of the transmission dynamics of gonorrhoeae.