浙江省桐乡市首例布鲁氏菌病原学诊断病例调查

Etiological diagnosis of the first case of brucellosis in Tongxiang

目的分离和鉴定布鲁氏菌,提高对布鲁氏菌病(布病)的认识,为病例的诊断和治疗提供依据。方法采集浙江省桐乡市疑似布病患者血液标本,进行虎红平板凝集试验(rose-bengal plate agglutination test,RBPT)和试管凝集试验(standard tube agglutination test,SAT),血清学阳性者采血接种双相血培养瓶增菌培养,获得纯培养者进一步采用布鲁氏菌属特异性PCR(BCSP31-PCR)和布鲁氏菌种型特异性PCR(AMOS-PCR)进行属和种/型鉴定。对患者进行个案流行病学调查和规范治疗。结果患者血清SAT为1∶3200(++),从血液中分离出羊种布鲁氏菌3型。患者用利福平、多西环素等联合6周治疗后痊愈。结论该病例为羊种布鲁氏菌实验室确诊病例,建议临床上对长期不明原因发热者应及时进行血培养,早发现并规范治疗。

Objective To understand the etiological characteristics of brucellosis and provide evidence for the diagnosis, treatment and control of brucellosis. Methods Blood samples collected from suspected brucellosis cases in Tongxiang to conduct rose-bengal plate agglutination test （RBPT） and standard tube agglutination test （SAT）. The blood samples were taken from the positive persons to conduct bacterium enrichment by using biphasic blood culture bottles and further identification of the specie/type was conducted by using BCSP31-PCR and AMOS-PCR. Results One brucellosis case infected with Brucella melitensis biovar 3 was detected, the serum SAT result was 1 ： 3200 （ ＋＋ ）. Epidemiological investigation and standard treatment was carried out for the patient. Conclusion The case was infected with Brucella melitensis biovar 3. It is suggested to conduct blood culture for the patient suffered from long time fever with unknown origin for the early detection and treatment of brucellosis.