流感嗜血杆菌的分型研究

Typing of Haemophilus influenzae

目的分析同济医院分离的流感嗜血杆菌的生物学分型及荚膜基因分型,了解本地区分离的流感嗜血杆菌的主要流行株。方法 2012年1月1日至2012年12月31日从华中科技大学同济医学院附属同济医院分离流感嗜血杆菌100株。根据脲酶、吲哚和鸟氨酸脱羧酶试验对流感嗜血杆菌进行传统的生物学分型,分为I^VIII八个生物型。回顾患者病史资料,分析生物学分型和流感嗜血杆菌所引起的疾病之间的关系。用流感嗜血杆菌荚膜编码基因(bexA)和a-f型特异性荚膜基因设计引物,采用PCR技术对流感嗜血杆菌进行荚膜基因检测。通过生物学分型和荚膜基因分型结果的比对,探讨两者之间的关联。结果分离的100株流感嗜血杆菌生物学分型结果如下:III型6株,IV型28株,V型1株,VI型54株,VII型11株。未分离到Ⅰ型、Ⅱ型和Ⅷ型。分析患者的临床诊断,发现主要流行株VI型流感嗜血杆菌主要引起患者肺炎(包括支气管肺炎和新生儿肺炎)和支气管炎(包括毛细支气管炎和喘息性支气管炎)。荚膜基因分型结果显示,未分离到b型和b-型流感嗜血杆菌。共分离到1株f型,其余99株均为无荚膜抗原的不可分型流感嗜血杆菌。生物学分型和荚膜分型之间无明显的相关性。结论该院分离的流感嗜血杆菌主要为生物型VI型。回顾患者病史,发现VI型主要引起肺炎和支气管炎。荚膜基因分型显示,本地区分离的流感嗜血杆菌主要为不可分型流感嗜血杆菌。生物学分型和荚膜基因分型之间无明显相关性。

Objective To investigate the prevalence of biotype and capsular genotype of Haemophilus influenzae iso- lated from Tongji Hospital in Wuhan and to learn about the major epidemic strain of the pathogen in the area. Methods One hundred strains of H. influenzae were isolated from Jan. 1 to Dec. 31 in 2012. All the strains were devided into eight different biotypes according to three biochemistry tests. Data of the related cases were reviewed to analyze the relations between the biotypes and different diseases caused by the pathogen. The primers of capsule-encoding genes and type-specific genes （ a-f ） were designed, and those genes of the isolates were detected by PCR. The correlations between biotypes and capsular genotypes were analyzed based on the detected results. Results Five biotypes were found among these detected strains. The predominant biotype was biotype Ⅳ （54 strains）. The others were biotype Ⅲ （6 strains）, biotype Ⅵ （28 strains）, biotype Ⅴ （1 strains） and biotype Ⅶ （ 11 strains）. Biotypes Ⅰ, Ⅱ and Ⅷ were not found. The predominant biotype Ⅵ was bound up with pneumonia （including bronchopneumonia nad neonatal pneumonia） and bronchitis （including bronchiofitis and asthmatoid bronchitis）. Ninety-nine strains of nontypeable H. influenzae （NTH. influenzae） and one strain of capsular type f （ H. influenzae f） were found. There was no correlation between biotypes and capsular types. Conclision The pre- dominant biotype of H. influenzae is biotype Ⅵ in our hospital that is closely related to pneumonia. The H. influ- enzae isolated in Wuhan area are mainly nontypeable ones. There is no apparent relations between biotype and cap- sular type.