海南省2009年-2011年发热病人立克次体病检测及结果分析

Analysis of the detection results of rickettsial disease among patients with fever in Hainan province from 2009 to 2011

目的分析海南省2009年-2011年不明原因发热病人中立克次体的感染状况及基因型别,探讨其防制对策。方法利用巢氏PCR方法,检测海南省不明原因发热病人血液标本立克次体gro EL基因的特异性片段,并对阳性结果进行序列测定及聚类分析。结果 236份病人标本中27份gro EL阳性,阳性率为11.4%。阳性PCR产物测序并聚类分析结果显示,恙虫病东方体序列与R.tsutsugamushi(M31887)恙虫病东方体同源性高;斑点热群立克次体和Rickettsia sibirica(AY059014)等11株斑点热群立克次体同源性较接近,而与2007年在澄迈县1例病人血标本中分离到Rickettsia sp Hainan 1(gb|EU402925)斑点热立克次体比较同源性较低;斑疹伤寒群立克次体和Rickettsia typhi str.B9991CWPP(CP003398)斑疹伤寒群立克次体共处于同一分支,同源性为100%。结论海南省不明原因发热病人中持续存在斑点热、斑疹伤寒和恙虫病感染的现象,应加强立克次体病的疾病监测和实验室检测能力。

Objective To analyze the infection status and genotype of rickettsia among patients with fever of unknown origin （FUO） in Hainan province from 2009 to 2011, and to explore its prevention Methods Nested PCR was con- ductcd to detect the specific fragment of groEL gene of rickettsia in blood samples of patients with FUO from Hainan province, and cluster analysis was carried out among the samples with positive results of sequencing. Results 27 groEL positive results were found in 236 blood samples of patients, and the positive rate was 11.4%. Cluster and sequencing analysis of positive PCR showed that tsutsugamushi sequence shared a high homology with R. tsutsugamushi （M31887）. The homology of eleven spotted fever group Rickettsia and Rickettsia sibirica （AY059014） were relatively close, but not with the spotted fever Rickettsia of Rickettsia sp Hainan 1 （ gb I EU402925 ） from a patient in Chengmai County in 2007. Typhus group rickettsiae and Rickettsia typhi str. B9991CWPP （CP003398） typhus group rickettsiae were in the same branch with 100% homology. Conclusion Spotted fever, typhus and scrub typhus persisted among patients with FUO in Hainan province. Disease surveillance and laboratory ca- pabilities of rickettsial disease should be strengthened to help prevent and control the disease. Key Words： Rickettsial disease ; Rickettsia ; Nested ; Polymerase chain reaction