肺炎链球菌血清型鉴定和分子鉴定方法研究进展

Research progress on serotype identification and molecular identification of Streptococcus pneumoniae

肺炎链球菌(Streptococcus pneumoniae, SP)通常又称为肺炎球菌,是肺炎、脑膜炎和其他侵入性疾病的主要病原菌,同时也是造成5岁以下儿童高发病率和死亡率的最常见的病原菌。准确鉴定出SP的血清型,对于肺炎球菌性疾病的诊治具有重要的意义。在我国,由于实验室检测水平在不同地区、医院及科室间差异较大以及表型检测方法的不一致等,往往延误早期SP的识别和确认。因此,我国关于疾病负担和血清型流行率的现有数据没有得到真正的估计。本文回顾了肺炎链球菌的各种分子鉴定和血清型鉴定方法,包括PCR、RT-PCR、MRT-PCR、肺炎链球菌不同特异性基因的序列分析、PCR结合RFLP等。此外,本文还综述了肺炎链球菌鉴定中常规使用的表型实验的优势和局限性以及目前面临的挑战。

Streptococcus pneumoniae(SP), also known as pneumococcus, is the main cause of pneumonia, meningitis and other invasive diseases. It is also the most common pathogen causing high morbidity and mortality in children under 5 years of age. Accurate identification of SP serotype is of great significance for the diagnosis and treatment of Streptococcus pneumoniae diseases. In China, the early identification and confirmation of SP is often delayed due to the large differences in laboratory testing levels in different regions, hospitals and departments, and the inconsistencies in phenotypic detection methods. As a result, our country’s available data on the burden of disease and serotype prevalence have not been truly estimated, thus limiting the use of existing Streptococcus pneumoniae vaccines. This paper reviewed various molecular identification and serotype identification methods of Streptococcus pneumoniae, including PCR, RT-PCR, MRT-PCR, sequence analysis of different specific genes of Streptococcus pneumoniae, PCR binding RFLP, etc. In addition, the advantages and limitations of phenotypic tests routinely used in the identification of Streptococcus pneumoniae as well as the current challenges are reviewed.