广州地区呼吸道感染产超广谱β-内酰胺酶基因分型研究

目的:调查广州地区下呼吸道感染产超广谱β-内酰胺酶(ESBL )大肠埃希菌和肺炎克雷伯菌的分离率及各种基因型的流行分布。方法:收集广州地区13家医院2 0 0 0 - 10～2 0 0 1- 12临床分离的大肠埃希菌和肺炎克雷伯菌共714株,采用美国临床实验室标准化委员会规定的ESBL表型筛选和确证试验确定ESBL的发生率、PCR扩增对产ES-BL菌初步分型,然后对部分PCR扩增阳性产物测序,序列分析进一步确定基因型。结果:大肠埃希菌和肺炎克雷伯菌产ESBL分离率分别为5 8.1%和4 0 .1% ;TEM型16 1株(49.8% ) ,均为TEM- 1型,CTX- M型10 7株(33.1% ) ,SHV型14 1株(43.6 % )。结论:CTX- M型和SHV型是广州地区下呼吸道感染产ESBL大肠埃希菌和肺炎克雷伯菌中流行的基因型。

Assessment of polymerase chain reaction and serology for detection of chlamydia pneumoniae in patients with acute respiratory tract infection

OBJECTIVE: To study Chlamydia pneumoniae (C. pneumoniae) infection in 110 patients with respiratory tract infection admitted to our hospital from January to December 1995 in Nanjing. METHODS: Sputum and throat swab specimens were taken and C. pneumoniae DNA was detected by using polymerase chain reaction (PCR) with the HM-1-HR-1 primer pair. At the same time, serum samples were taken and immunoglobulin G and M (IgG and IgM) fractions of antibodies to C. pneumoniae were studied by microimmunofluorescence test. RESULTS: Prevalence of specific IgG was 70% in patients with respiratory tract infection. Seventeen patients (15.5%) were serologically diagnosed as having recent C. pneumoniae infections and 12 patients (10.9%) had positive PCR in sputum and/or swab specimens. The total positive rate was 22.7% (25/110) detected by PCR combined with serological tests. Acute infection of C. pneumoniae was common in patients with asthma (57.1%), pneumonia (35.0%), COPD (25.9%) and bronchitis (25.0%). Clinical features between C. pneumoniae infection and non-C. pneumonia infection showed no significant differences. CONCLUSIONS: Chlamydia pneumoniae is an important pathogen that causes infection of the human respiratory tract and attention should be drawn to this special illness.