McLAUCHLIN J, Salmon J E, Ahmed S, Brazier J S, Brett M M, George R C, Hood J
Food Safety Microbiology Laboratory, Division of Gastrointestinal Infections and *Respiratory and Systemic Infection Laboratory, PHLS Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, †Department of Medical Microbiology and Public Health Laboratory and ‡PHLS Anaerobe Reference Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, §Greater Glasgow Health Board, 350 Vincent Street, Glasgow G3 8YU and ∥Department of Clinical Microbiology, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 OSF.
J Med Microbiol. 2002 Nov;51(11):990-1000. doi: 10.1099/0022-1317-51-11-990.
As part of the follow-up investigations associated with an outbreak of severe illness and death among illegal injecting drug users during 2000, 43 cultures of Clostridium novyi type A, 40 C. perfringens type A and 6 isolates of Bacillus cereus were characterised by amplified fragment length polymorphism (AFLP) analysis. Among the 43 C. novyi isolates, 23 different AFLP profiles were detected. The same AFLP profile was detected in isolates from 18 drug users investigated during 2000 from Scotland, England, the Republic of Ireland and Norway and a wound from a patient in 2000 who was not identified as a drug user. Unique AFLP profiles were obtained from four drug users from England and the Republic of Ireland, 10 historical isolates from culture collections, an isolate from food (1989) and three isolates from wounds (1995, 1991, 1988). The 40 C. perfringens isolates were from 13 drug users, the contents of one syringe and two samples of heroin. Sixteen AFLP types of C. perfringens were distinguished and there was little evidence for commonality among the isolates. The AFLP types of C. perfringens from heroin differed and were unique. Six isolates of B. cereus were from four drug users and two samples of heroin. Four different AFLP patterns were distinguished. Three AFLP types were isolated from four drug users. B. cereus isolates from an aspirate and a heroin sample collected from the same drug user were identical, and were also indistinguishable from an isolate from a groin infection in a second drug user. The AFLP type of the isolate from a second and unrelated heroin sample was unique. The AFLP results showed no or very limited evidence for commonality between the different isolates of B. cereus and C. perfringens. In marked contrast, the C. novyi isolates from the majority of the drug users during 2000 were homogeneous, suggesting a common source or clonal selection of a C. novyi type, or both, which either had an adaptive advantage in spore germination, survival or growth following the drug preparation and the injection procedure, or produced a more severe clinical presentation.
作为2000年非法注射吸毒者中严重疾病和死亡暴发相关后续调查的一部分，对43株A型诺维氏梭菌、40株A型产气荚膜梭菌和6株蜡样芽孢杆菌进行了扩增片段长度多态性（AFLP）分析。在43株诺维氏梭菌分离株中，检测到23种不同的AFLP图谱。在2000年对来自苏格兰、英格兰、爱尔兰共和国和挪威的18名吸毒者以及2000年一名未被确认为吸毒者的患者伤口分离株中检测到相同的AFLP图谱。从来自英格兰和爱尔兰共和国的4名吸毒者、来自培养物保藏中心的10株历史分离株、一份食品（1989年）分离株以及3份伤口（1995年、1991年、1988年）分离株中获得了独特的AFLP图谱。40株产气荚膜梭菌分离株来自13名吸毒者、一支注射器的内容物和两份海洛因样本。区分出了16种产气荚膜梭菌AFLP类型，且分离株之间几乎没有共同性的证据。来自海洛因的产气荚膜梭菌AFLP类型不同且独特。6株蜡样芽孢杆菌分离株来自4名吸毒者和两份海洛因样本。区分出了4种不同的AFLP模式。从4名吸毒者中分离出3种AFLP类型。从同一吸毒者采集的一份吸出物和一份海洛因样本中的蜡样芽孢杆菌分离株相同，并且与另一名吸毒者腹股沟感染分离株也无法区分。来自另一份不相关海洛因样本的分离株AFLP类型独特。AFLP结果显示，蜡样芽孢杆菌和产气荚膜梭菌不同分离株之间几乎没有或仅有非常有限的共同性证据。与之形成鲜明对比的是，2000年大多数吸毒者的诺维氏梭菌分离株具有同质性，这表明存在诺维氏梭菌类型的共同来源或克隆选择，或者两者皆有，这要么在药物制备和注射过程后的孢子萌发、存活或生长方面具有适应性优势，要么导致更严重的临床表现。
