Fenollar Florence, Birg Marie-Laure, Gauduchon Valérie, Raoult Didier
Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille cedex 05, France.
J Clin Microbiol. 2003 Aug;41(8):3816-22. doi: 10.1128/JCM.41.8.3816-3822.2003.
The culture of Tropheryma whipplei, the bacterium responsible for Whipple's disease, has been established only recently. Our objective is to describe, based on our experience, the culture of T. whipplei in HEL cells detected by immunofluorescence staining. Over 3 years, we received 18 samples for T. whipplei culture from 15 patients with Whipple's disease. Ten duodenal biopsy specimens from 10 patients with digestive symptoms were available. Five cardiac valves and three blood samples from five patients with endocarditis were also available. We correlated the results of culture with the type of sample and the culture procedure. Seven isolates were obtained, and three were subsequently established for more than 4 passages. The mean delay for the primary detection was 30 days. The bacterium was isolated more frequently from sterile specimens (5 of 8) than from duodenal biopsy specimens (2 of 10), but the difference (P = 0.14) was not significant. Decontamination of digestive samples containing colistin, amphotericin B, and cephalotin or ciprofloxacin did not impair the isolation of T. whipplei. The use of vancomycin precludes the primary isolation (7 of 12 versus 0 of 6; P = 0.08) and the establishment of T. whipplei (3 of 12 versus 0 of 6; P = 0.5). Omitting samples cultured with vancomycin, the establishment of the strain was significantly higher when antibiotics were prescribed for no more than 7 days (3 of 4 versus 0 of 8; P = 0.03). Our results demonstrate that samples must be collected within 1 week of an antibiotic regimen's initiation for the successful establishment of the bacterium.
惠普尔病的病原体——惠普尔嗜组织菌的培养直到最近才得以实现。我们的目标是根据我们的经验，描述通过免疫荧光染色在人胚肺成纤维细胞（HEL细胞）中对惠普尔嗜组织菌的培养情况。在3年多的时间里，我们从15例惠普尔病患者那里收到了18份用于惠普尔嗜组织菌培养的样本。有来自10例有消化系统症状患者的十二指肠活检标本。还有来自5例心内膜炎患者的5个心脏瓣膜和3份血样。我们将培养结果与样本类型和培养程序进行了关联。获得了7株分离菌，其中3株随后传代4次以上得以确立。初次检测的平均延迟时间为30天。该菌从无菌标本（8份中的5份）中分离出来的频率高于从十二指肠活检标本（10份中的2份），但差异（P = 0.14）不显著。含有黏菌素、两性霉素B以及头孢噻吩或环丙沙星的消化样本的去污处理并未损害惠普尔嗜组织菌的分离。使用万古霉素会妨碍惠普尔嗜组织菌的初次分离（12份中的7份对6份中的0份；P = 0.08）以及该菌的确立（12份中的3份对6份中的0份；P = 0.5）。在剔除用万古霉素培养的样本后，当抗生素使用不超过7天时，菌株的确立率显著更高（4份中的3份对8份中的0份；P = 0.03）。我们的结果表明，为了成功确立该菌，样本必须在抗生素治疗开始后的1周内采集。
