Sinha Sushmita, Prasad Kashi N, Pradhan Sunil, Jain Deepika, Jha Sanjeev
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India.
Trans R Soc Trop Med Hyg. 2004 Jun;98(6):342-6. doi: 10.1016/j.trstmh.2003.10.007.
Based on culture and serological evidence, a strong association between Campylobacter jejuni infection and Gullain-Barré syndrome (GBS) has been established. However, culture underestimates C. jejuni infection in GBS and the specificity of serology remains uncertain. Thus, a direct sensitive detection method for recent C. jejuni infection is required. We used the PCR technique in GBS patients to assess its role in the diagnosis of C. jejuni infection. From June 2001 to March 2003, stool specimens from 42 patients with GBS and an equal number of age- and gender-matched healthy controls were analysed for C. jejuni infection by culture and PCR. Gullain-Barré syndrome subtypes were classified by clinical and electrophysiological studies. Of the GBS patients, two (4.8%) and eight (19%) were positive by culture and PCR, respectively, and the difference was significant (P < 0.05). None of the controls were positive for C. jejuni by culture or PCR. All C. jejuni-positive GBS patients had axonal degeneration with or without sensory involvement. The incidence of C. jejuni-associated GBS cases was more frequent during summer than winter (7/19, 36.8% vs. 1/23, 4.3%, P < 0.01). Polymerase chain reaction appears to be a sensitive tool to detect preceding C. jejuni infection in GBS patients.
基于培养和血清学证据，空肠弯曲菌感染与吉兰-巴雷综合征（GBS）之间已确立了密切关联。然而，培养法会低估GBS患者中空肠弯曲菌的感染情况，且血清学的特异性仍不确定。因此，需要一种直接灵敏的方法来检测近期的空肠弯曲菌感染。我们对GBS患者使用聚合酶链反应（PCR）技术，以评估其在诊断空肠弯曲菌感染中的作用。2001年6月至2003年3月，对42例GBS患者以及数量相等、年龄和性别匹配的健康对照者的粪便标本进行培养和PCR分析，以检测空肠弯曲菌感染情况。通过临床和电生理研究对GBS亚型进行分类。在GBS患者中，培养法和PCR法检测阳性的分别有2例（4.8%）和8例（19%），差异有统计学意义（P<0.05）。对照者中培养法或PCR法检测空肠弯曲菌均为阴性。所有空肠弯曲菌阳性的GBS患者均有轴索性变性，伴或不伴有感觉障碍。空肠弯曲菌相关GBS病例的发病率夏季高于冬季（7/19，36.8%对1/23，4.3%，P<0.01）。聚合酶链反应似乎是检测GBS患者既往空肠弯曲菌感染的灵敏工具。
