Lindström Miia, Korkeala Hannu
Department of Food and Environmental Hygiene, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland.
Clin Microbiol Rev. 2006 Apr;19(2):298-314. doi: 10.1128/CMR.19.2.298-314.2006.
Botulism is a potentially lethal paralytic disease caused by botulinum neurotoxin. Human pathogenic neurotoxins of types A, B, E, and F are produced by a diverse group of anaerobic spore-forming bacteria, including Clostridium botulinum groups I and II, Clostridium butyricum, and Clostridium baratii. The routine laboratory diagnostics of botulism is based on the detection of botulinum neurotoxin in the patient. Detection of toxin-producing clostridia in the patient and/or the vehicle confirms the diagnosis. The neurotoxin detection is based on the mouse lethality assay. Sensitive and rapid in vitro assays have been developed, but they have not yet been appropriately validated on clinical and food matrices. Culture methods for C. botulinum are poorly developed, and efficient isolation and identification tools are lacking. Molecular techniques targeted to the neurotoxin genes are ideal for the detection and identification of C. botulinum, but they do not detect biologically active neurotoxin and should not be used alone. Apart from rapid diagnosis, the laboratory diagnostics of botulism should aim at increasing our understanding of the epidemiology and prevention of the disease. Therefore, the toxin-producing organisms should be routinely isolated from the patient and the vehicle. The physiological group and genetic traits of the isolates should be determined.
肉毒中毒是一种由肉毒杆菌神经毒素引起的潜在致命性麻痹疾病。A、B、E和F型人类致病性神经毒素由多种厌氧产芽孢细菌产生，包括I群和II群肉毒梭菌、丁酸梭菌和巴氏梭菌。肉毒中毒的常规实验室诊断基于对患者体内肉毒杆菌神经毒素的检测。在患者和/或载体中检测产毒素梭菌可确诊。神经毒素检测基于小鼠致死试验。已开发出灵敏且快速的体外检测方法，但尚未在临床和食品基质上进行充分验证。肉毒梭菌的培养方法发展不完善，且缺乏有效的分离和鉴定工具。针对神经毒素基因的分子技术是检测和鉴定肉毒梭菌的理想方法，但它们无法检测生物活性神经毒素，不应单独使用。除了快速诊断外，肉毒中毒的实验室诊断应旨在增进我们对该疾病流行病学和预防的了解。因此，应常规从患者和载体中分离产毒素生物体。应确定分离株的生理群和遗传特征。
