Tabaqchali S
Department of Medical Microbiology, St. Bartholomew's Hospital Medical College, London, United Kingdom.
Rev Infect Dis. 1990 Jan-Feb;12 Suppl 2:S192-9. doi: 10.1093/clinids/12.supplement_2.s192.
A wide range of epidemiologic markers have been identified for Clostridium difficile. These markers are based on phenotypic characteristics of the organism, such as antibiotic resistance, bacteriocin or bacteriophage susceptibility, electrophoretic protein patterns, and immunologic markers. Methods for determining genetic markers include plasmid and DNA restriction endonuclease analysis and ribosomal RNA restriction patterns. These methods have been applied to various degrees in epidemiologic studies and have contributed to a better understanding of C. difficile-associated disease. The method based on the use of [35S]methionine-labeled proteins and the development of an automated scanner with computer analysis made possible the recognition of 15 distinct types of C. difficile, based on the major radiolabeled protein patterns. These proteins were strain-specific and immunogenic, as demonstrated by immunoblotting and DNA restriction endonuclease analysis. Epidemiologic studies revealed cross-infection among patients, nosocomial acquisition, and a direct relation between symptoms and type of C. difficile. The development of DNA probes based on antibiotic resistance genes, toxin A, and cloned specific common antigens is discussed.
已确定了多种艰难梭菌的流行病学标志物。这些标志物基于该微生物的表型特征，如抗生素耐药性、细菌素或噬菌体敏感性、电泳蛋白图谱以及免疫标志物。确定遗传标志物的方法包括质粒和DNA限制性内切酶分析以及核糖体RNA限制性图谱。这些方法已在不同程度上应用于流行病学研究，并有助于更好地理解艰难梭菌相关疾病。基于使用[35S]甲硫氨酸标记的蛋白质以及开发带有计算机分析的自动扫描仪的方法，基于主要放射性标记蛋白质图谱，使得识别出15种不同类型的艰难梭菌成为可能。这些蛋白质具有菌株特异性且具有免疫原性，免疫印迹和DNA限制性内切酶分析证明了这一点。流行病学研究揭示了患者之间的交叉感染、医院内获得感染，以及艰难梭菌类型与症状之间的直接关系。还讨论了基于抗生素耐药基因、毒素A和克隆的特定共同抗原的DNA探针的开发。
