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[2005年安蒂奥基亚省阿帕塔多市两起伤寒热疫情的特征分析]

[Characterization of two typhoid fever outbreaks in Apartadó, Antioquia, 2005].

作者信息

Cardona-Castro Nora María, Sánchez-Jiménez Miryan Margot, Usuga-Silva Luz Yaned, Arboleda-Naranjo Margarita, Garzón Eliana, Vélez Aminta, Wiesner Magdalena, Muñoz Nélida, Agudelo Clara Inés

机构信息

Instituto Colombiano de Medicina Tropical-CES, Sabaneta-Apartadó, Antioquia, Colombia.

出版信息

Biomedica. 2007 Jun;27(2):236-43. Epub 2007 Aug 21.

Abstract

INTRODUCTION

The characterization of typhoid fever outbreaks is important because it is necessary to find the source of the infection and development control measures.

OBJECTIVE

A typhoid fever outbreak is described from Apartadó and the Salmonella Typhi isolates characterized by phenotypic and genotypic methods.

MATERIALS AND METHODS

From 44 patients, 15 blood cultures and 7 stools cultures were recovered. Phenotypic identification of isolates was done by biochemical and serological tests, and antibiotic susceptibility was tested. Genes hilA, invA and the IS200 marker were evaluated by polymerase chain reaction; pulsed field gel electrophoresis was used for the XbaI gene. Eight water samples were examined by polymerase chain reaction and culture methods in order to isolate Salmonella spp.

RESULTS

Fifteen patients were confirmed for typhoid fever, 13 by blood cultures and two by stools cultures. All S. Typhi isolates were susceptible to the antimicrobials tested. The presence of hilA, invA and IS200 were confirmed by polymerase chain reaction in all isolates. The pulsed field gel electrophoresis method grouped 10 isolates in COINJPP.X01.0035 pattern, three in COINJPPX01.0002, one in COINJPP.X01.0012 and one in COINJPPX01.0037. Water isolates were negatives for Salmonella spp.

CONCLUSIONS

Pulsed field gel electrophoresis discriminated the isolates in two outbreaks. Initially the cases were described as only one outbreak, by epidemiological criteria and phenotypic test. Additionally two isolates with different clonal origin were discriminated, indicating that they were unrelated to the other cases. It was not possible to confirm the infection source from water samples.

摘要

引言

伤寒热暴发的特征描述很重要,因为找到感染源并制定控制措施很有必要。

目的

描述阿帕塔多的一次伤寒热暴发,并通过表型和基因型方法对伤寒沙门氏菌分离株进行特征分析。

材料与方法

从44例患者中采集了15份血培养物和7份粪便培养物。通过生化和血清学试验对分离株进行表型鉴定,并检测抗生素敏感性。通过聚合酶链反应评估hilA、invA基因和IS200标记;对XbaI基因使用脉冲场凝胶电泳。通过聚合酶链反应和培养方法检测了8份水样,以分离沙门氏菌属。

结果

15例患者确诊为伤寒热,13例通过血培养确诊,2例通过粪便培养确诊。所有伤寒沙门氏菌分离株对所检测的抗菌药物均敏感。通过聚合酶链反应在所有分离株中均证实了hilA、invA和IS200的存在。脉冲场凝胶电泳方法将10株分离株归为COINJPP.X01.0035型,3株归为COINJPPX01.0002型,1株归为COINJPP.X01.0012型,1株归为COINJPPX01.0037型。水样中未分离出沙门氏菌属。

结论

脉冲场凝胶电泳区分了两次暴发中的分离株。最初,根据流行病学标准和表型试验,这些病例被描述为仅一次暴发。此外,区分出了两株克隆起源不同的分离株,表明它们与其他病例无关。无法从水样中确认感染源。

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