在韩国一家三级护理医院出现的产毒素A-B+艰难梭菌变异菌株导致了假膜性结肠炎。
Emerging toxin A-B+ variant strain of Clostridium difficile responsible for pseudomembranous colitis at a tertiary care hospital in Korea.
作者信息
Shin Bo-Moon, Kuak Eun Young, Yoo Soo Jin, Shin Won Chang, Yoo Hyeon Mi
机构信息
Department of Laboratory Medicine, Sanggye Paik Hospital, Inje University, Seoul 139-707, South Korea.
出版信息
Diagn Microbiol Infect Dis. 2008 Apr;60(4):333-7. doi: 10.1016/j.diagmicrobio.2007.10.022. Epub 2007 Dec 20.
Sixty percent to 80% of Clostridium difficile isolates in Korea have been reported to be toxigenic. However, over 1 year, we encountered a high number of tcdA-tcB+ strains associated with pseudomembranous colitis (PMC). C. difficile was isolated from 224 of 471 specimens (47.6%) from 371 patients. A subset of the culture-positive specimens (n = 106), containing no duplicate cases, was randomly selected for tcdA and tcdB polymerase chain reaction (PCR) assays. PCR results showed that tcdA+tcdB+ and tcdA-tcdB+ strains accounted for 39.6% (42/106) and 50.9% (54/106), respectively. Endoscopy, performed on 55/106 patients, revealed 29 with PMC, 5 with colitis, 14 with other colon diseases, and 7 normal cases. Among the 29 PMC cases, 21 (72.4%) were associated with tcdA-tcdB+ strains (P = 0.0016). These results revealed the possible emergence of tcdA-tcdB+ C. difficile strains in Korea, and these variant strains could evoke a higher rate of PMC than tcdA+tcdB+ strains.
据报道，韩国60%至80%的艰难梭菌分离株具有产毒性。然而，在1年多的时间里，我们遇到了大量与假膜性结肠炎（PMC）相关的tcdA - tcB+菌株。从371例患者的471份标本中分离出艰难梭菌224份（47.6%）。从培养阳性标本中随机选取一个子集（n = 106），其中不包含重复病例，进行tcdA和tcdB聚合酶链反应（PCR）检测。PCR结果显示，tcdA+tcdB+和tcdA - tcdB+菌株分别占39.6%（42/106）和50.9%（54/106）。对106例患者中的55例进行了内镜检查，结果显示29例患有PMC，5例患有结肠炎，14例患有其他结肠疾病，7例为正常病例。在29例PMC病例中，21例（72.4%）与tcdA - tcdB+菌株相关（P = 0.0016）。这些结果揭示了韩国可能出现了tcdA - tcdB+艰难梭菌菌株，并且这些变异菌株可能比tcdA+tcdB+菌株引发更高比例的PMC。
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