Hafiane A, Ravaoarinoro M
Department of Medical microbiology and Infectiology, CHUM Hôtel-Dieu, Montréal, Québec, Canada.
Med Mal Infect. 2008 May;38(5):238-47. doi: 10.1016/j.medmal.2008.02.005. Epub 2008 Apr 3.
Typing methods are essential to understand the epidemiology of bacterial infections. Strain typing is important for the detection of sources or routes of infections, identification between endemic and epidemic strains and prevention of transmission between patients. Some Pseudomonas aeruginosa cystic-fibrosis strains could not be typed with conventional typing methods. Due to the diverse phenotypic nature of P. aeruginosa, phenotyping methods are not discriminatory enough to identify strains belonging to the same genotype. Thus, molecular typing methods are required. These methods should be applied when data from phenotypic typing analysis becomes ambiguous, such as in cystic fibrosis. Molecular typing methods, developed over the past decade, are highly discriminatory in capacity and reproducibility. However, they are more likely applied in specialized laboratories since they are expensive and increase the workload. A reliable and low-cost typing system is required for better defining the epidemiology of this pathogen and designing more rational policies of infection control. Comparison between typing methods will pinpoint the limits and effectiveness of each method and will improve in turn the choice of a nonspecialized laboratory in terms of simplicity, time and cost.
分型方法对于了解细菌感染的流行病学至关重要。菌株分型对于检测感染源或感染途径、区分地方流行菌株和流行菌株以及预防患者之间的传播非常重要。一些铜绿假单胞菌囊性纤维化菌株无法用传统分型方法进行分型。由于铜绿假单胞菌具有多样的表型特性,表型分型方法在鉴别属于同一基因型的菌株时鉴别力不足。因此,需要分子分型方法。当表型分型分析的数据变得不明确时,如在囊性纤维化中,就应应用这些方法。在过去十年中发展起来的分子分型方法在鉴别能力和可重复性方面具有高度的鉴别力。然而,由于它们成本高昂且增加工作量,因此更有可能在专业实验室中应用。需要一个可靠且低成本的分型系统,以便更好地界定这种病原体的流行病学并制定更合理的感染控制策略。分型方法之间的比较将明确每种方法的局限性和有效性,进而在简便性、时间和成本方面改进非专业实验室的选择。