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[实时聚合酶链反应在不同蜱传感染诊断中的应用]

[Usage of real time polymerase chain reaction for diagnostics of different tick-borne infections].

作者信息

Karan' L S, Koliasnikova N M, Toporkova M G, Makhneva M A, Nadezhdina M V, Esaulkova A Iu, Romanenko V V, Arumova E A, Platonov A E, Maleev V V

出版信息

Zh Mikrobiol Epidemiol Immunobiol. 2010 May-Jun(3):72-7.

Abstract

AIM

To create and test the complex of polymerase chain reaction-based methods for detection of pathogens vectored by ticks in clinical and environmental samples.

MATERIALS AND METHODS

Real time PCR methods with hybridization-fluorescent detection were developed for detection of tick-borne encephalitis virus, Borrelia burgdorferi sensu lato, Anaplasma phagocytophillum, Erlichia muris/E. chaffeensis, and B. miyamotoi. First four methods were combined in one assay in multiprime format. Efficacy of the assay was assessed by testing of blood samples from patients with tickborreliosis (166 patients), tick-born encephalitis (22 patients) and mixed infection tick-borne encephalitis + borreliosis (21 patients) from Sverdlovsk region.

RESULTS

It was shown that using PCR-based assay for testing the blood samples obtained during admission, it was possible to determine the etiology of disease in 39% of patients, whereas on the basis of serological data diagnosis, as a rule, is made not earlier than on 2nd week of therapy. False-positive results of PCR diagnostics were not observed. Infections caused by Anaplasma or Erlichia were not observed. It was shown that > 50% of cases of tick borreliosis without erythema were caused by B. miyamotoi, whereas B. burgdorferi sensu lato predominated as a causative agent of erythemic form of borreliosis.

CONCLUSION

Proposed complex of methods is useful for rapid diagnostics of tick-borne infections including previously unknown infection caused by B. miyamotoi.

摘要

目的

创建并测试基于聚合酶链反应的方法组合,用于检测临床和环境样本中蜱传播的病原体。

材料与方法

开发了具有杂交荧光检测的实时PCR方法,用于检测蜱传脑炎病毒、伯氏疏螺旋体狭义种、嗜吞噬细胞无形体、鼠埃立克体/查菲埃立克体以及宫本疏螺旋体。前四种方法以多重引物形式组合在一个检测中。通过检测斯维尔德洛夫斯克地区蜱传莱姆病患者(166例)、蜱传脑炎患者(22例)以及蜱传脑炎+莱姆病混合感染患者(21例)的血样,评估该检测的有效性。

结果

结果表明,使用基于PCR的检测方法对入院时采集的血样进行检测,可在39%的患者中确定疾病病因,而基于血清学数据的诊断通常在治疗第二周后才能做出。未观察到PCR诊断的假阳性结果。未观察到由无形体或埃立克体引起的感染。结果表明,>50%无红斑的蜱传莱姆病病例由宫本疏螺旋体引起,而狭义伯氏疏螺旋体是有红斑型莱姆病的主要病原体。

结论

所提出的方法组合对于蜱传感染的快速诊断有用,包括由宫本疏螺旋体引起的先前未知感染。

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