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[软组织侵袭性感染中A组链球菌所致疾病的发生率及病原体特征]

[Frequency of diseases caused by group A streptococci among invasive infections of soft tissues and characteristics of the causative agent].

作者信息

Briko N I, Glushkova E V, Nosik A G, Dmitriev A V, Dmitrieva N F, Kleĭmenov D A, Lipatov K V

出版信息

Zh Mikrobiol Epidemiol Immunobiol. 2014 Sep-Oct(5):24-31.

Abstract

AIM

Determine frequency of diseases caused by group A streptococci (GAS) among invasive infections of soft tissues; identify emm-types of the isolated streptococci, determine the presence of bacteriophage integrases and toxin genes in their genomes.

MATERIALS AND METHODS

4750 case histories of patients with soft tissue infections of the purulent-surgical department of the 23rd City Clinical Hospital.of Moscow "Medsantrud" in 2008 - 2011 were analyzed. 46 strains of GAS isolated from patients with invasive streptococcus infection (ISI) were studied. GAS identification was carried out by latex-agglutination method. GAS emm-type was determined by molecular-genetic methods, as well as the presence of bacteriophage integrases int2, int3, int4, int5, int6, int7, int49, bacteriophage toxins speA, speI, sla, speC/J, speL, speH, speC, ssa and speB gene present on the chromosomal DNA.

RESULTS

132 cases (2.8%) were attributed to invasive infections. In 46 cases of invasive infections (35%) GAS were isolated. 22 different emm-types of invasive GAS strains were detected. Only speB gene among all the toxin genes (as well as the expression of the gene--SpeB toxin) was detected in all the strains, whereas sla and speI genes were not detected in any of the strains. Genes of the other toxins (ssa, speL, speC, speA, speH, speC/J) occurred in a number of strains. Genes of phage integrases were detected among all the strains however in varying combinations (from 1 to 4 genes).

CONCLUSION

Invasive infections caused by GAS are more frequently spread than had been previously assumed and a high degree of genetic heterogeneity of invasive GAS strains was detected.

摘要

目的

确定A组链球菌(GAS)在软组织侵袭性感染中所引发疾病的频率;鉴定分离出的链球菌的emm型,确定其基因组中噬菌体整合酶和毒素基因的存在情况。

材料与方法

分析了2008年至2011年莫斯科第23市临床医院“Medsantrud”化脓外科的4750例软组织感染患者的病历。对从侵袭性链球菌感染(ISI)患者中分离出的46株GAS进行了研究。采用乳胶凝集法进行GAS鉴定。通过分子遗传学方法确定GAS的emm型,以及染色体DNA上存在的噬菌体整合酶int2、int3、int4、int5、int6、int7、int49、噬菌体毒素speA、speI、sla、speC/J、speL、speH、speC、ssa和speB基因。

结果

132例(2.8%)归因于侵袭性感染。在46例侵袭性感染病例(35%)中分离出了GAS。检测到22种不同的侵袭性GAS菌株emm型。在所有菌株中仅检测到所有毒素基因中的speB基因(以及该基因的表达——SpeB毒素),而在任何菌株中均未检测到sla和speI基因。其他毒素(ssa、speL、speC、speA、speH、speC/J)的基因在一些菌株中出现。在所有菌株中均检测到噬菌体整合酶基因,但组合不同(从1至4个基因)。

结论

GAS引起的侵袭性感染比之前设想的更频繁传播,并且检测到侵袭性GAS菌株具有高度的遗传异质性。

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