Houinei Wendy, Godornes Charmie, Kapa August, Knauf Sascha, Mooring Eric Q, González-Beiras Camila, Watup Ronald, Paru Raymond, Advent Paul, Bieb Sivauk, Sanz Sergi, Bassat Quique, Spinola Stanley M, Lukehart Sheila A, Mitjà Oriol
Disease Control Branch, National Department of Health, Port Moresby, Papua New Guinea.
Department of Medicine, University of Washington, Seattle, Washington, United States of America.
PLoS Negl Trop Dis. 2017 May 10;11(5):e0004958. doi: 10.1371/journal.pntd.0004958. eCollection 2017 May.
Haemophilus ducreyi and Treponema pallidum subsp. pertenue are major causes of leg ulcers in children in Africa and the Pacific Region. We investigated the presence of DNA (PCR positivity) from these bacteria on asymptomatic people, flies, and household linens in an endemic setting.
METHODOLOGY/PRINCIPAL FINDINGS: We performed a cross-sectional study in rural villages of Lihir Island, Papua New Guinea during a yaws elimination campaign. Participants were asymptomatic subjects recruited from households with cases of leg ulcers, and from households without cases of leg ulcers. We rubbed swabs on the intact skin of the leg of asymptomatic individuals, and collected flies and swabs of environmental surfaces. All specimens were tested by PCR for H. ducreyi and T. p. pertenue DNA. Of 78 asymptomatic participants that had an adequate specimen for DNA detection, H. ducreyi-PCR positivity was identified in 16 (21%) and T. p. pertenue-PCR positivity in 1 (1%). In subgroup analyses, H. ducreyi-PCR positivity did not differ in participants exposed or not exposed to a case of H. ducreyi ulcer in the household (24% vs 18%; p = 0.76). Of 17 cultures obtained from asymptomatic participants, 2 (12%) yielded a definitive diagnosis of H. ducreyi, proving skin colonization. Of 10 flies tested, 9 (90%) had H. ducreyi DNA and 5 (50%) had T. p. pertenue DNA. Of 6 bed sheets sampled, 2 (33%) had H. ducreyi DNA and 1 (17%) had T. p. pertenue DNA.
CONCLUSIONS/SIGNIFICANCE: This is the first time that H. ducreyi DNA and colonization has been demonstrated on the skin of asymptomatic children and that H. ducreyi DNA and T. p. pertenue DNA has been identified in flies and on fomites. The ubiquity of H. ducreyi in the environment is a contributing factor to the spread of the organism.
杜克雷嗜血杆菌和 pertenue 亚种梅毒螺旋体是非洲和太平洋地区儿童腿部溃疡的主要病因。我们在地方病流行环境中，调查了无症状人群、苍蝇和家用亚麻制品中这些细菌的 DNA 存在情况（PCR 阳性）。
方法/主要发现：在巴布亚新几内亚利希尔岛的乡村开展了一项消除雅司病运动期间的横断面研究。参与者为从有腿部溃疡病例的家庭以及无腿部溃疡病例的家庭招募的无症状个体。我们在无症状个体腿部的完整皮肤上擦拭拭子，并收集苍蝇和环境表面的拭子。所有标本均通过 PCR 检测杜克雷嗜血杆菌和梅毒螺旋体 pertenue 亚种的 DNA。在 78 名有足够标本用于 DNA 检测的无症状参与者中，16 人（21%）杜克雷嗜血杆菌 PCR 呈阳性，1 人（1%）梅毒螺旋体 pertenue 亚种 PCR 呈阳性。在亚组分析中，家庭中接触或未接触杜克雷嗜血杆菌溃疡病例的参与者中，杜克雷嗜血杆菌 PCR 阳性率无差异（24% 对 18%；p = 0.76）。从无症状参与者获得的 17 份培养物中，2 份（12%）确诊为杜克雷嗜血杆菌，证明皮肤定植。在检测的 10 只苍蝇中，9 只（90%）有杜克雷嗜血杆菌 DNA，5 只（50%）有梅毒螺旋体 pertenue 亚种 DNA。在采样的 6 张床单中，2 张（33%）有杜克雷嗜血杆菌 DNA，1 张（17%）有梅毒螺旋体 pertenue 亚种 DNA。
结论/意义：这是首次在无症状儿童皮肤上证实杜克雷嗜血杆菌 DNA 和定植，以及在苍蝇和污染物上鉴定出杜克雷嗜血杆菌 DNA 和梅毒螺旋体 pertenue 亚种 DNA。杜克雷嗜血杆菌在环境中的普遍存在是该病原体传播的一个促成因素。
