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在俄罗斯西西伯利亚检测蜱传立克次体病原体:从临床样本中鉴定出拉乌尔立克次体和西伯利亚立克次体 DNA。

Detection of causative agents of tick-borne rickettsioses in Western Siberia, Russia: identification of Rickettsia raoultii and Rickettsia sibirica DNA in clinical samples.

机构信息

Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russian Federation.

Novosibirsk State Medical University, Novosibirsk, Russian Federation; Novosibirsk Municipal Clinical Hospital of Infectious Diseases No. 1, Novosibirsk, Russian Federation.

出版信息

Clin Microbiol Infect. 2018 Feb;24(2):199.e9-199.e12. doi: 10.1016/j.cmi.2017.06.003. Epub 2017 Jun 9.

Abstract

OBJECTIVES

The main causative agent of tick-borne rickettsioses in Siberia is considered to be Rickettsia sibirica; however, only a few cases have been genetically confirmed. Other pathogenic species of Rickettsia have been detected in ixodid ticks in Western Siberia. The aim of this study was to detect the aetiological agents of tick-borne rickettsioses in Western Siberia and compare their clinical manifestations.

METHODS

A total of 273 blood and 44 cerebrospinal fluid (CSF) samples from 273 patients hospitalized because of tick-transmitted infection in April-September 2016 were examined for the presence of Rickettsia spp., using nested PCR with subsequent sequencing.

RESULTS

DNA of Rickettsia spp. was found in samples from 10 patients. The gltA gene fragment sequence analysis revealed R. sibirica DNA in seven patients (blood samples) and Rickettsia raoultii DNA in three patients (two blood and one CSF sample). Most patients infected with R. sibirica showed typical clinical symptoms, including high-grade fever (38.9-39.5°С), myalgia, rash, eschar at the site of the tick bite, and elevated levels of serum aminotransferases. In contrast, patients infected with R. raoultii showed nonspecific symptoms with short-term fever (37.2-37.7°С); one patient had a short episode of meningeal syndrome.

CONCLUSIONS

We report the first finding of R. raoultii DNA in clinical samples from Russian patients. The clinical manifestations of this rickettsiosis were nonspecific and differed from those caused by R. sibirica.

摘要

目的

西伯利亚的蜱传立克次体病的主要病原体被认为是西伯利亚立克次体; 然而,只有少数病例得到了基因证实。在西西伯利亚的硬蜱中已检测到其他致病性立克次体物种。本研究旨在检测西西伯利亚蜱传立克次体病的病原体,并比较其临床表现。

方法

2016 年 4 月至 9 月,对因蜱传感染住院的 273 名患者的 273 份血液和 44 份脑脊液 (CSF) 样本进行了嵌套 PCR 检测,随后进行测序,以检测立克次体属的存在。

结果

从 10 名患者的样本中发现了立克次体属的 DNA。gltA 基因片段序列分析显示,7 名患者(血液样本)存在西伯利亚立克次体 DNA,3 名患者(2 份血液和 1 份 CSF 样本)存在拉乌尔立克次体 DNA。大多数感染西伯利亚立克次体的患者表现出典型的临床症状,包括高热(38.9-39.5°C)、肌痛、皮疹、蜱叮咬部位的焦痂和血清转氨酶水平升高。相比之下,感染拉乌尔立克次体的患者表现出非特异性症状,伴有短期发热(37.2-37.7°C);1 名患者出现短暂的脑膜综合征。

结论

我们首次在俄罗斯患者的临床样本中发现了拉乌尔立克次体 DNA。这种立克次体病的临床表现是非特异性的,与西伯利亚立克次体引起的临床表现不同。

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