2012 年至 2016 年加拿大马尼托巴省梅毒病例的分子分型和大环内酯类耐药情况。

Molecular Typing and Macrolide Resistance of Syphilis Cases in Manitoba, Canada, From 2012 to 2016.

出版信息

Sex Transm Dis. 2018 Apr;45(4):233-236. doi: 10.1097/OLQ.0000000000000734.

Abstract

BACKGROUND

The province of Manitoba, Canada, with a population of approximately 1.3 million, has been experiencing increased incidence of syphilis cases since 2015. In this study, we examined the detection of Treponema pallidum DNA in 354 clinical samples from 2012 to 2016, and determined molecular types and mutations conferring resistance to azithromycin in the polymerase chain reaction (PCR)-positive samples.

METHODS

T. pallidum DNA detection was done by PCR amplification of tpp47, bmp, and polA genes. Syphilis serology results were reviewed for the PCR-positive cases. Molecular typing of syphilis strains was done by analysis of the T, pallidum arp, tpr, and tp0548 gene targets as well as partial sequencing of the 23S rRNA gene for azithromycin resistance.

RESULTS

Of the 354 samples tested, 74 individual cases were PCR positive. A result from the treponemal antibody chemiluminescent microparticle immunoassay test was positive in 72 of these cases and that from the Venereal Disease Research Laboratory testing was positive in 66. Mutations conferring resistance to azithromycin were found in all 74 PCR-positive samples. Molecular typing was completed on 57 PCR-positive samples, and 12 molecular types were identified with 14d/g found in 63.2%. Increased strain diversity was observed with 8 molecular types detected in 2016, whereas only 2 to 3 types were found in 2012 to 2014. A patient with 2 episodes of infection 9 months apart caused by different molecular strain types was also identified.

CONCLUSIONS

The finding of an increase in genetic diversity in the strains in this study and an increase in macrolide resistance compared with previous Canadian reports highlighted the need for continued surveillance including strain characterization.

摘要

背景

加拿大马尼托巴省拥有约 130 万人口，自 2015 年以来，梅毒病例的发病率一直在上升。在这项研究中，我们检查了 2012 年至 2016 年间 354 例临床样本中梅毒螺旋体 DNA 的检测情况，并确定了聚合酶链反应（PCR）阳性样本中对抗生素阿奇霉素的耐药性的分子类型和突变。

方法

通过 tpp47、bmp 和 polA 基因的 PCR 扩增检测 T. pallidum DNA。对 PCR 阳性病例进行梅毒血清学检测结果回顾。通过分析 T、pallidum arp、tp r 和 tp0548 基因靶点以及 23S rRNA 基因部分测序进行梅毒菌株的分子分型，以检测对阿奇霉素的耐药性。

结果

在 354 个测试样本中，有 74 个单独的样本 PCR 呈阳性。72 例 PCR 阳性病例的梅毒螺旋体抗体化学发光微粒子免疫分析检测结果阳性，66 例的性病研究实验室检测结果阳性。所有 74 例 PCR 阳性样本均发现对抗生素阿奇霉素的耐药性突变。对 57 例 PCR 阳性样本进行了分子分型，鉴定出 12 种分子类型，其中 14d/g 在 63.2%中发现。2016 年检测到 8 种分子类型，而 2012 年至 2014 年仅发现 2 至 3 种，观察到菌株多样性增加。还发现了 1 例相隔 9 个月的 2 次感染的患者，其由不同的分子株型引起。