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[在哈塔伊卡车司机中检测到的输入性皮肤利什曼病病例]

[Imported cutaneous leishmaniasis cases detected in truck drivers in Hatay].

作者信息

Çulha Gülnaz, Doğramacı Asena Çiğdem, Kaya Tuğba, Çavuş İbrahim, Gülkan Burcu, Özbilgin Ahmet

机构信息

Mustafa Kemal University Faculty of Medicine, Department of Parasitology, Hatay, Turkey.

Mustafa Kemal University Faculty of Medicine, Department of Dermatology, Hatay, Turkey.

出版信息

Mikrobiyol Bul. 2018 Jul;52(3):316-323. doi: 10.5578/mb.66937.

Abstract

Leishmaniasis, seen in tropical and subtropical regions, is an infectious disease caused by the protozoan parasite Leishmania species. There are three main forms of leishmaniasis: cutaneous, mucocutaneous and visceral leishmaniasis. Cutaneous leishmaniasis (CL) has become an increasing problem as the number of travels around the world increases and people go to work in endemic areas. Turkey has received great numbers of immigrants in recent years, from its neighboring countries like Iraq, Islamic Republic of Iran, Afghanistan, Turkmenistan and the Syrian Arab Republic because of the political instabilities in these countries as well as the job opportunities caused by large-scale development projects undertaken by Turkey. In this report, imported CL cases detected in five truck drivers transporting from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran and Georgia, Uzbekistan and Azarbaijan countries were presented. The patients admitted to Mustafa Kemal University, Faculty of Medicine Dermatology Policlinic, with wound complaints on their bodies were directed to the Department of Parasitology to obtain smear samples from their wounds. The age range of the patients were 38 to 43 years. Patients with wound trail for a period ranging from one month to one year had a number of lesions varying between 2-7 and in all cases, a smear preparation was prepared from the lesions for diagnostic purposes. Clinical material obtained from five patients with pre-diagnosis of CL was firstly examined with Giemsa stain. Samples taken from the patients were inoculated into modified NNN (Novy-MacNeal-Nicolle) medium for the evaluation of the presence of the promastigotes. Promastigotes obtained from the inoculated medium were also genotyped using the ITS1 region. In all of the slides prepared from the clinical material taken from the patients amastigotes were determined. The growth of promastigotes were observed in only three of the clinical specimen inoculated media. The genotyped three species were Leishmania tropica, Leishmania infantum/donovani and Leishmania major. In this study, the importance of support for the diagnosis of different microbiological methods used in the diagnosis of leishmaniasis infection which occurred during the outbreaks of the disease has been put forward. In addition, it was aimed to draw attention to the importance of imported CL cases in our country diagnosed in five truck drivers making transportation from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran, Georgia, Uzbekistan and Azerbaijan.

摘要

利什曼病见于热带和亚热带地区,是一种由利什曼原虫寄生虫引起的传染病。利什曼病有三种主要形式:皮肤利什曼病、黏膜皮肤利什曼病和内脏利什曼病。随着全球旅行人数的增加以及人们前往流行地区工作,皮肤利什曼病(CL)已成为一个日益严重的问题。近年来,由于伊拉克、伊朗伊斯兰共和国、阿富汗、土库曼斯坦和阿拉伯叙利亚共和国等邻国的政治不稳定以及土耳其开展的大规模开发项目带来的就业机会,土耳其接收了大量移民。在本报告中,介绍了在五名从哈塔伊运往土库曼斯坦、叙利亚、沙特阿拉伯、伊朗、格鲁吉亚、乌兹别克斯坦和阿塞拜疆的卡车司机中检测到的输入性CL病例。因身体有伤口不适而入住穆斯塔法·凯末尔大学医学院皮肤科门诊的患者被转至寄生虫学系,以便从其伤口获取涂片样本。患者年龄范围为38至43岁。伤口持续时间在1个月至1年之间的患者有2至7个不等数量的病灶,所有病例均从病灶制备涂片用于诊断目的。首先用吉姆萨染色法检查了五名初步诊断为CL的患者的临床材料。从患者身上采集的样本接种到改良的NNN(诺维-麦克尼尔-尼科尔)培养基中,以评估前鞭毛体的存在情况。从接种培养基中获得的前鞭毛体也使用ITS1区域进行基因分型。在从患者采集的临床材料制备的所有载玻片上均发现了无鞭毛体。仅在接种培养基的三个临床标本中观察到前鞭毛体生长。基因分型的三个物种为热带利什曼原虫、婴儿利什曼原虫/杜氏利什曼原虫和硕大利什曼原虫。在本研究中,提出了支持在疾病暴发期间用于诊断利什曼病感染的不同微生物学方法诊断的重要性。此外,旨在提请注意在我国五名从哈塔伊运往土库曼斯坦、叙利亚、沙特阿拉伯、伊朗、格鲁吉亚、乌兹别克斯坦和阿塞拜疆的卡车司机中诊断出的输入性CL病例的重要性。

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