Instituto Nacional de Salud, Lima, Perú.
Rev Peru Med Exp Salud Publica. 2020 Oct-Dec;37(4):681-688. doi: 10.17843/rpmesp.2020.374.5169. Epub 2021 Feb 3.
To describe the results of laboratory tests performed on biological samples from patients with Guillain-Barré syndrome (GBS) submitted to the Instituto Nacional de Salud (INS) between 2018 and 2019.
We conducted an observational study on patients with GBS, by using data from the epidemiological surveillance system. Biological samples, previously analyzed at the INS, were obtained to study arboviruses, respiratory viruses, enteroviruses and enterobacteria, among others.
A total of 2,051 specimens were obtained from 906 patients with GBS. Three patients tested positive for dengue and three for Zika. In 19 patients, the stool culture was positive for Campylobacter jejuni. Phylogenetic analysis of 10 Campylobacter jejuni strains classified them as genotype ST2993, which was previously reported in China and associated to a GBS outbreak. Twelve cerebrospinal fluid samples tested positive for enterovirus by PCR in 2018, but none could be verified by culture or complete genome sequencing during the study. One patient was positive for influenza A, two for influenza B, two for adenovirus, five for respiratory syncytial virus, and ten for rinovirus.
Several pathogens were found in samples from patients with GBS. However, we found that the genotype ST2993 of Campylobacter jejuni was the most likely causal agent, a pathogen that is related to GBS outbreaks in different continents. It is necessary to confirm this hypothesis with additional analytical studies and it is important to describe the transmission mechanism of C. jejuni genotype ST2993 in order to implement prevention and control measures.
描述 2018 年至 2019 年期间提交给国立卫生研究院（INS）的格林-巴利综合征（GBS）患者生物样本的实验室检测结果。
我们对 GBS 患者进行了一项观察性研究，使用了流行病学监测系统的数据。获得了 INS 之前分析过的生物样本，以研究虫媒病毒、呼吸道病毒、肠道病毒和肠杆菌等。
从 906 例 GBS 患者中获得了 2051 份标本。3 例患者登革热检测阳性，3 例 Zika 检测阳性。19 例患者粪便培养出空肠弯曲菌阳性。对 10 株空肠弯曲菌的系统进化分析将其归类为 ST2993 基因型，该基因型之前在中国有报道，与 GBS 暴发有关。2018 年，12 份脑脊液样本通过 PCR 检测到肠道病毒阳性，但在研究期间，通过培养或全基因组测序均无法验证。1 例患者流感 A 阳性，2 例流感 B 阳性，2 例腺病毒阳性，5 例呼吸道合胞病毒阳性，10 例鼻病毒阳性。
在 GBS 患者的样本中发现了几种病原体。然而，我们发现空肠弯曲菌 ST2993 基因型最有可能是致病原因，这种病原体与不同大陆的 GBS 暴发有关。需要通过额外的分析研究来证实这一假设，并且描述空肠弯曲菌 ST2993 基因型的传播机制非常重要，以便实施预防和控制措施。
