Bingen E H, Denamur E, Elion J
Laboratoire de Microbiologie, Hôpital Robert Debré, Paris, France.
Clin Microbiol Rev. 1994 Jul;7(3):311-27. doi: 10.1128/CMR.7.3.311.
Over the past few years, genotypic methods based on the study of bacterial DNA polymorphism have shown high discriminatory power for strain differentiation and superiority over most phenotypic methods commonly available in the clinical microbiology laboratory. Some of the methods used, however, required either a high level of technology and sophisticated equipment (e.g., pulsed-field gel electrophoresis) or species-specific reagents of restricted availability (randomly cloned DNA probes or gene-specific probes). Because ribotyping uses a universal probe (rRNA) and is a rather simple technology, particularly since the advent of nonradioactive labelling systems, it has been widely used for strain differentiation of most bacterial species involved in nosocomial outbreaks. In vitro and in vivo stability of the markers studied has been demonstrated. Although there may be limitation to this approach, ribotyping was found to be highly discriminative, particularly for typing members of the family Enterobacteriaceae, Pseudomonas cepacia, and Xanthomonas maltophilia. In many cases, it has improved the understanding of the mechanism of nosocomial acquisition of organisms by allowing a distinction between endogenous and exogenous infections. Among exogenous infections, it has distinguished between individual and epidemic strains, thus differentiating cross-infection from independent acquisition.
在过去几年中，基于细菌DNA多态性研究的基因分型方法在菌株鉴别方面显示出很高的分辨能力，并且优于临床微生物实验室中常用的大多数表型方法。然而，所使用的一些方法要么需要高水平的技术和精密设备（如脉冲场凝胶电泳），要么需要可用性有限的种特异性试剂（随机克隆的DNA探针或基因特异性探针）。由于核糖体分型使用通用探针（rRNA）且是一项相当简单的技术，特别是自从非放射性标记系统出现以来，它已被广泛用于医院感染暴发中涉及的大多数细菌物种的菌株鉴别。已证明所研究标记的体外和体内稳定性。尽管这种方法可能存在局限性，但核糖体分型被发现具有高度分辨力，特别是对于肠杆菌科、洋葱伯克霍尔德菌和嗜麦芽窄食单胞菌家族的成员分型。在许多情况下，通过区分内源性和外源性感染，它有助于加深对医院感染病原体获取机制的理解。在外源性感染中，它区分了单个菌株和流行菌株，从而将交叉感染与独立获得区分开来。
