2016-2018年陕西省炭疽监测及基因溯源分析
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摘要
目的调查了解2016-2018年陕西省炭疽流行情况、病原学特征及分子流行病学特征。方法对2016-2018年报告炭疽病例开展个案调查,进行流行病学三间分布分析;采集病例生物样本及环境样本,进行炭疽杆菌分离培养、炭疽ELISA抗体检测及荧光定量PCR检测,对分离到的阳性标本以canSNP及MLVA15的方法进行分子分型,与陕西省历史菌株及国内部分省份菌株基因型进行聚类分析。结果 2016-2018年陕西省共炭疽病例14例,发病到诊断平均9天,地理分布以关中及陕北地区为主,8月份发病较多,人群分布性别比为6∶1(12/2),26～59岁占85.7%(12/14),农民占71.4%(10/14)。人体标本病原培养17份,分离到炭疽杆菌1株,阳性5.9%,环境标本培养77份均为阴性,ELISA检测阳性率83.3%(10/12),荧光定量PCR阳性率21.4%(3/14);陕西省炭疽菌株canSNP基因型为A.Br.001/002型,2015年、2018年及1953年菌株MLVA分型分别为MLVA15-38、31、CHN17基因型。结论 2016-2018年陕西省炭疽疫情属较低散发水平,主要分布在关中及陕北地区,8月为发病高峰,人群以青壮年男性农民为主。炭疽杆菌canSNP基因型为A.Br.001/002,与国内主要流行株相同。存在3种不同的MLVA15基因型。陕北地区MLVA15-38型,与北部内蒙古相近;关中地区MLVA15-31型,与甘肃省及新疆类似;历史上还曾有MLVA15-CHN17型。
Objective To investigate the epidemic situation,etiological characteristics and molecular epidemiological characteristics of anthrax in Shaanxi Province from 2016 to 2018.Methods We used case investigation of anthrax cases reported in 2016-2018 and epidemiological analysis of spatial,temporal and population distribution.Biological samples and environmental samples were collected for B.anthracis isolation culture,anthrax ELISA antibody detection and real-time PCR detection.The positive samples were molecularly typed by canSNP and MLVA15,and clustered with the historical strains of Shaanxi Province and the genotypes of some domestic provinces.Results A total of 14 cases were reported from 2016 to 2018 in Shaanxi Province.The average time from onset to diagnosis was 9 days.The geographical distribution was mainly in Guanzhong and Northern Shaanxi.There were more cases in August.The sex ratio of population distribution was 6:1(12/2).85.7%(12/14)were 26-59 years old,and 71.4%(10/14)were peasants.One strain of Bacillus anthracis was isolated from 17 human specimens,and the positive rate was 5.9%.77 environmental specimens were negative.The positive rate of ELISA was 83.3%(10/12).The positive rate of fluorescence quantitative PCR was 21.4%(3/14).CanSNP genotype of anthrax strain in Shaanxi Province was A.Br.001/002.MLVA genotypes of strains isolated in Shaanxi Province in 2015,2018 and 1953 were MLVA15-38,31 and CHN17 genotypes,respectively.Conclusion The anthrax epidemic in Shaanxi Province in 2016-2018 is at a low emission level.The cases are mainly distributed in Guanzhong and Northern Shaanxi.August is the peak incidence.The distribution of the population is dominated by young male farmers.The canSNP genotype A.Br.001/002 of Bacillus anthracis in Shaanxi Province is the same as that of the main domestic strains,and there are three different MLVA15 genotypes.MLVA15-38 in Northern Shaanxi is similar to Inner Mongolia.MLVA15-31 in Guanzhong is similar to Gansu Province and Xinjiang Province.There have also been MLVA15-CHN17 models in history.
Objective To investigate the epidemic situation,etiological characteristics and molecular epidemiological characteristics of anthrax in Shaanxi Province from 2016 to 2018.Methods We used case investigation of anthrax cases reported in 2016-2018 and epidemiological analysis of spatial,temporal and population distribution.Biological samples and environmental samples were collected for B.anthracis isolation culture,anthrax ELISA antibody detection and real-time PCR detection.The positive samples were molecularly typed by canSNP and MLVA15,and clustered with the historical strains of Shaanxi Province and the genotypes of some domestic provinces.Results A total of 14 cases were reported from 2016 to 2018 in Shaanxi Province.The average time from onset to diagnosis was 9 days.The geographical distribution was mainly in Guanzhong and Northern Shaanxi.There were more cases in August.The sex ratio of population distribution was 6:1(12/2).85.7%(12/14)were 26-59 years old,and 71.4%(10/14)were peasants.One strain of Bacillus anthracis was isolated from 17 human specimens,and the positive rate was 5.9%.77 environmental specimens were negative.The positive rate of ELISA was 83.3%(10/12).The positive rate of fluorescence quantitative PCR was 21.4%(3/14).CanSNP genotype of anthrax strain in Shaanxi Province was A.Br.001/002.MLVA genotypes of strains isolated in Shaanxi Province in 2015,2018 and 1953 were MLVA15-38,31 and CHN17 genotypes,respectively.Conclusion The anthrax epidemic in Shaanxi Province in 2016-2018 is at a low emission level.The cases are mainly distributed in Guanzhong and Northern Shaanxi.August is the peak incidence.The distribution of the population is dominated by young male farmers.The canSNP genotype A.Br.001/002 of Bacillus anthracis in Shaanxi Province is the same as that of the main domestic strains,and there are three different MLVA15 genotypes.MLVA15-38 in Northern Shaanxi is similar to Inner Mongolia.MLVA15-31 in Guanzhong is similar to Gansu Province and Xinjiang Province.There have also been MLVA15-CHN17 models in history.
引文
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[8] 刘东立,朱妮,马国柱,等.陕西省炭疽流行病学回顾性分析及防治对策探讨[J].中华疾病控制杂志,2017,21(1):52-55.
[9] Liu DL,Wei JC,Chen QL,et al.Genetic source tracking of an anthrax outbreak in Shaanxi province,China[J].Infectious Diseases of Poverty,2017,6:14.
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[12] 刘东立,李文涓,石一,等.TaqMan-LNA探针多重实时荧光定量PCR检测炭疽芽胞杆菌的研究[J].中国病原生物学杂志,2018,13(3):244-248,258.
[13] Zhang HJ,Zhang EM,He JR,et al.Genetic characteristics of Bacillus anthracis isolated from northwestern China from 1990 to 2016[J].PLOS Neglected Tropical Diseases,2018,12(11):0006908.
[14] 章文婧,李青华,王勇,等.2007～2011年中国皮肤炭疽流行病学分析[J].军事医学,2013,37(12):892-894.
[15] 周宇,张熙,李香,等.2006-2015年全国动物炭疽流行分析及防控[J].中国兽医学报,2018,38(2):336-340.
[16] 梁旭东,于德山,吕卫民,等.炭疽防控存在的问题及对策建议[J].疾病监测,2017,32(4):278-281.
[17] 吕卫民,于德山,周卫忠,等.2005-2016年甘肃省炭疽流行病学特征分析[J].疾病监测,2017,32(5):402-404.
[18] 马青,李世军,刘英,等.贵州省2006-2011年炭疽芽胞杆菌检出情况与致病性研究[J].中国人兽共患病学报,2014,30(6):632-635.
[19] Simonson TS,Okinaka RT,Wang B,et al.Bacillus anthracis in China and its relationship to worldwide lineages[J].BMC Microbiology,2009,9:71.
[2] Keim P,Price LB,Klevytska AM,et al.Multiple-locus variable-number tandem repeat analysis reveals genetic relationships within Bacillus anthracis[J].Journal of Bacteriology,2000,182(10):2928-2936.
[3] Ert MN,Easterday WR,Huynh LY,et al.Global genetic population structure of Bacillus anthracis[J].PLOS One,2007,2(5):e461.
[4] 王秉翔,SmithKL,Keys,等.中国的炭疽杆菌DNA分型及其地理分布[J].微生物学免疫学进展,2002,30(1):14-17.
[5] 魏建春,张恩民,张慧娟,等.中国炭疽芽胞杆菌中11个串联重复序列位点的特征和分布[J].中国人兽共患病学报,2012,28(8):765-768.
[6] 毛玲玲,田疆,雷露,等.辽宁省炭疽芽胞杆菌MLVA分型研究[J].中国人兽共患病学报,2015,31(3):232-234.
[7] 谈忠鸣,张忠献,董晨,等.一起皮肤炭疽疫情中炭疽杆菌分子特征分析[J].南京医科大学学报:自然科学版,2015,35(3):436-438.
[8] 刘东立,朱妮,马国柱,等.陕西省炭疽流行病学回顾性分析及防治对策探讨[J].中华疾病控制杂志,2017,21(1):52-55.
[9] Liu DL,Wei JC,Chen QL,et al.Genetic source tracking of an anthrax outbreak in Shaanxi province,China[J].Infectious Diseases of Poverty,2017,6:14.
[10] 中华人民共和国卫生部.WS 283-2008 炭疽诊断标准[S].北京:人民卫生出版社,2008.
[11] World Health Organization.Anthrax in humans and animals[M].Geneva:World Health Organization,2008.
[12] 刘东立,李文涓,石一,等.TaqMan-LNA探针多重实时荧光定量PCR检测炭疽芽胞杆菌的研究[J].中国病原生物学杂志,2018,13(3):244-248,258.
[13] Zhang HJ,Zhang EM,He JR,et al.Genetic characteristics of Bacillus anthracis isolated from northwestern China from 1990 to 2016[J].PLOS Neglected Tropical Diseases,2018,12(11):0006908.
[14] 章文婧,李青华,王勇,等.2007～2011年中国皮肤炭疽流行病学分析[J].军事医学,2013,37(12):892-894.
[15] 周宇,张熙,李香,等.2006-2015年全国动物炭疽流行分析及防控[J].中国兽医学报,2018,38(2):336-340.
[16] 梁旭东,于德山,吕卫民,等.炭疽防控存在的问题及对策建议[J].疾病监测,2017,32(4):278-281.
[17] 吕卫民,于德山,周卫忠,等.2005-2016年甘肃省炭疽流行病学特征分析[J].疾病监测,2017,32(5):402-404.
[18] 马青,李世军,刘英,等.贵州省2006-2011年炭疽芽胞杆菌检出情况与致病性研究[J].中国人兽共患病学报,2014,30(6):632-635.
[19] Simonson TS,Okinaka RT,Wang B,et al.Bacillus anthracis in China and its relationship to worldwide lineages[J].BMC Microbiology,2009,9:71.