巢式PCR在输入性三日疟实验室诊断中的效果评价
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摘要
目的评价疟疾参比实验室应用巢式PCR技术诊断输入性三日疟的效果。方法采用巢式PCR对2015-2017年湖北省网报疟疾病例和疑似病例血标本进行疟原虫核酸检测,筛查三日疟阳性标本,并与疟疾快速诊断试剂盒(RDTs)检测结果、吉氏染色显微镜镜检诊断结果进行比较。结果 367例网报输入性疟疾病例中,经巢式PCR共检出15例(4.1%)三日疟病例。在这15例三日疟病例中,省级疟疾参比实验室镜检13例诊断为三日疟,1例为间日疟,1例为卵形疟;市级疾病预防控制中心镜检7例为三日疟,8例为间日疟;RDTs方法阳性6例;阴性9例。结论在输入性三日疟的诊断和分型上,巢式PCR明显优于RDTs和镜检法,RDTs不能取代镜检对罕见疟疾进行诊断。
Objective To study the application of nested polymerase chain reaction( PCR) in diagnosis and identification of imported Plasmodium malariae in Malaria Reference Laboratory of Hubei Provence. Methods The nested PCR was used to detect malaria parasite DNA in the blood samples of malaria cases and suspected cases collected from Hubei Province in 2015-2017. The Plasmodium malariae-positive specimens were screened and compared with the results of the rapid diagnosis kits for malaria( RDTs) and the results of microscopic examination of the Gillian staining microscope. Results Of the 367 cases of imported malaria cases, 15(4.1%) cases of Plasmodium malariae were detected by nested PCR.Among the 15 cases of Plasmodium malariae, 13 cases were diagnosed as Plasmodium malariae, 1 case as Plasmodium vivax and 1 case as Plasmodium oval by the provincial malaria reference laboratory. At the municipal CDC, 7 cases were diagnosed as Plasmodium malariae and 8 cases as Plasmodium vivax. 6 cases were diagnosed as positive and 9 cases as negative by RDTs method. Conclusions Nested PCR is superior to RDTs and microscopy in the diagnosis and classification of imported Plasmodium malariae. RDTs cannot replace microscopic examination for the diagnosis of rare malaria.
Objective To study the application of nested polymerase chain reaction( PCR) in diagnosis and identification of imported Plasmodium malariae in Malaria Reference Laboratory of Hubei Provence. Methods The nested PCR was used to detect malaria parasite DNA in the blood samples of malaria cases and suspected cases collected from Hubei Province in 2015-2017. The Plasmodium malariae-positive specimens were screened and compared with the results of the rapid diagnosis kits for malaria( RDTs) and the results of microscopic examination of the Gillian staining microscope. Results Of the 367 cases of imported malaria cases, 15(4.1%) cases of Plasmodium malariae were detected by nested PCR.Among the 15 cases of Plasmodium malariae, 13 cases were diagnosed as Plasmodium malariae, 1 case as Plasmodium vivax and 1 case as Plasmodium oval by the provincial malaria reference laboratory. At the municipal CDC, 7 cases were diagnosed as Plasmodium malariae and 8 cases as Plasmodium vivax. 6 cases were diagnosed as positive and 9 cases as negative by RDTs method. Conclusions Nested PCR is superior to RDTs and microscopy in the diagnosis and classification of imported Plasmodium malariae. RDTs cannot replace microscopic examination for the diagnosis of rare malaria.
引文
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[11]Johnston SP,Pieniazek NJ,Xayavong MV,et al.PCR as a confir matory technique for laboratory diagnosis of malaria[J].J Clin Microbiol,2006,44(3):1087-1089.
[2]卫生部地方病防治局.疟疾防治手册[M].第3版.北京:人民卫生出版社,2007.
[3]黄光全,严本武,袁方玉,等.湖北省疟疾联防30年成绩与经验[J].公共卫生与预防医学,2004,15(6):66-68.
[4]黄光全,胡乐群,李凯杰,等.湖北省输入性恶性疟发病态势分析[J].热带医学杂志,2012,12(8):1016-1018.
[5]黄光全,袁方玉,胡乐群,等.湖北省2007-2009年疟疾流行态势分析[J].热带医学杂志,2010,10(10):1227-1229.
[6]Snounou G,Viriyakosol S,Zhu XP,et al.High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction[J].Mol Biochem Parasitol,1993,61(2):315-320.
[7]Calderaro A,Piccolo G,Perandin F,et al.Genetic polymorphisms influence Plasmodium ovale PCR detection accuracy[J].J Clin Microbiol,2007,45(5):1624-1627.
[8]燕贺,夏志贵,李美,等.2011-2013全国输入性三日疟与卵形疟疫情分析[J].国际医学寄生虫病杂志,2018,42(1):14-17.
[9]魏沨,万正,韩墨,等.非洲输入性三日疟2例[J].中国血吸虫病防治杂志,2014,26(2):232-233.
[10]王真瑜,张耀光,江莉,等.上海市1例输血性三日疟病例的实验室检测分析与诊断[J].中国血吸虫病杂志,2015,27(4):362-365.
[11]Johnston SP,Pieniazek NJ,Xayavong MV,et al.PCR as a confir matory technique for laboratory diagnosis of malaria[J].J Clin Microbiol,2006,44(3):1087-1089.