2002～2004年浙江省无菌性脑膜炎暴发疫情的病原学研究

2002～2004年浙江省发生了无菌性脑膜炎暴发疫情,为了及时查明病因,分析病原的分子特征并进行病原溯源,我们采集患者脑脊液和粪便样本271份,用RD和Hep-2细胞同时分离病毒,对分离株VP1和VP4/VP2基因测序,进行同源性与进化分析。结果从271份样本中分离到埃柯病毒30型(E30)78株;对31株分离株VP1区核苷酸(nt)序列测定,其长度均为876nt,推导编码292个氨基酸(aa)。浙江E30株与原型株Bastianni在VP1区的nt和aa同源性分别为84.7%～86.3%和92.1%～94.2%;浙江E30株之间nt和aa的同源性分别为87.1%～99.4%和96.2%～100%。在VP1基因进化树上浙江E30株分别位于G和H基因亚型分支上,与浙江E30G亚型株亲缘关系最近的国内外毒株分别为2003年江苏、山东株和1999年乌克兰株;与浙江E30H亚型株亲缘关系最近的毒株为2008年韩国株。VP4/VP2区同源性与进化分析结果与VP1相似。结果表明2002～2004年浙江省无菌性脑膜炎暴发疫情由E30G和H二类不同基因亚型流行株引起;H基因亚型株推测为新的E30变异株,首先分离于2002年浙江省。     

2007年北京市急性出血性结膜炎的病原与分子进化分析

2007年北京市发生了急性出血性结膜炎(Acute Hemorrhagic Conjunctivitis,AHC)疫情。为鉴定引起这次疫情的致病病原体,采集北京市门诊就诊的AHC患者眼结膜拭子标本共57份,使用PCR或RT-PCR法分别检测临床标本中腺病毒、人肠道病毒70型(Human Enterovirus 70,HEV70)和柯萨奇病毒A组24型变种(CoxsackievirusA24 variant,CVA24v)的基因,其中有38份检测结果为CVA24v阳性,阳性率为66.7%,而腺病毒和HEV70检测结果均为阴性,说明引起本次AHC流行的病原体是CVA24v。使用HEp-2细胞共分离到9株病毒,通过分子定型均鉴定为CVA24v,对9株CVA24v进行全长VP1区扩增和核苷酸序列测定和分析后,发现除0744/BJ/CHN/2007株之外,其它8株在全长VP1区核苷酸水平和氨基酸水平上差异都很小,同源性分别大于99.6%和100.0%,而0744/BJ/CHN/2007株与其它8株CVA24v的核苷酸和氨基酸同源性分别为96.8%~97.2%和99.7%。进化树图显示,2007年北京CVA24v分离株与...     

江西省2010年柯萨奇病毒A组24型变异株的全基因组序列分析

急性出血性结膜炎(Acute hemorrhagic conjunctivitis,AHC)是目前人类最常见的眼病之一,柯萨奇病毒A组24型变异株(Coxsackievirus A24 variant,CV-A24v)是近年来报道引起该病的主要病原体。本研究选取10株来自江西省2010年AHC暴发疫情的CV-A24v,采用特异性引物扩增并测定其全基因组序列。对该10条CV-A24v的全基因组序列进行系统发育分析以及重组分析,计算本研究测定的江西10条以及GenBank中所有22条CV-A24v的全基因组序列的氨基酸置换熵值,并预测其正向选择位点。结果表明,在江西10条CV-A24v基因组序列中未检测到重组。基于全基因组序列构建的最大似然树表明江西10株CV-A24v属于GIV基因型,且分处于两条传播链。对上述32条CV-A24v序列的氨基酸置换熵值计算,共得到25个易突变位点(熵值>0.6),易突变概率最高的区段为2A区。基于Datamonkey中FUBAR和FEL模型分析,发现位于结构蛋白VP2区的234位氨基酸为两种模型共同获得的CV-A24v的正向选择位点。本研究分析了江西10株CV-A24v的全基因组序列特征,为CV-A24v引起的AHC防控工作提供了基础资料。     

浙江地区呼吸道合胞病毒G基因分子特征分析

收集2004年冬季浙江省儿童医院呼吸道感染患儿的鼻咽吸引物,进行呼吸道合胞病毒(RSV)分离,对分离株用特异性RT-PCR鉴定;对鉴定阳性的RSV毒株进行G蛋白全基因序列测定,并与RSV国际标准株及各地参考株的G蛋白基因序列进行同源性比较并构建基因进化树。结果表明,在4株RSV浙江分离株中,3株G蛋白基因ORF全长897bp,另1株为894bp;各分离株之间的核苷酸与氨基酸同源性分别为98.05%、97.06%;与A型RSV标准株的核酸同源性为95.69%,与B型RSV标准株的同源性为78.79%;其3’端基因高变区核苷酸序列与RSVGA2亚型的同源性最高。提示2004年冬季浙江省RSV流行株属于RSVGA2亚型。     

山东省急性出血性结膜炎病原学鉴定及其柯萨奇A24病毒基因特征分析

为明确2010年引起山东省青岛市、临沂市急性出血性结膜炎(Acute hemorrhagic conjunctivitis,AHC)流行的病原,采集26例患者的眼结膜拭子标本,分别采用实时荧光定量PCR(Real time-PCR)和细胞培养方法进行检测。Real time-PCR结果显示,17份标本柯萨奇病毒A组24型(Coxsackievirus A24,CVA24)阳性,阳性率为65.39%,肠道病毒70型(Enterovirus 70,EV70)和腺病毒均为阴性;使用Hep-2细胞共分离到10株病毒,通过VP1区基因扩增及核苷酸序列测定,10株病毒均鉴定为CVA24,同源性分析显示其核苷酸和氨基酸同源性分别为99.3%～100.0%和99.5%～100.0%,在系统进化树上聚集成一簇,本次分离的毒株与山东省急性弛缓性麻痹(AFP)病例中分离到的毒株序列差异较大,分别属于5个不同的进化分支。提示CVA24可能为引起两地AHC流行的病原,且属于同一传播链。     

浙江地区呼吸道合胞病毒G基因分子特征分析

收集2004年冬季浙江省儿童医院呼吸道感染患儿的鼻咽吸引物,进行呼吸道合胞病毒(RSV)分离,对分离株用特异性RT-PCR鉴定;对鉴定阳性的RSV毒株进行G蛋白全基因序列测定,并与RSV国际标准株及各地参考株的G蛋白基因序列进行同源性比较并构建基因进化树.结果表明,在4株RSV浙江分离株中,3株G蛋白基因ORF全长897bp,另1株为894bp;各分离株之间的核苷酸与氨基酸同源性分别为98.05%、97.06%;与A型RSV标准株的核酸同源性为95.69%,与B型RSV标准株的同源性为78.79%;其3'端基因高变区核苷酸序列与RSV GA2亚型的同源性最高.提示2004年冬季浙江省RSV流行株属于RSV GA2亚型.     

肠道病毒ECHO13中国分离株的基因特征

为研究ECHO13病毒中国分离株的分子特征及其与世界其它分离株之间的基因关系,对1998年、2000年从中国福建省分离到2株ECHO13病毒进行基因序列对比分析.2株病毒分别命名为Fujian98-1和Fujian00-1,用逆转录-聚合酶链反应(RT-PCR)扩增出VP1蛋白编码基因全长861个核苷酸片段并进行序列测定,将2株ECHO13病毒的VP1序列与所有已发表的ECHO13病毒VP1基因全长进行同源性比较.结果显示,福建分离株之间核苷酸同源性为79.6%,氨基酸同源性为93.4%;与遗传距离最近的法国CF1089-91(AJ537604)毒株的核苷酸同源性分别为80%和88%,与代表株Del Carmen的核苷酸同源性分别为75.8%和77.9%.通过VP1基因分析,福建2株病毒均属于ECHO13病毒,与血清中和试验鉴定结果一致.下载所有已发表的ECHO13病毒VP1序列并构建进化树,发现福建2株病毒分属不同的分枝,提示这2株病毒来自不同的病毒传播链.进一步分析发现,整个ECHO13病毒可划分为3个不同的基因型:A、B和C基因型.福建Fujian98-1和Fujian00-1分别被划分在基因型B和C中,各基因型之间的核苷酸差异均大于20%.为验证该分型方法,将26株来自不同国家和时间的ECHO13病毒和2株福建分离ECHO13病毒部分VP1基因序列进行对比分析,建立进化树.结果显示,所有ECHO13病毒被分在A、B和C3个基因型中,而2株福建分离病毒仍然被分在B和C基因型中.除了B基因型1株病毒以外,所有3个基因型之间的核苷酸差异均大于15%,与VP1全长分型结果基本一致,说明部分VP1序列的基因分析也能用于对ECHO13病毒进行规律和分子流行病学的研究中.该研究首次报道了ECHO13病毒中国分离株的VP1蛋白基因全长序列,并推荐按VP1基因全长核苷酸差异≥20%作为划分基因型的标准,将已知的ECHO13病毒划分为A、B和C3个基因型.同时也可用病毒VP1基因5′端部分序列替代VP1全长序列来划分基因型.     

2014年陕西省柯萨奇病毒A10型相关手足口病的流行特征和其VP1区基因特征研究

了解陕西省手足口病(Hand,foot and mouth disease,HFMD)的致病病原体柯萨奇病毒A10型(CV-A10)的流行特征及VP1区基因特征。对2014年收集的HFMD病例标本,通过荧光定量PCR检测确定肠道病毒型别,对CV-A10引起的HFMD流行特征进行描述性分析。使用RD细胞进行病毒分离,RT-PCR扩增CV-A10的VP1区基因片段并进行序列测定,使用Meg Align软件进行核苷酸及氨基酸的同源性分析,并使用MEGA5.0软件构建系统进化树。2014年CV-A10是陕西HFMD病原谱中的第三大病原,占其他肠道病毒的57.71%,13例重症HFMD病例的致病病原体鉴定为CV-A10,占重症病例的9.03%。CV-A10感染HFMD病例以≤3岁年龄组儿童为主(83.07%),男女性别比为1.15∶1。发病时间主要集中在4～7月。实验室分离出101株CV-A10,覆盖全省10市(区)。完成测序的18株CV-A10核苷酸和氨基酸同源性分别为94.0%～100.0%和97.3%～100.0%,与A型原型株的核苷酸和氨基酸同源性分别为76.2%～77.5%和91.9%～93.0%,与近年来河北、湖南和河南地区流行株具有较高的同源性。系统进化显示陕西CV-A10分离株属于C基因型。CV-A10是2014年陕西HFMD的优势病原,能引起重症HFMD,本次分离到的CV-A10毒株均属于C基因型。     

2010年山东省环境污水中脊髓灰质炎病毒的监测及其基因特征分析

本研究在山东省开展了脊髓灰质炎病毒(Poliovirus,PV)的外环境监测,从济南、临沂两地采集污水标本,浓缩处理后进行病毒分离,对分离到的PV采用中和试验进行血清定型,并对其VP1及3D区进行序列测定,分析其基因突变和重组情况。2010年,共采集污水标本32份,PV阳性10份,阳性率31.3%;分离到18株PV(PV1型3株,PV2型9株,PV3型6株),均为疫苗相关株,VP1完整编码区核苷酸变异数在0~4个之间,在3株PV2型病毒和4株PV3型病毒的基因组中发现重组;对VP1区影响神经毒力的减毒位点分析发现,PV1型病毒中有1株在nt 2 749发生突变(A→G),PV2型病毒中有1株在nt2 908发生A→G突变,3株在nt2 909发生U→C突变,6株PV3型病毒全部在nt2 493发生C→U突变。环境污水中可以分离到PV,其基因重组率和主要减毒位点的回复突变率较高,未发现脊灰野毒株和疫苗衍生株脊灰病毒(Vaccine-derived poliovirus,VDPV)。     

荧光定量RT-PCR检测甲型H1N1病毒核酸的临床意义

目的观察荧光定量RT-PCR技术在检测甲型H1N1病毒核酸的临床意义。方法对135例经确诊为甲型H1N1的感染患者的咽式子采用荧光定量PCR技术检测H1N1病毒核酸,同时对40例健康体检者的咽式子做为对照组一同进行甲型H1N1病毒核酸检测。结果 135例确诊为甲型H1N1的患者经荧光定量PCR检测阳性129例,符合率为96.99%。40例健康体检者结果全阴性。结论荧光定量PCR检测甲型H1N1病毒核酸具有快速、特异性高等特点,在采用此方法诊断甲型H1N1时,阳性即可确诊,阴性者要结合临床。     

Comparison between two techniques for endometrial swab culture and between biopsy and culture in barren mares

The endometria of 77 barren mares was swabbed simultaneously using a swab guarded with a single cannula and distal, gelatin capsule (completely guarded swab - CGS) and a partially guarded swab (PGS) with an open cannula. Sheep blood (5%) agar plates were inoculated with each swab, while MacConkey's agar plates were inoculated with the swabs from 44 mares. The presence of bacterial or fungal growth was determined after 24 and 48 hours of aerobic incubation at 37 C. Organisms present were identified, counted, and categorized as saprophytic or pathogenic flora. The endometria of all mares were biopsied immediately following swabbing. Histologic evidence of inflammation in biopsy specimens was classified as (1) none, (2) slight, discrete, focal, and (3) slight or moderate, diffuse, widespread infiltration of inflammatory cells. The number of inflammatory cells migrating through the luminal epithelium was counted and averaged. There were significantly fewer CGS than PGS cultures that yielded growth at 24 and 48 hours of incubation after being streaked on blood agar and MacConkey's agar plates. There were fewer pathogenic bacterial or fungal colonies present at 48 hours of incubation on blood agar plates after being streaked with CGS as compared to PGS. There were no differences in the number of pathogenic bacterial or fungal colonies present at 24 hours of incubation on blood agar or at 24 and 48 hours of incubation on MacConkey's agar plates. There was no correlation between CGS or PGS culture of pathogens and severity of histologic inflammation. There was a positive correlation between culture of pathogens and number of inflammatory cells migrating through the luminal epithelium.     

Comparison of gauze swabs and membrane filters for isolation of Campylobacter spp. from surface water

The epidemiology of Campylobacter jejuni indicates that waterborne transmission is important; the organism has been isolated from seawater, fresh water, and estuarine sites. Membrane filtration, with and without use of an enrichment broth, has been the most common method for isolating C. jejuni from water. We evaluated two methods for isolating C. jejuni from water: membrane filtration and gauze filtration. The membrane filters evaluated included 0.22- and 0.45-micron-pore Millipore filters (Millipore Corp., Bedford, Mass.), 0.2- and 0.4-micron-pore Nuclepore filters (Nucleopore Corp., Pleasanton, Calif.), and a 0.45-micron-pore Zetapor filters (AMF Cuno, Meridian, Conn.). The gauze filters included both Moore and Spira swabs. Of the membrane filters evaluated, the 0.45-micron-pore Millipore and Zetapor filters were the most sensitive for recovery of C. jejuni from seeded waters. The 0.45-micron-pore Millipore filter placed in Oosterom broth was better for recovery of C. jejuni from seeded stationary surface waters than either the Spira or Moore swab. However, the 0.45-micron-pore Millipore filter placed on a plate or in enrichment broth was equivalent to the Spira gauze swab when used to examine water from Atlanta area streams. C. jejuni organisms were isolated from 9 of 24 surface water samples representing 5 of 12 streams.     

Comparison of gauze swabs and membrane filters for isolation of Campylobacter spp. from surface water.

The epidemiology of Campylobacter jejuni indicates that waterborne transmission is important; the organism has been isolated from seawater, fresh water, and estuarine sites. Membrane filtration, with and without use of an enrichment broth, has been the most common method for isolating C. jejuni from water. We evaluated two methods for isolating C. jejuni from water: membrane filtration and gauze filtration. The membrane filters evaluated included 0.22- and 0.45-micron-pore Millipore filters (Millipore Corp., Bedford, Mass.), 0.2- and 0.4-micron-pore Nuclepore filters (Nucleopore Corp., Pleasanton, Calif.), and a 0.45-micron-pore Zetapor filters (AMF Cuno, Meridian, Conn.). The gauze filters included both Moore and Spira swabs. Of the membrane filters evaluated, the 0.45-micron-pore Millipore and Zetapor filters were the most sensitive for recovery of C. jejuni from seeded waters. The 0.45-micron-pore Millipore filter placed in Oosterom broth was better for recovery of C. jejuni from seeded stationary surface waters than either the Spira or Moore swab. However, the 0.45-micron-pore Millipore filter placed on a plate or in enrichment broth was equivalent to the Spira gauze swab when used to examine water from Atlanta area streams. C. jejuni organisms were isolated from 9 of 24 surface water samples representing 5 of 12 streams.     

Detection of Corynebacterium kutscheri from the oral cavity of rats.

A simple and useful method for the detection of C. kutscheri from the oral cavity of living rats was devised. In 10 sacrificed rats from two naturally and subclinically infected conventional colonies, 10(4.28) or 10(3.84) CFU/ml C. kutscheri were isolated from upper incisor swab extractions, while 10(1.38) or 10(1.58) and < 10 or 10(1.56) CFU/ml from the upper soft palate and pharynx, respectively. In another survey with 26 living animals, which were reared on the same rack, organisms were detected from the upper incisor and gingival swabs in 15 of 26 rats (57.7%). The results were reproducible at a second survey 10 days later. No organisms were isolated from any sites of the orally negative rats. These results indicated that culture of swab specimens from the upper incisors and gingivae of incisors is useful for the detection of C. kutscheri infection in living rats.     

Laboratory Investigation and Phylogenetic Analysis of an Imported Middle East Respiratory Syndrome Coronavirus Case in Greece

Rapid and reliable laboratory diagnosis of persons suspected of Middle East respiratory syndrome coronavirus (MERS-CoV) infection is important for timely implementation of infection control practices and disease management. In addition, monitoring molecular changes in the virus can help elucidate chains of transmission and identify mutations that might influence virus transmission efficiency. This was illustrated by a recent laboratory investigation we conducted on an imported MERS-CoV case in Greece. Two oropharyngeal swab specimens were collected on the 1^st and 2^nd day of patient hospitalization and tested using two real-time RT-PCR (rRT-PCR) assays targeting the UpE and Orf-1a regions of the MERS-CoV genome and RT-PCR and partial sequencing of RNA-dependent RNA polymerase and nucleocapsid genes. Serum specimens were also collected and serological test were performed. Results from the first swab sample were inconclusive while the second swab was strongly positive for MERS-CoV RNA by rRT-PCR and confirmed positive by RT-PCR and partial gene sequencing. Positive serologic test results further confirmed MERS-CoV infection. Full-length nucleocapsid and spike gene coding sequences were later obtained from the positive swab sample. Phylogenetic analysis revealed that the virus was closely related to recent human-derived MERS-CoV strains obtained in Jeddah and Makkah, Saudi Arabia, in April 2014 and dromedary camels in Saudi Arabia and Qatar. These findings were consistent with the patient’s history. We also identified a unique amino acid substitution in the spike receptor binding domain that may have implications for receptor binding efficiency. Our initial inconclusive rRT-PCR results highlight the importance of collecting multiple specimens from suspect MERS-CoV cases and particularly specimens from the lower respiratory tract.     

A Rapid and Sensitive One Step-SYBR Green Based Semi Quantitative Real Time RT-PCR for the Detection of peste des petits ruminants Virus in the Clinical Samples

A sensitive and rapid single step real time (rt) RT-PCR was standardized using one-step Brilliant SYBR Green kit for detection and semi-quantitation of peste des petitis ruminants virus (PPRV) using the virus RNA and matrix (M) protein gene-specific primers and compared with established conventional RT-PCR and Taq Man RT-PCR. The assay amplifies a 124 bp fragment of the PPRV M gene with Tm of 78.28 to 78.50. The assay was linear within a range of 50 ng to 0.5 fg total virus RNA with a detection limit (sensitivity) of 0.5 fg. Based on the serial dilution of the live-attenuated PPR vaccine virus, the detection limit was ~0.0001 cell culture infectious dose 50% units (TCID50). Additionally, swab materials spiked with known titre of vaccine virus were equally well detected in the assay. The standardized rt RT-PCR was easily employed for the detection of PPRV nucleic acid directly in the field and experimental clinical samples. The assay detected the PPRV nucleic acid as early as 3 day post infection (dpi) and up to 20 dpi in swab materials from the experimental samples. The assay was rapid and more sensitive than TaqMan and conventional RT-PCR in the detection of PPRV nucleic acid from the PPR suspected clinical samples of sheep and goats. Therefore, the established, simplified SYBR green rt RT-PCR is an alternative test to the already existing various diagnostic assays and could be useful for rapid clinical diagnosis with advantage in reducing risk of contamination.     

应用RT-PCR技术检测动物组织中的口蹄疫病毒

通过对影响RT-PCR检出率的条件和试剂进行了筛选,确定了提取FMDVRNA的最佳方法的试剂。优选出RT-PCR反应的试剂和最佳反应条件,建立了检测口蹄疫病毒核酸的RT-PCR方法,应用所建立的方法检测送检的鲜牛奶,淋巴结,脊髓,牛备咽拭子,结果阳性率分别为41.4%(24/58),13.33%(2/15),20%(1/5),37.5%(12/32);检测4个屠宰场送检的组织样品40份,结果阳性率为10%——70%;检测送检的奶粉（1份）,水泡皮（1份）,老鼠（2份）,患儿口腔棉拭子（4份）,阳性率均为100%;而检测送检的蝉螂4份,阳性率为0。研究表明检测FMDV的RT-PCR技术能准确快速地检测肉类,奶类,分泌物,排泄物的带毒,排毒情况,可用于口蹄疫的诊断和流行病学调查。     

A rapid and sensitive one step-SYBR green based semi quantitative real time RT-PCR for the detection of <Emphasis Type="Italic">peste des petits ruminants</Emphasis> virus in the clinical samples

A sensitive and rapid single step real time (rt) RT-PCR was standardized using one-step Brilliant SYBR Green kit® for detection and semi-quantitation of peste des petitis ruminants virus (PPRV) using the virus RNA and matrix (M) protein gene-specific primers and compared with established conventional RT-PCR and TaqMan RT-PCR. The assay amplifies a 124 bp fragment of the PPRV M gene with T_m of 78.28 to 78.50. The assay was linear within a range of 50 ng to 0.5 fg total virus RNA with a detection limit (sensitivity) of 0.5 fg. Based on the serial dilution of the live-attenuated PPR vaccine virus, the detection limit was ～0.0001 cell culture infectious dose 50% units (TCID₅₀). Additionally, swab materials spiked with known titre of vaccine virus were equally well detected in the assay. The standardized rt RT-PCR was easily employed for the detection of PPRV nucleic acid directly in the field and experimental clinical samples. The assay detected the PPRV nucleic acid as early as 3 day post infection (dpi) and up to 20 dpi in swab materials from the experimental samples. The assay was rapid and more sensitive than TaqMan and conventional RT-PCR in the detection of PPRV nucleic acid from the PPR suspected clinical samples of sheep and goats. Therefore, the established, simplified SYBR green rt RT-PCR is an alternative test to the already existing various diagnostic assays and could be useful for rapid clinical diagnosis with advantage in reducing risk of contamination.