摘要
目的通过流行病学调查和分子生物学分析,确认输血传播疟疾病例。方法搜集1例输血感染恶性疟疾患者的临床资料,并进行流行病学调查;对患者和献血者采血,分别进行疟疾快速诊断试纸条检测(RDT)、疟原虫镜检和荧光定量PCR(qPCR)检测,对扩增的疟原虫的18SrRNA,裂殖子表面蛋白1和2基因(PfMSP1和2)测序进行比对分析并构建进化树。结果患者无疟疾流行区居留史和既往疟疾感染史,有输血史。外周血涂片查见恶性疟原虫,并经RDT、重新镜检和qPCR确认。经调查,该患者先后输入来自4位供血者的血液成分,4位供血者献血时留存血样经血涂片镜检和RDT均未查见疟原虫,仅1名献血者qPCR扩增恶性疟原虫18SrRNA阳性。随访献血者采集血样RDT检测阴性,血涂片疟原虫镜检阴性,qPCR检测恶性疟原虫18SrRNA阳性。献血者和患者血样均能扩增出18SrRNA,MSP1和MSP2基因序列同源性100%。结论该患者为输血传播恶性疟疾病例,因此应加强对献血者的疟疾筛查,控制输血传播疟疾的发生。
Objective To verify a case of transfusion-transmitted malaria（TTM）through an epidemiological investigation and molecular analysis. Methods Clinical data were collected from a patient with malaria,and an epidemiological investigation was conducted.Blood samples from the patient and donor were tested for Plasmodiumspp.using a rapid diagnostic test（RDT）,microscopy,and qualitative PCR（qPCR）.Nucleic acids of Plasmodium falciparum small subunit rRNA（18 SrRNA）and merozoite surface proteins 1 and 2（MPS1 and 2）from the patient and the donor were amplified with PCR.Sequences were aligned and a phylogenetic tree was constructed with software. Results The patient did not visit a malaria-endemic area and had no history of malaria but had received blood transfusions during surgery.The patient tested positive for P.falciparumaccording to the RDT,and microscopy and qPCR confirmed that finding.The patient received transfusions from four donors whose peripheral blood tested negative for P.falciparumaccording to microscopy and the RDT.Only one donor tested positive for P.falciparumaccording to qPCR.The donor tested negative according to the RDT and according to microscopy in the laboratory.Sequences of 18 SrRNA,MSP1,and MSP2 of P.falciparumhad a similarity of 100%. Conclusion P.falciparum was transmitted from a blood donor to a patient.The case was confirmed to be TTM.Health personnel should pay further attention to cases of TTM.Education of potential blood donors who reside in or travel to malaria-endemic areas should be enhanced.Blood collection personnel should be better trained at interviewing potential donors.More cost-effective and practical reagents to screen for malaria in the blood need to be studied and developed.
作者
林红
徐岁
邵雷
朱珊珊
胡文佳
朱绍汶
顾亚萍
杨蒙蒙
周华云
朱国鼎
LIN Hong;XU Sui;SHAO Lei;ZHU Shan-shan;HU Wen-jia;ZHU Shao-wen;GU Ya- ping;YANG Meng-meng;ZHOU Hua-yun;ZHU Guo-ding(Jiangsu Province Blood Center, Nanjing 210042, China;Jiangsu Institute of Parasitic Disease)
出处
《中国病原生物学杂志》
CSCD
北大核心
2017年第11期1105-1107,F0003,共4页
Journal of Pathogen Biology
基金
江苏省"333工程"(2016-Ⅲ-3345)
"六个一工程"项目(No.LGY2016045)
江苏省地方病学会项目(No.X201433)
关键词
输血
疟疾
疟原虫
恶性
快速检测
Transfusion
Malaria
Plasmodium falciparum
rapid detection
