摘要
目的探讨索氏梭菌在艰难梭菌感染实验室检测中的影响。方法收集2017年9～11月首都医科大学附属北京友谊医院住院成年腹泻患者粪便标本350份,采用酶免疫分析法(enzyme immunoassay, EIA)进行艰难梭菌毒素检测;采用艰难梭菌选择培养基和哥伦比亚血琼脂平板进行厌氧培养,对典型菌株进行质谱鉴定;对索氏梭菌和艰难梭菌菌株进行产毒素培养实验(EIA法);采用聚合酶链反应(polymerase chain reaction, PCR)方法对所有菌株进行艰难梭菌毒素A、B基因检测。结果粪便标本毒素检测阳性率9.14%;索氏梭菌培养检出率2.57%,艰难梭菌培养检出率16.57%;索氏梭菌和艰难梭菌培养特性及菌落特点相似;PCR检测艰难梭菌含有毒素基因77.59%,在未检出毒素基因的艰难梭菌菌株中有1例对应的粪便毒素阳性,假阳性率为0.28%;在产毒素培养实验中,9株索氏梭菌培养全部阳性,艰难梭菌阳性率77.59%。结论艰难梭菌感染实验室检测中,索氏梭菌对培养、毒素检测、产毒素培养实验均会产生干扰,在艰难梭菌实验室检测中应考虑索氏梭菌的影响,避免引起误诊。
Objective To analyze the impact of Clostridium sordellii in laboratory tests of Clostridium difficile infection. Methods A total of 350 fecal specimens from hospitalized adults with diarrhea from September to November 2017 were collected. Enzyme immunoassay (EIA) was used to detect Clostridium difficile toxin. Anaerobic culture was carried by Clostridium difficile selection medium and Columbia blood agar plates and the typical strains were identified by mass spectrometry. Clostridium difficile and Clostridium sordellii strains were subjected to toxigenic culture experiments (EIA method). All strains were tested for toxin genes by PCR methods. Results The positive rate of toxin in stool samples was 9.14%;the detection rate of Clostridium sordellii culture was 2.57%, the detection rate of Clostridium difficile culture was 16.57%;the culture characteristics and colony characteristics of Clostridium sordellii and Clostridium difficile were similar;Containing the toxin gene of Clostridium difficile was 77.59% by PCR, and 1 case of fecal toxin was positive in the Clostridium difficile strain not containing the toxin gene, and the false positive rate was 0.28%. In the toxigenic culture experiments, 9 strain of Clostridium sordellii were positive, the positive rate of Clostridium difficile was 77.59%. Conclusions In the laboratory test of Clostridium difficile infection, the culture, toxin detection and toxigenic culture experiments will interfere. The effect of Clostridium sordellii should be considered to avoid misdiagnosis.
作者
董文娟
王保亚
彭文雯
苏建荣
Dong Wenjuan;Wang Baoya;Peng Wenwen;Su Jianrong(Department of Clinical Laboratry, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)
出处
《北京医学》
CAS
2019年第3期202-205,共4页
Beijing Medical Journal
基金
首都医学发展科研基金(2018-2-1114)
关键词
艰难梭菌
索氏梭菌
培养
产毒素培养
Clostridium difficile', Clostridium sordellii
culture
toxigenic culture
