首页|江西省吉安市莱姆病疑似病例调查研究

江西省吉安市莱姆病疑似病例调查研究

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目的 了解江西省吉安市莱姆病疑似病例中确诊病例情况及其临床表现特征和地区来源分布,为莱姆病及时诊治提供依据.方法 2021年12月至2022年8月从吉安市中心人民医院收集了 133份莱姆病疑似病例血清,采用国际上通用的"两步法"进行莱姆病抗体检测,并采用巢式PCR方法检测血清中莱姆病螺旋体的基因,阳性标本进一步测序分析.结果 133份莱姆病疑似病例血清中有25份伯氏疏螺旋体检测阳性,总阳性率为18.80%.其中,20份样本抗体检测阳性,阳性率为15.04%;6份样本核酸检测阳性,阳性率为4.51%.6例核酸检测阳性的患者的5S-23S rRNA基因间隔区的序列均与扬子疏螺旋体(Borrelia yangtzensis)的相应序列一致,并且其中1份样本抗体检测也为阳性.25例阳性患者来自吉安市的9个县区,其中吉州区的患者最多,占44%.阳性患者出现莱姆病相关症状,包括关节病变、神经疾病、感染性发热、皮炎或胸痛,其中关节病变的病人最多,占72%.6例扬子疏螺旋体感染者来自吉州区,其中4例表现为关节病变,2例表现为感染性发热.结论 本次研究首次证实江西省吉安市存在莱姆病患者,并首次在我国南方的病人体内检测出扬子疏螺旋体.研究提示该地区医务人员在接诊具有关节炎、神经系统等症状的病例时,应考虑患者可能罹患莱姆病.研究表明吉安市存在莱姆病自然疫源地,应进一步开展莱姆病的调查和监测.
Research on suspected cases of Lyme disease in Ji'an City,Jiangxi Province
Confirmed cases of Lyme disease(LD)in Ji'an City,Jiangxi Province and the clinical manifestations and region-al distribution were assessed to provide a basis for timely diagnosis and treatment.In total,133 serum samples were collected from patients with suspected LD in Ji'an Central People's Hospital from December 2021 to August 2022.Serum antibodies a-gainst Borrelia burgdorferi were detected with a two-step testing process.In addition,a specific gene of B.burgdorferi in samples was identified by nested PCR.Sequencing analysis was conducted to confirm the positive samples.Overall,25(18.80%)serum samples were positive for B.burgdorferi nucleic acid and antibodies,which included 20(15.04%)positive for antibodies and 6(4.51%)positive for nucleic acids.The sequences of the 5S-23S rRNA gene spacer of 6 samples were con-sistent with the corresponding sequences of Borrelia yangtzensis and one of the six samples was also positive for antibodies.The 25 positive samples were collected from 9 counties in Ji'an City,with the majority in Jizhou District(44%).All positive patients may experience symptoms related to LD,including joint disorders,neurological disorders,infectious fever,der-matitis,and/or chest pain.The most common symptom was joint disorders(72%).Six cases positive for B.yangtzensis nucleic acids were mainly collected in the Jizhou District,of which four had joint lesions and two had infectious fever.This study confirms the existence of LD in Jiangxi Province,which may be the first confirmation of human infection with B.yan-gtzensis in southern China.Hence,doctors in this region should consider the possibility of LD for cases presenting with related symptoms.Although LD may occur in this region,further investigations and monitoring are warranted.

Lyme diseaseBorrelia yangtzensisnucleic acid testantibody test

刘志云、曾予、段立科、侯学霞、张琳、贺丽娟、郝琴

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吉安市中心人民医院,吉安 343000

中国疾病预防控制中心传染病预防控制所,传染病溯源预警与智能决策全国重点实验室,北京 102206

莱姆病 扬子疏螺旋体 核酸检测 抗体检测

吉安市科技计划指导项目(2023)中国疾病预防控制中心传染病预防控制所自主课题国家科技重大专项(十三五)

20233-043438320552017ZX10303404006003

2024

中国人兽共患病学报
中国微生物学会

中国人兽共患病学报

CSTPCD北大核心
影响因子:0.814
ISSN:1002-2694
年,卷(期):2024.40(4)
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