斐济人类粪便标本中弯曲菌检测

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ⷁ㆛᡹䘧

WPSAR Vol 5, No 4, 2014 | doi: 10.5365/wpsar.2014.5.2.007

www.wpro.who.int/wpsar

1

a ᶹᇨᮃ⡍໻ᄺˈ▇໻߽Ѯᮄफ࿕ᇨ຿Ǆ

b ᯚ຿݄໻ᄺˈ▇໻߽ѮᏗ䞠ᮃ⧁Ǆ

ᡩ〓᮹ᳳ˖2014ᑈ5᳜2᮹˗থ㸼᮹ᳳ˖2014ᑈ12᳜19᮹ doi: 10.5365/wpsar.2014.5.2.007

ᔃ

᳆㦠Campylobacter spp೼থ䖒೑ᆊ੠

থሩЁ೑ᆊഛЎ㝍⋏⮙㟈⮙㦠ˈᑊϨ೼ᆊ

⾑ǃ⠯ǃ⣾ǃ㕞ǃ吉右ǃ䋱㉏ㄝৃ԰Ў亳

⠽ⱘࡼ⠽Ё੠⣿ǃ⢫ㄝᅴ⠽Ё᱂䘡ᄬ೼^[1]Ǆᔃ᳆㦠 ᛳᶧ⮙՟ⱘЈᑞ⮛⢊Ϣ݊Ҫ㙴䘧ᛳᶧ㉏Ԑˈሑㅵ䗮 ᐌ݋᳝㞾䰤ᗻˈԚϔѯ䞡⮛⮙՟ⱘ⮙⿟ৃ㛑Ӯᣕ㓁

5㟇7໽

^[2]Ǆ

⬅Ѣᇮ᳾ᓎゟᔃ᳆㦠ᛳᶧⲥ⌟乍Ⳃˈ䆌໮থሩЁ

೑ᆊ㔎ᇥᔃ᳆㦠ⱘⷨお᭄᥂Ǆ᳝᡹ਞ⿄ˈথሩЁ೑ᆊ ⱘᔃ᳆㦠ᛳᶧ໮থ⫳೼

5

ቕҹϟܓスЁˈϨᐌ㹿䅸Ўᰃ ܓ⾥⮒⮙^[3]Ǆ෎ѢⳂࠡⱘⷨお㒧ᵰˈথ䖒೑ᆊ੠থሩ Ё೑ᆊϔ㠀Ҏ㕸ⱘᔃ᳆㦠ᛳᶧ⥛㑺Ў

90/10

ϛ^[3]Ǆ

㝍⋏⮙೼᭤⌢ሲѢ⊩ᅮ᡹ਞӴᶧ⮙Ǆ2011ᑈ᭤⌢

ि⫳䚼݅᥹ࠄ22 753՟㝍⋏⮙⮙՟᡹ਞˈ݊Ё281՟

Ўߎ㸔ᗻ㝍⋏⮙⮙՟^[4]Ǆ404՟ᔦЎ≭䮼㦠ᛳᶧᇐ㟈ⱘ 㙴⛁⮙ˈ݊ԭ⮙՟᳾᡹ਞ⮙ॳֵᙃǄ᳝ⷨお㸼ᯢথሩ Ё೑ᆊⱘ㚗㙴䘧⮒⮙ᑓ⊯⌕㸠^[5]Ǆ໾ᑇ⋟ഄऎ৘೑ⱘ

݀݅ि⫳㋏㒳गᏂϛ߿ˈ䆌໮೑ᆊഄ⧚ԡ㕂أۏϨ㒣

⌢䌘⑤᳝䰤^[6]ˈ಴ℸˈϔѯӴᶧ⮙ࣙᣀ亳⑤ᗻ⮒⮙᮶

᳾㒇ܹ⊩ᅮ᡹ਞӴᶧ⮙ˈг᳾ᓔሩᅲ偠ᅸⲥ⌟Ǆ᭤⌢

ⱘ໮᭄⮙ॳᅲ偠ᅸᇍ᠔䞛䲚ⱘ㉾֓ᷛᴀҙᓔሩᐌ㾘ⱘ ᆘ⫳㰿ǃ⮙↦੠㒚㦠՟བ≭䮼㦠੠ᖫ䌎㦠ˈԚϡࣙᣀ ᔃ᳆㦠Ẕ⌟Ǆ

ᴀⷨお⫼

PCR

⊩ᇍ᭤⌢ϸϾЏ㽕⮙ॳᅲ偠ᅸⱘҎ

㉏㉾֓ᷛᴀ䖯㸠ᔃ᳆㦠

Campylobacter

Ẕ⌟Ǆ

᭤⌢Ҏ㉏㉾֓ᷛᴀЁᔃ᳆㦠Ẕ⌟

Aruna Devi

^a

, Jenny Wilkinson

^a

, Timothy Mahony

^b

੠Thiru Vanniasinkam

^a

䗮䆃԰㗙˖Thiru Vanniasinkam (e-mail: [email protected])Ǆ

ᴤ᭭Ϣᮍ⊩

ᴀⷨお䗮䖛ᶹᇨᮃ⡍໻ᄺҎ㉏Ӻ⧚ྨਬӮ੠᭤⌢ि⫳

䚼೑ᆊⷨおӺ⧚ྨਬӮⱘᅵᡍǄ

ᷛᴀ䞛䲚

2 0 1 2

ᑈ

1 2

᳜ Ё ᯀ 㟇

2 0 1 3

ᑈ

2

᳜ ᑩ ҹ ঞ

2013

ᑈ

6

㟇

7

᳜ˈ೼ԡѢ᭤⌢Ё䚼ⱘ㢣⪺੠㽓䚼ⱘࢇ ᠬवⱘ

2

ϾЏ㽕ए䰶⮙ॳᅲ偠ᅸ݅ᬊ䲚

408

ӑ㝍⋏⮙

՟㉾֓ᷛᴀˈ݊Ё

208

ӑᴹ㞾㢣⪺ˈ

200

ӑᴹ㞾ࢇᠬ वǄᑈ啘੠ᗻ߿ֵᙃҢᅲ偠ᅸ㉾֓ᷛᴀⱏ䆄Ё᠟Ꮉ ᡘᔩ˗಴ফᯊ䯈੠䆓䯂䰤ࠊˈ᳾㛑㦋পࠄ᠔᳝ᷛᴀ ⱘⳌֵ݇ᙃǄ

ᷛᴀ䞛䲚ৢᬒܹ᮴㦠ᆍ఼ˈ㕂ѢބЁ㹿䖤䗕㟇᭤

⌢೑ゟ໻ᄺⱘᅲ偠ᅸ䖯㸠PCRẔ⌟Ǆ2Ͼए䰶ᅲ偠ᅸ೼

ᅠ៤ᐌ㾘ᖂ⫳⠽Ẕ⌟ৢेᇚᷛᴀᦤկ㒭ᴀⷨおՓ⫼ˈ ᬊࠄᷛᴀৢˈ㢣⪺ए䰶ᅲ偠ᅸ೼4–6ᇣᯊݙǃࢇᠬवए 䰶ᅲ偠ᅸ೼8–10ᇣᯊݙᇚ݊䗕㟇᭤⌢೑ゟ໻ᄺǄ

DNA

ᦤপ

⫼

Norgen

㉾֓

DNA

䆩ࠖⲦࡴᣓ໻

Norgen Biotek

݀ৌ

㞾㉾֓ᷛᴀЁᦤপᘏ

DNA

Ǆপ

200μl

㉾֓ᷛᴀ㕂Ѣ

2ml

ⱘ

Eppendorf

ㅵЁˈ

70°C

ࡴ⛁

10

ߚ䩳Ǆᣝ✻ѻક䇈ᯢк 䖯㸠

DNA

ᦤপǄ

DNA

ⱘ᳔㒜⋫㜅ԧ⿃Ў

100μl

Ǆᦤপৢ

ⱘ

DNA

೼

–20°C

ބㆅֱᄬᕙẔǄ

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WPSAR Vol 5, No 4, 2014 | doi: 10.5365/wpsar.2014.5.2.007 www.wpro.who.int/wpsar

2

Deviㄝ

᭤⌢ᔃ᳆㦠

䅼䆎

ᴀ ᭛ ᡹ ਞ њ 㞾

2012ᑈ12᳜ Ё ᯀ ࠄ2013ᑈ 2᳜ ҹ ঞ 2013ᑈ6–7᳜䞛䲚ⱘ᭤⌢㝍⋏⮙՟㉾֓ᷛᴀЁẔߎᔃ

᳆㦠ⱘⷨお㒧ᵰǄᴀⷨおЁˈ໮᭄59%㝍⋏⮙՟ⱘ Јᑞ㉾֓ᷛᴀৃẔߎᔃ᳆㦠Ǆ䖭ϔⷨお㒧ᵰϢ೼⋄೑

ⱘ㕢೑ݯџҎਬ෍䆁Ёⱘⷨお㒧ᵰⳌԐ^[8]Ǆ

ᴀⷨおЁᔃ᳆㦠

PCR

⹂䆞⮙՟ⱘᑈ啘ߚᏗϢ೼

݊ҪথሩЁ೑ᆊ᠔ᓔሩⱘⷨお㒧ᵰⳌԐˈ

5

ቕҹϟܓ ス೼⮙՟Ёऴ䕗催↨՟^[5]Ǆ偀ᢝ㓈ⱘϔ乍ⷨおথ⦄ˈ

21%

ⱘ

5

ቕҹϟ㝍⋏⮙՟Ўᔃ᳆㦠ᛳᶧˈ

14%

ⱘ᮴⮛⢊

ܓスৃẔߎᔃ᳆㦠^[9]Ǆܓスߎ⦄㝍⋏⮛⢊ৢˈᆊ䭓᳈

ᜓᛣᏺᄽᄤህएˈ಴ℸˈܓス㝍⋏⮙՟ⱘ㉾֓ᷛᴀ㒣 ᐌӮ㹿䗕㟇⮙ॳᅲ偠ᅸ䖯㸠Ẕ⌟Ǆ

᭤⌢ᔃ᳆㦠ⱘᛳᶧᴹ⑤ᇮϡ⏙ἮǄᏆথ⦄Ԣ∈ᑇ ⱘ亳⠽໘⧚ᡔᴃ੠亳કि⫳Ў㝍⋏⮙ⱘॳ಴ˈ⌕㸠⮙

ᄺ䇗ᶹгথ⦄佂⫼⫳⠯ཊ^[9]੠亳⫼᳾❂❳៪ফ∵ᶧⱘ

⾑㙝^[10]ৃᇐ㟈ᔃ᳆㦠ᛳᶧǄ䖭ৃ㛑䛑ᰃ᭤⌢㝍⋏⮙⌕

㸠ⱘॅ䰽಴㋴Ǆ

ᔃ᳆㦠ᛳᶧⱘ⹂䆞䗮ᐌ䞛⫼㒚㦠෍ݏⱘᮍ⊩ˈ

᳝ᯊ䞛⫼

PCR

⊩^[10]Ǆ

PCR

⊩ⱘӬ⚍೼Ѣৃҹ೼Јᑞᷛ

ᴀЁẔ⌟Ꮖ⅏ⱘᔃ᳆㦠ˈ䖭ᇍ೼ᙊࡷᴵӊϟټᄬⱘᷛ

ᴀⱘẔ⌟ᴹ䇈ᕜ䞡㽕ǄⳂࠡˈ᭤⌢ⱘ⮙ॳᅲ偠ᅸᑊ᳾

ᇚᔃ᳆㦠Ẕ⌟԰Ў㝍⋏ᷛᴀⱘᐌ㾘Ẕ⌟ݙᆍǄህᴀ᭛

԰㗙᠔ⶹˈᴀⷨおᰃ᭤⌢㄀ϔϾ೼㝍⋏ᷛᴀЁ䇗ᶹᔃ

᳆㦠⌕㸠⥛ⱘⷨおǄ

ᴀⷨおথ⦄᭤⌢㝍⋏⮙՟Ёᔃ᳆㦠⌕㸠⥛䕗催ˈ 䖭ϔ㒧ᵰ䳔㽕䴴䖯ϔℹⱘ䇗ᶹⷨおএ䆕ᅲǄ᳾ᴹⱘⷨ

おᑨ㒇ܹعᒋҎ㕸ˈҹ⹂ᅮ᭤⌢ϔ㠀Ҏ㕸ⱘᔃ᳆㦠ᨎ

PCR

Ẕ⌟ᔃ᳆㦠

⫼ ᮶ ᕔ ⷨ お ᠔ ⫼ ᓩ ⠽

1 6 S r R N A

⡍ ᓖ ෎ ಴ ⠛ ↉

C 4 1 2 F 5

ÿ

- G G ATA C A C T T T T C G G A G C - 3

ÿ ੠

C1288R5ÿ-CATTGTAGCACGTGTGTC-3ÿ䖯㸠PCRᠽ

๲^[7]Ǆ↣ϾPCRডᑨㅵ25μlࡴܹ԰ЎPCRডᑨ㓧ކ

⎆ⱘGoTaq® Green Master Mix㕢೑Promega݀ৌˈ

৿᳝400μM dATP400μM dGTP400μM dCTP3mM

MgCl

₂੠↣⾡ᓩ⠽৘50μMǄ῵ᵓ'1$嘕O೼PCRᠽ๲

ҾEppendorfϞᠽ๲35Ͼᕾ⦃ˈᠽ๲ᴵӊЎ˖94°C বᗻ5ߚ䩳ˈ58°C䗔☿30⾦ˈ72°CᓊԌ1ߚ䩳ˈ᳔ৢ

೼72°CᓊԌ5ߚ䩳^[7]ǄPCRᠽ๲ѻ⠽㒣1%⨐㛖㊪ޱ㛊

⬉⋇ǃ⒈Э䬁ᶧ㡆ৢ೼㋿໪♃ϟ䖯㸠㾖ᆳǄ᠔᳝PCR 䆩偠ഛՓ⫼ぎ㙴ᔃ᳆㦠Campylobacter jejuniNCTC

11351԰Ў䰇ᗻᇍ✻ˈᑊ䆒䰈ᗻᇍ✻Ǆࠨ䰸䰈ᗻᇍ✻

㒧ᵰЎ䰇ᗻⱘ䆩偠㒧ᵰǄ᳾ᇍᔃ᳆㦠䰇ᗻᷛᴀخ䖯ϔ ℹⱘ㦠⾡䡈ᅮǄ

㒧ᵰ

㒣PCRẔ⌟ˈ408ӑ㉾֓ᷛᴀ㢣⪺ᷛᴀ208ӑǃࢇᠬ वᷛᴀӑЁⱘ241ӑ59.1%Ўᔃ᳆㦠䰇ᗻǄ㢣

⪺ᷛᴀⱘ䰇ᗻ⥛n=141ӑ67.8%ᰒ㨫催Ѣࢇᠬव n=100ӑ50%P<0.008Ǆ

229

Ͼᷛᴀ᳝ᑈ啘ֵᙃˈ

236

Ͼᷛᴀ᳝ᗻ߿ֵᙃ

⬋ᗻ

132

Ҏˈཇᗻ

104

ҎǄ㢣⪺੠ࢇᠬव⮙՟ⱘ ᗻ߿੠ᑈ啘ߚᏗ≵᳝ᰒ㨫Ꮒᓖ

P

ؐߚ߿Ў

0.982

੠

0.357

Ǆ ሑ ㅵ ⬋ ᗻ ⮙ ՟ ᷛ ᴀ Ё ᔃ ᳆ 㦠 Ẕ ߎ ⥛ 䕗 ཇ ᗻ ⮙ ՟ 催 ⬋ ᗻ Ў

55.3%

ˈ ཇ ᗻ Ў

44.7%

ˈ Ԛ Ѡ 㗙 ⱘ Ꮒ ᓖ ᮴ 㒳䅵 ᄺ ᛣ Н

P = 0 . 1 2 5

Ǆ

0 – 4

ቕ 㒘 ⮙ ՟ ᷛ ᴀ ⱘ ᔃ ᳆ 㦠 Ẕ ߎ ⥛ ᳔ 催

21.6%

ˈ݊⃵Ў

15–34

ቕ㒘

15%

㸼

1

Ǆ

㸼ᔃ᳆㦠䰇ᗻᷛᴀⳌᑨ⮙՟ⱘᑈ啘੠ᗻ߿ߚᏗQ ӑ

ᑈ啘㒘ቕ Ẕ⌟

ᷛᴀ᭄

ড়䅵 ⬋ ཇ

䰇ᗻ᭄ 䰇ᗻ↨՟% 䰇ᗻ᭄ 䰇ᗻ↨՟% 䰇ᗻ᭄ 䰇ᗻ↨՟%

0–4 45 43 21.6 30 27.3 13 14.6

5–14 19 16 8.0 8 7.3 8 9.0

15–24 33 29 14.6 13 11.8 16 18.0

25–34 36 31 15.6 17 15.5 14 15.7

35–44 29 21 10.6 15 13.6 6 6.7

45–54 27 22 11.1 8 7.3 14 15.7

55–64 24 22 11.1 14 12.7 8 9.0

65–74 14 14 7.0 5 4.5 9 10.1

75 ቕঞҹϞ 2 1 0.5 0 0.0 1 1.1

ড়䅵 199 100.0 110 55.3 89 44.7

* 42Ͼ䰇ᗻᷛᴀⱘ⮙՟ᑈ啘੠ᗻ߿ֵᙃϡ䆺Ǆ

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WPSAR Vol 5, No 4, 2014 | doi: 10.5365/wpsar.2014.5.2.007

www.wpro.who.int/wpsar

3

᭤⌢ᔃ᳆㦠 Deviㄝ

খ㗗᭛⤂

1. Strachan NJC, Forbes KJ. The growing UK epidemic of human campylobacteriosis. Lancet, 2010, 376:665–667. doi:10.1016/

S0140-6736(10)60708-8 pmid:20663545

2. Islam Z et al. Comparative population structure analysis of Campy- lobacter jejuni from human and poultry origin in Bangladesh. Eu- ropean Journal of Clinical Microbiology & Infectious Diseases, 2014, 33:2173–2181. doi:10.1007/s10096-014-2184-x pmid:24962195

3. Randremanana RV et al. Campylobacter infection in a cohort of rural children in Moramanga, Madagascar. BMC Infectious Diseases, 2014, 14:372. doi:10.1186/1471-2334-14-372 pmid:24996559

4. Ministry of Health Annual Report 2011. Suva, Ministry of Health, 2011 (http://health.gov.fj, accessed 3 December 2014).

5. Mshana SEJM et al. Campylobacter spp among children with acute diarrhea attending Mulago hospital in Kampala–Uganda. African Health Sciences, 2009, 9:201–205. pmid:20589152

6. Dunn JP et al. Laboratory-based Salmonella surveillance in Fiji, 2004–2005. Pacific Health Dialog, 2005, 12:53–59.

pmid:18181494

7. Inglis GD, Kalischuk LD. Use of PCR for direct detection of Campylobacter species in bovine feces. Applied and Environ- mental Microbiology, 2003, 69:3435–3447. doi:10.1128/

AEM.69.6.3435-3447.2003 pmid:12788747

8. Tribble DR et al. Diagnostic approach to acute diarrhoeal illness in a military population on training exercises in Thailand, a re- gion of campylobacter hyperendemicity. Journal of Clinical Mi- crobiology, 2008, 46:1418–1425. doi:10.1128/JCM.02168-07 pmid:18234869

9. Mason J et al. Campylobacter infection in children in Malawi is common and is frequently associated with enteric virus co- infections. PLoS ONE, 2013, 8:e59663. doi:10.1371/journal.

pone.0059663 pmid:23555739

10. Newell DG et al. Food-borne diseases - the challenges of 20 years ago still persist while new ones continue to emerge. Interna- tional Journal of Food Microbiology, 2010, 139 Suppl 1;S3–15.

doi:10.1016/j.ijfoodmicro.2010.01.021 pmid:20153070

ᏺ⥛Ǆᇍϔ㠀Ҏ㕸᠔ᨎᏺⱘᔃ᳆㦠㦠⾡ⱘ䡈ᅮгᕜ᳝

ᖙ㽕Ǆℸ໪ˈ⹂䅸ᔃ᳆㦠䰇ᗻⱘ㝍⋏⮙՟ᷛᴀЁᰃ৺

ᄬ೼݊Ҫ⮙ॳгᕜ᳝ӋؐǄᴀⷨお᳾ᇍᔃ᳆㦠੠≭䮼㦠៪݊Ҫ⮙ॳ݅ৠᛳᶧⱘᚙމخⷨおǄ

ᘏПˈᴀⷨお㒧ᵰ㸼ᯢˈᔃ᳆㦠ᛳᶧ೼᭤⌢䕗Ў ᱂䘡ˈ䖭Ϣ݊ҪথሩЁ೑ᆊ੠থ䖒೑ᆊⱘᚙމⳌԐǄ

෎䞥

ᴀⷨお⬅▇໻߽Ѯᶹᇨᮃ⡍໻ᄺCOMPACT༪ᄺ䞥ҹঞ

᭤⌢೑ゟ໻ᄺएᄺǃᡸ⧚੠ि⫳⾥ᄺᄺ䰶Aruna Deviम

຿⫳乍Ⳃᦤկ㒣䌍䌘ࡽǄ

߽Ⲟކさ

᳾⬇᡹Ǆ 㟈䇶

ᛳ䇶᭤⌢ि⫳䚼ᡍޚᴀⷨおˈᛳ䇶᭤⌢೑ゟ໻ᄺएᄺ 䰶ᦤկᅲ偠ᅸ䆒ᮑˈᛳ䇶㢣⪺੠ࢇᠬवⱘ⮙ॳᅲ偠ᅸ ᖂ⫳⠽䚼ᦤկᷛᴀǄ

ᓩ⫼ᴀ᭛ഄഔ˖

Devi A et al. Detection of Campylobacter in human faecal samples in Fiji. Western Pacific Surveillance and Response Journal, 2014, 5(4):30–33. doi:10.5365/