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分子诊断和埃斯卡尔拭子样本的持续时间阳性性 在草伤寒患者的多西环林后治疗中
Rimjhim Kanaujia1, Harpreet Singh2, Kamlesh Bisht1
1Departments of Medical Microbiology.
Transactions of the Royal Society of Tropical Medicine and Hygiene
|November 23, 2024
概括
埃斯卡尔 (Eschar) 抹布在诊断草原伤寒时是有效的,即使是在多西环林治疗后. 这种方法有助于识别Orientia tsutsugamushi菌株,并在治疗后的几天内保持阳性.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 分子诊断学 分子诊断学
背景情况:
- 扫伤寒的诊断可能具有挑战性,因为伤痕并不总是存在.
- 患者经常在获得三级护理之前接受多西环林,从而使诊断复杂化.
- 在多西环林后的患者中,评估皮伤寒的替代诊断方法至关重要.
研究的目的:
- 评估埃斯卡尔扫描片在诊断多西环林治疗后呈现的患者的草地伤寒时的有用性.
- 为了比较血样和血样的诊断产量.
- 为了确定多西环林管理后,在埃斯卡尔拭子中诊断标记的持久性.
主要方法:
- 每天从草伤寒患者那里收集血液,骨擦除和骨抹面样本.
- 使用实时PCR (groEL),TaqMan探针PCR (47kDa) 和嵌套PCR (56kDa) 进行Orientia tsutsugamushi检测.
- 进行了56kDa基因的桑格序列测序和植物遗传学分析.
主要成果:
- 与血液 (63.2%) 相比,Eschar擦除显示出高阳性 (89.5%).
- 通过嵌套PCR (43.5%),47kDaPCR (39.1%) 和groELPCR (13%) 测试的Eschar拭子样本呈阳性.
- 在开始使用多西环林后的1-4天内,Eschar swab仍然呈阳性,其序列与Karp样菌株聚集在一起.
结论:
- 埃斯卡尔 (Eschar) 抹布为灌木伤寒诊断和基因定型提供了一种可行的替代方案.
- 尽管接受了多西环林治疗,但埃斯卡尔拭子的持续阳性是显著的优势.
- 这种方法支持早期和准确的诊断和菌株识别在灌木伤寒管理.
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