在斯里兰卡,奇孔古尼亚伪装成登革热感染,被元基因组学揭露出来
K M Ahsanul Kabir1, Chathurani Sigera2, Sachith Maduranga1
1Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.
PloS one
|July 7, 2025
概括
在最初怀疑为登革热的患者中,元基因组测序发现了错过的 chikungunya 和登革热病毒感染. 从临床上区分这些树虫病毒具有挑战性,需要在特有地区改进诊断.
科学领域:
- 医学昆虫学 医学昆虫学
- 传染性疾病 传染性疾病
- 基因组学就是基因组学.
背景情况:
- 登革热是南亚和东南亚的主要健康问题,在爆发期间经常在没有确定的诊断的情况下进行临床治疗.
- 这种诊断缺口可能导致其他树木病毒 (如寨卡病毒和奇孔古尼亚病毒) 的错过感染.
- 甲基因组下一代测序 (mNGS) 为识别各种病原体提供了一个潜在的解决方案.
研究的目的:
- 利用mNGS来诊断模仿登革热但被常规测试遗漏的树状病毒感染.
- 调查mNGS在登革热爆发期间识别共流传或误诊的病毒感染的实用性.
主要方法:
- 来自斯里兰卡60名登革热阴性患者 (疑似登革热) 的血样本使用mNGS进行了分析.
- 核酸 (DNA和RNA) 被提取并测序.
- 对已识别的病毒序列进行了植物遗传学分析.
主要成果:
- 在5名患者中,mNGS检测到 chikungunya 病毒,在另外5名患者中检测到登革热病毒.
- 此外,还发现了一例Klebsiella肺炎感染病例.
- 临床特征和常规实验室检测无法在早期阶段可靠地区分 chikungunya 和登革热.
- 奇孔古尼亚的序列在遗传学上与邻近亚洲国家的菌株有关.
结论:
- 奇孔古尼亚可能与登革热类似,导致在资源有限的环境中误诊,依靠临床怀疑.
- 独特的临床结果和疾病进展强调了对这两种感染的准确诊断的需要.
- 开发可负担得起和易于使用的诊断工具来诊断小孔古尼亚和登革热对于流行病国家至关重要.
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