基于培养阴性痰血清特异性基因检测的嗜肺军团菌血清13群肺炎1例。

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Japanese journal of infectious diseases Pub Date : 2024-03-21 Epub Date: 2023-11-30 DOI:10.7883/yoken.JJID.2023.302
Junji Seto, Jun Takahashi, Mika Sampei, Tatsuya Ikeda, Katsumi Mizuta
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引用次数: 0

摘要

嗜肺军团菌血清组(SG) 1是军团病的主要病因,可通过尿抗原检测试剂盒进行诊断;然而,下呼吸道标本培养是必要的,以确定嗜肺乳杆菌SG 2-15。我们试图检测嗜肺乳杆菌sg特异性基因从培养阴性痰标本怀疑有军团病的肺炎患者。对两种针对嗜肺乳杆菌的多重PCR方法进行了改进,并检测到SG13特异性扩增子。直接测序结果显示扩增子与嗜肺乳杆菌SG13的核苷酸序列相同。根据患者的表现和临床病程(发热、肌肉疼痛、意识障碍、高c反应蛋白滴度、横纹肌溶解、低磷血症、左氧氟沙星治疗后症状改善),结合嗜肺乳杆菌sg特异性基因检测,我们怀疑为嗜肺乳杆菌SG13肺炎。嗜肺乳杆菌非sg1型肺炎由于实验室诊断困难,被认为被低估了。本研究所建立的下呼吸道标本改良多重PCR系统有可能提高嗜肺乳杆菌SG13及其他SGs所致军团病的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case of Legionella pneumophila Serogroup 13 Pneumonia Based on the Detection of Serogroup-Specific Genes in Culture-Negative Sputum.

Legionella pneumophila serogroup (SG) 1, the main cause of Legionnaires' disease, can be diagnosed using urinary antigen testing kits. However, lower respiratory tract specimen cultures are required to identify L. pneumophila SG 2-15. We attempted to detect L. pneumophila SG-specific genes in a culture-negative sputum specimen from a patient with pneumonia who was suspected to have Legionnaires' disease. Two multiplex PCR methods targeting L. pneumophila were modified and amplicons considered to be SG13 specific were detected. Direct sequencing revealed that the amplicons were identical to the nucleotide sequence of L. pneumophila SG13. Based on the presentation and clinical course (fever, muscle pain, disturbance of consciousness, high C-reactive protein titer, rhabdomyolysis, hypophosphatemia, and symptomatic improvement with levofloxacin treatment), in combination with the detection of L. pneumophila SG-specific genes, we suspected L. pneumophila SG13 pneumonia. L. pneumophila non-SG1 pneumonia is thought to be underestimated because of its difficult laboratory diagnosis. The modified multiplex PCR system for lower respiratory tract specimens revealed in this study is likely to improve the diagnosis of Legionnaires' disease caused by L. pneumophila SG13 and other SGs.

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来源期刊
CiteScore
4.50
自引率
4.50%
发文量
172
审稿时长
2 months
期刊介绍: Japanese Journal of Infectious Diseases (JJID), an official bimonthly publication of National Institute of Infectious Diseases, Japan, publishes papers dealing with basic research on infectious diseases relevant to humans in the fields of bacteriology, virology, mycology, parasitology, medical entomology, vaccinology, and toxinology. Pathology, immunology, biochemistry, and blood safety related to microbial pathogens are among the fields covered. Sections include: original papers, short communications, epidemiological reports, methods, laboratory and epidemiology communications, letters to the editor, and reviews.
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