中国寄生虫学与寄生虫病杂志 ›› 2018, Vol. 36 ›› Issue (2): 199-封三.

• 研究简报 • 上一篇    

人体感染曼氏迭宫绦虫成虫的病原体鉴定和流行病学分析

张玲玲1, 吴斌2, 丰燕1, 骆小君2, 陈华良1, 潘金仁1, 阮卫1, 姚立农1,*()   

  1. 1 浙江省疾病预防控制中心,杭州 310051
    2 金华市疾病预防控制中心,金华 321002
  • 收稿日期:2017-09-07 出版日期:2018-04-28 发布日期:2018-04-24
  • 通讯作者: 姚立农

Pathogen identification and epidemiological analysis in a case of human infection with adult Spirometra mansoni

Ling-ling ZHANG1, Bin WU2, Yan FENG1, Xiao-jun LUO2, Hua-liang CHEN1, Jin-ren PAN1, Wei RUAN1, Li-nong YAO1,*()   

  1. 1 Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
    2 Jinhua Municipal Center for Disease Control and Prevention, Jinhua 321002, China
  • Received:2017-09-07 Online:2018-04-28 Published:2018-04-24
  • Contact: Li-nong YAO

摘要:

对首诊为带绦虫感染的曼氏迭宫绦虫成虫感染者进行病原鉴定和流行病学分析。收集患者临床症状和体征、诊疗过程等信息资料,询问患者既往饮食史和生活习惯。使用槟榔-南瓜子对患者进行驱虫治疗。显微镜检确认患者排出虫体的头节、孕节、虫卵等形态学特征。采用PCR法扩增阔节裂头绦虫、曼氏迭宫绦虫特异性基因片段,对扩增阳性产物进行测序,并对测序序列进行BLAST分析。ELISA法检测患者血清中曼氏裂头蚴抗体。患者自述近4年来不时有虫体随粪便排出,无食生肉制品史,但有食用烧烤肉制品史。ELISA结果显示曼氏裂头蚴抗体阴性。驱虫治疗后,患者排出长2.1 m的虫体。虫体头节背腹面可见一纵行的吸槽,孕节片宽度大于长度,虫卵为长椭圆形,有卵盖。根据虫体和虫卵特征,初步判断为假叶目绦虫。PCR扩增出曼氏迭宫绦虫目的基因片段,经BLAST分析,其序列同GenBank中欧猬迭宫绦虫(曼氏迭宫绦虫同物异名)序列(GenBank登录号为AP017668.1)同源性为99%。综合患者临床特征、虫体形态、基因检测和序列分析结果,确诊该病例为曼氏迭宫绦虫成虫感染病例。

关键词: 曼氏迭宫绦虫, 成虫, 感染, PCR

Abstract:

The pathogen identification and epidemiological analysis were conducted to a patient infected with Spirometra mansoni adult worm, who was first diagnosed as Taenia infection. Information on clinical symptoms and signs, previously received diagnosis and treatment, and dietary history and habit was collected from the patient. The patient received treatment with pumpkin seeds combined with areca for deworming. The morphological characteristics of scole, gravid proglottides and eggs expelled from the patient were observed by microscopy. The specific gene fragments of Spirometra mansoni and Diphyllobothrium latum were amplified using PCR, and the amplification products were sequenced and analyzed by BLAST. The serum antibody for Sparganum mansoni was detected with ELISA. The patient reported occasional excretion of "worms" with feces in the past four years. No dietary history of raw meat products was reported, but a history of meat barbecue was noted. ELISA results showed that the serum showed negative for Sparganum mansoni-specific antibody. A worm of 2.1 m in length was expelled, with a pair of long bothria in the scolex. The width of gravid proglottid was greater than the length, and the eggs were shaped as a long oval with an egg cap. The worm was preliminarily determined to be pseudophyllidean according to the features of worm body and eggs. PCR results showed a specific band of Spirometra mansoni, and BLAST analysis revealed a 99% homology with Spirometra erinaceieuropaei (synonym of Spirometra mansoni) (GenBank accession number: AP017668.1). The case is therefore confirmed as an infection of S. mansoni based on the clinical features, morphological characteristics of the worm, and the PCR and sequencing results.

Key words: Spirometra mansoni, Adult worm, Infection, PCR

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