广东省1例输血性恶性疟病例的实验室检测和溯源调查

摘要/Abstract

摘要：

2017年10月,广东省疾病预防控制中心报告了1例无流行病学史、近期有输血史的恶性疟病例。收集患者的临床资料,并开展流行病学溯源调查,采集患者和供血者血样进行疟疾快速试验（RDT检测）、血涂片镜检和巢式PCR检测,并对阳性血样进行分子溯源和裂殖子表面蛋白基因分型。结果表明,患者与其中1位供血者在RDT检测和PCR检测中,均为恶性疟原虫阳性。两者血样核糖体小亚基（SSU） rRNA基因序列同源性为100%,且均为恶性疟原虫K1型,确定该患者的恶性疟确因输入该供血者的血液而感染。

关键词: 疟疾, 恶性疟原虫, 输血, 传播, 溯源分析

Abstract:

A clinical case of falciparum malaria with no history of travel but a recent history of blood transfusion, was reported by Guangdong Provincial Center for Disease Control and Prevention in October 2017. We collected clinical data of the patient and carried out an epidemiological traceability survey. Blood samples were collected from the patient and 20 blood donors for malaria rapid diagnostic tests(RDT), microscopic observation of blood smears, and nested PCR. The positive specimens were traced using molecular methods and genotyped. Results of RDT and PCR tests revealed the occurrence of falciparum malaria in the patient and a donor. Their blood samples showed a 100% homology in SSU rRNA sequence, and both were infected with K1 genotype of Plasmodium falciparum. This patient was thus confirmed with Plasmodium falciparum infection via blood transfusion from a donor.

Key words: Malaria, Plasmodium falciparum, Blood transfusion, Transmission, Traceability analysis

中图分类号:

R513.3

毛强, 裴福全, 岑咏珍, 刘梦然, 张豪, 邓卓晖. 广东省1例输血性恶性疟病例的实验室检测和溯源调查[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(5): 529-533.

Qiang MAO, Fu-quan PEI, Yong-zhen CEN, Meng-ran LIU, Hao ZHANG, Zhuo-hui DENG. Laboratory testing and traceability analysis of a case of transfusion-transmitted falciparum malaria in Guangdong Province[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2018, 36(5): 529-533.

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引物名称	引物(5′→3′)	长度/bp
属特异性引物	F: CCTGTTGTTGCCTTAAACTTC	1 200
属特异性引物	R: TTAAAATTGTTGCAGTTAAAACG
种特异性引物恶性疟原虫	F: TTAAACTGGTTTGGGAAAACCA- AATATATT	205
种特异性引物恶性疟原虫	R: ACACAATGAACTCAATCATGA- CTACCCGTC
间日疟原虫	F: CGCTTCTAGCTTAATCCACATA- ACTGATAC	120
	R: ACTTCCAAGCCGAAGCAAAGA- AAGTCCTTA
三日疟原虫	F: ATAACATAGTTGTACGTTAAGA- ATAACCGC	141
	R: AAAATTCCCATGCATAAAAAA- TTATACAAA
卵形疟原虫	F: ATCTCTTTTGCTATTTTTTAGTA- TTGGAGA	800
	R: GGAAAGGACACATTAATTGTAT- CCTAGTG

扩增基因	引物	引物(5′→3′)	长度/bp
MSP1	第1轮	F: CTAGAAGCTTTAGAAGATGCAGTATTG
		R: CTTAAATAGATTCTAATTCAAGTGG- ATCA
	第2轮
	K1	F: AAATGAAGAAGAAATTACTACAAAA- GGTGC	150
		R: GCTTGCATCAGCTGGAGGGCTTGCA- CCAGA
	MAD20	F: AAATGAAGGAACAAGTGGAACAGCT- GTTAC	260~390
		R: ATCTGAAGGATTTGTACGTCTTGAAT TACC
	RO33	F: TAAAGGATGGAGCAAATACTCAAGT- TGTTG	270
		R: CAAGTAATTTTGAACTCTATGTTTTA- AATCAGCGTA
MSP2	第1轮	F: GAAGGTAATTAAAACATTGTC
		R: GAGGGATGTTGCTGCTCCACAG
	第2轮
	FC27	F: GCTTATAATATGAGTATAAGGAGAA	330~500
		R: GCATTGCCAGAACTTGAA
	3D7	F: GCTTATAATATGAGTATAAGGAGAA	200~330
		R: CTGAAGAGGTACTGGTAGA