Epidemiological and pathobiological profiles of Clostridium perfringens infections: review of consecutive series of 33 cases over a 13-year period.
Epidemiological and pathobiological profiles of Clostridium perfringens infections: review of consecutive series of 33 cases over a 13-year period.
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发表时间：
2015
影响因子：
1.4
通讯作者：
Yuji Shindo;Y. Dobashi;T. Sakai;C. Monma;H. Miyatani;Y. Yoshida
中科院分区：
文献类型：
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作者：
Yuji Shindo;Y. Dobashi;T. Sakai;C. Monma;H. Miyatani;Y. Yoshida
背景虽然产气荚膜梭菌（C.产气荚膜杆菌）是众所周知的几种形式的肠道疾病的病原体，但精确的流行病学和病理生物学方面仍是未知的。方法回顾性分析我院2001年至2013年采集的标本培养结果。此外，对于C.在6例病例中，使用从石蜡包埋组织中提取的DNA进行基于聚合酶链反应扩增（PCR）的快速分析。结果33例患者35份标本C.产气荚膜杆菌，占0.017%（35/205，114）。33例患者中，21例出现脓毒症，7例出现菌血症。其中一例败血症病例并发致命性血管内溶血，因此，在C.产气荚膜杆菌感染（1/33）。直接致病的疾病或状态。在18名患者中鉴定出产气荚膜杆菌感染：手术或癌症干预，8名患者;癌症化疗，2名患者;非肿瘤性疾病手术或干预，6名患者;肝硬化，3名患者等。产气荚膜杆菌仅在一名死于大规模溶血的患者的组织中检测到α毒素基因;在所检查的其他5个病例中，没有毒素基因可以扩增。结论显性C.产气荚膜杆菌感染率较低，但一旦发现，应密切监测感染患者是否有由A型C引起的致命性急性溶血。产气荚膜杆菌此外，建立了基于PCR的快速检测C.通过档案病理材料进行产气荚膜杆菌和产毒素分型可用作诊断工具。
BACKGROUND Although Clostridium perfringens (C. perfringens) is well known as the causative agent of several forms of enteric disease, precise epidemiological and pathobiological aspects are still unknown. METHODS We retrospectively reviewed the culture results of samples collected in our hospital from 2001 through 2013. In addition, for the detection and toxinogenic typing of C. perfringens, polymerase-chain-reaction amplification (PCR)-based rapid analysis was performed in 6 cases using DNA extracted from paraffin-embedded tissues. RESULTS A total of 35 samples from 33 cases were positive for C. perfringens, representing an incidence of 0.017% (35/205, 114). Among 33 patients, 21 patients manifested sepsis and 7 patients had bacteremia. One of the septic cases was complicated by fatal intravascular hemolysis and thus, the prevalence was estimated at 3.0% among C. perfringens infections (1/33). The direct causative disease or state for C. perfringens infection was identified in 18 patients: surgery or intervention for cancers, 8 patients; chemotherapy for cancer, 2 patients; surgery or intervention for non-neoplastic disease, 6 patients; liver cirrhosis, 3 patients, etc. PCR-based toxinogenic typing of C. perfringens detected the alpha-toxin gene only in tissue from a patient who died of massive hemolysis; none of the toxin genes could be amplified in the other 5 cases examined. CONCLUSIONS The prevalence of overt C. perfringens infection is low, but upon detection, infected patients should be carefully monitored for fatal acute hemolysis caused by type A C. perfringens. Furthermore, PCR-based rapid detection of C. perfringens and toxinogenic typing by archival pathological material is applicable as a diagnostic tool.