The epidemic of Q fever in 2018 to 2019 in Zhuhai city of China determined by metagenomic next-generation sequencing.
The epidemic of Q fever in 2018 to 2019 in Zhuhai city of China determined by metagenomic next-generation sequencing.
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DOI：
10.1371/journal.pntd.0009520
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发表时间：
2021-07
影响因子：
3.8
通讯作者：
Xia J
中科院分区：
文献类型：
--
作者：
Huang M;Ma J;Jiao J;Li C;Chen L;Zhu Z;Ruan F;Xing L;Zheng X;Fu M;Ma B;Gan C;Mao Y;Zhang C;Sun P;Liu X;Lin Z;Chen L;Lu Z;Zhou D;Wen B;Chen W;Xiong X;Xia J
Q 热是由伯内氏立克次体 (Cb) 引起的世界性人畜共患病。 2018年1月至2019年11月，采用宏基因组二代测序（mNGS）对中国珠海市一家医院2382名不明原因急性发热患者的血浆样本进行了检测。在接受检测的患者中，138 名患者 (5.8%) 根据 mNGS 检测到的 Cb 基因组 DNA 被诊断为 Q 热。其中，2018年11月至2019年3月期间出现78例（56.5%），提示Q热爆发。选取暴发期间发生的55例具有详细临床信息的病例进行进一步分析。来自 Cb-mNGS 阳性患者的绝大多数血浆样本在 Cb 特异性定量聚合酶链反应 (n = 38) 和/或间接免疫荧光测定 (n = 26) 中呈阳性。手机追踪数据用于确定疫情期间的感染区域。这表明可能的感染源是珠海市唯一官方授权屠宰场感染CB的山羊和牛。基于基因组序列的系统发育分析表明，在患者、山羊和牛中鉴定的Cb菌株形成一个分支，与以从山羊中分离的菌株为主的Cb基因组群关系最密切。我们的研究表明，Q热于2018-2019年在珠海市流行，这是中国当代城市首次确诊的Q热流行。一般来说，由伯内特立克次体引起的急性Q热的临床诊断是基于血清学方法，检测身体产生的抵抗感染的抗体。然而，感染和产生抗体之间的滞后时间限制了使用这种方法的早期诊断。在此，我们利用临床宏基因组下一代测序 (mNGS) 和手机定位数据，确认了中国当代城市珠海存在人类 Q 热疫情。我们的研究结果表明，珠海市唯一官方授权屠宰场感染Cb的山羊和牛可能是Q热疫情的感染源。更重要的是，我们证明 mNGS 是快速有效地应对急性细菌感染的公共卫生反应的有用工具。
Q fever is a worldwide zoonosis caused by Coxiella burnetii (Cb). From January 2018 to November 2019, plasma samples from 2,382 patients with acute fever of unknown cause at a hospital in Zhuhai city of China were tested using metagenomic next-generation sequencing (mNGS). Of those tested, 138 patients (5.8%) were diagnosed with Q fever based on the presence of Cb genomic DNA detected by mNGS. Among these, 78 cases (56.5%) presented from Nov 2018 to Mar 2019, suggesting an outbreak of Q fever. 55 cases with detailed clinical information that occurred during the outbreak period were used for further analysis. The vast majority of plasma samples from those Cb-mNGS-positive patients were positive in a Cb-specific quantitative polymerase chain reaction (n = 38) and/or indirect immunofluorescence assay (n = 26). Mobile phone tracing data was used to define the area of infection during the outbreak. This suggested the probable infection source was Cb-infected goats and cattle at the only official authorized slaughterhouse in Zhuhai city. Phylogenic analysis based on genomic sequences indicated Cb strains identified in the patients, goat and cattle were formed a single branch, most closely related to the genomic group of Cb dominated by strains isolated from goats. Our study demonstrates Q fever was epidemic in 2018–2019 in Zhuhai city, and this is the first confirmed epidemic of Q fever in a contemporary city in China. Generally, the clinical diagnosis of acute Q fever, which is caused by Coxiella burnetii, is based on serologic methods that detect the presence antibodies produced by the body to fight the infection. However, the lag time between becoming infected and production of antibodies limits early diagnosis using this method. Here, we confirmed an epidemic of human Q fever in Zhuhai, a contemporary city in China, using clinical metagenomic next-generation sequencing (mNGS) and cell phone location data. Our results indicate that Cb-infected goats and cattle at the only official authorized slaughterhouse in Zhuhai were the likely infection source for the Q fever epidemic. More importantly, we demonstrate that mNGS is a useful tool for rapid and effective public health responses to acute bacterial infections.
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DOI：
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发表时间：
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影响因子：
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