Case of Human Infection with Anaplasma phagocytophilum in Inner Mongolia, China
Case of Human Infection with Anaplasma phagocytophilum in Inner Mongolia, China
复制标题
内蒙古一例人类嗜吞噬细胞无形体感染病例
DOI：
10.7883/yoken.jjid.2017.450
复制
发表时间：
2018-03-01
影响因子：
2.2
通讯作者：
Ohashi, Norio
中科院分区：
文献类型：
--
作者：
Gaowa;Wulantuya;Ohashi, Norio
嗜吞噬细胞无原体是一种专性细胞内细菌，可引起人类和牲畜的发热性疾病。患者49岁，女，发热、乏力、关节痛、全身疼痛、厌食2周。随后，她参观了中国内蒙古巴彦淖尔疾病预防控制中心医院。基于分子的血液诊断分析显示，嗜吞噬胞杆菌p44 DNA阳性，但布鲁氏菌p31、斑点热组立克次体gltA、恙虫病东方体16S rDNA和埃利希体p28阴性。从患者身上获得的9个嗜吞噬细胞芽孢杆菌p44克隆的氨基酸序列相似性为44 ~ 100%，与先前从家犬（Canis familiaris）中鉴定的p44克隆的氨基酸序列密切相关。KJV64194)；BAN28309)。采用患者血清进行血清学检测，间接免疫荧光法检测对嗜吞噬细胞芽孢杆菌抗原的免疫球蛋白M （IgM）和IgG滴度分别为160和20，Western blot法检测对重组P44蛋白（rP44-1、rP44-18ES和/或rP44-47）的反应。因此，本研究结果强烈提示患者感染了嗜吞噬胞芽胞杆菌。据我们所知，这是内蒙古自治区首例人类无形体病感染病例。
Anaplasma phagocytophilum is an obligate intracellular bacterium that causes febrile illness in humans and livestock. A 49-year-old woman was suffering from feverish symptoms, fatigue, arthralgia, general body pain, and anorexia for 2 weeks. Later, she visited the Bayannur Centers for Disease Control and Prevention Hospital in Inner Mongolia, China. Molecular-based diagnostic analysis of the patient's blood revealed that A. phagocytophilum p44 DNA was positive, but Brucella omp31, spotted fever group Rickettsia gltA, Orientia tsutsugamushi 16S rDNA, and Ehrlichia p28 were negative. The amino acid sequences of 9 A. phagocytophilum p44 clones obtained from the patient shared 44-100% similarity among them and were closely related to those of previously identified p44 clones from Canis familiaris (accession no. KJV64194) and from Ixodes persulcatus tick (no. BAN28309). Serological tests using the patient's serum showed that immunoglobulin M (IgM) and IgG titers to A. phagocytophilum antigens were 160 and 20, respectively, determined using indirect immunofluorescence assay, and the reaction to recombinant P44 proteins (rP44-1, rP44-18ES, and/or rP44-47) was confirmed using Western blot analysis. Thus, the results obtained in this study strongly suggest that the patient was infected with A. phagocytophilum. To our knowledge, this is the first case of human anaplasmosis infection in the Inner Mongolia Autonomous Region.