切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 424 -430. doi: 10.3877/cma.j.issn.1674-0785.2023.04.011

临床研究

海南省一例足部皮肤感染海藻施万菌的鉴定分析
张冠男, 吴开丘, 曹佩佩, 陈智凌, 周晓君, 牛莉娜()   
  1. 570100 海口,海南医学院热带转化医学教育部重点实验室 海南医学院-香港大学热带传染病联合实验室
    57031 海口,海南医学院附属海南医院 海南省人民医院显微手外科
    570311 海口,海南医学院附属海南医院 海南省人民医院检验科
  • 收稿日期:2022-11-03 出版日期:2023-04-15
  • 通信作者: 牛莉娜
  • 基金资助:
    海南省科技专项资助项目(ZDYF2022SHFZ114); 国家自然科学基金项目(82060377); 2021年海南医学院研究生创新科研课题(HYYS2021A09,HYYS2021A22)

Identification and analysis of a case of foot skin infection with Schwanella algae in Hainan Province

Guannan Zhang, Kaiqiu Wu, Peipei Cao, Zhiling Chen, Xiaojun Zhou, Lina Niu()   

  1. Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Haikou 570311, China
    Department of Microsurgery, Hainan General Hospital, Hainan Hospital Affiliated to Hainan Medical University, Haikou 570311, China
    Clinical Laboratory, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, China
  • Received:2022-11-03 Published:2023-04-15
  • Corresponding author: Lina Niu
引用本文:

张冠男, 吴开丘, 曹佩佩, 陈智凌, 周晓君, 牛莉娜. 海南省一例足部皮肤感染海藻施万菌的鉴定分析[J]. 中华临床医师杂志(电子版), 2023, 17(04): 424-430.

Guannan Zhang, Kaiqiu Wu, Peipei Cao, Zhiling Chen, Xiaojun Zhou, Lina Niu. Identification and analysis of a case of foot skin infection with Schwanella algae in Hainan Province[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(04): 424-430.

目的

本研究对2022年5月海南省1例足部皮肤感染患者伤口分泌物分离培养的菌株进行鉴定并分析其耐药基因和药物敏感性。

方法

采用革兰染色方法,VITEK 2 Compat和MALDI-TOF MS质谱检测系统对分离株进行鉴定,并通过16S rRNA、gyrB基因序列和ANI进行溯源分析,同时采用肉汤稀释法开展药敏试验并进行耐药基因检测。

结果

该分离株镜检为革兰氏阴性杆菌,VITEK 2 Compat和MALDI-TOF MS质谱检测系统鉴定结果为海藻施万菌,鉴于临床鉴定系统有一定的局限性,因此进一步基于基因水平对其16S rRNA序列、gyrB保守基因和全基因组序列进行比对分析,最终溯源分析该菌株为海藻施万菌。

结论

海藻施万菌的鉴定需要临床鉴定系统结合基因水平的分子生物学方法进行,该研究首次在我国海南岛的临床病例中鉴定到1株海藻施万菌,为临床微生物实验室准确鉴定罕见人兽共患病病原菌提供了较为全面的方法学参考,同时提示海南地区临床工作人员要加强对施万菌引起的临床感染的认识和监测。

Objective

To isolate a strain of Shewanella algae from wound secretion culture of a patient with foot skin infection in Hainan Province in May 2022 and to analyze its antimicrobial resistance related genes and antimicrobial susceptibility.

Methods

A strain of Shewanella algae was isolated from a patient with foot skin infection, identified by Gram staining, VITEK 2 Compat, and matrix-assisted laser desorption ionization-time of flight mass spectrometry, and analyzed by 16S rRNA sequencing, gyrB gene sequencing, and average nucleotide identity. The antimicrobial susceptibility test and detection of resistance related genes were then carried out.

Results

Microscopic examination of the isolate revealed a Gram-negative bacillus. Since the clinical identification system has certain limitations, the 16S rRNA sequence, gyrB gene sequence, and whole genome sequence were analyzed. Finally, the strain was determined to be Shewanella algae.

Conclusion

The clinical identification system combined with molecular biology methods are required for Shewanella algae identification. This study was the first to identify a strain of Shewanella algae in a clinical case on Hainan Island in China, which provides a comprehensive methodological reference for clinical microbiology laboratories to accurately identify rare zoonotic pathogens, and clinical staff in Hainan should strengthen the understanding and monitoring of clinical infection caused by Shewanella.

图1 病人右足碾压伤口。图a为可见约12.0 cm×7.0 cm不规则椭圆形创面,创面内大量漂浮组织和脓性分泌物;图b为患者术后修复创面
图2 16S rRNA(A)和gyrB(B)序列进化树鉴定结果
图3 分离株与23种施万菌的平均核苷酸同源性
表1 药敏试验结果
表2 分离株Shewanella algae Hainan的耐药基因
1
Lemaire O N, Méjean V, Iobbi-Nivol C. The Shewanella genus: ubiquitous organisms sustaining and preserving aquatic ecosystems [J]. FEMS Microbiol Rev, 2020, 44(2): 155-170.
2
Cai J, Chen H, Thompson KD, et al. Isolation and identification of Shewanella alga and its pathogenic effects on post-larvae of abalone Haliotis diversicolor supertexta [J]. J Fish Dis, 2006, 29(8): 505-508.
3
Hong J, Steen C, Wong E, et al. Shewanella: an important, emerging and lethal pathogen in a patient with recurrent presentations of cholangitis [J]. BMJ Case Rep, 2020, 13(12): e237655.
4
Vignier N, Barreau M, Olive C, et al. Human infection with Shewanella putrefaciens and S. algae: report of 16 cases in Martinique and review of the literature [J]. Am J Trop Med Hyg, 2013, 89(1): 151-156.
5
Poovorawan K, Chatsuwan T, Lakananurak N, et al. Shewanella haliotis associated with severe soft tissue infection, Thailand, 2012 [J]. Emerg Infect Dis, 2013, 19(6): 1019-1021.
6
Holt HM, Gahrn-Hansen B, Bruun B. Shewanella algae and Shewanella putrefaciens: clinical and microbiological characteristics [J]. Clin Microbiol Infect, 2005, 11(5): 347-352.
7
Yousfi K, Bekal S, Usongo V, et al. Current trends of human infections and antibiotic resistance of the genus Shewanella [J]. Eur J Clin Microbiol Infect Dis, 2017, 36(8): 1353-1362.
8
Srinivas J, Pillai M, Vinod V, et al. Skin and soft tissue infections due to Shewanella algae-an emerging pathogen [J]. J Clin Diagn Res, 2015, 9(2): DC16-20.
9
Ng WW, Shum HP, To KK, et al. Emerging infections due to Shewanella spp.: a case series of 128 cases over 10 years [J]. Front Med (Lausanne), 2022, 9: 850938.
10
Rennie RP, Brosnikoff C, Turnbull L, et al. Multicenter evaluation of the Vitek 2 anaerobe and Corynebacterium identification card [J]. J Clin Microbiol, 2008, 46(8): 2646-2651.
11
Américo FM, Machado Siqueira LP, Del Negro GMB, et al. Evaluating VITEK MS for the identification of clinically relevant Aspergillus species [J]. Med Mycol, 2020, 58(3): 322-327.
12
Weisburg WG, Barns SM, Pelletier DA, et al. 16S ribosomal DNA amplification for phylogenetic study [J]. J Bacteriol, 1991, 173(2): 697-703.
13
Martin-Rodriguez AJ, Suarez-Mesa A, Artiles-Campelo F, et al. Multilocus sequence typing of Shewanella algae isolates identifies disease-causing Shewanella chilikensis strain 6I4 [J]. FEMS Microbiol Ecol, 2019, 95(1).
14
Jain C, Rodriguez RL, Phillippy AM, et al. High throughput ANI analysis of 90K prokaryotic genomes reveals clear species boundaries [J]. Nat Commun, 2018, 9(1): 5114.
15
Hu Y, Yang X, Qin J, et al. Metagenome-wide analysis of antibiotic resistance genes in a large cohort of human gut microbiota [J]. Nat Commun, 2013, 4: 2151.
16
Liu PY, Lin CF, Tung KC, et al. Clinical and microbiological features of Shewanella bacteremia in patients with hepatobiliary disease [J]. Intern Med, 2013, 52(4): 431-438.
17
Bauer MJ, Stone-Garza KK, Croom D, et al. Shewanella algae infections in United States Naval Special Warfare Trainees [J]. Open Forum Infect Dis, 2019, 6(11): ofz442.
18
Weiss TJ, Barranco-Trabi JJ, Brown A, et al. Case Report: Shewanella algae pneumonia and bacteremia in an elderly male living at a long-term care facility [J]. Am J Trop Med Hyg, 2021, 106(1): 60-61.
19
Davidson NL, Subedi S, Wilks K, et al. A case of Shewanella algae endocarditis: an emerging pathogen with a diverse clinical spectrum [J]. BMJ Case Rep, 2018, 2018.
20
Kitaoka M, Ishida M, Sakaeda H. Shewanella algae bacteremia in patients with biliary tract malignancy: report of three cases [J]. Nihon Shokakibyo Gakkai Zasshi, 2019, 116(10): 850-857.
21
梁胜楠, 姜祥坤, 杜银菊, 等. 2016年山东省聊城市临床病例中2种罕见施万菌的鉴定 [J]. 疾病监测, 2019, 34(9): 817-821.
22
Byun JH, Park H, Kim S. The phantom menace for patients with hepatobiliary diseases: Shewanella haliotis, often misidentified as Shewanella algae in biochemical tests and MALDI-TOF analysis [J]. Jpn J Infect Dis, 2017, 70(2): 177-180.
23
Case RJ, Boucher Y, Dahllöf I, et al. Use of 16S rRNA and rpoB genes as molecular markers for microbial ecology studies [J]. Appl Environ Microbiol, 2007, 73(1): 278-288.
24
Crosby LD, Criddle CS. Understanding bias in microbial community analysis techniques due to rrn operon copy number heterogeneity [J]. Biotechniques, 2003, 34(4): 790-794, 796, 798 passim.
25
蔡红艳, 方玉洁, 于可艺, 等. 基于16S rRNA和gyrB基因的施万菌种水平鉴定分析 [J]. 疾病监测, 2021, 36(01): 42-47.
26
Patel R, Abraham A, Thomas J, et al. A rare case of pneumonia caused by Shewanella putrefaciens [J]. Case Rep Med, 2012, 2012: 597301.
[1] 李维, 莫俊俏. 儿童呼吸道耐药流感嗜血杆菌基因型鉴定及耐药分析对抗菌药物治疗选择的意义[J]. 中华实验和临床感染病杂志(电子版), 2023, 17(05): 315-323.
[2] 尹九湖, 卢晓明, 孙科, 易忠权, 沈园园, 刘亚东. 基于16S rRNA测序分析糖尿病尿路感染者尿液菌群特征[J]. 中华实验和临床感染病杂志(电子版), 2023, 17(03): 164-172.
[3] 曹敬荣, 王岩, 谢威, 李文军, 陈典典, 段园园, 刘云屹, 闵嵘, 王培昌. 质谱技术快速鉴定临床分离丝状真菌的应用[J]. 中华实验和临床感染病杂志(电子版), 2020, 14(05): 374-379.
[4] 吴开进, 赖昌生. 人型支原体泌尿生殖道外和肺外感染诊断研究进展[J]. 中华实验和临床感染病杂志(电子版), 2019, 13(04): 269-272.
[5] 曹敬荣, 王岩, 王育英, 谢威, 陈典典, 段园园, 闵嵘, 王培昌. 神经型布鲁菌病临床特点和实验室诊断分析[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(03): 235-239.
[6] 梁浩, 谢炬平, 黄镇辉, 张大伟, 蒋小峰, 薛平. 人肝癌组织原代巨噬细胞的提取与鉴定[J]. 中华普通外科学文献(电子版), 2019, 13(03): 180-183.
[7] 陈恒, 宋振涛, 刘小盾, 曲廷瑜. 人中鼻甲来源嗅鞘细胞培养与鉴定的初步研究[J]. 中华细胞与干细胞杂志(电子版), 2019, 09(05): 262-266.
[8] 王淑慧, 刘斯琦, 邓秋连, 钟华敏, 关小珊, 黄莲芬, 高坎坎, 刘海英. MALDI-TOF MS在儿童血培养阳性病原菌快速鉴定中的应用[J]. 中华临床实验室管理电子杂志, 2021, 09(01): 53-58.
[9] 张云聪, 黄文庆, 魏俊杰, 郭天姿, 周世乔. 毛细管超速离心法在地中海贫血患者Rh血型鉴定中的运用[J]. 中华临床实验室管理电子杂志, 2020, 08(04): 237-240.
[10] 邓穗燕, 郭旭光, 何文茵, 易江华, 夏勇. 实时荧光环介导等温扩增检测毛癣菌属方法的建立[J]. 中华临床实验室管理电子杂志, 2020, 08(04): 211-216.
[11] 刘红伟, 李晓非, 苏俊华, 钱绍丽, 张建瑞, 普玨. 昆明市75例非结核分枝杆菌鉴定及药敏结果分析[J]. 中华临床实验室管理电子杂志, 2020, 08(03): 170-174.
[12] 欧阳颖仪, 陈盛强, 田丽如, 杨晓怡, 邢晓敏, 庄海明, 黄晓妃, 邓小燕. Fmr1基因敲除型小鼠肠道菌群结构分析[J]. 中华临床实验室管理电子杂志, 2020, 08(03): 158-165.
[13] 裴世静, 刘金萍, 马斌国. 山西省细菌鉴定室间质量评价结果回顾分析[J]. 中华临床实验室管理电子杂志, 2018, 06(04): 234-239.
[14] 买买提·依斯热依力, 王永康, 吾布力卡斯木·吾拉木, 阿巴伯克力·乌斯曼, 克力木·阿不都热依木. 基于16s rRNA测序分析心理应激小鼠肠道菌群结构特征[J]. 中华胃食管反流病电子杂志, 2022, 09(04): 181-186.
[15] 买买提·依斯热依力, 王永康, 阿巴伯克力·乌斯曼, 克力木·阿不都热依木. 基于16s rRNA测序分析小鼠高脂饮食诱导肥胖的肠道菌群结构特征[J]. 中华肥胖与代谢病电子杂志, 2023, 09(01): 12-16.
阅读次数
全文


摘要