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目的对1例疑似肉毒毒素中毒的婴儿病例灌肠液样品进行实验室检测并确证。方法对患儿的灌肠液样品进行肉毒梭状芽胞杆菌分离及肉毒毒素检测。结果患儿灌肠液样品TPGY培养物腹腔注射小鼠后可致小鼠出现类似肉毒毒素中毒表现(竖毛、呼吸困难并出现典型的蜂腰、四肢麻痹)继而死亡。培养物经胰酶处理后小鼠仍出现中毒并死亡,但培养物经100℃加热处理后再次染毒动物,小鼠不出现中毒和死亡。A、B、C、D、E、F六种混合型肉毒毒素诊断血清及B型单价肉毒毒素诊断血清可对小鼠起到保护作用。患儿灌肠液样品中分离到梭状芽胞杆菌,该菌经表型、生化、PCR肉毒毒素产毒基因鉴定,结果为产B型肉毒毒素的肉毒梭状芽胞杆菌。结论患儿疾病与B型肉毒毒素中毒相关。
OBJECTIVE: To test and confirm a case of infant enema sample suspected botulinum toxin poisoning. Methods The samples of enema from children were isolated from Clostridium botulinum and detected for botulinum toxin. Results The intraperitoneal injection of TPGY into the intestinal fluid of infants showed similar symptoms of botulinum toxin poisoning (vertical hair, difficulty breathing and typical paralysis of the bee and quadriplegia) and then death. After the cultures were trypsinized, the mice were still poisoned and died. However, the animals were re-exposed to heat after treatment at 100 ° C without poisoning and death. The diagnostic serotypes of six mixed botulinum toxin diagnostic serotypes and B monovalent botulinum toxin were effective to protect mice from A, B, C, D, E and F. Clostridium bacteria isolated from children’s enema samples. The bacteria were identified by phenotypic, biochemical and PCR toxin-producing genes of botulinum toxin. The result was Clostridium botulinum B type botulinum toxin. Conclusion The disease in children is related to botulinum toxin type B poisoning.