臺灣博碩士論文加值系統

鉤端螺旋體病為一高致病率及死亡率的人畜共通疾病，病原為Leptospira interrogans sensu lato。國外有許多關於貓鉤端螺旋體的血清學抗體陽性報告，且於人工感染貓隻鉤端螺旋體後偵測到鉤端螺旋體尿。由於流浪貓可能在感染鉤端螺旋體後，經由鉤端螺旋體尿將病原散播至環境中。因此，評估貓鉤端螺旋體盛行率及鉤端螺旋體尿的偵測，是相當重要的課題。為了調查台灣雲林、嘉義、台南及高雄地區，貓隻感染鉤端螺旋體的現況，本研究共收集198個貓隻血漿樣本進行顯微凝集試驗，134個血漿樣本及100個貓隻尿液樣本，以PCR進行鉤端螺旋體的偵測。結果發現，MAT之總抗體陽性率為11.11% (22/198)，主要之血清群為Shermani，顯示這些地區的貓隻曾經感染鉤端螺旋體病原。血漿PCR之總陽性率為8.96% (12/134)，可知貓於感染鉤端螺旋體後，可能發生鉤端螺旋體血症。尿液樣本進行鉤端螺旋體PCR檢測之總陽性率為70% (70/100)。此結果顯示，貓隻可能經由鉤端螺旋體尿造成公共衛生的感染疑慮。由於貓隻感染陽性率最高的血清群不僅與鼠類相同，也與人類相同。因此推測貓可能與囓齒類同為鉤端螺旋體病保菌者的角色，藉由鉤端螺旋體尿將菌體維持於自然環境中，如土壤或水源，而於重大風、水災之後造成對人類的威脅。

Leptospirosis is caused by Leptospira interrogans sensu lato. It is a zoonotic disease with high mortality and morbidity rates. In cats, antibodies against leptospires have been reported in many countries and leptospiruria may present after infection experimentally. Because stray cats might shed leptospires via leptospiruria, the prevalence of feline leptospirosis and the detection of leptospires in urine of cats is important to be determined. To investigate the current status of feline leptospirosis in Taiwan, we collected the blood from 198 cats and urine samples from 100 cats in Yunlin, Chiayi ,Tainan and Kaohsiung areas. Blood samples of cats were screened by microscopic agglutination test (MAT). Plasma and urine samples of cats were analyzed by PCR to detect the specific nucleic acid segments of leptospires. The serologic prevalence of antibody against feline leptospirosis is 11.11% (22/198), indicating cats from these areas may have contacted with leptospires. The positive rate of plasma PCR is 8.96% (12/134), which implies the possibility of leptospiremia. The result of PCR for the feline urine samples was 70% positive (70/100). It suggests that cats may cause a problem to public health via leptospiruria. Due to the main serogroup identified in cats is identical to the main serogroup of human and rodents, we presume that feline and rodents may both play the role of carriers in leptospirosis. In conclusion, cats may maintain the leptospires in environments by leptospiruria, and makes a threat to public health especially after typhoon and flood occured.

摘要 ii
Abstract iii
目錄 iv
圖次 vii
表次 ix
第一章 前言 1
第二章 文獻探討 3
第一節 鉤端螺旋體的發現及分類 3
1.1 血清學分類 4
1.2 基因型分類 6
第二節 鉤端螺旋體的病原特性 8
2.1 生物學特性 8
2.2 分子生物學特性 9
2.3鉤端螺旋體LPS的O抗原結構 10
第三節 鉤端螺旋體的致病機制及臨床症狀 11
3.1 鉤端螺旋體的致病機制 11
3.2 鉤端螺旋體病的臨床症狀 13
第四節 鉤端螺旋體病的診斷方法 15
4.1 病原體偵測 15
4.1.1 顯微鏡檢查 15
4.2 血清學診斷 19
第五節 鉤端螺旋體病的流行病學 21
5.1 台灣地區鉤端螺旋體病的流行病學 22
第三章 材料與方法 27
第一節 樣本來源及採集方法 27
1.1 血液採集 28
1.2 尿液採集 28
第二節 顯微凝集試驗 29
第三節 樣本之核酸萃取 31
3.1 血漿樣本之核酸萃取 31
3.2 尿液樣本之核酸萃取 31
3.3 陽性對照細菌株來源 32
3.4 病原核酸引子對之敏感性試驗 32
3.5 病原核酸引子對之特異性試驗 32
3.7 陽性樣本之基因選殖 33
第四節 PCR及產物純化 36
4.1 引子之選用 36
4.2 PCR反應條件 37
4.3 DNA電泳分析 38
4.4 尿液樣本與陽性對照組混合之聚合酶鏈鎖反應 38
第五節 統計分析 38
第四章 結果 39
第一節 病原核酸引子對之敏感性及特異性試驗結果 39
1.1 病原核酸引子對之敏感性試驗結果 39
1.2 病原核酸引子對之特異性試驗結果 43
第二節 顯微凝集試驗結果 47
第三節 血漿樣本聚合酶鏈鎖反應結果 53
第四節 尿液樣本聚合酶鏈鎖反應結果 56
第五節 顯微凝集試驗結果與血漿及尿液樣本聚合酶鏈鎖反應結果之比對 61
第六節 血漿及尿液樣本以聚合酶鏈鎖反應偵測血清群分類之結果 63
第七節 尿液樣本與陽性對照組混合之聚合酶鏈鎖反應結果 64
第八節 陽性樣本之基因選殖 66
第五章 討論 67
第六章 結論 73
參考文獻 74
附錄 89

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