國立臺灣大學附設動物醫院門診及檢疫區寵物犬貓腸肝螺旋桿菌群之盛行率調查

Abstract

在近二十五年，許多螺旋桿菌被發現且許多菌種被證實會感染多種動物。有些螺旋桿菌菌株具有人畜共通傳染的危險性，並會造成人類的胃炎、胃潰瘍、胃癌、肝膽系統的疾病及敗血症等病症。這些具有人畜共通傳染可能性的菌株常在犬貓測得，多引起犬貓的不顯性感染，可能是人類所面對最親近的感染源，因此有效且準確地診斷被螺旋桿菌感染的動物就顯得格外重要。在台灣，於前期研究發現檢疫區進口寵物犬貓感染腸肝螺旋桿菌群之盛行率可高達58%，且帶有具人畜共通傳染危險性的菌株，H. cinaedi與H. canis。此結果建議這些病原菌已藉由境外移入的寵物犬貓進入台灣，其中也包括了具人畜共通傳染危險性的菌株。目前尚未針對腸肝螺旋桿菌群在台灣犬貓盛行率與人畜共通傳染危險性的菌株在犬貓感染的調查研究。本研究目的即是為了解台灣地區寵物犬貓感染螺旋桿菌的情形、檢疫區之進口寵物犬貓是否持續傳入新型的螺旋桿菌及台灣地區與檢疫區之進口寵物犬貓是否帶有人畜共通傳染潛在危險性的螺旋桿菌。本研究成功建立了一套非侵入性，針對糞材樣本進行檢測的雙重聚合酶鏈鎖反應診斷方法，並利用此方法作為本研究的檢測方式。本研究從國立台灣大學附設動物醫院及檢疫區分別採集了92及361個糞材樣本進行檢測，其螺旋桿菌盛行率分別為52%及64%。在這些螺旋桿菌陽性的糞材樣本中，隨機選取共35個樣本進行序列分析。親緣性分析結果顯示，台灣地區及檢疫區的寵物犬貓均有發現具有人畜共通傳染的潛在性危險性的螺旋桿菌，例如H. canis、Helicobacter sp. Flexispira taxon 8、H. felis及兩株新型菌株。根據本研究結果顯示，在台灣地區與檢疫區的寵物犬貓感染螺旋桿菌群的情形均相當普遍，且有些菌株具有人畜共通傳染的潛在性，因此可能會危害至第一線的獸醫相關人員與飼主，也可能經由糞便的排放而汙染整個環境與水源，進而感染其他動物或人類。依據本研究之結果，應呼籲政府需強烈重視此人畜共通傳染潛在危險性螺旋桿菌的問題，並應持續監控台灣地區與檢疫區寵物犬貓感染螺旋桿菌的情形，以了解是否仍有新型且具人畜共通傳染潛在危險性的螺旋桿菌持續輸入台灣境內。未來的研究方向，應與人類醫學合作，雙向地，針對有臨床表徵的飼主及其所飼養的寵物犬貓進行病原菌的調查，以釐清螺旋桿菌是否確實會在人類與寵物間進行傳播。並利用無病原菌的犬貓實驗動物及非人類靈長類實驗動物進行致病性的研究，以釐清螺旋桿菌的致病性。

Helicobacter infections have been reported in multiple species in the past twenty five years. Some of them are demonstrated to be zoonotic and shown to induce gastritis, gastric ulcer, gastric cancer, enterohepatic disorders and septicemia in human. Nevertheless, these pathogens usually induce asymptomatic infection in dogs and cats, it is important to identify/diagnose the infected animals. A previous study demonstrated that the infectious rate of helicobacter infection was 58% for the pet dogs and cats in a quarantine center in Taiwan. Some potential zoonotic helicobacters, including H. cinaedi and H. canis were identified in positive samples. These potential zoonotic helicobacters might be imported into Taiwan through the infected pets. However, limited studies were focus on the prevalence of enterohepatic helicobacter infection in pets in Taiwan. This study will aim at (i) prevalence of enterohepatic helicobacter infection in pet dogs and cats in Taiwan, (ii) detection of newly helicobacters in the pet dogs and cats from quarantine center, (iii) and detection the potential zoonotic helicobacters in the pet dogs and cats in Taiwan or from quarantine center. A non-invasive fecal duplex PCR assay has been successfully developed and applied in this study. Fecal samples collected from 92 pets from the National Taiwan University Animal Hospital (NTUAH) and from 361 quarantined pets were screened by the fecal duplex PCR for helicobacters. The prevalence of helicobacter infection from NTUAH and quarantine center is 52% and 64% respectively. Within the helicobacter-positive samples, 35 samples were randomly selected and sequenced. Phylogenic analyses revealed that several potential zoonotic helicobacters, such as H. canis, Helicobacter sp. Flexispira taxon 8 and H. felis-like and some newly identified helicobacters were detected in the fecal samples collected from the NTUAH and quarantine center. The result of this study suggested that enterohepatic helicobacter infection is common in pets in Taiwan and in quarantine center and zoonotic helicobacters have been detected in these animals. The helicobacter-infected pets have the potential to hazard the clinicians or owners, contaminate the environment and further infect other people and animals. It is highly recommended to include the helicobacteriosis, an emerging infectious disease, in the routine health monitoring list for pets and imported animals in quarantine centers.. Further colaboration with physician to survey the zoonotic helicobacter infection in pet owner and pets will be performed to clarify the role of pets in the transmission of zoonotic helicobacters.