摘要
目的分析新生儿感染B族链球菌(group B streptococcus,GBS)的临床情况与毒力基因的分布及多位点序列分型(multilocus sequence typing,MLST)的关系。方法选取2017年1月至2019年9月广东省妇幼保健院收治的发生B族链球菌感染的患儿为研究对象,共27例。使用血清凝集法和MLST对菌株进行血清以及基因分型,并根据血清分型分为血清Ⅲ型组与其他型组;PCR检测菌株4种毒力基因(fbsA、ScpB、lmb和hylB);收集27例新生儿临床情况。结果27例新生儿中,分离出B族链球菌27株;血清Ⅲ型组中男10例,女5例,Ⅲ型15株(55.6%);其他型组中男8例,女4例,Ⅰa型1株(3.7%)、Ⅰb型3株(11.1%)、Ⅱ型5株(18.5%)和Ⅴ型3株(11.1%);两组新生儿的性别、出生体质量、白细胞计数及C-反应蛋白比较,差异均无统计学意义(均P>0.05)。血清Ⅲ型组发生早发型败血症10例,晚发型败血症5例、降钙素原>2.0μg/ml的有15例、脑脊液葡萄糖<2.5 mmol/L的有10例、脑脊液蛋白>450 mg/L的有14例、平均住院天数为26 d,其他型组分别为12例、0例、8例、2例、6例、10 d;两组各项比较,差异均有统计学意义(均P<0.05)。MLST分型显示:ST17为11株,占总数的40.74%(11/27),并且ST17均检出4种毒力基因。结论新生儿GBS脑膜炎感染以ST17为主,ST17同时携带fbsA、ScpB、lmb和hylB 4种毒力基因。
Objective To analyze the relationship of the clinical conditions of neonates infected by group B streptococcus(GBS)with distribution of virulence genes and multilocus sequence typing(MLST).Methods Twenty-seven neonates infected with GBS treated at our hospital from January,2017 to September,2019 were selected as the study objects.The serum agglutination method and MLST were used to confirm the strains'serum typing and genotyping.According to the serum types,the strains were divided into a serum typeⅢgroup and an other type group.The virulence genes,fbsA,ScpB,lmb,and hylB,were detected by PCR.The 27 neonates'clinical data were collected.Results Twenty-seven strains of GBS were isolated from the 27 neonates.There were 10 males and 5 females and 15 strains(55.6%)in the serum typeⅢgroup.There were 8 males and 4 females in the other type group.In the other type group,1 strain(3.7%)was typeⅠa,3(11.1%)typeⅠb,5(18.5%)typeⅡ,and 3(11.1%)typeⅤ.There were no statistical differences in gender,birth weight,white blood cell count,and C-reactive protein between the two groups(all P>0.05).In the serum typeⅢgroup and the other type group,10 and 12 cases occurred early onset sepsis,5 and 0 got late onset sepsis,15 cases'and 8 cases'procalcitonin levels were over 2.0μg/ml,10 cases'and 2 cases'cerebrospinal fluid glucose was less than 2.5 mmol/L,and 14 cases'and 6 cases'cerebrospinal fluid protein was over 450 mg/L,with statistical differences(all P<0.05).The average hospital stay was 26 d in the serum typeⅢgroup and 10 d in the other type group,with a statistical difference(P<0.05).MLST showed that 11 strains were ST17,accounting for 40.74%(11/27)of the total number,and four virulence genes were detected in all the ST17.Conclusion ST17 strain,which carries fbsA,ScpB,lmb,and hylB,is the main virulence gene of neonatal GBS meningitis.
作者
麦荣嘉
李碧婷
马丹娟
欧阳凯
邓文喻
穆小萍
Mai Rongjia;Li Biting;Ma Danjuan;Ouyang Kai;Deng Wenyu;Mu Xiaoping(Guangdong Province Maternal and Child Health Hospital,Guangzhou 510100,China)
出处
《国际医药卫生导报》
2021年第9期1321-1324,共4页
International Medicine and Health Guidance News
基金
广州市科技创新委员会项目(201804010447)。
