摘要
目的了解海南省Y群脑膜炎奈瑟菌(Neisseria meningitidis,Nm)流行病学、分子特征及对抗菌药物的敏感性,为Y群流行性脑脊髓膜炎(流脑)的预防控制和治疗提供科学依据。方法对海口市2022年5月发现的2例流脑病例患者血液标本和密切接触者咽拭子进行脑膜炎奈瑟菌分离培养、生化和普通聚合酶链反应种属鉴定,将得到的Nm用玻片凝集法和荧光聚合酶链反应进行血清分群和基因分群;用二代全基因组测序技术对7株Nm进行全基因组测序;用E-test试纸条法进行13种抗菌药物敏感性试验。结果2例患者都是青少年。从患者和密切接触者中共获得7株Nm分离株,其中2株来自患者,5株来自密切接触者。7株Nm血清分群结果与基因分群结果一致,均是Y群Nm。所有分离株基因序列GC含量在51.84%~51.86%,序列型是ST-1655型,属于ST-23克隆群。外膜蛋白porA(P1.5-1,10-1)、porB(3-117)和fetA(F4-1)基因分型结果均一致。7株Nm的耐药相关基因序列完全相同。所有菌株对青霉素、氨苄西林、头孢噻肟、头孢曲松、美罗培南、氯霉素、阿奇霉素、米诺环素、利福平、环丙沙星、萘啶酸、左氧氟沙星敏感,对复方新诺明耐药。结论海南省已发现ST-1655型血清Y群Nm感染病例,应加强该地区流脑菌群监测,推广流脑ACWY群四价疫苗接种,防止Y群流脑发病和死亡。
Objective To understand the epidemiology,molecular characteristics,and antibiotic susceptibility analysis of Neisseria meningitidis serogroup Y(NmY)in Hainan Province,and to provide a scientific basis for the prevention,control,and therapy of meningococcal disease caused by NmY.Methods Blood samples from two patients with meningitis discovered in Haikou City in May 2022,as well as swab samples from close contacts,were subjected to Nm isolation and culture.Species identification of the suspected Nm isolates was performed using biochemical tests and conventional polymerase chain reaction.The serogroups and genogroups of Nm isolates were determined by slide agglutination and real-time PCR,respectively.Whole genome sequencing and analysis were performed on seven Nm isolates.The susceptibility to thirteen antibiotics was tested using E-test.Results Both patients were teenagers.A total of seven Nm strains were obtained from the patients and their close contacts,with two strains from the patients and five from the close contacts.The serogrouping results were consistent with the gene grouping results,all identifying the isolates as serogroup Y Nm.The GC content of all NmY isolates ranged from 51.84%to 51.86%,and all isolates belonged to sequence type ST-1655,which is part of the ST-23 clonal complex.The types of outer membrane proteins of all isolates were identical porA(P1.5-1,10-1),porB(3-117),and fetA(F4-1).The sequences of antibiotic-related genes of all isolates were identical.The isolates were all susceptible to penicillin,ampicillin,cefotaxime,ceftriaxone,meropenem,chloramphenicol,azithromycin,minocycline,rifampicin,ciprofloxacin,nalidixic acid,and levofloxacin,but resistant to trimethoprim-sulfamethoxazole.Conclusions Cases of infection with ST-1655 serogroup Y N.meningitides have been identified in Hainan Province.It is necessary to strengthen the surveillance of meningococcal disease and promote the meningococcal ACWY quadrivalent meningococcal vaccine to prevent meningococcal disease caused by NmY.
作者
王少玲
黄雅靖
李丹丹
吴庆梓
蔡英桂
邝仕壮
劳世军
马焱
WANG Shaoling;HUANG Yajing;LI Dandan;WU Qingzi;CAI Yinggui;KUANG Shizhuang;LAO Shijun;MA Yan(Hainan Provincial Center for Disease Control and Prevention,Hainan Academy of Preventive Medicine,Haikou,Hainan 571129,China)
出处
《中国热带医学》
CAS
北大核心
2024年第10期1238-1242,共5页
China Tropical Medicine
基金
海南省自然科学基金项目(No.814339)。
关键词
流行性脑脊髓膜炎
脑膜炎奈瑟菌
Y血清群
序列型
克隆群
药物敏感性
Epidemic cerebrospinal meningitis
Neisseria meningitidis
serogroup Y
sequence type
clone complex
drug sensitivity
