广州市儿童致咽炎β溶血性链球菌的流行情况及其emm基因分型  

Prospective Surveillance of Streptococcal Sore Throat for Guangzhou Children

作　　者：丁月霞[1] 倪琼琼[1] 刘金来[1] 

机构地区：[1]中山大学第三附属医院心血管内科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2011年第3期411-414,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2008B080701023)

摘　　要：【目的】了解近期广州市儿童致咽炎β溶血性链球菌(BHS)的流行情况及其emm基因分型。【方法】对我院儿科门急诊1190例急性咽扁桃体炎的患儿进行咽拭子培养。鉴定为BHS者包括A、B、C和G组溶血性链球菌(groupA、B、C、Gstreptococcal,GAS、GBS、GCS和GGS)进行细菌组DNA的提取;通过PCR扩增emm基因并测序;其结果与NCBI和CDCHome中已知的基因序列进行同源性比对大于95%则认为是同型菌株,藉此确定其分型。【结果】在1190例符合条件的患儿咽拭子标本中[男:678例,(6.96±2.73)岁;女:512例,(6.70±2.60)岁],鉴定为BHS的共有46例(3.87%)。其中GAS、GBS、GCS和GGS分别有4例、20例、2例和20例,分别占BHS约8.7%、43.5%、4.3%和43.5%;而GAS、GBS、GCS和GGS的阳性率分别约为0.37%、1.68%、0.17%和1.68%。男患儿BHS的阳性率约为5.01%,女患儿约为2.34%,两组比较(χ2=26.431,P<0.001)有统计学意义。除了GBS外,其他BHS(GAS、GC/GS)均有emm基因表达(1000～1500bp)。经测序共有15型emm,其中4株GAS分别表达emm1和emm12(7.69%)。【结论】致咽炎GAS阳性率低于0.5%,而GBS、GGS阳性率接近2%。但GBS无emm表达,GAS表达emm1和emm12,而GCS、GGS无明确的emm优势型。[Objective] To understand carriage status of beta-hemolytic streptococci（BHS） in nasopharynx of children with acute throat infection or tonsillitis in Guangzhou recently and later to make its emm gene types.[Methods] Prospective surveillance of school children aged 4 to 15 years with pharyngitis or tonsillitis in Guangzhou during a 4-month period in 2010 an initial phase of pharyngeal swabbing to determine the prevalence of BHS carriage and then to descript the molecular epidemiology of group A streptococcal（GAS）,group B streptococcal（GBS）,group C streptococcal（GCS） and group G streptococcal（GGS） by emm typing.[Results] A total of 1 190 children were enrolled.The prevalence of GAS carriage was 0.37%,while the prevalence of GCS and GBS carriage were 0.17% and 1.68%,respectively.GGS carriage was as same as GBS.Between male group and female group,the percent of BHS culture-positive sore throat was different（χ2 = 26.431,P 〈0.001）.Of the 46 BHS isolates that emm sequence typed there were 15 emm types with no dominant types except GBS.[Conclusions] GAS culture-positive sore throat was more sparse than expected.Group B and group G streptococci were more frequently isolated in throat cultures than GAS,although their contribution to pharyngeal infection and acute rheumatic fever and rheumatic heart disease is not clear.The molecular epidemiology of pharyngeal GAS in our study differed greatly from that in industrialized nations and this has implications for GAS vaccine clinical research in our country.

关 键 词：Β溶血性链球菌 急性咽扁桃体炎 emm基因 

分 类 号：R183[医药卫生—流行病学]