一起聚集性发热事件病原菌的分离鉴定  

Isolation and Identification of pathogen causing a cluster of fever cases

作　　者：刘媛[1] 邹自英[1] 王文博[2] 谭积善 熊杰[1] 

机构地区：[1]成都军区总医院检验科,成都610083 [2]成都军区疾病预防控制中心

出　　处：《西南国防医药》2018年第1期42-45,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：国家自然科学基金青年项目(81301445);全军医学科技青年培育项目(14QNP057);上海市医学生物防护重点实验室开放课题(SKLM1401)

摘　　要：目的对一起聚集性发热事件的病原体进行分离鉴定,为今后类似事件的预防和诊断提供参考。方法 2017年8月,某部报告营区内出现不明原因群体性发热病例。发病后第2~3 d,医院收治8例发热病例,采集其咽拭子标本,分别进行呼吸道病毒核酸荧光定量PCR检测、细菌学涂片、细菌分离培养和鉴定及药敏试验。结果 8例咽拭子标本中,6例血培养分离出溶血性链球菌,经全自动微生物分析仪鉴定为停乳链球菌似马亚种。药敏实验发现该菌株耐药性较低,对青霉素、氨苄西林、环丙沙星等常用抗生素均较为敏感,对红霉素、克林霉素、四环素耐药。患者经阿莫西林或左氧氟沙星治疗,症状消失,细菌复检为阴性。结论引起这次聚集性发热事件的病原菌为乙型溶血性停乳链球菌似马亚种,细菌分离株耐药性较低。Objective To isolate and identify the pathogen that has caused a cluster of fever cases and to provide reference for future prevention and diagnosis in case of similar events. Methods In August 2017, the occurrence of a cluster of fever cases of unknown origin in a camp was reported by a military unit. On the 2-3rd d after the outbreak of fever, eight patients with fever were admitted to our hospital, the throat swab specimens were collected from these patients, and the quantitative real time polymerase chain reaction （PCR） detection for the nuclei acid of viruses associated with respiratory infection, the preparation of bacteriological smears, the isolation, cultivation and identification of bacteria and the antimicrobial susceptibility test were performed respectively. Results Among the eight throat swab specimens, strains of streptococcus hemolyticus were isolated from the blood culture of six specimens and identified by automatic microorganism analyzer as streptococcus dysgalactiae subspecies equisimilis. The antimicrobial susceptibility test suggested that these strains had low drug resistance and they were sensitive to penicillin, ampicillin, ciprofloxacin and other commonly used antibiotics and resistant to erythromycin, clindamycin and tetracycline. After treatment with amoxicillin or levofloxacin, patients recovered from symptoms and the bacterial re-examination turned out to be negative. Conclusion The pathogen that has caused this cluster of fever cases is beta-hemolytic streptococcus dysgalactiae subspecies equisimilis and the bacterial isolates have low drug resistance.

关 键 词：聚集性发热事件 停乳链球菌似马亚种 分离 鉴定 诊断 

分 类 号：R446[医药卫生—诊断学]