北京市2015-2017年猩红热及咽部感染患者A组链球菌超抗原基因特征研究  

Study on the super-antigen genes of group A Streptococcus pyogenes strains isolated from patients with scarlet fever and pharyngeal infection, in Beijing, 2015-2017

作　　者：马春娜[1] 彭晓旻[1] 吴双胜[1] 张代涛[1] 赵佳琛[1] 卢桂兰[1] 潘阳[1] 崔淑娟[1] 刘医萌[1] 石伟先[1] 张漫[1] 王全意[1] 杨鹏[1] Ma Chunna;Peng Xiaomin;Wu Shuangsheng;Zhang Daitao;Zhao Jiachen;Lu Guilan;Pan Yang;Cui Shujuan;Liu Yimeng;Shi Weixian;Zhang Man;Wang Quanyi;Yang Peng(Beijing Municipal Center for Disease Control and Prevention,Beijing Research Center for Preventive Medicine,Beijing 100013,China)

机构地区：[1]北京市疾病预防控制中心北京市预防医学研究中心,100013

出　　处：《中华流行病学杂志》2018年第10期1375-1380,共6页Chinese Journal of Epidemiology

基　　金：北京市卫生系统高层次卫生技术人才培养计划项目（2013-3-098）;北京市优秀人才培养资助青年拔尖个人项目（2014000021223ZK36）

摘　　要：目的分析2015－2017年北京市猩红热及咽部感染患者A组链球菌（GAS）超抗原基因特征。方法采集猩红热及咽部感染患者咽拭子标本进行GAS分离鉴定，采用实时荧光PCR法检测超抗原基因（speA、speC、speG、speH、speI、speJ、speK、speL、speM、smeZ和ssa），PCR法扩增后测序确定GAS的emm基因型别。结果2015年5月至2017年7月采集的6 801份咽拭子标本中共分离到377株GAS菌株（阳性率5.5%）。超抗原基因speC、speG、speH和speK的检出率3年间出现较明显变化。共检测到45种超抗原基因谱，占比较高的2种超抗原基因谱在emm1和emm12型间分布差异均有统计学意义（χ2=38.196，P〈0.001；χ2=72.310，P〈0.001）。超抗原speA、speH、speI和speJ在emm1和emm12型GAS间分布差异均有统计学意义（χ2=146.154，P〈0.001；χ2=52.31，P〈0.001；χ2=58.43，P〈0.001；χ2=144.70，P〈0.001）。结论2015－2017年北京市猩红热及咽部感染患者GAS超抗原基因speC、speG、speH和speK的检出率有较明显变化，speA、speH、speI和speJ在emm1和emm12基因型之间的分布存在差异，GAS菌株所携带的超抗原基因谱更宽，但主要流行谱未发生改变。Objective To analyze the characteristics of super-antigen （SAg） of group A Streptococcus pyogenes （GAS）, isolated from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017.Methods Throat swab specimens from patients with scarlet fever or pharyngeal infections were collected and tested for GAS. Eleven currently known SAg genes including SpeA, speC, speG, speH, speI, speJ, speK, speL, speM, smeZ and ssa were tested by real-time PCR while M protein genes （emm genes） were amplified and sequenced by PCR.Results A total of 377 GAS were isolated from 6 801 throat swab specimens, with the positive rate as 5.5%. There were obvious changes noticed among speC, speG, speH and speK in three years. A total of 45 SAg genes profiles were observed, according to the SAgs inclusion. There were significant differences appeared in the frequencies among two of the highest SAg genes profiles between emm1 and emm12 strains （χ2=38.196, P〈0.001; χ2=72.310, P〈0.001）. There also appeared significant differences in the frequencies of speA, speH, speI and speJ between emm1 and emm12 strains （χ2=146.154, P〈0.001; χ2=52.31, P〈0.001; χ2=58.43, P〈0.001; χ2=144.70, P〈0.001）.Conclusions Obvious changes were noticed among SAg genes including speC, speG, speH and speK from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. SAg genes including speA, speH, speI and speJ appeared to be associated with the emm 1 and emm 12 strains. More kinds of SAg genes profiles were isolated form GAS but with no significant differences seen in the main SAg genes profiles, during the epidemic period.

关 键 词：A组链球菌 猩红热 超抗原 emm基因 咽部感染 

分 类 号：R515.1[医药卫生—内科学]