珠海市首例Y群流行性脑脊髓膜炎病例流行病学和病原学特征  

Epidemiological and pathogenic characteristics of the first group Y meningococcal meningitis case in Zhuhai city

作　　者：方艳梅[1] 高盛庭 刘美真[2] 杨春晓[1] 龙冬玲 魏泉德[1] Fang Yanmei;Gao Shengting;Liu Meizhen;Yang Chunxiao;Long Dongling;Wei Quande(Zhuhai Municipal Center for Disease Control and Prevention,Zhuhai 519064,Guangdong,China;Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,Guangdong,China)

机构地区：[1]珠海市疾病预防控制中心,广东珠海519064 [2]广东省疾病预防控制中心,广东广州511430

出　　处：《中国疫苗和免疫》2021年第4期398-402,共5页Chinese Journal of Vaccines and Immunization

基　　金：珠海市科技计划医疗卫生项目(一般项目)(ZH2202200072HJL);珠海市科技计划医疗卫生项目(重大项目)(ZH2201200004HJL)。

摘　　要：目的分析珠海市1例Y群流行性脑脊髓膜炎(流脑)病例流行病学和病原学特征。方法对该病例开展流行病学调查,采集病例脑脊液和密切接触者咽拭子,进行脑膜炎奈瑟菌(Neisseria meningitidis,Nm)分离培养和鉴定、药物敏感试验、全基因组测序和单核苷酸多态性(Single nucleotide polymorphism,SNP)分析。结果该病例为18岁大学生,在某酒吧工作,2020年7月22日发病。从该病例及其186名密切接触者中共获得8株Nm分离株,均鉴定为Y血清群。所有分离株基因序列GC含量在50.10%-52.01%间,序列型均为ST1655,属于cc23克隆群;基因亚型为Y:P1.5-1,10-1:F4-1:ST1655(cc23)。全基因SNP分析显示所有分离株处于同一分支。所有分离株对甲氧苄啶/磺胺甲恶唑耐药,对其他11种抗生素敏感。经采取相关预防措施后该Y群Nm传播终止。结论该病例为珠海市首例Y群Nm流脑病例,流行病学和病原学监测对病例诊断和治疗、Nm鉴定和采取控制措施起到了重要作用。Objective To identify epidemiological and pathogenic characteristics of the first group Y meningococcal meningitis(MM)case in Zhuhai city.Methods We conducted an epidemiological case investigation,collected a cerebrospinal fluid sample from the case and throat swabs from close contacts;isolated and identified Neisseria meningitidis(Nm),and conducted drug sensitivity tests,whole genome sequencing,and single nucleotide polymorphism(SNP)analyses.Results The individual was an 18-year-old university student who worked in a bar.He became ill on July 22,2020.A total of 8 Nm strains were isolated from the case and his 186 close contacts;all were serogroup Y.GC content of the gene sequences for all isolates ranged from 50.10%to 52.01%.The sequence type of all isolates was ST1655,belonging to clones complex 23(cc23).Subtypes were Y:p1.5-1,10-1:f4-1:ST1655(cc23).SNP analysis of whole genome sequences showed that all isolates clustered in the same branch.All isolates were resistant to trimethoprim/sulfamethoxazole but sensitive to 11 other antibiotics.Group Y Nm circulation was interrupted after taking relevant preventive measures.Conclusions This individual was the first group Y MM case in Zhuhai.Epidemiological and pathogenic monitoring played an important role in diagnosis and treatment,identification,and control.

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 基因型 

分 类 号：R184.6[医药卫生—流行病学] R512.2[医药卫生—公共卫生与预防医学]