湖南省新发X群Y群流行性脑脊髓膜炎病例菌株的病原学特征分析  

Etiological characteristics of strains from cases of epidemic cerebrospinal meningitis due to newly isolated Neisseria meningitidis serogroups X and Y in Hunan Province

作　　者：夏昕[1] 方明礼[1] 覃迪[1] 贺子翔 高立冬[1] 湛志飞[1] XIA Xin;FANG Ming-li;QIN Di;HE Zi-xiang;GAO Li-dong;ZHAN Zhi-fei(Hunan Provincial Center for Disease Control and Prevention,Changsha,Hunan 410005,China)

机构地区：[1]湖南省疾病预防控制中心,湖南长沙410005

出　　处：《实用预防医学》2021年第11期1295-1298,共4页Practical Preventive Medicine

基　　金：国家科技重大专项(2018ZX10713003-002-008)湖南省细菌性传染病病原谱流行规律及变异研究。

摘　　要：目的了解2019—2020年本省分离到的新发X群和Y群脑膜炎奈瑟菌病例菌株的药物敏感性及分子分型特征。方法从病人血液和脑脊液中分离到的脑膜炎奈瑟菌经生化鉴定后,进行血清学分群、药敏试验以及多位点序列分型分析。结果新发的X群、Y群脑膜炎奈瑟菌药敏试验中对青霉素、氨苄青霉素、米诺环素、头孢曲松、头孢噻肟、氯霉素、阿奇霉素、美罗培南和利福平全部敏感;对复方磺胺甲噁唑耐药;与B群菌株的药物敏感性比较具有对青霉素、氨苄青霉素以及氟喹诺酮类抗菌药物更高的敏感性,多位点序列分型结果显示X菌株为ST-5克隆群,两株Y群菌株为ST-23克隆群。结论 X群有可能是从A群菌株荚膜转换而来,Y群菌株与国际高致病流行ST克隆群一致,二者均有可能成为新的流脑流行群并引起暴发疫情,需引起重视。Objective To understand the drug susceptibility and molecular typing characteristics of strains from cases of epidemic cerebrospinal meningitis due to newly isolated Neisseria meningitidis serogroups X and Y in Hunan Province from 2019 to 2020. Methods Blood and cerebrospinal fluid specimens were collected from patients with epidemic cerebrospinal meningitis. Serogroups X and Y were identified and detected by culture and isolation, serological groups and susceptibility testing, multi-locus sequence typing( MLST). Results Serogroups X and Y strains were all sensitive to penicillin,ampicillin,minocycline,ceftriaxone,cefotaxime,chloramphenicol,azithromycin,meropenem and rifampicin in drug susceptibility test,but resistant to cotrimoxazole. Compared with serogroup B strains, the new strains were more sensitive to penicillin, ampicillin and fluoroquinolones. MLST results showed that strain X was the clone group of ST-5,and two strains of strain Y were the clone group of ST-23. Conclusion Serogroup X may be converted from serogroup A,while serogroup Y is consistent with the international highly pathogenic ST clone group. Both of them may become new epidemic serogroups and cause epidemic cerebrospinal meningitis outbreaks,which should be paid attention to.

关 键 词：流行性脑脊髓膜炎 脑膜炎奈瑟球菌 药物敏感性 多位点序列分型 

分 类 号：R512.3[医药卫生—内科学]