2013一2022年新疆猩红热流行特征及A族链球菌基因组遗传进化分析  

Epidemiological characteristics of scarlet fever and genomic genetic evolution of Group A Streptococcus in Xinjiang from 2013 to 2022

作　　者：刘艳[1] 木合亚提·胡塞英[1] 沙比拉·吐拉江 马鑫[1] 马合木提[1] 郜振国[1] 郭荣[1] 周海健[2] 木合塔尔·阿米尔 LIU Yan;Muheyati HUSAIYING;Shabila TULAJIANG;MA Xin;Mahemuti;GAO Zhen-guo;GUO Rong;ZHOU Hai-jian;Muhetaer AMIER(The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830002,China;不详)

机构地区：[1]新疆维吾尔自治区疾病预防控制中心,乌鲁木齐830002 [2]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《疾病预防控制通报》2024年第2期1-7,共7页Bulletin of Disease Control & Prevention(China)

基　　金：新疆维吾尔自治区自然科学基金面上项目(2021D01C125)。

摘　　要：目的 分析2013-2022年新疆猩红热发病和流行趋势及A族链球菌(GAS)基因组特征,为猩红热疫情精准溯源提供依据。方法 采用描述流行病学方法,分析2013-2022年新疆传染病疫情监测系统中猩红热病例资料;采集2021-2023年哨点医院病例的咽拭子标本,并开展菌株分离与鉴定、药物敏感性试验、脉冲场凝胶电泳(PFGE)分型和全基因组测序,应用FastTree对全基因组单核苷酸多态性(wgSNP)序列构建进化树。结果 2013-2022年新疆猩红热共报告病例20 954例,年均报告发病率8.66/10万;发病总体呈双峰型;年均报告发病率居前3位的地区是克拉玛依市55.05/10万、哈密市22.55/10万和乌鲁木齐市21.55/10万;报告病例以1~10岁儿童为主、占97.04%。29株GAS对青霉素、莫西沙星、头孢噻肟等12种抗生素敏感,对红霉素、四环素、克林霉素耐药;emm12型和ST36型为新疆GAS优势株型,spy005和spy006为PFGE优势带型;测序菌株28株,共测出13种耐药基因和38种毒力基因;本地区28株与国内及周边国家共计103株GAS的wgSNP系统进化分析,共分为7个分支,各分支菌株间有遗传亲缘关系。结论 2013-2018年新疆猩红热发病总体上升,自2019年发病有所下降;新疆GAS以emm12型、ST36型为主要流行株,并与国内流行株联系紧密,未发现新的emm基因型。Objective To analyze the incidence and epidemic trend of scarlet fever and the genomic characteristics of Group A Streptococcus(GAS)in Xinjiang from 2013 to 2022,and provide evidence for accurate source tracing of scarlet fever epidemic.Methods Descriptive epidemiological method was used to analyze the data of scarlet fever cases from Xinjiang infectious disease surveillance system during 2013 to 2022.The throat swab samples were collected from sentinel hospitals during 2021 to 2023 for strain isolation and identification,drug sensitivity test,PFGE typing and whole genome sequencing.The phylogenetic tree was constructed by FastTree as the whole genome-based single-nucleotide polymorphisms(wgSNP)sequence.ResultsA total of 20954 cases with scarlet fever were reported in Xinjiang from 2013 to 2022,with an average annual incidence of 8.66/100000.The incidences showed two peaks.Karamay,Hami and Urumqi were the top three regions ranked as incidence,and the annual reported incidence was 55.05/100000,22.55/100000 and 21.55/100000,respectively.The cases of children aged 1-10 years accounted for 97.04%.29 strains of GAS were sensitive to 12 antibiotics such as penicillin,moxifloxacin and cefotaxime et al.,and resistant to erythromycin,tetracycline and clindamycin.The emm12 and ST36 were the dominant strains of Xinjiang GAS,and spy005 and spy006 were the dominant strains of PFGE.There were 13 drug resistance genes and 38 virulence genes detected in 28 strains.Phylogenetic analysis based on wgSNP was carried out in all 103 GAS strains in China and neighboring countries include local 28 GAS strains.The results showed the strains divided into 7 branches,and the genetic relationships existed in them.Conclusions The incidence of scarlet fever increased in Xinjiang from 2013 to 2018,and decreased since 2019.The main endemic strains of Xinjiang GAS are emm12 and ST36,which closely relate to the domestic endemic strains.No new emm genotype is found.

关 键 词：猩红热 流行特征 A族链球菌 基因组进化 

分 类 号：R515.1[医药卫生—内科学]