1例Y群ST167型脑膜炎奈瑟菌输入病例的流行病学和病原学分析  

Epidemiological and pathogenic analysis of an imported case of Y serogroup ST167 complex Neisseria meningitidis

作　　者：李振翠 李镕 方艳梅[2] 张昌 邵晓萍[1] 刘英良 刘美真[1] Li Zhencui;Li Rong;Fang Yanmei;Zhang Chang;Shao Xiaoping;Liu Yingliang;Liu Meizhen(Institute of Pathogenic Microbiology of Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,China;Institute of Microbiology of Zhuhai Center for Diseases Control and Prevention,Zhuhai 519060,China)

机构地区：[1]广东省疾病预防控制中心病原微生物检验所,广州511430 [2]珠海市疾病预防控制中心微生物检验所,珠海519060

出　　处：《中华微生物学和免疫学杂志》2024年第6期480-484,共5页Chinese Journal of Microbiology and Immunology

基　　金：广东省科技计划(2023B1212010010)。

摘　　要：目的对1例疑似脑膜炎奈瑟菌阳性病例进行病原学鉴定诊断,评估疫情传播风险。方法采集患者血液进行脑膜炎奈瑟菌分离培养,通过菌落形态学和菌体革兰染色观察、生化鉴定、乳胶凝集试验、血清玻片凝集试验、核酸检测进行病原鉴定和血清群分群,检测菌株对12种抗生素的敏感性;对病例开展现场流行病学调查并采取疫情防制措施。结果经多种实验室方法鉴定,该疑似病例确诊为脑膜炎奈瑟菌感染,菌株血清群为Y群,多位点序列分型(MLST)为767,属ST167克隆群,对青霉素、氨苄西林、美罗培南等9种抗生素敏感,对环丙沙星和左氧氟沙星中介,对甲氧苄啶/磺胺甲噁唑耐药。病例的密切接触者和环境检测结果为阴性。结论本病例经检测明确病因为脑膜炎奈瑟菌侵袭性感染,菌株为Y群ST167型。流行病学调查显示该病例引发疫情传播流行的风险较低,后续需要持续关注和监测。Objective To detect the pathogen and clinically diagnose for a suspected case of Neisseria meningitidis with positive blood culture result,and assess the risk of disease transmission among the community.Methods Blood sample was collected for Neisseria meningitidis isolation and culture.Pathogen identification and serogroup typing were conducted by colony morphology,Gram staining,biochemical tests,latex agglutination test,slide agglutination test,and nucleic acid testing.The susceptibility to 12 antibiotics was also tested.Epidemiological investigation was conducted on the case,and epidemic control measures were also implemented.Results Through various detection,the suspected case was diagnosed as Neisseria meningitidis invasive infection.The isolated strain belonged to group Y serotype,type 767(multilocus sequence typing),and the ST167 clonal complex.The strain was sensitive to nine antibiotics,including penicillin,ampicillin,and meropenem.It exhibited intermediate sensitivity to ciprofloxacin and levofloxacin,and resistance to methicillin/sulfamethoxazole.Close contacts of the case and environmental testing results were negative.Conclusions The case is confirmed to be an invasive infection caused by group Y Neisseria meningitidis,the ST167 clonal complex.Epidemiological investigation shows a relatively low risk of epidemic transmission.Continuous monitoring and surveillance are necessary for further assessment.

关 键 词：脑膜炎奈瑟菌 ST167克隆群 多位点序列分型 耐药性 

分 类 号：R515.2[医药卫生—内科学] R181.3[医药卫生—临床医学]