临沂市一起B群脑膜炎奈瑟菌感染导致侵袭性肺炎病例的调查分析  

Investigation and analysis of a case of invasive pneumonia caused by group B Neisseria meningitidis infection in Linyi City

作　　者：刘祥亮 尹德清[1] LIU Xiangliang;YIN Deqing(Linyi Center for Disease Control and Prevention,Linyi 276000,Shandong,China)

机构地区：[1]临沂市疾病预防控制中心,山东临沂276000

出　　处：《中国校医》2024年第7期505-509,共5页Chinese Journal of School Doctor

摘　　要：目的 对2021年临沂市1例B群脑膜炎奈瑟球菌(Nesseria meningtidis,Nm)感染导致的侵袭性肺炎开展流行病学调查,为流脑科学防控提供依据。方法 对病例家人及其家人所在学校的部分学生采集咽拭子,现场接种巧克力双抗琼脂平板;采用普通聚合酶链反应(PCR)技术对可疑菌株进行鉴定和分型;利用NextSeq2000测序仪进行二代测序,获得全基因组序列,使用CLC软件进行全基因组聚类分析。结果 共调查103人,获得103份咽拭子样本,培养获得6株Nm菌株,PCR分群均为B群。Nm流脑病例密接和感染者密接性别间差异无统计学意义,病例密接同感染者密接间有统计学差异;全基因组聚类分析结果显示:病例同感染者2携带的Nm亲缘关系最近,其次为感染者1携带的Nm及感染者1密接携带的Nm。结论 感染者1将Nm传染给病例导致其发病,感染者1及其部分密接为携带B群Nm的健康人群。加强健康教育是脑膜炎防治的重要措施,并重点关注基层学校。Objective This study investigated the epidemiological characteristics of a case of invasive pneumonia caused by Neisseria meningitidis(Nm) group B infection in Linyi City,China,in 2021,to provide a scientific basis for the prevention and control of meningococcal meningitis.Methods Throat swabs were collected from the family members of the patient and from several students at the school where the family members studied.Nm strains were immediately isolated with double anti-chocolate plates.Standard polymerase chain reaction was used to identify and characterize the suspicious strains.The whole genome nucleotide sequence was obtained through second-generation sequencing technology with a NextSeq 2000 sequencer.Whole genome cluster analysis was performed with CLC software.Results A total of 103 people were investigated,and 103 throat swabs were collected.Six strains of Nm were isolated,all of which were group B.No significant sex-specific differences were observed among close contacts of the case;however,a significant difference between sexes was observed between close contacts of the case versus the infector.Whole genome cluster analysis indicated that the Nm isolated from the case was closest to the Nm isolated from infector 2,followed by the Nm carried by infector 1 and her close contacts.Conclusions Infector 1 was infected with Nm and transmitted the infection to infector 2 and the case,thus causing his illness.Infector 1 and her close contacts carried Nm but remained healthy.Therefore,the development and application of group B meningococcal meningitis vaccines must be accelerated.Health education and publicity measures should be strengthened before the large-scale application of group B meningococcal meningitis vaccines,and greater attention should be paid to health status in primary schools and rural areas.

关 键 词：脑膜炎奈瑟球菌 测序 全基因组聚类分析 

分 类 号：R378.15[医药卫生—病原生物学]