2022年福建省一株引起流行性脑膜炎病例的血清不可分群脑膜炎奈瑟菌病原学特征分析  

Etiological characteristics of a case of meningococcal meningitis caused by nongroupable Neisseria meningitidis in Fujian,2022

作　　者：高亚东 梁雪晨 郑恩惠[1] 翁顺太[1] 李曲文[1,3] Gao Yadong;Liang Xuechen;Zheng Enhui;Weng Shuntai;Li Quwen(Fujian Provincial Key Laboratory of Zoonosis Research,Fujian Provincial Center for Disease Control and Prevention,Fuzhou 350012,Fujian,China;School of Public Health,Fujian Medical University,Fuzhou 350108,Fujian,China;Professional Teaching Practice Base of School of Public Health,Fujian Medical University,Fuzhou 350012,Fujian,China)

机构地区：[1]福建省疾病预防控制中心,福建省人兽共患病研究重点实验室,福建福州350012 [2]福建医科大学公共卫生学院,福建福州350108 [3]福建医科大学公共卫生学院专业教学实习基地,福建福州350012

出　　处：《疾病监测》2025年第1期106-112,共7页Disease Surveillance

基　　金：福建省卫生健康青年科研课题(No.2022QNA056)。

摘　　要：目的分析2022年福建省1株引起流行性脑脊髓膜炎(流脑)病例的血清不可分群脑膜炎奈瑟菌(Nm)的病原学特征。方法对1株分离自患者血液的菌株(NMFJ202205)进行菌株鉴定、血清群和基因群鉴定、药物敏感性试验及全基因组序列分析。结果该流脑病例患者为17岁男高中生,自其血液中分离的菌株为血清不可分群Y基因群Nm菌株。药敏结果显示,其对复方新诺明耐药,对其余抗生素均敏感。分子分型结果显示,序列型(ST)为ST-1655,属于ST-23克隆群(CC23),PorA和FetA型别为P1.5-1,10-1:F4-1。核心基因组多位点序列分型、平均核苷酸一致性分析和单核苷酸多态性分析结果发现,相较于中国广东省和上海市分离株,NMFJ202205分离株与英国、瑞典、日本和芬兰的一些分离株亲缘关系更密切。荚膜多糖基因簇结构分析显示其排布方式为“D’-E-C-A-D-B”,其血清不可分群的机制可能是A区cssA和csy基因含有内部终止密码子。结论该病例为福建省首次报道的由血清不可分群Y基因群Nm引起的流脑病例,提示今后需加强不可分群Nm流行病学和病原学监测。Objective To analyze the etiological characteristics of a case of meningococcal meningitis caused by nongroupable Neisseria meningitidis.Methods The isolate from the case's blood sample was analyzed by strain identification,serogroup and genogroup identification,antimicrobial susceptibility test,and whole-genome sequencing.Results The meningococcal meningitis case was a boy student aged 17-years,and the strain isolated from case's blood sample was identified as nongroupable N.meningitides,belonging to genogroup Y.The antimicrobial susceptibility test to 12 antibiotics showed that it was resistant to trimethoprim-sulfamethoxazole and sensitive to other antibiotics.The sequence type(ST)was ST-1655,belonging to the ST-23 clonal complex(CC23),and the finetyping antigen profile was P1.5-1,10-1:F4-1.The results of core genome multilocus sequence typing(cgMLST),average nucleotide identity(ANI),and single nucleotide polymorphism(SNP)analysis showed that the isolate was more closely related to some isolates from the United Kingdom,Sweden,Japan and Finland compared with the isolates from Guangdong and Shanghai in China.The analysis on the capsular polysaccharide synthesis locus showed that the arrangement was"D'-E-C-A-D-B"and the underlying mechanism of the failure in serogroup identification of the isolate might be internal stop codons in the cssA and csy genes in region A.Conclusion This was the first reported case of meningococcal meningitis caused by nongroupable N.meningitides genogroup Y in Fujian,suggesting that further epidemiological and etiological surveillance for nongroupable N.meningitides strains need to be strengthened in the future.

关 键 词：流行性脑脊髓膜炎 脑膜炎奈瑟菌 血清不可分群 Y基因群 荚膜多糖基因簇 

分 类 号：R211[医药卫生—中医学] R515.2