【摘要】 目的对贵州省遵义市2016年4月发现的1例B群流行性脑脊髓膜炎(流脑)病例进行病原学分析。方法采集患者血液标本,分离菌株,进行生化鉴定和血清分型、多位点序列分型(multilocus sequence typing,MLST);采用KB纸片扩散法和Etest法对菌株进行药敏试验。结果从患者血液中分离到的菌株其菌落形态、生化特征均符合脑膜炎奈瑟菌特性,玻片凝集试验和Real-time PCR鉴定其血清型为B群,基因MLST分型为ST-12885型。该菌对青霉素、氨苄西林、头孢噻肟、头孢曲松、阿奇霉素、美罗培南、米诺环素、氯霉素、利福平等抗生素敏感,对复方新诺明、左氧氟沙星、环丙沙星耐药。结论贵州省1例流脑患者血液中首次检出B群脑膜炎奈瑟菌,属ST-4821高致病性克隆群。因此应加强对流脑病原菌的检测,采取有效防控措施,合理使用抗菌药物。更多还原

【Abstract】 Objective To analyze the etiological characteristics of one case of epidemic cerebrospinal meningitis due to Neisseria meningitides serogroup B from City of Zunyi,Guizhou Province in April 2016. Methods Bacteria were isolated from the patient’s blood,plated on chocolate agar plates and blood agar plates,and identified with a biochemical test,a slide agglutination test,and a real-time polymerase chain reaction(real-time PCR).The genomes of isolates were analyzed using multilocus sequence typing(MLST)based on methods used in PubMLST databases.Antimicrobial susceptibility testing of isolates was performed using the K-B method and Etest method in accordance with the 26 th edition of the CLSI’s Performance Standards for Antimicrobial Susceptibility Testing. Results One bacterial strain was isolated from the patient’s blood.Its colony morphology and biochemical characteristics were consistent with N.meningitides.Its serotype was identified as group B according to the slide agglutination test and real-time PCR.MLST identified the isolate as ST-12885,which is a new type belonging to the ST-4821 complex.This strain was sensitive to 9 antibiotics(penicillin,ampicillin,cefotaxime,ceftriaxone,azithromycin,meropenem,minocycline,chloramphenicol,and rifampicin),and resistant to trimethoprim-sulfamethoxazole,levofloxacin,and ciprofloxacin. Conclusion This is the first time that a serogroup B strain has been isolated from the blood of a patient infected with N.meningitidesin Guizhou Province.MLST identified this serogroup B strain as ST-12885,which belongs to the ST-4821 complex of highly pathogenic molecular clones.Therefore,surveillance of pathogens causing meningitis should be enhanced,effective prevention and control measures should be taken,and antimicrobial agents should be used rationally.更多还原