【摘要】 目的 了解北京市西城区儿童A族链球菌(GAS)感染病例emm基因型别分布情况。方法 采集2011—2024年北京市西城区哨点医院猩红热和咽部感染病例咽拭子标本，进行GAS菌株的分离鉴定，通过聚合酶链反应(PCR)方法对emm基因进行扩增、测序，判定基因型别，并比较不同组间型别差异。结果 共采集咽拭子标本3 130份，分离GAS菌株400株，阳性率为12.78%,其中2011年阳性率最高(19.93%)。猩红热阳性率(45.71%)高于咽部感染(6.14%)(P<0.001)。emm基因阳性菌株391株，不同病例间emm基因阳性率差异有统计学意义(P<0.001)。共检出7种基因型和27种基因亚型，不同组别间emm基因型均以emm12和emm1为主，emm基因亚型均以emm12.00和emm1.00为主。除个别年份外，基因型及其亚型均以emm12和emm12.00占主导，2011—2019年两主要基因型及其亚型分布差异均有统计学意义(P<0.001)。不同年龄组基因型及亚型存在差异(P=0.002)。结论 2011—2024年北京市西城区儿童GAS感染病例emm基因优势型别为emm12和emm1,优势基因亚型为emm12.00和emm1.00,应全面加强相关基因型监测，及时掌握emm基因分布情况及变化规律。更多还原

【Abstract】 Objective To understand the distribution of M protein gene(emm) of group A streptococcus(GAS) infections among children in Xicheng District of Beijing. Methods Throat swab samples from scarlet fever and pharyngeal infection cases were collected in sentinel hospitals of Xicheng District, Beijing from 2011 to 2024.GAS strains were isolated and identified, and emm gene was amplified and sequenced by PCR to determine the genotype.The differences in emm genotype between different groups were compared. Results A total of 3 130 throat swab samples were collected, and 400 GAS strains were isolated, with a positive rate of 12.78%.The highest positive rate was 19.93% in 2011.The positive rate of scarlet fever(45.71%) was higher than that of pharyngeal infection(6.14%)(P<0.001).There were 391 emm gene positive strains, and the differences in the positive rate of emm gene among different cases were statistically significant(P<0.001).A total of 7 genotypes and 27 gene subtypes were detected.Among different groups, the emm genotypes were mainly emm12 and emm1.The emm gene subtypes were mainly emm12.00 and emm1.00.Except for some years, the genotypes and their subtypes were dominated by emm12 and emm12.00,and the distribution differences of the two major genotypes and their subtypes were statistically significant from 2011 to 2019(P<0.001).There were differences in genotypes and subtypes among different age groups(P=0.002). Conclusion The dominant types of emm genes in group A streptococcus infections among children were emm12 and emm1 in Xicheng District of Beijing from 2011 to 2024,and the dominant gene subtypes were emm12.00 and emm1.00.It is necessary to comprehensively strengthen the monitoring of relevant genotypes, timely grasp the distribution and variation of emm gene.更多还原