【摘要】 目的 分析2024年河北省张家口市某月子中心1例B群脑膜炎奈瑟菌（Neisseria meningitidis, Nm）感染致流行性脑脊髓膜炎（简称“流脑”）病例的流行病学及病原学特征。方法 对病例进行流行病学调查，采集病例和密切接触者的样本进行分离培养，对获得的分离株进行菌株鉴定和血清群分析及药物敏感性实验；与2024年河北省收集到的其他地市的13株B群Nm菌株（包括病例、密切接触者和健康人群）进行分子分型、平均核苷酸一致性（ANI）检验分析和单核苷酸多态性（SNP）分析。结果 张家口病例分离株和密切接触者分离株均为B血清群Nm菌株。12种药物敏感性结果表明，分离自病例（HE2024ZJK001）与1例密切接触者（HE2024ZJK002）的分离株均对头孢噻肟、头孢曲松、美罗培南、阿奇霉素、米诺环素、氯霉素和利福平共7种药物敏感；对环丙沙星、左氧氟沙星、复方新诺明、氨苄西林和青霉素不敏感。HE2024ZJK001和HE2024ZJK002均属于新的序列型（sequence type,ST）即ST-18512，并且属于同一克隆群（CC）CC4821克隆群，ProA分型均为P1.20,23,FHbp(H因子结合蛋白)均为变异2型（v2），亚变型均是v2.16,NHBA氨基酸型为Peptide 669，均不含有NadA基因。ANI及SNP系统进化分析结果一致，表明张家口分离株（HE2024ZJK001、HE2024ZJK002）属于同一菌株，且与河北石家庄分离株（HE12NME031）、广东省分离株（Nm441107）亲缘关系最密切。结论 此病例为张家口自2011年来首次出现的流脑病例，并且发生在月子中心这种母婴人员密集的场所；应进一步加强接触婴幼儿特殊人群的健康监测，特别是流脑的监测，防止出现局部暴发。更多还原

【Abstract】 Objective To analyze the epidemiological and etiological characteristics of a case of epidemic cerebrospinal meningitis caused by Neisseria meningitidis(Nm) serogroup B infection in a maternity center in Zhangjiakou city,Hebei province in 2024. Methods An epidemiological investigation was carried out for the case, and samples of the case and close contacts were collected for isolation and culture. The isolates were subjected to strain identification, serogroup identification, and antimicrobial susceptibility testing. Molecular typing, average nucleotide consistency(ANI) analysis,and single nucleotide polymorphism(SNP) analysis were performed with 13 Nm serogroup B strains(including cases,close contacts, and healthy people) collected in Hebei province, 2024. Results Both the isolates from the case in Zhangjiakou and the isolates from close contacts were Nm strains of the B serogroup. The results of antimicrobial susceptibility testing showed that the isolate from the case(HE2024 ZJK001) and one close contact(HE2024 ZJK002)were sensitive to cefotaxime, ceftriaxone, meropenem, azithromycin, minocycline, chloramphenicol, and rifampin, while they were not sensitive to ciprofloxacin, levofloxacin, compound sulfamethoxazole, ampicillin, or penicillin. Both HE2024 ZJK001 and HE2024 ZJK002 belonged to a new sequence type(ST) ST-18512 and the same clonal complex(CC) CC4821. In addition, the two strains showed the ProA typing results of P1.20, 23, H factor-binding protein of variant 2(v2), the sub-variant of v2.16, and the NHBA amino acid type of Peptide 669, and neither carried the NadA gene. The results of phylogenetic analyses based on ANI and SNP showed that the Zhangjiakou isolates(HE2024 ZJK001 and HE2024 ZJK002) had the same source and were most closely related to the Shijiazhuang isolate in Hebei province(HE12 NME031) and the Guangdong isolate(Nm441107). Conclusions This case has been the first epidemic cerebrospinal meningitis case in Zhangjiakou since 2011, and it occurs in a place where mothers and infants are crowded. The results suggest that in the future, the health monitoring, especially epidemic cerebrospinal meningitis monitoring, should be strengthened for special groups of infants and young children to prevent local outbreaks.更多还原