一起小规模群体肺炎链球菌感染流行的报告

The prevalence of streptococcus pneumoniae among a military camp

目的明确一次小规模不明原因发热疫情的病因。方法常规提取6例发热患者和11例密切接触者咽拭子DNA和RNA,采用荧光定量PCR法检测15种病原体,取扩增产物进行测序鉴定,并与常规培养结果比对;采用荚膜肿胀试验检测肺炎链球菌血清型。结果在17例咽拭子中培养出肺炎链球菌阳性11例(64.7%),血清型鉴定为6群6A型,未分离到其他病原菌;在17例咽拭子标本中,检出13例(76.5%)肺炎链球菌DNA阳性2,例(11.8%)嗜肺军团菌DNA阳性,3例(17.6%)肺炎支原体阳性,1例(5.9%)乙型流感病毒RNA阳性;在其中5例中3,例肺炎链球菌与肺炎支原体同时阳性,1例肺炎链球菌与乙型流感病毒同时阳性,另1例密切接触者同时检出肺炎链球菌与嗜肺军团菌;对所有CT值小于35的咽拭子DNA经普通PCR扩增后测序,并经NCBI基因库比对,结果与相应病原体的基因组序列相符。结论肺炎链球菌为引起此次疫情流行的主要病因。

Objective To investigate the etiological causes of fever with unknown origin in soldiers in a military camp.Methods The DNA and RNA from throat swabs in six soldiers with fever of unknown origin and eleven close contacts without fever were detected by real-time fluorescent quantitative PCR assay for fifteen species of common respiratory pathogens and the serotypes of streptococcus pneumoniae were determined by Quel-lung test.Results The positive of streptococcus pneumoniae detected by swab culture was 64.7%（11/17） and the predominant strain was serotype 6A.Out of the 17 swabs,the streptococcus pneumoniae was positive in 13（76.5%） by PCR.Legionella pneumophila was in 2（11.8%）,mycoplasma pneumoniae in 3（（17.6）%） and influenze B virus in 1（5.9%）.All specimens were positive for streptococcus pneumoniae detected by real-time fluorescent quantitative PCR and were confirmed by sequencing.Conclusion Streptococcus pneumoniae is the pathogen for this upper-respiratory infection in a military camp.The real-time PCR assay used in this study is sensitive and specific for detecting common pathogens in nasopharyngeal swabs.