河北省首例W135群脑膜炎奈瑟菌感染病例调查

Investigation of first case infeced with Neisseria meningitidis serogroup W135 in Hebei province

目的调查河北省首例W135群脑膜炎奈瑟菌(Neisseria meningitidis,Nm)感染病例。方法查阅病例病案,进行流行病学调查,采集病例及密切接触者标本进行实验室检测。结果患者发热、间断性呕吐、伴有颈项强直,无惊厥、无皮肤瘀点瘀斑;血白细胞计数8.1×109个/L;脑脊液外观混浊、蛋白质2.63g/L、白细胞2.78×106个/L。脑脊液培养得到可疑Nm菌株。初步诊断为流脑。最终脑脊液标本经荧光定量PCR基因检测确诊为W135群Nm感染病例。患者经抗菌药物治疗已痊愈出院。结论河北省存在W135群Nm流行可能性,应警惕W135群流脑疫情暴发。荧光定量PCR方法具有快速、微量、可靠等优点,在流脑诊断方面实用价值较高。

Objective To investigate the first case of infection with Neisseria meningitidis serogroup W135 in Hebei province. Methods Reviewing the medical records, carrying out epidemiological investigation, collecting the samples of the patient and the close contacts,laboratory testing. Results The patient had got symptoms of fever,intermittent vomiting, neck stiffness, and no convulsions, petechiae, ecchymosis. The clinical laboratory results showed white blood cell count 8.1 x 109/L; cerebrospinal fluid cloudy appearance,protein 2.63g/L,leukocyte 2.78 x 106/L. A suspicious Nm strain was isolated from the CSF sample. The primary diagnosis was epidemic cerebrospinal meningitis. At last he was diagnosed as meningococcal disease serogroup W135 by the method of Real-time PCR. The patient was cured by antibiotic therapy. Conclusions There is possibility of the outbreak of meningococcal disease serogroup W135 in Hebei province,it is necessary to alert. Real-time PCR has the advantages of fast,trace,reliability,and it is valuable in the diagnosis of the epidemic cerebrospinal meningitis.