一起幼儿园猩红热疫情的实验室检测分析

Analysis of laboratory test of a scarlet fever epidemic happening in a kindergarten

目的对一起幼儿园猩红热疫情进行病原菌分离和实验室分析。方法按照国家行业标准WS 282-2008进行病原菌分离和鉴定,应用PCR法扩增致热外毒素基因,药敏试验采用美国临床实验室标准化委员会(CLSI)推荐的纸片扩散法,脉冲场凝胶电泳分析参照PulseNet发布的单核细胞增生李斯特菌的PFGE操作程序。结果 21份咽拭子中检出5株A群链球菌。分离株均扩增出致热外毒素基因speA、speB和speC。菌株对青霉素、头孢拉定、氨苄西林、左氧氟沙星、氯霉素和万古霉素均敏感,对红霉素、克拉霉素、阿奇霉素和四环素均耐药。PFGE分析显示其来源相同。结论加强重点人群和重点场所的管理是预防猩红热的主要措施,及时判定疫情、确定传染源是控制猩红热疫情的必要手段,实验室检测特别是病原菌同源性分析将为疫情的控制提供可靠的保证。

Objective Identifying pathogen and analyzing homology of a scarlet fever epidemic happening in a kindergarten. Methods Pathogen was isolated and identified according to the national indu^-＇ial standard WS 282 - 2008, pymgenic exotoxin gene was amplified by PCR method, Antimicrebial susceptibility test was detected by Kirby - Bauer method recommended by CLSI, and PFGE analysis was done according to PulseNet Listeria monocytosis PFGE protocol. Results 5 stains of group A streptococcus were isolated from 21 throat swabs, All the isolates were amplified Pyregenic exotoxin gene speA ,spell and speC, All the isolates were susceptible to penicillin, ampicillin, cefradine, levofloxacin, chloramphenicol, vancomycin and resistant to erythromycin, clarithromycin, azithromycin, tetracycline,PFGE analysis exhibited their same source. Conclusion Strengthe- ning the management of the key population and key place is the main measure to prevent scarlet fever, Judging the epidemic and determining the source of infection timely is a necessary means to control scarlet fever epidemic, and laboratory testing in parti- cular pathogen homology analysis will provide a reliable guarantee for epidemic control.