海南省首例B群流行性脑脊髓膜炎病例病原学分析

Etiological analysis of first case of serogroup B epidemic cerebrospinal meningitis in Hainan

目的对海南省海口市2015年2月发现的1例新生儿B群流行性脑脊髓膜炎(流脑)病例进行病原学分析。方法采集新生儿血液接种于血培养瓶,对培养出的菌株采用生化鉴定、血清学分型和普通聚合酶链反应(polymerasechain reaction,PCR)技术鉴定、基因分型;分离株进行多位点序列分型(multilocus sequence typing,MLST)及14种抗生素敏感性试验。结果从新生儿血液中培养出的菌株经生化鉴定、血清学分型与PCR技术鉴定、基因分型结果一致,均是B群脑膜炎奈瑟菌。该菌株MLST结果为序列型ST-7962,属无序列群分类。该菌株对青霉素、氨苄西林、头孢噻肟、头孢曲松、美罗培南、氯霉素、阿奇霉素、米诺环素、利福平敏感,对左氧氟沙星中介,对复方新诺明、磺胺、环丙沙星、萘啶酸耐药。结论海南省发现新生儿感染B群脑膜炎奈瑟菌病例,应加强病原菌监测与研究,以便采取针对性的防控措施,合理使用抗生素。

Objective To analyze the pathogenic characters of the serogroup B epidemic cerebrospinal meningitis base on the first case found in Haikou City of Hainan Province in February,2015.Methods The blood sample was collected in the blood culture bottle from a neonatal case for the isolation,biochemistry test and serological identification of the pathogen.The isolated strain was detected by polymerase chain reaction（PCR）and genotyping and multilocus sequence typing（MLST）.Drug susceptibility tests to 14 antibiotics were conducted.Results The biochemistry test,serotyping and PCR test,and genotyping showed that this strain was serogroup B Neisseria meningitidis.The results of MLST indicated that the strain was ST-7962 and belonged to unassigned complex sequence types.The strain was sensitive to ampicillin,cefotaxime,ceftriaxone,meropenem,chloramphenicol,rifampicin,azithromycin,and minocycline,and resistant to cotrimoxazole,sulfamethoxazole,ciprofloxacin,and nalidixic acid.Conclusions A neonate infected with Neisseria meningitidis serogroup B is found in Hainan Province.Therefore,we should strengthen the pathogen monitoring and research,in order to take targeted prevention and control measures,and also we should rationally use antibiotics.