湖南省B群脑膜炎奈瑟菌药物敏感性及分型

近年来,湖南省流行性脑脊髓膜炎(简称流脑)流行以C群脑膜炎奈瑟菌(Nm)为主[1],2009年2月,首次从流脑患者身上分离出B群脑膜炎奈瑟菌,2010年在健康人群流脑咽拭子中,同时分离到4株B群脑膜炎奈瑟菌.为掌握湖南省B群脑膜炎奈瑟菌的分子生物学特征,为有效的预防和控制其流行提供依据,本研究采用传统检验方法和聚合酶链反应(polymerase chain reaction,PCR)、脉冲场凝胶电泳(pulsedfield gel electrophoresis,PFGE)等方法对上述B群流脑奈瑟菌分离株进行了鉴定和分型分析.现将结果报告如下.     

濮阳市流脑W135群基因型别及脑膜炎奈瑟菌检测分析

目的明确流脑菌群在濮阳市的分布及W135群在不同人群中的基因型别,为防控流脑提供依据。方法对健康人群、密切接触者的咽拭子,流脑患者的脑脊液、血液进行细菌培养、血清凝集、PCR鉴定、MLST基因分型、Por A基因亚型分型。结果 2009年-2013年健康人群检出Nm菌49株(B群27株,C群3株,W135群5株,未定群14株);流脑患者W135群1株;密切接触者W135群2株。流脑患者与密切接触者W135群菌株MLST基因分型均为ST-11,Por A VR基因亚型均为P1.5,2型。结论濮阳市流脑带菌以B群、W135群、C群为主,带菌谱与流脑发病有一定关联,有高致病性的W135群ST-11克隆系和致病性菌株P1.5,2型存在。应注意流脑菌群变化,加大监测和疫苗的应用,预防流脑流行。     

济南市2008年-2015年健康人群脑膜炎奈瑟菌带菌状况监测结果分析

目的了解济南市健康人群脑膜炎奈瑟菌(Nm)携带情况及携带菌的血清群分布情况。方法采集2008年-2015年不同流行时期、不同年龄健康人群的咽拭子标本,用奈瑟菌分离培养基进行分离培养、生化试验、血清学凝集试验。结果 2008年-2015年共检测2 362份健康人群咽拭子标本,分离出24株Nm,健康人群平均带菌率为1.02%。其中流行前期带菌率为1.08%,流行期带菌率为1.53%,流行后期带菌率为0.00%。8年间以7岁人群带菌率较高,3岁儿童中未检出Nm。检出的24株Nm,A群5株,C群7株,W135群5株,X群2株,B群1株,Y群1株,未分群3株。结论济南市健康人群带菌率处于较低水平,流行前期和流行期带菌率高;中小学生带菌率高;成年人也不可忽视。血清群以A群、C群、W135群为主。     

湖北省22株B群脑膜炎奈瑟菌分子分型分析

湖北省自2006年以来多次出现B群流行性脑脊髓膜炎(流脑)病例,健康人群B群菌株的带菌率也很高,占96.56％[1].本研究对湖北省2006-2010年流脑病例和健康人群分离的22株B群脑膜炎奈瑟菌(Nm)菌株进行分析.     

河北省2006～2013年健康人群脑膜炎奈瑟菌带菌情况分析

目的了解河北省健康人群脑膜炎奈瑟菌(Nm)携带情况,为流行性脑脊髓膜炎(流脑)防治提供科学依据。方法 2006~2013年在全省11个设区市,以按年龄分层整群随机抽样方式采集健康人群咽拭子,分离培养Nm。结合流行病学调查资料对菌株检出情况进行分析。结果 8年共监测28 447人,分离到293株Nm,总带菌率1.03%;石家庄和邢台为Nm"高高"聚集区;15~24岁年龄组带菌率较高;Nm中不可分群者占45.05%,B群占14.33%,C群占12.63%,W135群占12.29%。结论建议继续加强健康人群Nm携带情况的监测,结合人群、地区分布特点及菌群变迁趋势,制定科学合理有针对性的流脑防控措施。     

健康人群脑膜炎奈瑟菌带菌率以及血清群分布特征研究

目的了解来宾市健康人群脑膜炎奈瑟菌（Neisseria meningitidis,Nm）的带菌状况,揭示优势菌群,评估流行性脑脊髓膜炎（流脑）流行风险,为制定流脑预防控制策略提供参考。方法将调查对象分为5个年龄组,每个年龄组至少调查200人。每个调查对象采集1份咽拭子,共采集1311份咽拭子进行Nm分离培养和血清群鉴定。结果2011年,来宾市健康人群Nm带菌率为8.54%,其中B群占31.25%,W135群占15.18%,C群占1.79%,A群、X群、Y群各占0.89%,不可分群占49.11%;青年人带菌率高于少年儿童,男性带菌率高于女性。同年来宾市发生的3例流脑均为W135群。结论来宾市健康人群Nm带菌以不可分群菌株为主,可分群菌株中以B群和W135群为优势菌群;W135群为来宾市流脑的主要流行菌群,应在继续推行A＋C群脑膜炎球菌疫苗（Meningococcal Vacune,MenV）接种的同时,加强W135群MenV的接种,以期有效预防控制流脑疫情。     

2021年美姑县2例B群流脑病例密切接触人群脑膜炎奈瑟菌携带状况调查

目的 了解2例B群流脑病例周围人群脑膜炎奈瑟菌（nesseria meningtidis,Nm）携带情况,为流脑防控提供科学依据。方法 2021-07对美姑县2例B群流脑病例居住地密切接触人群采集咽拭子,现场接种双抗巧克力平板进行脑膜炎奈瑟菌分离培养;使用实时荧光聚合酶链反应（Real-time PCR）技术对可疑菌株进行鉴定。采用普通聚合酶链反应（PCR）技术以及血清玻片凝集法对流脑菌株进行分群鉴定。结果 共调查60人,年龄中位数为35.50岁,其中男性占46.67%,女性占53.33%。采集到60份健康人咽拭子,从28份咽拭子中分离到流脑菌株,分离阳性率为46.67%。28株Nm中B群占21.43%(6/28);Y群占14.28%(4/28),其他群及NG菌株占64.29%(18/28)。2例B群流脑病例周围人群不同性别、年龄间Nm分离率差异无统计学意义。结论 2例B群流脑病例周围人群流脑携带率较高,以不可分群菌株及B群为主,同时存在Y群Nm菌株。应持续加强该地区的流脑监测及防控工作。     

中国C群脑膜炎奈瑟菌脉冲场凝胶电泳分析

目的对中国C群脑膜炎奈瑟菌分离株进行脉冲场凝胶电泳（PFGE）分析，了解安徽省C群流行性脑脊髓膜炎（流脑）暴发菌株及国内C群脑膜炎奈瑟菌菌株的分子流行病学特征。方法212株C群脑膜炎奈瑟菌菌株分离自流脑患者、密切接触者和健康人群鼻咽部，包括安徽省C群流脑菌株48株，其中38株与C群流脑暴发相关。脉冲场凝胶电泳选用NheI限制性内切酶，聚类分析选用BioNumerics软件。结果212株C群脑膜炎奈瑟菌菌株共分为43个PFGE带型，命名为AH1～AH43，AH1是中国C群脑膜炎奈瑟菌主要的带型，占69．3％（”=147），分布于11个省市。安徽省48株C群菌株共分为3个PFGE型别（AH1、AH2、AH3），45株（93．8％）为AH1型。安徽省38株与C群流脑暴发相关的菌株中，37株（97．4％）为AH1型。全国53株流脑患者分离菌株中，AH1型菌株占67．9％（36／53）；121株流脑病例密切接触者分离菌株中，AH1型占71．9％（87／121），38株健康人群鼻咽部分离菌株中，AH1型占63．2％（24／38）。结论AH1型C群脑膜炎奈瑟菌是中国目前C群流脑流行的主要克隆群，安徽省C群流脑暴发是由AH1型C群脑膜炎奈瑟菌引起的，已在全国呈扩散流行的趋势。     

陕西省关中地区健康人群脑膜炎奈瑟菌带菌状况调查与分析

目的了解陕西省关中地区健康人群脑膜炎奈瑟菌(Neisseria meningitidis,Nm)的带菌状况,为流行性脑脊髓膜炎(流脑)防治提供依据。方法在西安市和宝鸡市共选择998名健康人群采集咽拭子进行细菌分离培养和PCR核酸检测,并将阳性Nm株进行分群。结果关中地区健康人群Nm总带菌率为6.42%(64/998)。宝鸡市人群Nm带菌率(8.25%)显著高于西安市(4.50%)(χ~2=5.85,P0.05)。15-24岁年龄组带菌率(13.45%)显著高于0-2岁年龄组(4.71%)(χ~2=7.89,P0.05)。在64株Nm阳性菌株中,A、B、C和不可分群分别占1.56%、7.81%、25.00%和65.63%。结论关中地区健康人群Nm带菌率总体较低,菌群分布与中国其他地区基本一致。     

四川省B群脑膜炎奈瑟菌脉冲场凝胶电泳分型分析

[目的]对四川省B群脑膜炎奈瑟菌分离菌株进行脉冲场凝胶电泳(PFGE)分析,了解四川省B群脑膜炎奈瑟菌菌株的分子流行病学特征.[方法]对健康人群和流行性脑脊髓膜炎病例密切接触者分离的55株B群脑膜炎奈瑟菌使用限制性内切酶NheI酶切、脉冲场凝胶电泳,电泳结果用BioNumerics软件进行聚类分析.[结果]55株B群脑膜炎奈瑟菌共分为33种PFGE型,呈现高度的多态性.其中健康带菌者的45株菌分为24个型,带型分布在年份和地区上没有关联,但局部地区的菌株呈现出PFGE型别一致的特征;10株病例的密切接触者分离的菌株分为9个型,无优势型别.[结论]四川省B群脑膜炎奈瑟菌菌株具有高度的遗传多样性,但在局部地区菜一时间段存在优势的PFGE型别的B群脑膜炎奈瑟菌菌株.     

中国流行性脑脊髓膜炎流行菌群变化趋势分析

目的研究中国(未包括香港、澳门特别行政区和台湾地区,下同)流行性脑脊髓膜炎(流脑)流行菌群的变迁趋势。方法对中国1956~2006年分离的1 819株流脑菌株的血清群构成进行分析。结果1956~2002年的922株流脑菌株中,A群占69.20%,B群占27.55%,C群占0.97%,其它群2.28%。2003~2006年的897株流脑菌株中,A群占35.90%,B群占29.21%,C群占23.97%,其它群占10.92%。C群流脑病人来源菌株比例由0.88%上升至48.67%,A群流脑病例菌株比例由80.4%下降至50.44%。健康人群鼻咽部携带C群流脑菌株比例由1.07%上升至20.41%,A群由58.33%下降至33.80%。结论中国流脑病人及健康人群携带菌株中,C群流脑菌株的比例呈上升趋势,流脑流行菌群正在发生从A群到C群的变化。     

2013年湖南省一起B群流脑聚集性疫情菌株分子分型分析

目的了解湖南湘西地区B群流脑聚集性疫情中病例及其密切接触人群中分离到的B群脑膜炎奈瑟菌的分子分型特征及其流行关系。方法对病例的血液标本及其密切接触者的咽拭子标本进行分离、培养及生化鉴定,确认为脑膜炎奈瑟菌后,对菌株进行血清学分群和药敏试验;采用多位点序列分型(multilocus sequence typing,MLST)以及脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)方法对菌株进行分子分型。结果共分离到3株B群脑膜炎奈瑟菌,均对复方磺胺甲恶唑(SXT)耐药,对青霉素(PEN)和氨苄青霉素(AMP)的药敏结果为中介度,对其他9种抗生素米诺环素(MIN)、头孢曲松(CRO)、头孢噻肟(CTX)、利福平(RIF)、阿奇霉素(AZM)、氯霉素(CHL)、环丙沙星(CIP)、左氧氟沙星(LVX)和美洛培南(MEM)均敏感,PFGE结果显示3株菌株为同一带型,MLST结果显示3株菌株均为ST-4821 complex高致病克隆群。结论该起湖南湘西地区B群流脑聚集性疫情中病人与其密切接触者中分离到的B群脑膜炎奈瑟菌在分子分型实验中呈现高度一致性,提示为同一来源。流脑菌在湖南省的菌群已经发生变迁,带致病性克隆群的B群菌株可能成为优势菌株,引起流脑的暴发流行。     

MLEE and PFGE characterization of Neisseria meningitidis serogroup C and B isolated in the Slovak Republic in 1998

In the Slovak Republic the incidence and mortality of invasive meningococcal disease increased after 1995 when the new meningococcal clone of Neisseria meningitidis C:2a:P1.2,P1.5, ET-1.5/37 emerged. The new clone spread between 1995 and 1998 throughout the whole country. Morbidity of invasive meningococcal disease was 1.6/100,000 of the population and fatality reached the highest level of 23% in the Slovak Republic in 1998. The new clone caused a new emergent epidemiological and clinical situation. The occurrence of invasive meningococcal disease caused by this clone has continually risen since 1995. In 1998 72% of all diseases in Slovakia were caused by serogroup C. The emerging clone C:2a:Pl.2,P1.5 represented 74% of the serogroup C isolates. Clonality and genetic diversity of 15 selected meningococcal strains causing invasive meningococcal disease was compared by multilocus enzyme electrophoresis (MLEE) and DNA macrorestriction analysis by pulsed-field gel electrophoresis (PFGE). The strains of serogroup C and B were isolated in all regions of Slovakia in 1998. The majority of isolates belong to hypervirulent clone ET-15 as determined by MLEE. By PFGE a higher degree of diversity was observed.     

张家界市首例C群流脑死亡病例及其密接人群中分离的脑膜炎奈瑟菌实验室分析和PFGE分型

目的了解张家界市首例C群流脑死亡病例及其密切接触人群中分离到的11株脑膜炎奈瑟菌的病原学特征及其流行关系。方法经培养及生化鉴定后,对菌株进行血清学及聚合酶链反应（PCR）鉴定分群,最后采用最低抑菌浓度（MIC）琼脂稀释法进行药敏试验;脉冲场凝胶电泳对菌株进行PFGE分型分析。结果通过生化、血清学和PCR实验共鉴定到9株C群脑膜炎奈瑟菌和2株W135群脑膜炎奈瑟菌,药敏试验中所有菌株对青霉素、氨苄西林、米诺环素、头孢曲松、头孢噻肟、氯霉素、阿奇霉素、美罗培南和利福平全部敏感;对复方磺胺甲口恶唑全部耐药;对环丙沙星和左氧氟沙星部分耐药,PFGE结果显示11株菌株共分为两个带型,其中9株C群脑膜炎奈瑟菌菌株带型完全相同。结论 C群和W135群可能成为新的流脑流行群引起疾病,分离的菌株对大部分抗生素仍较敏感,但要注意耐药趋势,造成该病例死亡的病原菌为C群脑膜炎奈瑟菌,与其密接同学中分离到的C群脑膜炎奈瑟菌的PFGE分型呈现高度一致性,提示为同一克隆群。     

Molecular surveillance of Neisseria meningitidis capsular switching in Portugal, 2002-2006

Neisseria meningitidis capsular switching has been reported in several countries. In order to establish the genetic relationship within group B and C strains expressing subtypes 2a or 2b, and to evaluate whether C to B capsular switching occurred in Portugal, 64 meningococci (56 serogroup C and 8 serogroup B) isolated from invasive meningococcal disease were typed using molecular methods. The studied phenotypes, 2b:P1.5,2 and 2a:P1.5-1,10-8, were the most frequent among serogroup C, but were uncommon among serogroup B strains. The multi-locus sequence typing (MLST) allelic profile and the pulsed-field gel electrophoresis (PFGE) fingerprints showed that seven serogroup B strains were genotypically identical to C strains, suggesting that capsular switching occurred. Active laboratory surveillance to find evidence of capsule switching is a now priority as MenC was introduced in the Portuguese vaccination schedule in January 2006.     

湖南省C群及W135群脑膜炎奈瑟菌的流行病学及病原学特征分型

目的了解湖南省C群和W135群脑膜炎奈瑟菌的流行病学及病原学特征。方法收集2006—2016年湖南省流行性脑脊髓膜炎患者的血液或脑脊液、患者密切接触者以及健康人群的咽拭子标本中分离到的脑膜炎奈瑟菌菌株,进行生化检测、血清学分群。选取其中的C群和W135群部分菌株进行药敏试验,并采用脉冲场凝胶电泳(PFGE)分型以及多位点序列分型(MLST)方法对菌株进行分子分型,分析其流行病学特征。结果经生化和血清学确认后,选取22株C群脑膜炎奈瑟菌和9株W135群脑膜炎奈瑟菌进行药敏试验,结果显示对大部分检测抗菌药物全部敏感,但对复方磺胺甲口恶唑C群菌株全部耐药,而W135群菌株的耐药率为55.56%,两者比较差异有统计学意义(χ~2=7.61,P=0.006)。经PFGE分型后,22株C群脑膜炎奈瑟菌共分为5种PFGE带型,其中5株HNC-01带型和13株HNC-02带型属同一亚型;2006年湖南省第1例C群患者分离菌株的PFGE带型为HNC-02,与2012、2013年患者以及患者密切接触者分离菌株的图谱完全一致,与带型为HNC-01的2008、2010、2013年的患者分离菌株仅有一个带型的差异,均属于优势带型。9株W135群脑膜炎奈瑟菌PFGE分型后共分为2个带型,其中首例患者与2013、2016年患者分离菌株的带型一致,均为HNW-01型。选取其中优势带型菌株经MLST后,结果 C群脑膜炎奈瑟菌为ST4821型,W135群脑膜炎奈瑟菌为ST11型,均属于脑膜炎奈瑟菌的高致病性克隆群。结论湖南省C群流脑和W135群流脑自首例病例出现后,各自都成为了该群病例的优势流行克隆群,C群流脑近年有减少态势,但出现了新的流行型别;W135群自2012年起成为我省新的流脑流行株,其优势菌株与国际上侵袭性的W群分型一致,可能引起新的大流行,应及时制定相应的防控政策。     

Usefulness of the DNA-fingerprinting pattern and the multilocus enzyme electrophoresis profile in the assessment of outbreaks of meningococcal disease.

The objective of the study was to assess whether genotypic characterization by means of DNA-fingerprinting pattern (DFP) and multilocus enzyme electrophoresis (MEE) profile as compared to phenotypic characterization would improve the differentiation of Neisseria meningitidis strains associated with outbreaks from strains associated with sporadic cases of meningococcal disease. In addition, the differentiation of serogroup C carrier strains from those associated with an outbreak of serogroup C meningococcal disease was investigated. A total of 118 N. meningitidis strains were available for the study: 59 from patients involved in outbreaks of meningococcal disease (2 serogroup B and 2 serogroup C), 37 patients considered to be sporadic cases and 22 serogroup C carrier strains. Among the 59 strains from patients involved in outbreaks the 4 strains isolated from the patient registered as the first in each outbreak were designated the index strains. Among the remaining 55 outbreak strains 52 were either DFP-identical or DFP-indistinguishable when compared with the one relevant out of the 4 index strains. This was only the case for 17 of the 37 strains isolated from sporadic cases caused by the same serogroup of meningococci during the outbreak periods, and 5 of the 22 meningococcal strains isolated from healthy carriers. Among the 56 (52 + 4) DFP-identical or DFP-indistinguishable outbreak strains 5 different electrophoretic types were identified by MEE. Among 59 assumed outbreak strains a total of 4 were identified as genotypically distinct. Among the 37 mainly DFP-indistinguishable or DFP-different strains from sporadic cases 17 different ETs were identified, and among the 22 mainly DFP-different carrier strains 13 different ETs were identified. Two strains among those selected from sporadic cases were identical to the outbreak strain. None of the local serogroup C carrier strains isolated during the outbreak of serogroup C disease were identical to the outbreak strain. Both DNA-fingerprinting and MEE improved the differentiation of meningococci when compared with phenotypic characterization. The results indicate that tracing a virulent strain within a open group of contacts is irrelevant.     

Annual report of the Australian Meningococcal Surveillance Programme, 1998. The Australian Meningococcal Surveillance Programme

The National Neisseria Network has undertaken meningococcal isolate surveillance by means of a collaborative laboratory-based initiative since 1994. The phenotype (serogroup, serotype and serosubtype) and antibiotic susceptibility of 323 isolates of Neisseria meningitidis from invasive cases of meningococcal disease were determined in 1998. Ninety per cent of the invasive isolates were either serogroup B or C. Serogroup B strains predominated in all States and Territories and were isolated from sporadic cases of invasive disease. Serogroup B phenotypes were diverse. Serogroup C isolates were most prominent in New South Wales, especially in adolescents and young adults. C:2a:P1.5 was the most frequently encountered phenotype and C:2b:P1.5,2 strains were also distributed widely. About three-quarters of all isolates showed decreased susceptibility to the penicillin group of antibiotics (MIC 0.06 to 0.5 mg/L). Four isolates showed reduced susceptibility to rifampicin, one to ciprofloxacin and one to chloramphenicol.     

一起流行性脑脊髓膜炎疫情病例密切接触者及周围人群的脑膜炎奈瑟菌菌属类型及抗体检出情况调查

目的 对流行性脑脊髓膜炎患者的密切接触者及周围人群进行脑膜炎奈瑟菌菌属类型及抗体检测调查,为流脑防控工作提供科学依据。方法 采集病例密切接触者和周围人群的血清和咽拭子进行带菌及抗体检测。结果 共采集流脑患者密切接触者30人和周围人群147人,其中密切接触者共3人检出脑膜炎奈瑟菌阳性,且均为C群;周围人群共19人检出脑膜炎奈瑟菌阳性,其中B群17人,W135群2人。在抗体检测中,其中周围人群的检出率高于密切接触者（χ2 = 7.885,P＜0.05）;密切接触者中Y群检出率高于周围人群（χ2 = 12.638,P＜0.05）。在疫苗接种与抗体检出中,密切接触者的A群流脑多糖疫苗、A + C脑膜炎球菌结合疫苗的接种率与周围人群比较均无统计学上差异（P＞0.05）,同时A群与A + C群抗体检测在统计学上也无差异（P＞0.05）。但在未全程接种的A + C群抗体检测中,未全程接种的周围人群抗体阳性率高于密切接触者（χ2 = 6.021,P＜0.05）。结论 本起疫情检测菌属以B群为主,抗体检出以为A群为主,且疫苗接种率越高,抗体阳性检出率越高。