2009-2015年邯郸市健康人群流行性脑脊髓膜炎带菌率调查及分子分型研究

目的 了解邯郸市健康人群流行性脑脊髓膜炎带菌状况以及菌群分布变化情况,为预测流脑发病趋势、合理制定流脑防控措施提供依据。 方法 2009-2015年间,采集7个年龄组健康人群的咽拭子,接种于巧克力双抗琼脂平板进行脑膜炎奈瑟菌分离培养鉴定。 结果 共采集3 528份健康人群咽拭子,其中阳性100株,带菌率为2.83%;通过血清分群鉴定出71株,其中A群8株, B群36株, C群18株, W135群 9株;未分群29株,包括多凝菌(12株)、自凝菌(8株)、不凝菌(9株),并且以15～岁年龄组的带菌率最高。通过PCR的方法对未分群的菌株进行分子分型,鉴定出18株,分型率为62.1%;其中A群3株,B群8株,C群6株,29E群1株,仍有11株未分型。 结论 2009-2015年邯郸市健康人群流行性脑脊髓膜炎带菌率较低,但10~25岁年龄组带菌率显著。流行株在2009-2011年主要以B群为主,并且集中在10~25岁之间,但是到2014年、2015年的流行株就有所改变,主要是C群和W135群。这更应该引起关注,进一步加大卫生宣传力度和流脑疫苗接种率。

Germ-carrying rate of epidemic cerebrospinal meningitis and molecular typing of bacteria among healthy population in Handan City, 2009-2015

Objective To investigate the germ-carrying rate of epidemic cerebrospinal meningitis and the changes of bacteria type distribution among healthy population in Handan City, and to provide a basis for forecasting the tendency of incidence of epidemic cerebrospinal meningitis and rationally formulating its prevention and control measures. Methods The throat swab specimens were collected from 7 age groups of healthy population during 2009-2015, and then inoculated in chocolate double anti-AGAR plate to isolate, cultivate and identify Neisseria meningitidis (N. meningitidis). Results A total of 3,528 throat swab specimens were collected from healthy population, and 100 positive strains were detected, with the germ-carrying rate being 2.83%. 71 strains were identified by serum grouping, of which 8 strains were characterized in serogroup A, 36 strains in serogroup B, 18 strains in serogroup C and 9 strains in serogroup W135. 29 strains were unidentified, including 12 strains of multiple-coagulate bacteria, 8 strains of self-coagulate bacteria and 9 strains of non-coagulate bacteria, and the germ-carrying rate of the age group of 15- years was the highest. The unidentified strains were typed molecularly by PCR, and 18 strains were identified (with the typing rate being 62.1%), including 3 strains in serogroup A, 8 strains in serogroup B, 6 strains in serogroup C, 1 strain in serogroup 29E. But 11 strains still remained unidentified. Conclusions The germ-carrying rate of epidemic cerebrospinal meningitisamong the healthy population in Handan City from 2009 to 2015 was low,but the carrying rates in the age groups of 10-, 15- and 25- years were slightly higher. Serogroup B N. meningitidis strains prevailed and mainly prevailed in the age groups of 10-15 yearsduring the period of 2009-2011, and were supplanted by serogroup C and serogroup W135 N. meningitidis strains in 2014-2015. Therefore, more attention should be paid to intensifying health propaganda and expanding the coverage rate of meningococcal meningitis vaccine.