一起学校流行性脑脊髓膜炎暴发疫情的病原学鉴定及其MLST分型分析

目的报告一起学校流行性脑脊髓膜炎（流脑）暴发疫情的病原学鉴定及病原学特征。方法对疑似流脑病例进行流行病学调查；采集患者血和脑脊液标本，进行实时荧光定量PCR检测，对分离菌株进行生化鉴定并进行E—test法药敏试验和多位点序列分型（multilocus sequence typing，MLST）分析。结果此疫情由C群脑膜炎奈瑟菌引起，分离菌株对磺胺甲基异嗯唑、环丙沙星、萘啶酸耐药。MLST分析该菌为ST-9792型，属于ST4821高致病克隆群。结论该起流脑疫情由C群脑膜炎奈瑟菌ST-9792型引起，确诊病例数多。提示应加强对当地流脑的监测，在流行季节开展人群C群流脑疫苗接种。

Determination of the etiology of an outbreak of epidemic cerebrospinal meningitis in a school and MLST analysis of the pathogen responsible

Objective To identify the etiology and characteristics of an outbreak of epidemic cerebrospinal meningitis （ECM） in a school. Methods Suspected cases of ECM were investigated epidemiologically and blood and cerebrospinal fluid samples were collected from patients. The samples were biochemically tested and PCR was used to identify target genes. A drug susceptibility test was performed using the E test method. Strains of pathogens were analyzed using multilocus sequence typing （MLST）. Results The outbreak of meningitis was caused by serogroup C Neisseria meningitides. Isolates were not sensitive to sulfamethoxazole, ciprofloxacin, or nalidixic acid. MLST results revealed that the iso lares were ST-9792 and belonged to the ST4821 complex. Conclusion An outbreak of ECM was caused by serogroup C N. meningitides that MLST revealed to be ST-9792. Numerous cases were confirmed. These findings indicate that the etiology of local ECM should be monitored further and that vaccination against serogroup C N. rneningitides should be en hanced at times when N. meningitides is prevalent.