摘要
目的 对2024年11月河南省郑州市某学校发生的1例流行性脑脊髓膜炎(流脑)死亡病例及其密切接触者开展病原学调查,旨在了解其病原学特征,为调查和处置提供依据。方法 采集病例血液、脑脊液和密切接触者咽拭子进行分离培养,分离的菌株进行血清分群、药敏试验和全基因组测序及多位点序列分型(MLST),分析菌株遗传进化关系。结果 从病例血液中分离出1株Y群脑膜炎奈瑟菌(Nm),20名密切接触者中分离出5株Nm。患者分离株MLST分型为ST-1655,克隆群为CC23,与密切接触者2、3分离株显示其遗传相关性。患者分离株药敏结果显示菌株对氨苄西林、头孢噻肟、头孢曲松、美罗培南、阿奇霉素、米诺环素、环丙沙星、左氧氟沙星、复方新诺明、利福平、氯霉素等11种药物敏感,对青霉素中介。结论 该病例为河南省首例Y群Nm引起的流脑死亡病例。应密切关注密切接触者Nm的高携带率,加强主动监测,降低发病和传播风险。
Objective To conduct an etiological investigation and analysis of a suspected case of meningococcal meningitis(meningitis)death and its close contacts in a school in Zhengzhou City,Henan Province in November 2024.This study aims to understand the etiological characteristics and provide an experimental basis for investigation and management.Methods Blood,cerebrospinal fluid,and throat swab samples were collected from patient and close contacts for culture isolation.Isolated strains underwent serotyping,antimicrobial susceptibility testing,whole-genome sequencing,and multilocus sequence typing(MLST)to analyze the genetic evolutionary relationships of the strains.Results One strain of Neisseria meningitidis(Nm)was isolated from the patient's blood and classified as group Y.Five additional Nm strains were isolated from 20 close contacts.MLST identified the patient's isolate as ST-1655,belonging to clonal complex CC23,and showed genetic relatedness to isolates from close contacts 2 and 3.Antimicrobial sensitivity testing revealed that the patient's isolate was sensitive to 11 antibiotics,including ampicillin,cefotaxime,ceftriaxone,meropenem,azithromycin,minocycline,ciprofloxacin,levofloxacin,cotrimoxazole,rifampicin,and chloramphenicol,but exhibited intermediate resistance to penicillin.Conclusions This case represents the first reported death due to meningococcal disease caused by group Y Neisseria meningitidis in Henan Province.The high carriage rate of Nm among close contacts in the region are concerning.Active surveillance should be strengthened to reduce the risk of disease onset and transmission.
作者
赵雪蕾
程春荣
周鹏
张晓甍
孔江南
ZHAO Xuelei;CHENG Chunrong;ZHOU Peng;ZHANG Xiaomeng;KONG Jiangnan(Zhengzhou Center for Disease Control and Prevention,Zhengzhou,Henan 450007,China;Henan Provincial Center for Disease Control and Prevention)
出处
《现代疾病预防控制》
2025年第8期577-580,586,共5页
MODERN DISEASE CONTROL AND PREVENTION
