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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。
Objective To investigate the molecular typing characteristics and epidemiological characteristics of Neissez meningitidis serogroup B isolated from cases of agglomeration meningitis in Group B in western Hunan and their close contacts. Methods The blood samples of throat swabs and their throat swab specimens from close contacts were isolated, cultured and biochemically identified. After confirmed as Neisseria meningitidis, the strains were divided into serogroups and drug susceptibility tests. Multi-locus sequence (MLST) and pulsed-field gel electrophoresis (PFGE). Results Three strains of Neisseria meningitidis B were isolated and all of them were resistant to Sulfamethoxazole (SXT), the medium sensitivity to penicillin (PEN) and ampicillin (AMP) The antibiotics minocycline, ceftriaxone (CRO), cefotaxime (CTX), rifampicin (RIF), azithromycin (AZM), chloramphenicol (CHL), ciprofloxacin Levofloxacin (LVX) and meropenem (MEM) were sensitive, PFGE results showed that the three strains of the same band type, MLST results showed that the three strains were ST-4821 complex high-pathogenic clonal group. CONCLUSIONS Neissez meningitidis group B isolated from patients and their close contacts in Group B meningitis congregation epidemics in Hunan western Hunan showed a high degree of identity in molecular typing experiments suggesting the same origin. Mycobacterium meningitis in Hunan Province has changed flora, with pathogenic clonal group B strains may become the dominant strains, causing the outbreak of epidemic encephalitis.