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目的对河北省首例B群流行性脑脊髓膜炎(流脑)死亡病例进行病原学分析。方法采集患儿血和脑脊液标本,进行生化鉴定和PCR目的基因的检测,对分离菌株进行Etest法药敏试验和多位点序列分型(multilocus sequence typing,MLST)分析。结果该病例证实为B群脑膜炎奈瑟菌引起的脑膜炎病例,该菌株对磺胺甲基异噁唑、环丙沙星、萘啶酸耐药,对米诺霉素、阿奇霉素等敏感。MLST结果分析该菌为ST-9754型,属于ST-4821高致病克隆群。结论该病例为河北省首例B群流脑死亡病例,病原菌为具有高致病性的ST-9754型脑膜炎奈瑟菌,提示应要加强流脑病原学监测。
Objective To analyze the etiological analysis of the first death from epidemic cerebrospinal meningitis group B in Hebei Province. Methods Blood and cerebrospinal fluid samples of children were collected for biochemical identification and PCR analysis of the target genes. The drug susceptibility test and multilocus sequence typing (MLST) analysis of the isolates were performed. Results The case was confirmed as meningitis caused by Neisseria meningitidis group B, which was sensitive to sulfamethoxazole, ciprofloxacin, nalidixic acid and to minocycline and azithromycin. MLST analysis of the bacteria ST-9754 type, belonging to the ST-4821 high-cloned group. Conclusions This case was the first case of death from flow-group B in Hebei Province. The pathogen was highly pathogenic Neisseria meningitides ST-9754, which suggested that we should strengthen the surveillance of meningococcal disease.