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目的分析北京地区儿童携带的酿脓链球菌酿脓链球菌的emm分型及携带超抗原speA及speC基因情况。方法应用PCR对2007年1-12月155株北京地区猩红热、咽扁桃体炎患儿及健康儿童咽部酿脓链球菌emm基因及超抗原speA和speC基因进行扩增。结果健康儿童、猩红热患儿及咽扁桃体炎患儿中有emm1.0(51.6%)、emm4.0(0.6%)、emm12.0(41.3%)、emm18.0(1.9%)、emm22.0(0.6%)、st1815(1.3%)、st5240(0.6%)及stG485(1.9%)8种酿脓链球菌克隆株流行。其中13.5%酿脓链球菌只携带超抗原speA基因,26.5%只携带超抗原speC基因,40.6%同时携带超抗原speA和speC基因,19.4%2种基因均不携带。25.0%emm1.0型酿脓链球菌只携带超抗原speA基因,2.5%emm1.0型和51.6%emm12.0型酿脓链球菌只携带超抗原speC基因,68.8%emm1.0型和12.5%emm12.0型酿脓链球菌同时携带speA及speC基因,3.8%emm1.0型和35.9%emm12.0型酿脓链球菌2种基因均不携带。27.3%致猩红热emm1.0型酿脓链球菌只携带超抗原speA基因,4.5%只携带超抗原speC基因,61.4%同时携带超抗原speA和speC基因,6.8%克隆株2种基因均不携带。18.8%致咽扁桃体炎emm1.0型酿脓链球菌只携带超抗原speA基因,81.2%emm 1.0型酿脓链球菌同时携带超抗原speA和speC基因。50.0%健康儿童携带的emm1.0型酿脓链球菌只携带超抗原speA基因,50.0%同时携带超抗原speA和speC基因。39.1%致猩红热emm12.0型酿脓链球菌只携带超抗原speC基因,17.4%同时携带超抗原speA和speC基因,43.5%2种基因均不携带。73.3%致咽扁桃体炎emm12.0型酿脓链球菌只携带超抗原speC基因,10.0%同时携带超抗原speA和speC基因,16.7%2种基因均不携带。18.2%健康儿童携带的emm12.0型酿脓链球菌只携带超抗原speC基因,9.1%同时携带超抗原speA和speC基因,72.7%2种基因均不携带。结论 emm1.0型和emm12.0型酿脓链球菌是导致北京地区儿童发生猩红热及咽扁桃体炎的2个主要克隆菌株。stG485、emm18.0、emm1.0型和emm12.0型酿脓链球菌是北京地区健康儿童携带的4个主要克隆菌株。不同emm分型酿脓链球菌、致猩红热酿脓链球菌、致急性咽扁桃体炎酿脓链球菌及健康儿童携带的酿脓链球菌对超抗原speA和speC基因携带率各有不同。
Objective To analyze the emm typing and the speA and speC genes carrying Streptococcus pyogenes in children in Beijing. METHODS: PCR was used to amplify the emm gene and the speA and speC genes of Streptococcus pyogenes in 155 children with scarlet fever and pharyng tonsillitis in Beijing from January 2007 to December 2007. Results There were emm1.0 (51.6%), emm4.0 (0.6%), emm12.0 (41.3%), emm18.0 (1.9%) and emm22.0 in healthy children, children with scarlet fever and pharyngitis tonsillitis (0.6%), st1815 (1.3%), st5240 (0.6%) and stG485 (1.9%) 8 strains of Streptococcus pyogenes. Among them, 13.5% of Streptococcus pyogenes carried only the superantigen speA gene, 26.5% of the superantigen speC genes, 40.6% of the superantigen speA and speC genes, and 19.4% of the two genes were not carried. 25.0% of Streptococcus pyogenes emm1.0 only carry superantigen speA gene, 2.5% emm1.0 type and 51.6% emm12.0 Streptococcus pyogenes only carry superantigen speC gene, 68.8% emm1.0 type and 12.5% emm12.0 Streptococcus pyogenes both speA and speC genes, 3.8% emm1.0 type and 35.9% emm12.0 Streptococcus pyogenes two kinds of gene are not carried. 27.3% of Streptococcus thermophiatus emm1.0 carrying only the super antigen speA gene, 4.5% carrying only the super antigen speC gene, 61.4% carrying both the super antigen speA and speC gene, 6.8% of the cloned two genes are not carried. 18.8% Atypical tonsillitis emm1.0 Streptococcus pyogenes carries only the superantigen speA gene and 81.2% emm1.0 Streptococcus pyogenes carries both the superantigen speA and speC genes. 50.0% of healthy children carrying the Streptococcus pyogenes emm1.0 carry only the super antigen speA gene, 50.0% carrying both the super antigen speA and speC genes. 39.1% caused by the genitalium emm12.0 pyogenes Streptococcus pyogenes carrying only the super antigen speC gene, 17.4% carrying both the super antigen speA and speC gene, 43.5% of the two genes are not carried. 73.3% caused by pharyngitis tonsillitis emm12.0 Streptococcus pyogenes carrying only the super antigen speC gene, 10.0% carrying both the super antigen speA and speC gene, 16.7% of the two genes are not carried. 18.2% of healthy children carrying the Streptococcus pyogenes emm12.0 only carry superantigen speC gene, 9.1% carry both superantigen speA and speC genes, 72.7% of the two genes are not carried. Conclusion The emm1.0 and emm12.0 Streptococcus pyogenes are the two major clonal strains that cause scarlet fever and pharyngitis in children in Beijing. StG485, emm18.0, emm1.0 and emm12.0 Streptococcus pyogenes are the four major clonal strains carried by healthy children in Beijing. Streptococcus pyogenes with different emm types, Streptococcus pyogenes caused by Streptococcus aureus, Streptococcus pyogenes caused by acute pharyngotrophic tonsillitis and Streptococcus pyogenes carried by healthy children have different carrying rates for the speA and speC genes of superantigens.