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目的对一起幼儿园猩红热疫情进行病原菌分离和实验室分析。方法按照国家行业标准WS 282-2008进行病原菌分离和鉴定,应用PCR法扩增致热外毒素基因,药敏试验采用美国临床实验室标准化委员会(CLSI)推荐的纸片扩散法,脉冲场凝胶电泳分析参照PulseNet发布的单核细胞增生李斯特菌的PFGE操作程序。结果 21份咽拭子中检出5株A群链球菌。分离株均扩增出致热外毒素基因speA、speB和speC。菌株对青霉素、头孢拉定、氨苄西林、左氧氟沙星、氯霉素和万古霉素均敏感,对红霉素、克拉霉素、阿奇霉素和四环素均耐药。PFGE分析显示其来源相同。结论加强重点人群和重点场所的管理是预防猩红热的主要措施,及时判定疫情、确定传染源是控制猩红热疫情的必要手段,实验室检测特别是病原菌同源性分析将为疫情的控制提供可靠的保证。
Objective To isolate and laboratory analyze the pathogen of a scarlet fever in kindergarten. Methods The pathogen was isolated and identified according to the national industry standard WS 282-2008. PCR was used to amplify the exothermic exotoxin gene. The susceptibility test was based on the disc diffusion method recommended by the American Clinical Laboratory Standardization Committee (CLSI), pulsed field gel Electrophoretic analysis follows PulseNet’s PFGE protocol for Listeria monocytogenes. Results A total of 5 group A streptococci were detected in 21 throat swabs. All the isolates amplified pyogenic exotoxin genes speA, speB and speC. The strains were sensitive to penicillin, cephradine, ampicillin, levofloxacin, chloramphenicol and vancomycin, and resistant to erythromycin, clarithromycin, azithromycin and tetracycline. PFGE analysis showed the same source. Conclusion Strengthening the management of key populations and key places is the main measure to prevent scarlet fever. It is necessary to determine the epidemic situation and determine the source of infection in time to control the epidemic of scarlet fever. Laboratory tests, especially pathogenic homology analysis, will provide a reliable guarantee for the control of epidemic situation .