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[目的]了解脑膜炎奈瑟菌菌群分布、变异及耐药情况,为流行性脑脊髓膜炎(流脑)防治工作提供科学依据。[方法]对2008/2009年度山东省流脑疑似病例及流脑监测点流行期检测资料进行分析。[结果]调查健康人群1 097人,从咽拭子检出脑膜炎双球菌13人,带菌率为1.19%,分离菌株中,A群3株,B群1株,C群1株,W135群4,I群2株,X群2株。带菌率,15~19岁为5.77%,其他年龄为0.43%(P<0.01)。检测10例流脑病例脑脊液(或血清),其密切接触者咽拭子30份,“两脑”项目哨点医院送检脑炎、脑膜炎疑似病例脑脊液(或血清)标本184份,RT-PCR检出1株A群菌(流脑病例)、3株C群菌(“两脑”病例)。用分离的9株菌株进行药敏试验,1株B群菌株对12种抗生素均敏感;其他8株对氨苄青霉素、阿齐霉素、美洛培能、头孢曲松、头孢噻肟、阿齐霉素、氯霉素、利福平、萘啶酸均敏感,对复方新诺明均耐药,对青霉素1株耐药,对环丙沙星6株耐药,对左氧氟沙星6株耐药。[结论]目前山东省流脑疫情以A群、C群为主,从健康人群中检出W135群菌株,部分菌株对常用抗菌药物表现耐药。
[Objective] To understand the distribution, variation and drug resistance of Neisseria meningitidis flora and provide a scientific basis for the prevention and treatment of epidemic cerebrospinal meningitis. [Methods] The data of suspected cases of meningitis in Shandong Province during the epidemic period of epidemic cerebrospinal meningitis in epidemic period of Shandong Province in 2008/2009 were analyzed. [Results] A total of 1 097 healthy people were investigated. 13 meningococci were detected from throat swabs with a carriage rate of 1.19%. Among the isolates, 3 strains of A group, 1 strain of B group, 1 strain of C group, 1 strain of W135 group 4, I group 2 strains, X group 2 strains. The carrier rate was 5.77% at 15-19 years old and 0.43% at other age (P <0.01). Ten cases of cerebrospinal fluid (or serum) were detected in 10 cases of cerebrospinal meningitis. Thirty swallowing swabs were in close contact with them. Sentinel encephalitis and 184 samples of cerebrospinal fluid (or serum) One strain of group A (meningitis cases) and three strains of group C (“two brain” cases) were detected by RT-PCR. Nine strains were isolated for susceptibility testing. One strain of group B was sensitive to 12 antibiotics. The other 8 strains were sensitive to ampicillin, azithromycin, meropenem, ceftriaxone, cefotaxime, All of them were sensitive to cotrimoxazole, resistant to penicillin, resistant to 6 ciprofloxacin, resistant to 6 levofloxacin. [Conclusion] At present, the epidemic situation of meningitis in Shandong Province mainly consists of group A and group C, W135 strain is detected from healthy population, and some strains are resistant to common antibiotics.