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目的了解张家界市首例C群流脑死亡病例及其密切接触人群中分离到的11株脑膜炎奈瑟菌的病原学特征及其流行关系。方法经培养及生化鉴定后,对菌株进行血清学及聚合酶链反应(PCR)鉴定分群,最后采用最低抑菌浓度(MIC)琼脂稀释法进行药敏试验;脉冲场凝胶电泳对菌株进行PFGE分型分析。结果通过生化、血清学和PCR实验共鉴定到9株C群脑膜炎奈瑟菌和2株W135群脑膜炎奈瑟菌,药敏试验中所有菌株对青霉素、氨苄西林、米诺环素、头孢曲松、头孢噻肟、氯霉素、阿奇霉素、美罗培南和利福平全部敏感;对复方磺胺甲口恶唑全部耐药;对环丙沙星和左氧氟沙星部分耐药,PFGE结果显示11株菌株共分为两个带型,其中9株C群脑膜炎奈瑟菌菌株带型完全相同。结论 C群和W135群可能成为新的流脑流行群引起疾病,分离的菌株对大部分抗生素仍较敏感,但要注意耐药趋势,造成该病例死亡的病原菌为C群脑膜炎奈瑟菌,与其密接同学中分离到的C群脑膜炎奈瑟菌的PFGE分型呈现高度一致性,提示为同一克隆群。
Objective To understand the etiological characteristics and epidemiological characteristics of Neisseria meningitides isolated from the first case of C group meningitis in Zhangjiajie City and its close contact with the population. Methods After culture and biochemical identification, the strains were identified by serology and polymerase chain reaction (PCR), and finally drug susceptibility test was performed by MIC agar dilution method. The PFGE Typing Analysis. Results Nine strains of Neisseria meningitides and two W135 strains of Neisseria meningitidis were identified by biochemical, serological and PCR assays. All strains in the susceptibility test were resistant to penicillin, ampicillin, minocycline, Cortisone, cefotaxime, chloramphenicol, azithromycin, meropenem and rifampicin were all sensitive; they were all resistant to the compound sulfamethoxazole; some were resistant to ciprofloxacin and levofloxacin, PFGE results showed that 11 strains Divided into two bands, of which 9 strains of Neisseria meningitidis strain with the same type. Conclusion C and W135 groups may be the new meningococcal epidemic group caused by the disease, the isolated strains are still sensitive to most of the antibiotics, but pay attention to the drug resistance trend, resulting in the case of pathogenic bacteria died of Neisseria meningitides group C, The PFGE genotypes of Neisseria meningitides of group C isolated from its close contacts with students were highly consistent, suggesting the same clonal group.