董梅, 邵祝军, 黄芳. 我国首例脑膜炎球菌肺炎的病原学研究[J]. 疾病监测, 2016, 31(8): 633-637. DOI: 10.3784/j.issn.1003-9961.2016.08.005
引用本文: 董梅, 邵祝军, 黄芳. 我国首例脑膜炎球菌肺炎的病原学研究[J]. 疾病监测, 2016, 31(8): 633-637. DOI: 10.3784/j.issn.1003-9961.2016.08.005
DONG Mei, SHAO Zhu-jun, HUANG Fang. Etiology of the first meningococcal pneumonia case in China[J]. Disease Surveillance, 2016, 31(8): 633-637. DOI: 10.3784/j.issn.1003-9961.2016.08.005
Citation: DONG Mei, SHAO Zhu-jun, HUANG Fang. Etiology of the first meningococcal pneumonia case in China[J]. Disease Surveillance, 2016, 31(8): 633-637. DOI: 10.3784/j.issn.1003-9961.2016.08.005

我国首例脑膜炎球菌肺炎的病原学研究

Etiology of the first meningococcal pneumonia case in China

  • 摘要: 目的 对我国第1株从肺炎患者下呼吸道标本分离的脑膜炎奈瑟菌进行病原学和分子特征分析。方法 通过细菌学、血清学、实时荧光定量PCR核酸检测的方法,对分离自肺炎病例的菌株进行鉴定、血清分群和脑膜炎奈瑟菌荚膜基因检测,通过多位点序列分型(MLST)分析及脑膜炎奈瑟菌外膜蛋白porA和fetA基因检测,进一步了解分离菌株特征,采用Etest方法对分离菌株药物敏感性进行检测。结果 从肺炎患者支气管吸取物中分离到的菌株,经以上实验确诊为不可分群脑膜炎奈瑟菌,PCR检测到脑膜炎奈瑟菌种特异性基因ctrA和Y血清群特异基因siaD;porA为VR1.1-5,VR2.P10-4,fetA为F1-5;国际PubMLST网络数据库授予该菌株基因序列类型新编号ST-11039,属于ST-92克隆群。该菌株对复方新诺明、阿奇霉素、环丙沙星和左氧氟沙星耐药。结论 国内首次报道从肺炎患者支气管吸取物中分离到脑膜炎奈瑟菌,可能还存在类似病例,需要开展进一步监测,以确定其是否在我国已经流行,为科学评估脑膜炎奈瑟菌疾病负担提供数据支持。

     

    Abstract: Objective To investigate the pathogenic and molecular characteristics of the first Neisseria meningitidis strain isolated from a pneumonia case in China. Methods Species and serogroup identification for the strain were performed using bacteriological tests and slide agglutination, respectively. Real-time PCR were used to determine the genotypic capsular group. Further isolate characterization was performed using multiple locus sequence typing (MLST) and porA, fetA genotyping. The antimicrobial susceptibility was tested by Etest. Results The isolate from endobronchial aspirate of the pneumonia patient was non-groupable N. meingitidis with Y serogroup-specific capsular gene. The porA genotype was VR1.1-5, VR2.P10-4 and the fetA genotypewas F1-5. The designated number of the strain by MLST database is ST-11039, which belongs to ST-92 clonal complex (cc). The strain was resistant to compound sulfamethoxazole, azithromycin, ciprofloxacin and lecofloxacin. Conclusion This is the first report of the isolation of N. meningitidis from pneumonia patient in China. Whether there have been other meningococcal pneumonia cases occurred in China needs further data support in order to evaluate the disease burden.

     

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