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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por A和fet A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ctr A和Y血清群特异基因sia D;por A为VR1.1-5,VR2.P10-4,fet A为F1-5;国际Pub MLST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。
Objective To analyze the etiological and molecular features of N. meningitidis isolates from the lower respiratory tract of pneumonia patients in China. Methods The strains isolated from pneumonia were identified by bacteriological, serological and real-time fluorescence quantitative PCR. The serogroups and capsular gene of Neisseria meningitidis were detected by MLST. Analysis and detection of Neisseria meningitidis outer membrane protein por A and fet A gene, to further understand the characteristics of isolates, using Etest method to test the drug susceptibility of isolates. Results The strains isolated from the bronchial aspirate of pneumonia patients were identified as Neisseria meningitidis which can not be differentiated by the above experiment. The genotypes of ctr A and Y serogroup specific genes of Neisseria meningitides were detected by PCR. A is VR1.1-5, VR2.P10-4 and fet A is F1-5. The international Pub MLST network database grants the strain ST-11039 a new gene sequence type, belonging to the ST-92 clonal group. The strain of cotrimoxazole, azithromycin, ciprofloxacin and levofloxacin resistance. Conclusions The first domestic report of Neisseria meningitidis isolated from bronchial aspirates from patients with pneumonia may have similar cases and further monitoring is needed to determine whether it has become prevalent in our country to provide a scientific basis for assessing the burden of Neisseria meningitides disease data support.