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目的分离脑膜炎球菌并进行鉴定及血清分群,为做好福建省流脑防制工作提供科学依据。方法采用常规培养法和PCR检测对分离株进行鉴定;用Etest法进行药敏试验,病人血清要用ELISA方法进行流脑抗体检测。结果3份脑脊液培养,有2份培养阳性,检出菌株分别编号为2007-5、2007-23经鉴定均为C群脑膜炎奈瑟菌(Nm),PCR检测CrgA基因及SiaD(C)基因均呈阳性。1份培养阴性(样品编号为2007-4),但PCR检测CrgA基因及SiaD(C)基因均呈阳性。病例1及病例2双份血清流脑C群抗体滴度均为1:320,呈4倍增高。2株检出菌株对头孢三嗪、头孢噻肟、利福平等6种抗菌药物均敏感,但对磺胺甲基异噁唑高度耐药,环丙沙星也产生耐药。结论2007年福建省3例流脑病例均系由C群脑膜炎球菌所致。该省流脑病原学发生新变迁,即A群和C群并存。福建省流脑病例治疗可首选头孢类、利福平等敏感抗菌药物,磺胺甲基异噁唑不适宜继续作为治疗和预防药物。
Objective To isolate and identify meningococci and to identify the serogroups in order to provide a scientific basis for the prevention of meningococcal disease in Fujian Province. Methods The strains were identified by routine culture and PCR. Drug susceptibility test was performed by Etest method. The serum of patients was detected by ELISA. Results Three cerebrospinal fluid cultures were positive and two were positive. The isolates were identified as Neisseria meningitides serogroup C (Nm) from 2007-5 and 2007-23, respectively. The CrgA and SiaD (C) genes were detected by PCR All were positive. One culture negative (sample number 2007-4), but the PCR detection CrgA gene and SiaD (C) gene were positive. Case 1 and case 2 double serum meningitis group C antibody titers were 1: 320, showed a 4-fold increase. The two strains were sensitive to cefotaxime, cefotaxime, rifampin and other six kinds of antimicrobial agents are sensitive, but highly resistant to sulfamethoxazole, ciprofloxacin also resistant. Conclusion Three cases of meningitis in Fujian Province in 2007 were all caused by Group C meningococci. The province encephalopathy etiology new changes occur, that coexist A and C groups. Fujian meningitis cases preferred treatment of cephalosporins, rifampicin and other sensitive antibiotics, sulfamethoxazole is not suitable to continue as a treatment and prevention of drugs.