安徽省3~18岁健康儿童青少年脑膜炎奈瑟菌带菌状况

苏颖; 陈霞; 王斌冰; 罗献伟; 程鹏博; 周淑洁

doi:10.16835/j.cnki.1000-9817.2024167

安徽省3~18岁健康儿童青少年脑膜炎奈瑟菌带菌状况

doi: 10.16835/j.cnki.1000-9817.2024167

安徽省疾病预防控制中心免疫预防科，合肥 230601

基金项目:

长三角免疫规划领军人才研究项目 CSJP035

中国乙肝防控科研基金项目 YGFK20230119

详细信息

作者简介:
苏颖(1982-)，女，安徽黄山人，硕士，副主任医师，主要从事疫苗针对疾病的预防与控制工作

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R181.3⁺² R515.2
计量
- 文章访问数: 182
- HTML全文浏览量: 86
- PDF下载量: 21
- 被引次数: 0
出版历程
- 收稿日期: 2024-03-08
- 修回日期: 2024-04-02
- 网络出版日期: 2024-06-27
- 刊出日期: 2024-06-25

Prevalence of Neisseria meningitidis among healthy children and adolescents aged 3-18 in Anhui Province

Department of Immunoprophylaxis, Anhui Provincial Center for Disease Control and Prevention, Hefei (230601), Anhui Province, China

摘要

摘要: 目的监测安徽省3~18岁健康儿童青少年脑膜炎奈瑟菌带菌情况，为开展流行性脑脊髓膜炎(以下简称“流脑”)防控工作提供支持。方法于2021年和2022年每年9—10月采用分层随机抽样方法，共选取安徽省长江以北地区(毫州、阜阳、蚌埠、淮南、滁州、合肥)和长江以南地区(芜湖、马鞍山、铜陵、安庆、池州、宣城)4 033名3~18岁健康儿童青少年，采集儿童青少年悬雍垂后上方咽后壁上的分泌物，采用细菌培养和核酸检测两种方法同时进行菌株鉴定。采用McNemar检验和Kappa一致性检验进行统计学分析；率的比较采用χ²检验和χ²趋势检验。结果细菌培养和核酸检测的脑膜炎奈瑟菌带菌率分别为0.47%和1.07%，核酸检测敏感性更高。检出菌群中，B群占比最大，为76.74%；其后依次为C群(4.65%)、Y群(4.65%)、W 135群(2.33%)和X群(2.33%)。男生带菌率高于女生(χ²=11.44)；随着年龄升高，儿童青少年带菌率呈增高趋势(χ_趋势²=42.69)；长江以北地区儿童青少年带菌率高于长江以南地区儿童青少年(χ²=23.19)；无免疫史的儿童青少年带菌率高于有免疫史的儿童青少年(χ²=11.02)(P值均 < 0.01)。结论 B群脑膜炎奈瑟菌已成为安徽省流行菌株，高年龄段儿童青少年成为流脑防控的重点人群。应继续做好流脑疾病监测，重点关注B群流脑病例，防范学校聚集性疫情的发生。
- 奈瑟球菌, 脑膜炎 /
- 核酸扩增技术 /
- 细菌培养 /
- 儿童 /
- 青少年
Abstract: Objective To monitor the prevelance of Neisseria meningitidis among healthy children and adolescents aged 3-18 in Anhui Province, so as to provide support for epidemic cerebrospinal meningitis prevention and control. Methods From September to October in 2021 and 2022, 4 033 healthy children and adolescents aged 3-18 were selected by stratified random sampling from Anhui Province, including areas north of the Yangtze River (Bozhou, Fuyang, Bengbu, Huainan, Chuzhou, Hefei) and areas south of the Yangtze River (Wuhu, Ma'anshan, Tongling, Anqing, Chizhou, Xuancheng) and the secretions of children and adolescents were collected from the posterior pharyngeal wall above the uvula, and the strains were identified by bacterial culture and nucleic acid detection. McNemar test and Kappa consistency test were used for statistical analysis. Chi-square test and Chi-square trend test were used to compare the rates. Results The carrier rates of Neisseria meningitidis were 0.47% and 1.07%, respectively. The sensitivity of nucleic acid detection was higher. Among the detected bacteria, group B accounted for the largest proportion of 76.74%. It was followed by group C (4.65%), group Y (4.65%), group W 135 (2.33%) and group X (2.33%). The bacteria bearing rate of male students was higher than that of female students (χ²=11.44); with the increase of age, the bacteria bearing rate of children and adolescents showed an increasing trend (χ_trend²=42.69); the bacterial bearing rate of children and adolescents in the north of the Yangtze River was higher than that in the south of the Yangtze River (χ²=23.19); the bacteria bearing rate of children and adolescents without immune history was higher than that with immune history (χ²=11.02)(P < 0.01). Conclusions Neisseria meningitidis group B has become an epidemic strain in Anhui Province, and senior children and adolescents have become the key population of epidemic prevention and control. It is necessary to continue to do a good job in the surveillance of epidemic cerebrospinal meningitis disease and focuse on group B disease cases, so as to prevent the occurrence of cluster outbreaks in schools.
- Neisseria meningitidis /
- Nucleic acid amplification techniques /
- Bacterial cultivation /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同组别健康儿童青少年儿童青少年Nm带菌率比较

Table 1. Comparrison of Nm bacteria bearing rate of healthy children and adolescents in different groups

组别	选项	调查数	带菌人数	χ²值	P值
性别	男	2 061	33(1.60)	11.44	< 0.01
	女	1 972	10(0.51)
年龄/岁	3~6	2 004	7(0.35)	55.17	< 0.01
	7~12	1 005	4(0.40)
	13~18	1 024	32(3.13)
地区	长江以北	1 817	35(1.93)	23.19	< 0.01
	长江以南	2 216	8(0.36)
免疫史	有	3 376	28(0.83)	11.02	< 0.01
	无	657	15(2.28)
注： ()内数字为带菌率/%。

下载: 导出CSV

参考文献(21)

[1]	王斌冰, 毛雷婧, 罗献伟, 等. 2004—2019年安徽省0~2岁儿童流行性脑脊髓膜炎流行病学特征[J]. 实用医学杂志, 2021, 37(12): 1613-1618. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202112020.htm WANG B B, MAO L J, LUO X W, et al. Current epidemiological analysis of epidemic cerebrospinal meningitis cases among children aged 0-2 years in Anhui Province, 2004-2019[J]. J Pract Med, 2021, 37(12): 1613-1618. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202112020.htm
[2]	中华人民共和国卫生部. 全国流行性脑脊髓膜炎监测方案(卫办疾控[2006]93号)[Z]. 2006-05-19. Ministry of Health of the PRC. National epidemic cerebrospinal meningitis surveillance program (CDC[2006]No. 93)[Z]. 2006-05-19. (in Chinese)
[3]	周洋, 张颖, 周莉薇, 等. 2023年宁夏回族自治区两个县健康人群脑膜炎奈瑟菌携带率[J]. 中国疫苗和免疫, 2023, 29(6): 665-668. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202306010.htm ZHOU Y, ZHANG Y, ZHOU L W, et al. Neisseria meningitidis carriage among a healthy population in two counties of Ningxia Hui Autonomous Region in 2023[J]. Chin J Vaccin Immun, 2023, 29(6): 665-668. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202306010.htm
[4]	毛雷婧, 罗献伟, 陈霞, 等. 2004—2017年安徽省流行性脑脊髓膜炎流行特征及菌群变迁分析[J]. 疾病监测, 2018, 33(8): 636-639. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC201808007.htm MAO L J, LUO X W, CHEN X, et al. Epidemiological characteristics of meningococcal meningitis and changing trend of serogroup of Neisseria meningitidis in Anhui, 2004-2017[J]. Dis Surveill, 2018, 33(8): 636-639. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC201808007.htm
[5]	关静, 谢娜, 张建. 一起学校A群流行性脑脊髓膜炎聚集性疫情流行病学调查[J]. 中国学校卫生, 2018, 39(11): 1736-1737, 1742. doi: 10.16835/j.cnki.1000-9817.2018.11.041 GUAN J, XIE N, ZHANG J. An epidemiological investigation of A cluster epidemic of epidemic cerebrospinal meningitis in a school group[J]. Chin J Sch Health, 2018, 39(11): 1736-1737, 1742. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2018.11.041
[6]	MARÍA N C B, ARACELI S N, LUCILA M M, et al. Diagnosis of bacterial meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus infuenzae using a multiplex real time PCR technique[J]. Br J Microbiol, 2022, 53(4): 1951-1958. doi: 10.1007/s42770-022-00826-x
[7]	刘昌坤, 廖虹瑜, 李文博, 等. 培养法与PCR法在流脑密切接触者带菌筛查中的运用[J]. 寄生虫病与感染性疾病, 2022, 20(4): 227-230. https://www.cnki.com.cn/Article/CJFDTOTAL-SJCB202204009.htm LIU C K, LIAO H Y, LI W B, et al. Application of culture method and PCR method in bacterial screening of close contacts with Neisseria meningitidis[J]. Parasit Infect Dis, 2022, 20(4): 227-230. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SJCB202204009.htm
[8]	陈紫曼, 谢娜, 徐丽, 等. 2019年新疆喀什地区健康人群脑膜炎奈瑟菌携带情况调查研究[J]. 疾病监测, 2021, 36(4): 360-363. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202104019.htm CHEN Z M, XIE N, XU L, et al. Investigation of Neisseria meningitidis in healthy population in Kashgar, Xinjiang, 2019[J]. Dis Surveill, 2021, 36(4): 360-363. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202104019.htm
[9]	胡伟军, 王锐泽, 王月祺, 等. 陕西省健康人群脑膜炎奈瑟菌带菌率调查及其血清群分布特征[J]. 实用医学杂志, 2020, 36(6): 796-800. doi: 10.3969/j.issn.1006-5725.2020.06.018 HU W J, WANG R Z, WANG Y Q, et al. Neisseria meningitidis carriage prevalence and serogroup distribution among a healthy population of Shaanxi Province[J]. J Pract Med, 2020, 36(6): 796-800. (in Chinese) doi: 10.3969/j.issn.1006-5725.2020.06.018
[10]	骆金俊, 吕静, 李婷婷, 等. 2013—2018年湖北省健康人群脑膜炎奈瑟菌带菌率监测结果分析[J]. 应用预防医学, 2021, 27(2): 180-182, 184. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX202102029.htm LUO J J, LÜ J, LI T T, et al. Monitoring results of Neisseria meningitidis carrier rate in healthy population in Hubei Province, 2013-2018[J]. J Appl Prev Med, 2021, 27(2): 180-182, 184. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX202102029.htm
[11]	陈强, 许燕, 孙翔, 等. 2019—2020年江苏省健康人群脑膜炎奈瑟菌携带情况调查[J]. 中华预防医学杂志, 2023, 57(2): 236-240. doi: 10.3760/cma.j.cn112150-20220328-00294 CHEN Q, XU Y, SUN X, et al. Investigation on the carriage prevalence of Neisseria meningitidis in healthy population in Jiangsu Province in 2019 and 2020[J]. Chin J Prev Med, 2023, 57(2): 236-240. (in Chinese) doi: 10.3760/cma.j.cn112150-20220328-00294
[12]	刘然, 方明礼, 夏昕, 等. 2008-2021年湖南省健康人群脑膜炎奈瑟菌携带率和药物敏感性监测[J]. 中国疫苗和免疫, 2023, 29(3): 326-331. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202303014.htm LIU R, FANG M L, XIA X, et al. Surveillance for carriage and antibiotic susceptibility of Neisseria meningitidis among a healthy population in Hunan Province, 2008-2021[J]. Chin J Vaccin Immun, 2023, 29(3): 326-331. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202303014.htm
[13]	李军宏, 吴丹, 温宁, 等. 2015-2019年中国流行性脑脊髓膜炎血清群分布特征[J]. 中国疫苗和免疫, 2020, 26(3): 241-244. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202003002.htm LI J H, WU D, WEN N, et al. Serogroup distribution of meningococcal meningitis in China, 2015-2019[J]. Chin J Vaccin Immun, 2020, 26(3): 241-244. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202003002.htm
[14]	ZHU B, XU Z, DU P, et al. Sequence type 4 821 clonal complex serogroup B Neisseria meningitidis in China, 1978-2013[J]. Emerg Infect Dis, 2015, 21(6): 925-932.
[15]	赵盼, 朱兵清, 张艾煜, 等. 中国脑膜炎奈瑟菌ST-4821克隆群荚膜基因簇分布特征[J]. 疾病监测, 2020, 35(6): 508-512. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202006012.htm ZHAO P, ZHU B Q, ZHANG A Y, et al. Distribution characteristics of capsule locus of Neisseria meningitidis clonal complex ST-4821 in China[J]. Dis Surveill, 2020, 35(6): 508-512. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202006012.htm
[16]	张岩, 李漫时, 刘桂芳, 等. 2008—2020年山东省健康人群脑膜炎奈瑟菌携带特征分析[J]. 中华预防医学杂志, 2021, 55(8): 973-977. ZHANG Y, LI M S, LIU G F, et al. Analysis of Neisseria meningitidis carriage characteristics among healthy population in Shandong Province from 2008 to 2020[J]. Chin J Prev Med, 2021, 55(8): 973-977. (in Chinese)
[17]	胡伟军, 王锐泽, 侯铁军, 等. 西安地区健康人群流脑带菌率状况调查[J]. 现代预防医学, 2020, 47(14): 2656-2658, 2662. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202014041.htm HU W J, WANG R Z, HOU T J, et al. Investigation on the prevalence of Neisseria meningitidis of healthy people in Xi'an[J]. Mod Prev Med, 2020, 47(14): 2656-2658, 2662. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202014041.htm
[18]	唐继海, 罗献伟, 陈霞, 等. 安徽省流行性脑脊髓膜炎空间自相关分析[J]. 中国疫苗和免疫, 2015, 21(4): 369-372, 468. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201504005.htm TANG J H, LUO X W, CHEN X, et al. Spatial autocorrelation of epidemic cerebrospinal meningitis in Anhui Province[J]. Chin J Vaccin Immun, 2015, 21(4): 369-372, 468. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201504005.htm
[19]	邵祝军. 中国流行性脑脊髓膜炎流行变异趋势[J]. 中华预防医学杂志, 2013, 47(10): 891-893. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM200706012.htm SHAO Z J. Epidemic variation trend of epidemic cerebrospinal meningitis in China[J]. Chin J Prev Med, 2013, 47(10): 891-893. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM200706012.htm
[20]	KIMBERLY D, MARTA V P, NICK J A, et al. Immunogenicity of the UK group B meningococcal vaccine (4CMenB) schedule against groups B and C meningococcal strains (Sched3): outcomes of a multicentre, open-label, randomised controlled trial[J]. Lancet Infect Dis, 2021, 21(5): 688-696.
[21]	MARK M, BING W, ANN P K, et al. Impact of meningococcal B vaccine on invasive meningococcal disease in adolescents[J]. Clin Infect Dis, 2021, 73(1): 233-237.