Shao Zhujun, Li Wei, Ren Jun, Liang Xiaofeng, Xu Li, Diao Baowei, Li Machao, Lu Meijuan, Ren Hongyu, Cui Zhigang, Zhu Bingqing, Dai Zhenwei, Zhang Li, Chen Xia, Kan Biao, Xu Jianguo
National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), PO Box 5, Changping, Beijing 102206, China.
Lancet. 2006 Feb 4;367(9508):419-23. doi: 10.1016/S0140-6736(06)68141-5.
Outbreaks of a new serogroup C meningococcal disease emerged during 2003-04 (five outbreaks with 43 cases) and in 2004-05 (five outbreaks with 29 cases), all in Anhui province, China. We describe the molecular epidemiology and features of the causative bacterial strains.
We used pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) to analyse the strains.
Of 34 strains of Neisseria meningitidis cultured during 2003-04 from Anhui province, 31 were group C meningococci, 28 of which were associated with three of five outbreaks; one from a patient and 27 from close contacts of eight patients. Of 30 strains isolated from Anhui province during 2004-05, 17 were identified as serogroup C meningococci, ten of which were associated with four of five outbreaks. In a nationwide survey, 542 strains were isolated during 2004-05; 58 were serogroup C meningococci interspersed among 11 other provinces where no serogroup C outbreak occurred. Of the 106 serogroup C strains analysed, 89 had identical PFGE patterns, designated AH1. Of 28 strains selected for MLST analyses, 25 were sequence type 4821 (ST-4821), which did not belong to any of the previously reported sequence types that can form a new hypervirulent lineage.
ST-4821 seems to be unique and caused the serogroup C meningitis outbreaks during the two seasons from 2003 to 2005 in Anhui province. The emergence of this sequence type has epidemiological importance that should be monitored for future spread in China and the rest of the world.
2003 - 2004年期间（5起疫情，43例病例）以及2004 - 2005年期间（5起疫情，29例病例）出现了新的C群脑膜炎球菌病疫情，均发生在中国安徽省。我们描述了致病菌株的分子流行病学及特征。
我们使用脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）来分析菌株。
2003 - 2004年从安徽省培养的34株脑膜炎奈瑟菌中，31株为C群脑膜炎球菌，其中28株与5起疫情中的3起有关；1株来自患者，27株来自8名患者的密切接触者。2004 - 2005年从安徽省分离的30株菌株中，17株被鉴定为C群脑膜炎球菌，其中10株与5起疫情中的4起有关。在一项全国性调查中，2004 - 2005年期间分离出542株菌株；58株为C群脑膜炎球菌，散布于其他11个未发生C群疫情的省份。在分析的106株C群菌株中，89株具有相同的PFGE图谱，命名为AH1。在选择进行MLST分析的28株菌株中，25株为序列型4821（ST - 4821），它不属于任何先前报道的可形成新的高毒力谱系的序列型。
ST - 4821似乎是独特的，并且在2003年至2005年的两个季节中导致了安徽省的C群脑膜炎疫情。这种序列型的出现具有流行病学重要性，应加以监测，以防其未来在中国及世界其他地区传播。
