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甘露聚糖结合凝集素缺陷婴儿患 B 组链球菌脑膜炎的风险增加。

Increased risk of group B Streptococcus causing meningitis in infants with mannose-binding lectin deficiency.

机构信息

Department of Medical Microbiology, Capital Medical University, Beijing, China.

Department of Infectious Diseases, Beijing Children's Hospital, Beijing, China.

出版信息

Clin Microbiol Infect. 2019 Mar;25(3):384.e1-384.e3. doi: 10.1016/j.cmi.2018.10.003. Epub 2018 Oct 25.

Abstract

OBJECTIVES

To evaluate the association of mannose-binding lectin (MBL) deficiency with susceptibility and clinical features of group B Streptococcus (GBS) causing meningitis in Chinese infants.

METHODS

During 2014-2017, 33 infants with laboratory-confirmed GBS meningitis were included. Six polymorphisms (H/L, Y/X, P/Q, A/D, A/B and A/C) of MBL were sought for in these patients and in 330 healthy controls by PCR-based sequencing. Serum MBL concentration was determined.

RESULTS

Significantly higher frequency of MBL variant genotype A/B was found in patients than controls (15/33, 45%, vs. 79/330, 24%, p=0.011). Patients with variant genotype A/B had significantly lower serum MBL than those with wild-type genotype A/A (median, 482.87 vs. 1455.13 ng/mL, p=0.002). Moreover, patients with genotype A/B had significantly higher level of C-reactive protein (median, 146 vs. 41 mg/L, p=0.007), neutrophil (median, 58.1% vs. 45.7%, p=0.033) and neutrophil-to-lymphocyte ratio in blood (median, 2.32 vs. 1.03, p=0.018) compared to those with genotype A/A. No significant differences were observed in clinical features of patients with different genotypes.

CONCLUSIONS

Our result suggested that infants with MBL deficiency are at higher risk of meningitis caused by GBS. Further studies in different populations with larger number of subjects are needed.

摘要

目的

评估甘露聚糖结合凝集素(MBL)缺乏与中国婴儿 B 群链球菌(GBS)引起脑膜炎易感性和临床特征的关系。

方法

2014 年至 2017 年期间,纳入了 33 例实验室确诊的 GBS 脑膜炎患儿。通过 PCR 测序,在这些患儿和 330 名健康对照中寻找 MBL 的 6 个多态性(H/L、Y/X、P/Q、A/D、A/B 和 A/C)。测定血清 MBL 浓度。

结果

患儿中 MBL 变异基因型 A/B 的频率明显高于对照组(15/33,45%,vs. 79/330,24%,p=0.011)。变异基因型 A/B 的患儿血清 MBL 明显低于野生型基因型 A/A(中位数,482.87 与 1455.13ng/ml,p=0.002)。此外,基因型 A/B 的患儿 C 反应蛋白(中位数,146 与 41mg/L,p=0.007)、中性粒细胞(中位数,58.1%与 45.7%,p=0.033)和中性粒细胞与淋巴细胞比值(中位数,2.32 与 1.03,p=0.018)均明显高于基因型 A/A 的患儿。不同基因型患儿的临床特征无明显差异。

结论

我们的结果表明,MBL 缺乏的婴儿患 GBS 脑膜炎的风险较高。需要在不同人群中进行更多的研究。

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