Bevanger L, Bergh K, Gisnås G, Caugant D A, Frøholm L O
Department of Microbiology, Regional Hospital, Norwegian University of Science and Technology, Trondheim.
J Med Microbiol. 1998 Nov;47(11):993-8. doi: 10.1099/00222615-47-11-993.
The clustering of four cases of meningococcal disease during a 3-month period in a small community with 2233 inhabitants prompted an interventional carrier survey in persons < 19 years old and in family members of the patients. The aims of the survey were to identify the nasopharyngeal carriers and the carriage rate of the outbreak strain, to offer chemoprophylaxis to those carrying the outbreak strain, and to study the discriminatory power of phenotypic methods versus pulsed-field gel electrophoresis (PFGE) on carrier isolates during an outbreak. A high percentage of the population in the age group 0-19 years (73.7%) participated in the study. Among the 469 samples collected in this age group, meningococci were grown from 43 (9.2%). The highest carriage rates were in the age group 18-19 years (36.4%). With a provisional definition of the outbreak strain (group B or non-groupable Neisseria meningitidis with reduced sulphonamide sensitivity), six carriers were identified. All were treated with a single dose of ofloxacin. Four of these persons (0.76% of all tested) were later shown to have harboured the outbreak strain when analysed by PFGE. Three of them were epidemiologically closely related to one of the index cases. Serogrouping alone is not sufficient for the identification of an epidemic strain of N. meningitidis. Complete concordance of type and subtype antigens correctly identified the outbreak strain in this study. PFGE is well suited for the identification of an outbreak strain of N. meningitidis versus non-epidemic strains in tonsillo-pharyngeal specimens.
在一个有2233名居民的小社区中，3个月内发生了4例脑膜炎球菌病聚集性病例，这促使对19岁以下人群及患者家庭成员进行了干预性带菌者调查。该调查的目的是确定鼻咽部带菌者及暴发菌株的带菌率，为携带暴发菌株者提供化学预防，并研究在暴发期间表型方法与脉冲场凝胶电泳（PFGE）对带菌者分离株的鉴别能力。0 - 19岁年龄组的很大一部分人群（73.7%）参与了该研究。在这个年龄组收集的469份样本中，培养出脑膜炎球菌的有43份（9.2%）。带菌率最高的是18 - 19岁年龄组（36.4%）。根据暴发菌株的临时定义（B群或不可分型的对磺胺敏感性降低的脑膜炎奈瑟菌），确定了6名带菌者。所有带菌者均接受了单剂量氧氟沙星治疗。其中4人（占所有检测者的0.76%）在通过PFGE分析时后来被证明携带暴发菌株。他们中有3人与其中一名指示病例在流行病学上密切相关。仅血清群分型不足以鉴定脑膜炎奈瑟菌的流行菌株。在本研究中，型和亚型抗原的完全一致性正确鉴定出了暴发菌株。PFGE非常适合于在扁桃体 - 咽标本中鉴别脑膜炎奈瑟菌的暴发菌株与非流行菌株。
