北京市郊妇幼保健院门诊儿童感染A族链球菌的耐药性与分子特征
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

R446.5 R181.3+2

基金项目:


Resistance and molecular characteristics of Group A Streptococcus from children in outpatient setting of a maternal and child health hospital in the suburb of Beijing
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 文章评论
    摘要:

    目的 了解北京市某郊区最新流行的A族链球菌(GAS)病原分子特征。方法 采集2023年1月—2025年6月北京市某郊区监测哨点医院疑似GAS感染的门诊患儿咽拭子标本,分离培养GAS菌株,进行12种抗菌药物的药物敏感性试验,并利用全基因组测序技术深入分析GAS菌株的分子流行病学特征。结果 共收集326例临床疑似GAS感染的门诊患儿资料,分离培养出41株GAS菌株,检出率为12.58%。GAS阳性组患儿在前颈部淋巴结肿大、扁桃体充血和颚部充血肿大方面所占比例较GAS阴性组高,差异均有统计学意义(均P<0.05)。41株GAS菌株均携带erm(B)和tet(M)耐药基因,且均表现为结构型(cMLS)耐药表型。所有emm12型菌株均为ST36型,emm1型菌株为ST28型,共检出6种emm12亚型和1种emm1亚型,分别为emm12.2、emm12.95、emm12.69、emm12.17、emm12.19、emm12.149和emm1.12。其中emm12.149为新发现的亚型,且基因序列175 100位的碱基发生了A→T的变异。共检出5种噬菌体和6种超抗原;emm12.0型和emm12亚型基因组中多核苷酸多态性(MNPs)和插入数量比较,差异均有统计学意义(均P<0.05)。系统发育树显示该地区GAS菌株高度克隆群23株,占57.50%。结论 该地区流行的GAS菌株为emm12型,发现emm12.149为新亚型,耐药基因和表型为erm(B)、tet(M)和结构型(cMLS),基因组具有丰富的遗传多态性,多株GAS基因组序列高度克隆化,存在克隆传播的可能,提示应继续加强哨点医院GAS的监测,为GAS的流行防控提供理论依据。

    Abstract:

    Objective To understand the pathogenic molecular characteristics of the latest prevalent Group A Streptococcus (GAS) in a suburban area of Beijing. Methods Throat swab specimens from children suspected of GAS infection in the outpatient setting of a sentinel surveillance hospital in a suburban area of Beijing from January 2023 to June 2025 were collected. GAS strains were detected and cultured. Antimicrobial susceptibility testing on 12 antimicrobial agents were performed, and molecular epidemiological characteristics of GAS strains was further analyzed by whole genome sequencing technique. Results Data of 326 children suspected of GAS infection in outpatient setting were collected. A total of 41 GAS strains were detected and cultured, with a detection rate of 12.58%. The proportions of children with anterior cervical lymph node enlargement, tonsil congestion, and jaw congestion in the GAS positive group were all higher than those in the GAS negative group, and differences were all statistically significant (all P < 0.05). All 41 GAS strains carried both erm (B) and tet (M) resistance genes and exhibited a structural type (cMLS) resistance phenotype. All of the emm12 strains were ST36, and emm1 strains were ST28. A total of 6 emm12 subtypes and 1 emm1 subtype were detected, namely emm12.2, emm12.95, emm12.69, emm12.17, emm12.19, emm12.149, and emm1.12. Among them, emm12.149 was a newly discovered subtype. Nucleobase at the 175 100 locus in gene sequence had undergone an A → T mutation. A total of 5 bacteriophages and 6 superantigens were detected. There were statistically significant differences in multi-nucleotide polymorphisms (MNPs) and insertion numbers in the genomes of emm12.0 and emm12 subtypes (both P < 0.05). The phylogenetic tree presented a highly clonal group of 23 GAS strains in this area, accounting for 57.50%. Conclusion The prevalent GAS strain in this area is emm12. emm12.149 is a new subtype. The resistance genes and phenotypes are erm (B), tet (M), and structural type (cMLS). The genome has plenty genetic polymorphism, and the genome sequences of multiple GAS strains are highly cloned, indicating the possibility of clone transmission. This suggests that the surveillance of GAS in sentinel hospitals should continue to be strengthened, so as to provide theoretical basis for the prevention and control of GAS epidemics.

    参考文献
    相似文献
引用本文

董珍珍,喻金玉,王艺錞,等.北京市郊妇幼保健院门诊儿童感染A族链球菌的耐药性与分子特征[J]. 中国感染控制杂志,2025,24(10):1395-1401. DOI:10.12138/j. issn.1671-9638.20252521.
DONG Zhenzhen, YU Jinyu, WANG Yichun, et al. Resistance and molecular characteristics of Group A Streptococcus from children in outpatient setting of a maternal and child health hospital in the suburb of Beijing[J]. Chin J Infect Control, 2025,24(10):1395-1401. DOI:10.12138/j. issn.1671-9638.20252521.

复制
分享
文章指标
  • 摘要阅读次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2025-05-19
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2025-10-29
  • 出版日期: