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Abstract：
Serogroup Y Neisseria meningitidis (NmY) is rare in China, and only serogroup A and C meningococcal polysaccharide vaccines (MPVs) are included in the national vaccination schedule. We describe a case of fulminant meningococcemia caused by NmY, which occurred in a pediatric patient (2 years old) for the first time in China, confirmed by culture. Although the boy was treated in time, the dry gangrene in his toes and fingers left him with severe sequelae. An NmY isolate was cultured from the blood of the patient, and showed decreased susceptibility to penicillin (minimum inhibitory concentration of 0.125 μg/ml), with sequence type (ST) 1655 assigned to clonal complex (cc) 23. Genomic analysis showed it was clustered with isolates from Italy, UK, Finland, and South Africa, sharing designation of Y:P1.5-1,10-1:F4-1:ST-1655(cc23). The emergence of NmY invasive meningococcal disease cases challenges local immunization strategy and warrants wider usage of MPV-ACYW if there is sustained circulation of NmY.
摘要：
血清群Y型脑膜炎奈瑟菌（NmY）在中国很少见，并且只有血清群A和C脑膜炎球菌多糖疫苗（MPV）被包括在国家疫苗接种时间表中。我们描述了一例由NmY引起的暴发性脑膜炎球菌血症，在中国首次发生在儿科患者（2岁）中，文化证实。虽然男孩得到了及时的治疗,他脚趾和手指上的干性坏疽给他留下了严重的后遗症。从患者的血液中培养出NmY分离物，并显示对青霉素的敏感性降低（最小抑制浓度为0.125μg/ml），序列类型（ST）1655分配给克隆复合物（cc）23。基因组分析显示它聚集了来自意大利的分离株，英国,芬兰,南非,Y的共享名称:P1.5-1,10-1:F4-1:ST-1655(CC23)。NmY侵袭性脑膜炎球菌病病例的出现挑战了局部免疫策略，如果NmY持续循环，则需要更广泛地使用MPV-ACYW。
