四川省83例人感染猪链球菌病患者的临床特征  

Clinical analysis of 83 patients infected by streptococcus suis type 2 (S.suis type 2)

作　　者：江南[1] 杨兴祥[1] 唐荣珍[1] 吴家玉[1] 刘华[1] 严英俊[1] 祝标[1] 谢明道 沈骥[2] 赵小光[2] 苏林[2] 鲜明[2] 杨勇[2] 王书杰[3] 杨维中 景怀齐 吴建林[5] 祝小平[5] 刘伦光[5] 袁顺清 罗文光[6] 杨欣[6] 

机构地区：[1]四川省成都四川省人民医院感染科,610041 [2]四川省卫生厅 [3]北京协和医院 [4]国家疾病控制中心 [5]四川省疾病控制中心 [6]四川省资阳市第一人民医院

出　　处：《中华急诊医学杂志》2005年第11期891-894,共4页Chinese Journal of Emergency Medicine

摘　　要：目的探讨四川省2005年7月下旬至8月上旬83例猪链球菌病患者的临床特征。方法收集83例住院患者资料,包括病原学、流行病学、临床表现、细菌学检查、毒力基因鉴定结果、药敏试验等,进行分析。结果(1)从病死猪心血培养物和肝组织培养物分离到的细菌与从死亡患者脾组织培养物、患者血、脑脊液培养物分离到的细菌,经鉴定均含猪链球菌Ⅱ型的毒力基因猪链球菌Ⅱ型荚膜多糖基因(cps2A),溶菌酶释放相关蛋白基因(sly),溶血素基因(sly),且高度同源;来自人、猪的猪链球菌Ⅱ型对四环素、链霉素耐药,来自人的两株菌对环丙沙星中介。(2)83例患者均有宰杀、肢解病死猪和猪血浆成份(血、组织液)直接接触史,皮肤有可见伤口者,感染率高。(3)临床分为普通型、脑膜炎型、休克型、混合型四型。(4)普通型脑膜炎型预后良好,休克型、混合型预后相对较差,与本病相关的总死亡率是14·50%(12/83)。结论(1)猪链球菌Ⅱ型是本次猪链球菌病病原体,传染源是患病死亡的猪。(2)主要传播途径是直接接触病死猪的血浆成份,无第二代患者产生。(3)重症患者早期就诊是提高存活率重要措施。(4)重视抗菌药物在家畜、家禽中的合理应用。Objective To investigate clinical characteristics of 83 patients infected with S. suis type 2. Methods All data of the 83 patients were collected and analyzed. Pathogenic gene of S. suis type 2 were verified by PCR, such as cps 2A, mrp, and sly. Results （ 1 ） Pathogenic gene of S. suis type 2 from those patients were the same as those from pigs. Drug sensitive tests showed S. suis type 2 from patients and pigs were resistant to tetracycline and strepotomycin. （2） All the patients had butchered and/or directly contacted blood plasma composition of dead pigs. The persons with wound in the skin were easy to be infected. （3） Patients were clinically classfied into four types： general, meningitis, shock, and shock with meningitis. Mortality rate was 14.5 % . Conclusion （ 1 ） S. suis type 2 was pathogene of the 83 patients. The dead pigs were the infection source. （2） The main method of infection was to butchering or/and directly contacting the plasma composition of dead pigs. No secondary patients were found. （3） The patients with shock should be treated as early as possible. （4） Special attention should be paid to the use of antibiotics in animals.

关 键 词：猪链球菌病 猪链球菌Ⅱ型 四川省 猪链球菌病 患者资料 临床特征 四川省 感染率 猪链球菌Ⅱ型 细菌学检查 组织培养物 毒力基因 

分 类 号：R515[医药卫生—内科学]