人猪链球菌病42例  

Forty two cases infected with swine streptococcosis

作　　者：王华雨[1] 董德平[1] 谢群[1] 周广鑑 卢洪洲[2] 杨爱平[1] 

机构地区：[1]南通大学附属海安医院感染病科,226600 [2]复旦大学附属华山医院感染病科

出　　处：《中华传染病杂志》2007年第12期750-752,共3页Chinese Journal of Infectious Diseases

摘　　要：目的了解江苏省部分地区1998年以来夏秋流行人猪链球菌病的临床特点、诊断、治疗及预后。方法分析1998至2005年42例人猪链球菌病患者流行病学调查及临床观察结果,并对分离菌株进行生化特征鉴定、流行菌株同源性比较。结果42例患者均有畏寒、发热、头痛、头晕、全身不适等急性感染性中毒症状;以链球菌中毒性休克综合征或脑膜炎综合征为主要表现;普通型占7.1%,休克型占38.1%,脑膜炎型占54.7%,10例死亡患者均为休克型,余32例经治疗后痊愈。分离病原菌API-Strep鉴定为猪链球菌Ⅱ型,生化反应编码为0641473,鉴定百分率为99.9%,分离自患者和病猪猪链球菌Ⅱ型菌株经基因指纹图分析具有较高同源性。联合应用青霉素、头孢曲松抗感染治疗有效。结论人猪链球菌病是由猪链球菌Ⅱ型所致人畜共患病,临床表现多样化,休克型来势凶猛,病死率高,普通型、脑膜炎型预后较好,经有效抗感染治疗后多能康复。Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of human swine streptococcosis occurred in some areas of Jiangsu Province from late summer to autumn since 1998. Methods The epidemiologic and clinical features of 42 cases were collected and analyzed. The biochemical features of strains isolated from patient＇s blood or cerebrospinal fluid（CSF） were tested, and the homogeneity were compared among 15 Streptococcus suis Ⅱ. Results All patients had acute infection toxemic symptoms such as chill, fever, headache and malaise etc. Toxic shock syndrome or meningitis syndrome were the major clinical manifestations. Forty two cases of human swine streptococosis were classified into 3 types：the rates of general, shock and meningitis type were 7.1%（3/42）, 38.1%（16/42） and 54.7%（23/42）, respectively. Ten patients were died of shock type, 32 were cured. Strain isolated from patients was identified as Streptococcus suis Ⅱ by API-Strep, the biochemical reactional code was 0641473, and appraised result was 99. 9%. There was highly homogeneity in the strains of Streptococcus suis Ⅱ isolated from patients and sick pigs identified by genomic fingerprinting. Combined therapy of large doses of penicillin G and ceftriaxone was effective in these patients. Conclusions Human swine streptococosis is zoonosis caused by Streptococcus suis Ⅱ and the clinical manifestations are variable. In the cases of shock type, the onset of disease is stormy and the fatality rate is very high. While the prognosis of general and meningitis type is good and the majority of the cases are cured by effective antibiotic therapy.

关 键 词：链球菌 猪 链球菌感染 人类 休克 脓毒性 脑膜炎 

分 类 号：R515[医药卫生—内科学]