贵州省1999-2007年伤寒副伤寒流行特征分析  

Epidemiological Analysis on Typhoid fever and paratyphoid fever from 1999 to 2007 in Guizhou Province

作　　者：姚光海[1,2] 王涛[2] 田克诚[1] 游旅[1] 马青[1] 韦小俞[1] 唐光鹏[1] 王定明[1] 

机构地区：[1]贵州省疾病预防控制中心,550004 [2]北京大学公共卫生学院

出　　处：《医学动物防制》2009年第3期161-163,165,共4页Journal of Medical Pest Control

摘　　要：目的了解贵州省伤寒副伤寒发病规律,掌握流行趋势,为制订伤寒副伤寒防治对策提供科学依据。方法对贵州省1999～2007年伤寒副伤寒疫情资料及部分实验室检测资料作描述性流行病学分析。结果1999-2007年共报告伤寒副伤寒103419例,年均发病率30.79/10万,年均病死率0.09%,总体发病呈下降趋势,2007年发病率为全国发病率的4.38倍。报告伤寒病例占73.54%。年均发病率最高地区为黔西南州,其次是贵阳市和安顺市。全年均可发病,5～9月发病占62.30%。男女病例之比为1.28∶1,5～55岁发病占88.31%。农民发病占33.43%,学生占25.53%。伤寒副伤寒暴发疫情423起,报告病例20214例占19.55%,暴发疫情呈逐年减少趋势;暴发地点多在贫困农村、学校和城郊结合部;水型暴发起数占50.57%,食物型18.39%。流行菌型79.87%为甲型副伤寒沙门菌,伤寒19.31%。伤寒沙门菌对奈啶酸、复方新诺明、氨苄西林、庆大霉素、头孢噻吩及四环素等药物的耐药率分别为26.44%、11.49%、8.05%、4.6%、2.3%及1.15%;甲型副伤寒沙门菌对多种抗菌素敏感,对奈啶酸、复方新诺明及头孢噻吩的耐药率分别为93.18%、2.27%及1.62%;丙型副伤寒沙门菌呈多重耐药。结论全省伤寒副伤寒发病率明显降低,部分地区发病率仍较高,伤寒副伤寒沙门菌耐药日益严重,流行形势依然严峻,流行菌型及药敏监测势在必行,采取以切断传播途径为主导的综合控制措施,保证"洁净的饮用水、卫生的食物和有效的健康教育"等最基础和重要的措施落在实处,才能从根本上遏制伤寒副伤寒流行或暴发。Objective This analysis helped us gain some insight into the onset rules of Typhoid fever and Paratyphoid fever and grasp the epidemic trend so as to provide scientific basis for the implementation of preventive and cure countermeasures against it. Methods Reviewing analysis of Typhoid fever and Paratyphoid fever from 1999 to 2007 and some laboratory records in guizhou was conducted. Results 103 419 typhoid and paratyphoid cases were reported from 1999 to 2007 in Guizhou province, the annual average morbidity and fatality rate were respectively 30. 79/100000 and 0. 10 %. The tendency of incidence was descend. Compared the national morbidity , the morbidity was 4. 38 times higher in Guizhou. typhoid cases accounted for 73.54 %. There was the highest annual average morbidity in Qian xinan （68. 77/100 000） next Guiyang and Anshun city. Season distribution was the whole year and high peak period was from May to September. Age distribution was from 5 to 55 years old for the most part. Male to female was 1.28 ： 1. Farmers （ accounted for 33.43% ） and students （ accounted for 25.53% ） were the main targets. There were 423 outbreak of typhoid and paratyphoid and 20214 reported cases accounted for 19. 55% in total reported cases. The outbreak descended year after year. Poor countryside, school and suburban combing site were the main outbreak places, the outbreak of water resources and food resources respectively accounted for 50. 57% and 18.39%. S. paratyphoid A was the most bacterial strain following S. typhoid. The tolerant coefficient of S. typhoid for NAL, SMZ. AMP, GEN, CTX and C were respectively 26.44%, 11.49%, 8.05%, 4.6%, 2. 3% and 1.15%. S. paratyphoid A was sensitive to multiple antibiotics, but the tolerant coefficient for NAL, SMZ and CTX were respectively 93.18%, 2.27% and 1.62%. S. paratyphoid D was tolerant for multiple drugs. Conclusion The total morbidity of typhoid and paratyphoid was obviously descend in Guizhou , but some areas were still higher. It was increasingly serious that S. typho

关 键 词：伤寒 副伤寒 流行特征 

分 类 号：R516.3[医药卫生—内科学]