2013—2015年江苏省细菌性痢疾流行病学特征及病原学监测分析  

Analysis on the epidemic and etiological characteristics of bacterial dysentery in Jiangsu province from 2013 to 2015

作　　者：艾静[1] 嵇红[1] 张雪峰[1] 彭志行[2] 鲍倡俊[1] 钱慧敏[1] AI Jing;JI Hong;ZHANG Xue-feng;PENG Zhi-hang;BAO Chang-jun;QIAN Hui-min(Jiangsu Provincial Center for Disease Control and Prevention,Jiangsu Nanjing 210009,China)

机构地区：[1]江苏省疾病预防控制中心,江苏南京210009 [2]南京医科大学

出　　处：《江苏预防医学》2018年第6期619-622,共4页Jiangsu Journal of Preventive Medicine

基　　金：江苏省医学重点学科(ZDXKA2016008)

摘　　要：目的 了解江苏省细菌性痢疾发病情况及变化趋势，掌握志贺菌流行菌群、菌型以及耐药的分布及变迁情况，为疾病防控和临床治疗提供科学依据。 方法 采用描述性统计方法对2013—2015年江苏省细菌性痢疾的流行病学资料进行分析，菌群和菌型鉴定采用系统生化条和血清凝集法，耐药性鉴定采用K-B纸片法。 结果 2013—2015年细菌性痢疾年均发病率5.21/10万，发病率逐年下降。徐州、南京、无锡发病总数居全省前3位，南京、盐城、宿迁在2015年的发病有较为明显的上升趋势。病例以＜5岁散居儿童为主，男性发病多于女性，学生的发病构成呈较为明显的逐年上升趋势。福氏志贺菌为主要的感染菌群，但所占优势呈现逐年下降趋势，宋内志贺菌群构成上升明显，各年居首位的优势菌型均为F2a型志贺菌。志贺菌耐药性普遍存在，其中萘啶酸的耐药率最高，其次为氨苄西林、四环素和复方新诺明；各菌群的耐药顺次有所不同，且多重耐药现象普遍，阿莫西林/克拉维酸和庆大霉素的耐药率呈逐年下降趋势。 结论 江苏省细菌性痢疾发病率逐年下降，但所居甲乙类传染病的位次依然很高，今后仍然需要将此类疾病作为重点防控传染病。各类志贺菌菌群和菌型构成比正在发生变化，菌株耐药和多重耐药情况日益严重。Objective To understand the incidence and trends of bacterial dysentery in Jiangsu province; to understand the distribution and changes in bacterial flora, type and the susceptibility to antimicrobials of shigella isolated in Jiangsu province; to provide scientific basis for disease control and prevention as well as clinical treatment. Methods The surveillance results of bacterial dysentery in Jiangsu province from 2013 to 2015 was analyzed using descriptive epidemiology. Biochemieal test strips were used for confirmation of Shigella spp.;while serum agglutination and K-B methods were used for serotyping and drug susceptibility analysis. Results Annual average incidence of bacterial dysentery was 5.21 per 100 000 in Jiangsu province from 2013 to 2015. The incidence rate decreased year by year. Xuzhou,Nanjing,Wuxi ranked top three for patients numbers. The incidences of Nanjing, Yancheng and Suqian showed significant ascending trend in 2015. The highest incidence was seen for children of five years old or younger. Male patients were more than female patients. The incidence of students showed an increasing trend year by year. Dominant strain of infection was S. flexneri and the composition decreased every year while composition of S. sonnei increased significantly. The dominant serotype was F2a Shigella, The drug resistance rate to nalidixic acid appeared to be the highest, following with ampicillin, tetracycline and cotrimoxazole. The order of drug resistance of each flora was different, multiple drug resistance phenomenon was common. The drug resistance rates to amoxicillin/clavulanic acid and gentamicin showed an descending trend year by year. Conclusion The incidence of bacillary dysentery decreased obviously in Jiangsu province.However, bacillary dysentery still ranked top among category A and B legal infectious diseases, which should be key diseases for control and prevention in the future. The composition of Shigella flora and bacterial types was changing, while drug resistance and multiple drug resistan

关 键 词：细菌性痢疾 流行病学特征 菌群 菌型 耐药 

分 类 号：R516.4[医药卫生—内科学]