2010-2017年西安市细菌性痢疾流行特征及病原学监测结果分析  

Study on epidemic characteristics of bacillary dysentery and surveillance results of bacterial dysentery in Xi'an city from 2010 to 2017

作　　者：张辉[1] 魏争 王春娟[1] 谢龙[1] ZHANG Hui;WEI Zheng;WANG Chun-juan;XIE Long(Xi'an Center for Disease Control and Prevention,Xi'an,Shaanxi 710054,China)

机构地区：[1]西安市疾病预防控制中心,陕西西安710054 [2]西安市高陵区疾病预防控制中心,陕西西安710200

出　　处：《现代预防医学》2019年第8期1494-1497,共4页Modern Preventive Medicine

摘　　要：目的了解2010-2017年西安市细菌性痢疾的流行病学特征和病原学变迁情况,以更好地指导其防治工作。方法采用描述性流行病学方法对2010-2017年西安市细菌性痢疾的发病数据和病原学监测结果进行分析。结果共报告细菌性痢疾27 265例,年均发病率39.75/10万,呈逐年下降趋势。病例全年均有发生且有明显的季节性特征,高峰月份为5-10月,报告病例数占68.23%(18 602/27 265);城区年均发病率(56.18/10万)高于郊县(23.28/10万);职业构成以散居儿童,学生和农民为主,共占病例总数的62.78%(17 117/27 265),其中散居儿童占比逐年上升;5岁以下(294.17/10万)和85岁以上(92.43/10万)人群发病率较高。细菌性痢疾实验室诊断率较低(14.03%)且年变化趋势不明显。病原学监测发现2010-2015年志贺菌检出率为3.50%(65/1 855),2016-2017年则未检出。检出菌中福氏志贺菌为优势菌型(30株,占46.15%),其次是宋内志贺菌(25株,占38.46%),痢疾志贺菌(8株,占12.31%)和鲍氏志贺菌(2株,占3.08%);福氏志贺菌构成比逐渐下降,宋内志贺菌构成比逐渐上升。结论西安市细菌性痢疾发病有明显的时间、地区和人群分布特征。每年的夏秋季节是其防控的重要时段,城区是其防控的重点地区,散居儿童、学生和农民是其防控的重点人群。应以此为基础制定有针对性的重点防控策略。此外,志贺菌菌型的变迁提示应继续加强菌痢的病原学监测工作。Objective To explore the epidemic characteristics and pathogenic features of bacillary dysentery from 2010 to2017 in Xi’an city, and thus to provide scientific reference for prevention and control strategies. Methods The data of bacterial dysentery in Xi’an were analyzed by descriptive epidemiological method. Results Totally 27 265 cases of bacillary dysentery were reported in Xi’an city from 2010 to 2017. The average incidence of bacillary dysentery was 39.75 per 100000, and it had downward trend. The disease occurred year-round and it had an obvious seasonal peak during May to December. In total,18 602 cases(68.23%) were reported during the peak period. The morbidity in central districts(56.18/100000) was higher than those in suburban districts(23.28/100 000). The occupations of the cases were mainly scattered children,students and peasants, totally accounting for 62.78%(17 117/27 265). And scattered children were the largest proportion among the reported cases and increased year by year.The incidence rate was higher in people below 5 years old(294.17/100000) and above the age of 85(92.43/100 000). The laboratory diagnostic rate of bacillary dysentery was low(14.03%) and showed no obvious trend.From 2010 to 2015,a total of 65 isolates were isolated and the detection rate was 3.50%(65/1 855).And no shigella strains were isolated during 2016 to 2017. Of the shigella strains, 30 were Shigella flexneri(46.15%), 25 were Shigella sonnei(38.46%), 8 were Shigella dysenteriae(12.31%) and 2 were Shigella bogdii(3.08%). The constituent ratio of Shigella flexneri showed an obvious downtrend while the constituent ratio of Shigella sonnei showed an obvious uptrend during 2010 to 2015. Conclusion Bacillary dysentery in Xi’an city exhibited obvious features of distribution by time,place and people.The prevention and control measures should be implemented in summer and fall and focused on central districts.Scattered children, students and peasants were the main population to control the spread of bacillary dysentery.So

关 键 词：细菌性痢疾 志贺菌 发病率 流行病学特征 病原监测 

分 类 号：R181.2[医药卫生—流行病学]