淄博市2015-2019年猩红热流行特征和病原学监测分析  

Epidemiological characteristics and pathogenic surveillance of scarlet fever in Zibo,2015-2019

作　　者：王玲[1] 曹海霞[1] 孙涛 马明远 崔峰[1] 房明[3] 张玲[1] 任睿 WANG Ling;CAO Hai-xia;SUN Tao;MA Ming-yuan;CUI Feng;FANG Ming;ZHANG Ling;REN Rui(Department of Infectious Disease Prevention and Control,Zibo Center for Disease Control and Prevention,Zibo,Shandong 255026,China)

机构地区：[1]淄博市疾病预防控制中心传染病防制所,山东淄博255026 [2]山东大学临床医学院,山东济南250012 [3]山东省疾病预防控制中心细菌性传染病防制所,山东济南250014

出　　处：《现代预防医学》2020年第21期3998-4001,共4页Modern Preventive Medicine

基　　金：国家科技重大专项子任务山东省病原菌实验室网络化监测技术体系的应用研究(2018ZX10714002-003-004)。

摘　　要：目的分析淄博市2015-2019年猩红热流行特征和病原学监测结果,为开展防控工作提供依据。方法利用描述性流行病学方法,对淄博市2015-2019年猩红热疫情资料进行分析,采集2016-2019年部分临床诊断猩红热/咽峡炎病例和猩红热密切接触者咽拭子标本,培养分离GAS,应用PCR扩增emm基因,确定基因型别,进行药敏实验。结果2015-2019年共报告猩红热病例1975例,年均发病率8.44/10万,每年有春夏季(4-6月)和秋冬季(11-1月)2个发病高峰,分别占报告病例总数的40.76%和28.10%,以3~8岁年龄组为主,占85.22%,职业分布以幼托儿童和小学生为主,分别占报告病例总数的59.24%和28.86%。采集猩红热病例标本374份,GAS阳性率为19.25%,采集咽峡炎病例标本60份,未检出阳性菌株,采集猩红热病例密切接触者标本491份,GAS阳性率为11.41%。对2017年间分离到的21株GAS菌株进行emm基因检测,共检测出2个基因型,分别为emm1型(12株)、emm12型(9株)。对21株GAS进行耐药性检测,菌株对对左氧沙星、青霉素、美罗培南、利奈唑胺、氯霉素、万古霉素、头孢噻肟、头孢吡肟敏感性均为100%。结论淄博市2015-2019年间猩红热呈现持续增长趋势,每年有两个发病高峰,以托幼儿童和小学低年龄组儿童为主要发病群体,猩红热病例密切接触者带菌率较高,近年来主要优势基因型别未发生改变,青霉素仍是首选药物。应加强猩红热病原学监测,提高聚集性疫情报告敏感性。Objective To analyze the epidemiological characteristics and pathogenic surveillance of scarlet fever in Zibo City from 2015 to 2019,so as to provide evidence for preventing and controlling scarlet fever.Methods Descriptive statistical analysis was performed on epidemiological data of scarlet fever from 2015 to 2019.The throat swabs were collected from case who were clinically diagnosed as scarlet fever,angina,and close contacts of scarlet fever cases,and from which GAS were isolated,polymerase chain reaction(PCR)was conducted to amplify the emm gene,and to determine the genotype of emm,then drug sensitive tests were proceeded.Results A total of 1975 cases were reported in the whole city from 2015 to 2019,with the average annual incidence of 8.44/100000.The two peak stages occurred in spring(Apr.-Jun.)and winter(Nov.-Jan.)each year,accounting for 40.76%and 28.10%,respectively.The age group of 3-8 years was the main group,accounting for 85.22%.The occupational distribution was dominated by kindergarten children and primary school students,accounting for 59.24%and 28.86%,respectively.The rate of group A streptococcus among 374 cases of scarlet fever and 491 close contacts was 19.25%and 11.41%,respectively.There was no GAS in 60 cases of angina.The emm gene of 21 gas strains isolated in 2017 was detected,and two genotypes were detected,which were emm1(12 strains)and emm12 type(9 strains).The drug resistance of 21 strains of gas was tested.The sensitivity of strains to levofloxacin,penicillin,meropenem,linezolid,chloramphenicol,vancomycin,cefotaxime and cefepime was 100%.Conclusion From 2015 to 2019,the incidence of scarlet fever in Zibo City shows a continuous growth trend,with two peaks each year.The main incidence groups are kindergarten children and low age children in primary school.The carrier rate of close contacts of scarlet fever cases is high.In recent years,the main dominant gene type has not changed.Penicillin is still the first choice drug.It is necessary to strengthen the etiological monitoring of scarl

关 键 词：猩红热 流行特征 病原学监测 

分 类 号：R181.3[医药卫生—流行病学] R515.1[医药卫生—公共卫生与预防医学]