2012-2019年北京市顺义区猩红热病原学监测分析  

Pathogenic Surveillance of Scarlet Fever in Shunyi District,Beijing from 2012 to 2019

作　　者：朱美娟[1,2] 康颖 杨杰[1,2] 荆红波[1,2] 李颖[1,2] ZHU Mei-juan;KANG Ying;YANG Jie;JING Hong-bo;LI Ying(Shunyi District Center for Disease Control and Prevention,Beijing 101320,China;Workstation for Microbial Infectious Disease Shunyi District Center for Disease Control and Prevention,Beijing 101320,China)

机构地区：[1]北京市顺义区疾病预防控制中心,北京101320 [2]北京市顺义区疾病预防控制中心微生物感染性疾病检测工作站,北京101320

出　　处：《医学信息》2022年第4期146-149,共4页Journal of Medical Information

摘　　要：目的分析2012-2019年顺义区猩红热病原学监测结果,以期为开展猩红热防控工作提供依据。方法采集顺义区妇幼保健院2012-2019年儿科门诊诊断为猩红热或链球菌感染/扁桃体炎/咽峡炎的1205例患儿的咽拭子,均进行A组溶血性链球菌(GAS)的分离培养鉴定,结合监测病例流行病学资料进行分析。结果 2012-2019年从1205件咽拭子中共检出GAS 275株,检出率为22.82%,其中2014年和2017年GAS检出率较高,分别为34.15%和34.64%;猩红热临床诊断病例共29例,诊断率为2.41%,其中2017年最高,为6.54%;猩红热临床诊断率低于GAS检出率,差异有统计学意义(P<0.05);不同性别、户籍GAS检出率比较,差异无统计学意义(P>0.05);是否服用抗生素间GAS检出率比较,差异有统计学意义(P<0.05)。诊断为猩红热和链球菌感染的患者中GAS检出率高于诊断为扁桃体炎和咽颊炎的患者,差异有统计学意义(P<0.05);而诊断为猩红热和链球菌感染、扁桃体炎和咽颊炎患者中GAS检出率比较,差异无统计学意义(P>0.05)。不同临床症状中扁桃体肿大、咽颊红肿、口腔黏膜充血、草莓舌、杨梅舌、皮疹和指压痕阳性的GAS检出率高于猩红热临床诊断率,差异有统计学意义(P<0.05);而不同临床症状中口周苍白圈或巴氏线的猩红热临床诊断率和GAS检出率比较,差异无统计学意义(P>0.05)。结论本地区猩红热发病呈波动性,猩红热临床诊断率低于其病原菌的检出率,应提升医护人员对猩红热的诊断水平,同时加强猩红热病原学监测,为临床诊断和科学制定防控措施提供实验室依据。Objective To analyze the etiological monitoring results of scarlet fever in Shunyi District from 2012 to 2019,so as to provide the basis for the prevention and control of scarlet fever.Methods Pharyngeal swabs were collected from 1205 children diagnosed as scarlet fever or streptococcus infection/tonsillitis/pharyngitis in pediatric outpatient department of Shunyi Maternal and Child Health Hospital from 2012 to 2019.The isolation,culture and identification of group A streptoccoccus(GAS) were carried out,and the epidemiological data of the monitored cases were analyzed.Results A total of 275 GAS strains were detected from 1205 pharyngeal swabs in 2012-2019,with the detection rate of 22.82%;the detection rates of GAS in 2014 and 2017 were relatively high,accounting for 34.15% and 34.64%,respectively.A total of 29 cases of scarlet fever were clinically diagnosed,and the diagnostic rate was 2.41%;the detection rates of scarlet fever in 2017 was high,accounting for 6.54%.The clinical diagnosis rate of scarlet fever was lower than that of GAS,and the difference was statistically significant(P<0.05);there was no significant difference in the detection rate of GAS between different genders and household registration(P>0.05);there was a statistically significant difference in the detection rate of GAS between taking antibiotics or not(P<0.05).The detection rate of GAS in patients with scarlet fever and streptococcus infection was higher than that in patients with tonsillitis and pharyngitis,and the difference was statistically significant(P<0.05);there was no significant difference in the detection rate of GAS among patients diagnosed as scarlet fever,streptococcus infection,tonsillitis and pharyngitis( P>0.05).The GAS detection rates of tonsil enlargement,pharyngeal cheek swelling,oral mucosal congestion,strawberry tongue,bayberry tongue,rash and positive finger indentation in patients with different clinical symptoms were higher than those of scarlet fever,and the difference was statistically significant( P <0.05);there

关 键 词：猩红热 A组溶血性链球菌 病原学监测 

分 类 号：R515.1[医药卫生—内科学]