广东省2006-2021年流行性脑脊髓膜炎流行病学和病原学监测  

Epidemiological and etiological surveillance of meningococcal meningitis in Guangdong province,2006-2021

作　　者：刘美真[1] 梁剑[1] 李振翠 何思敏 李柏生[1] 柯碧霞[1] 何冬梅[1] 邵晓萍[1] Liu Meizhen;Liang Jian;Li Zhencui;He Simin;Li Baisheng;Ke Bixia;He Dongmei;Shao Xiaoping(Guangdong Provincial Center for Disease Control and Prevention/Guangdong Workstation for Emerging Infectious Disease Control and Prevention,Guangzhou 511430,Guangdong,China)

机构地区：[1]广东省疾病预防控制中心,广东新发突发传染病防治工作站,广东广州511430

出　　处：《中国疫苗和免疫》2022年第6期659-665,共7页Chinese Journal of Vaccines and Immunization

基　　金：广东省重点领域研发计划项目(2022B1111020003)。

摘　　要：目的分析广东省流行性脑脊髓膜炎(流脑)流行病学和脑膜炎奈瑟菌(Neisseria meningitidis,Nm)血清群谱。方法收集广东省2006-2021年流脑报告病例、2006-2012年健康人群Nm带菌率调查、2016-2017年脑膜炎和脑炎监测(Acute meningitis and encephalitis surveillance,AMES)、2007-2019年Nm耐药性试验等数据,分析流脑流行特征、Nm血清群分布和耐药率。结果广东省2006-2021年报告流脑118例,年均报告发病率为0.007/10万;0-4、5-9、10-14、15-19、≥20岁分别占总病例数的37.29%、4.24%、5.93%、18.64%、33.90%。流脑病例Nm检出率为71.19%(84/118),其中A、B、C、W、Y、不可分群分别占4.76%、52.38%、26.19%、8.33%、7.14%、1.19%;健康人群Nm带菌率为0.56%(32/5743),各血清群分别占0.00%、65.63%、9.38%、3.13%、0.00%、21.88%;AMES病例Nm检出率为1.33%(13/981),均为B群。Nm菌株对甲氧苄啶/磺胺甲恶唑、萘啶酸、环丙沙星、青霉素、氨苄青霉素的耐药率分别为80.2%、47.7%、33.3%、3.2%、0.0%。结论广东省流脑发病率维持在较低水平,优势流行Nm血清群由A群和C群向B群、Y群和W群转变。应继续加强流脑流行病学和病原学监测以及Nm菌株耐药性监测。Objective To analyze epidemiological characteristics of meningococcal meningitis(MM)and the pathogenic spectra of Neisseria meningitidis(Nm)in Guangdong province.Methods We collected data on MM cases reported from 2006 to 2021,Nm carriage surveys among healthy populations from 2006 to 2012,acute meningitis and encephalitis surveillance(AMES)from 2016 to 2017,and Nm drug resistance tests from 2007 to 2019 to determine Nm epidemiological characteristics,serogroup distribution,and drug resistance rates.Results There were 118 MM cases reported in Guangdong from 2006 to 2021,for an average annual reporting incidence of 0.007 cases per 100000 population.Cases 0-4,5-9,10-14,15-19,and≥20 years of age accounted for 37.29%,4.24%,5.93%,18.64%,and 33.90%of all cases,respectively.The positivity rate of Nm among MM cases was 71.19%(84/118),among which A,B,C,W,Y,and unclassifiable serogroups accounted for 4.76%,52.38%,26.19%,8.33%,7.14%,and 1.19%.The Nm carriage rate among healthy populations was 0.56%(32/5743),in which corresponding serogroups accounted for 0.00%,65.63%,9.38%,3.13%,0.00%,and 21.88%.The Nm positivity rate in AMES cases was 1.33%(13/981),and all were seregroup B.The Nm resistance rates against trimethoprim sulfamethoxazole,nalidixic acid,ciprofloxacin,penicillin,and ampicillin were 80.2%,47.7%,33.3%,3.2%,and 0.0%.Conclusions The MM incidence in Guangdong remained low.The predominant Nm serogroup changed from serogroups A and C to serogroups B,Y,and W.We should strengthen MM epidemiological and etiological surveillance and drug resistance testing of Nm.

关 键 词：流行性脑脊髓膜炎 脑膜炎奈瑟菌 流行病学 病原学 血清群 耐药性 监测 

分 类 号：R186[医药卫生—流行病学] R515.2[医药卫生—公共卫生与预防医学]