两例人感染猪链球菌病病例的流行病学调查  

Epidemiological investigation of two cases of human infection with swine streptococosis

作　　者：倪秀贤 覃媛媛 陆芳芳 杨嘉政 林伽嘉 吕秋莹[4] 李苑[5] NI Xiuxian;QIN Yuanyuan;LU Fangfang;YANG Jiazheng;LIN Jiajia;LV Qiuying;LI Yuan(Department of Disease Control Division,Public Health Service Center of Bao′an District,Shenzhen,Guangdong 518100,China;不详)

机构地区：[1]深圳市宝安区公共卫生服务中心疾病控制科,广东深圳518100 [2]深圳市宝安区福永人民医院 [3]深圳市宝安区现场流行病学培训项目 [4]深圳市疾病预防控制中心传染病预防控制所 [5]深圳市宝安区疾病预防控制中心

出　　处：《医学动物防制》2024年第12期1176-1181,共6页Journal of Medical Pest Control

基　　金：广东省医学科学技术研究基金项目(C2020012)。

摘　　要：目的调查分析2023年深圳市宝安区两例人感染猪链球菌病病例的感染来源和途径,为预防控制疫情提供依据。方法2023年8月通过询问病例的病史、流行病学及现场环境卫生学调查,并采集病例的血液标本开展细菌培养、生化鉴定和PCR检测。结果病例的临床表现为发热、头痛、头晕,伴恶心、呕吐,出现听力下降,甚至昏迷,血常规结果显示白细胞计数增高[(11.22~18.38)×10^(9)/L]、中性粒细胞比例增高(87.1%~94.5%)、淋巴细胞比例增高(4.4%~4.5%)、C-反应蛋白增高(76.80~145.75mg/L)、D-二聚体增高(1.34~14.54mg/L)、降钙素原增高(0.85~7.81ng/ml)。病例从首次就诊到确诊用时2~3d,感染菌株为2型猪链球菌;病例在发病前7d内均有明确的生猪肉接触史,在接触生猪肉前手部有伤口,且在接触过程中未佩戴手套,通过手部伤口感染;病例发病前购买的生猪肉来源于不同的猪肉档口,涉疫档口的生猪肉均由深圳市S公司供应,在涉疫档口的砧板、生猪肉和电子称中均检测出2型猪链球菌。结论在接触生猪肉及其制品过程中,尤其是当手部有伤口时,佩戴手套和采取适当的个人防护措施是预防控制人感染猪链球菌病的关键措施。Objective To investigate and analyze the infection sources and routes of two cases of human infection with swine streptococosis in Bao′an District of Shenzhen City in 2023,and to provide a basis for the prevention and control of the epidemic.Methods In August 2023,bacterial cultures,biochemical identifications and PCR tests were performed by inquiring about the medical history of the cases,epidemiological and on-site environmental hygiene investigations,and collecting blood specimens from the cases.Results The clinical manifestations of the case were fever,headache,dizziness with nausea and nausea,vomiting,experiencing hearing loss,and even coma.Routine blood results showed increased white blood cell counts[(11.22-18.38)×10^(9)/L],increased neutrophil proportions(87.1%-94.5%),increased lymphocyte proportions(4.4%-4.5%),increased C-reactive protein levels(76.80-145.75mg/L),increased D-dimer levels(1.34-14.54mg/L),and increased procalcitonin levels(0.85-7.81ng/ml).Cases took 2-3 days from the first visit to a definitive diagnosis.The infecting strain was identified as Streptococcus suis type 2.Cases had clear histories of contact with raw pork within 7 days before the onset of the disease,had wounds on their hands before the contact with raw pork,did not wear gloves during the contact and became infected through the hand wounds.The raw pork purchased by the cases before the onset of the disease originated from different pork stalls.All the raw pork of the stalls involved in the epidemic was supplied by Company S in Shenzhen City.Streptococcus suis type 2 was detected in the cutting boards,raw pork and electronic scales of the implicated stalls involved in the epidemic.Conclusion During contact with raw pork and its products,especially when there are wounds on the hands,wearing gloves and taking appropriate personal protective measures aere key measures for the prevention and control of human infection with swine streptococosis.

关 键 词：猪链球菌 人畜共患病 脑膜炎 病例报告 临床特征 流行病学 

分 类 号：R378.12[医药卫生—病原生物学] R515.9[医药卫生—基础医学]