海南省29例人感染猪链球菌病患者流行病学及临床特征分析  

Epidemiological and clinical characteristics of 29 cases of human infection with Streptococcus suis in Hainan Province

作　　者：陈元泽 汪宇雁 汪琦 牛莉娜 郑小静 蔡东尧 杜永国 张丽媛 Chen Yuanze;Wang Yuyan;Wang Qi;Niu Lina;Zheng Xiaojing;Cai Dongyao;Du Yongguo;Zhang Liyuan(Department of Infectious Diseases and Tropical Diseases,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China;College of Basic Medicine and Life Sciences,Hainan Medical University,Haikou 571199,China)

机构地区：[1]海南医科大学第二附属医院感染病与热带病科,海口570311 [2]海南医科大学基础医学与生命科学学院,海口571199

出　　处：《中华地方病学杂志》2024年第12期1004-1009,共6页Chinese Journal of Endemiology

基　　金：国家自然科学基金(82060377);海南省重点研发项目(ZDYF2022SHFZ098)

摘　　要：目的掌握海南省人感染猪链球菌病患者的流行病学及临床特征。方法收集2017年1月至2023年12月海南医科大学第二附属医院确诊的人感染猪链球菌病患者的临床资料,回顾性分析其流行病学特点、临床表现、辅助检查结果、治疗及预后情况等。结果共纳入29例人感染猪链球菌病患者,男性26例(89.66%)、女性3例(10.34%);年龄为(54.52±10.89)岁,51~60岁患者最多,为12例(41.38%);职业以农民为主(72.41%,21/29)。44.83%(13/29)的患者存在直接或者间接死猪、病猪接触史。1-12月发病人数分别为0、0、2、2、4、8、2、3、2、2、3、1例,6月为发病高峰期(27.59%,8/29)。临床表现主要为发热(100.00%,29/29)、意识状态改变(51.72%,15/29)、头痛(48.28%,14/29)、听力障碍(44.83%,13/29)。临床分型中,普通型、脑膜炎型及混合型分别占20.69%(6/29)、75.86%(22/29)、3.45%(1/29)。病原学检查中,29例患者均行血培养,18例(62.07%)血培养阳性;26例患者行脑脊液培养,8例(30.77%)脑脊液培养阳性。89.66%(26/29)的患者使用头孢曲松钠进行治疗;55.17%(16/29)的患者联合糖皮质激素进行治疗,其中11例使用地塞米松、5例使用甲泼尼龙。经治疗,7例患者治愈出院,22例患者病情好转出院。出院时血培养和(或)脑脊液培养均转为阴性。出院6个月后进行电话随访,20例患者无后遗症;9例患者仍遗留听力障碍,其中1例并发行走障碍。结论海南省人感染猪链球菌病患者以中老年、男性、农民为主,6月为发病高峰期。临床表现以发热、意识状态改变、头痛、听力障碍为主。随访后仍有患者遗留听力障碍,临床上对发热伴有听力障碍的患者应尽早考虑该病。Objective To study the epidemiological and clinical characteristics of patients infected with Streptococcus suis in Hainan Province.Methods Clinical data of patients diagnosed with human infection with Streptococcus suis at the Second Affiliated Hospital of Hainan Medical University from January 2017 to December 2023 were collected,and their epidemiological characteristics,clinical manifestations,auxiliary examination results,treatment and prognosis were retrospectively analyzed.Results A total of 29 patients infected with Streptococcus suis were included,with 26 males(89.66%)and 3 females(10.34%).The age of the patients was(54.52±10.89)years old,with the highest number of patients aged 51 to 60 years,accounting for 41.38%(12 cases).Farmers were the main occupation(72.41%,21/29).Forty-four point eighty-three percent(13/29)of the patients had a history of direct or indirect contact with dead or sick pigs.The number of cases from January to December was 0,0,2,2,4,8,2,3,2,2,3,and 1,respectively.June was the peak period of incidence(27.59%,8/29).The main clinical manifestations were fever(100.00%,29/29),altered state of consciousness(51.72%,15/29),headache(48.28%,14/29),and hearing impairment(44.83%,13/29).In clinical classification,common type,meningitis type,and mixed type accounted for 20.69%(6/29),75.86%(22/29),and 3.45%(1/29),respectively.In the pathogen examination,all 29 patients underwent blood culture,and 18 patients(62.07%,18/29)had positive blood culture;26 patients underwent cerebrospinal fluid culture,and 8 cases(30.77%)tested positive for cerebrospinal fluid culture.Eighty-nine point sixty-six percent(26/29)of the patients were treated with ceftriaxone sodium;55.17%(16/29)of the patients were treated with combined treatment of ceftriaxone sodium and glucocorticoids,including 11 cases treated with dexamethasone and 5 cases treated with methylprednisolone.After treatment,7 patients were cured and discharged,and 22 patients showed improvement in their condition and discharged from hospital.At discharge,bo

关 键 词：猪链球菌病 流行病学特征 临床特征 听力障碍 

分 类 号：R516.7[医药卫生—内科学]