贵州省流行性脑脊髓膜炎实验室监测结果分析

Abstract

目的：了解引起贵州省流脑暴发和流行的主要菌群、菌群分布特征、菌株耐药特性，了解健康人群流脑免疫水平状况，为流脑防控提供科学依据。方法：对报告病例采集的脑脊液和/或血液标本、健康人群咽拭子标本和血清标本进行实验室检测和结果分析。结果：1) 2006年全省共报告疑似流脑病例243例，采集123例报告病例脑脊液和/或血液(清)标本共167份。共检测出流脑阳性病例42例，其中A群病例占90.5%。2) 采集健康人群咽拭子标本共726份，分离培养出A群脑膜炎奈瑟菌(Nm)2株，B群1株，健康人群中Nm的带菌率为0.41%。3) 采集健康人群血清标本共715份，流脑A群IgG抗体阳性率62.0%，流脑C群IgG抗体阳性率43.1%。4) Nm菌株药物敏感性检测结果为，流行菌株除对磺胺类和氧氟沙星类药物耐药和部分敏感外，对其余10种常用抗生素均100%敏感。结论：1) 目前引起贵州省流脑暴发和流行的主要菌群仍然为A群Nm；健康人群中Nm以A群为主；2) 健康人群流脑免疫水平不高，小年龄组(5岁以下)抗体水平偏低，尤其是流脑C群抗体水平较低。3) 应加强我省重点地区、重点人群流脑的预防控制、疫情监测和病原学监测工作。 Objective: To understand the main bacteria group, serogroup distribution and antimicrobial susceptibility of Neisseria meningitides (Nm) result in the outbreak and epidemic of Epidemic Cerebrospinal Meningitis (ECM), and to know the situation of population immunity against ECM, so as to provide a scientific basis for the prevention and control of ECM in Guizhou Province. Methods: Carry out the laboratory test to the serum and/or CSF specimens from reported ECM cases, as well as the throat swabs and serum specimens from healthy people, And made an anal-ysis to the test result. Results: 1) 243 cases with ECM were reported in 2006, and a total of 167 serum and/or CSF samples were collected from 123 reported ECM cases. After detection, it showed that there were 42 ECM confirmed cases with 34.1% positive ratio of Nm detection and 17.3% lab confirmed ratio of ECM cases in all reported cases. Among them, ECM cases of sero-group A accounted for 90.5%. 2) 726 throat swabs samples were collected, and 3 Nm strains were isolated including 2 serogroup A and 1 serogroup B with 0.41% carrier rate of Nm patho-gen in healthy people. 3) 715 serum samples were collected. After detection, the positive rate of serogroup A antibody was 62.0%. The positive rate of serogroup C antibody was 43.1%. 4) In addition to drug resistance and part sensitive to Sulfa and Levofloxacin drugs, the epidemic strains were 100% sensitive to the other 10 kinds of common antibiotics. Conclusion: 1) The major dominant strains were still Serogroup A Neisseria meningitides in ECM cases, and sero-group A was the dominant strain in healthy people yet. 2) The immune level of Nm was not high in the healthy people. Small age group (under the age of 5 years) antibody level was lower. Es-pecially, the level of serogroup C antibody was very low. 3) It is suggested that it should streng-then the prevention and control, supervision and etiological surveillance of ECM to the key areas and key population in Guizhou province.