人-猪链球菌感染性综合征临床分析

Analysis of infectious syndrome caused by streptococcus suis Ⅱ

目的分析江苏省部分地区1998～1999年夏秋流行的人猪链球菌突发感染性疾病。方法对流行病学调查及临床观察结果分析,并对分离菌株进行生化特征鉴定、流行菌株同源性比较。结果患者均有屠宰病猪或售病猪肉史,起病急骤,有严重的毒血症状,伴有红色斑丘疹或出血点,很快发生休克、DIC,可有脑膜刺激征。流行后期病例以化脑征象为主,周围血白细胞明显升高,多有肝、肾功能受损。分离病原菌APIStrep鉴定为猪链球菌,分离出病人和病猪4株猪链球菌型菌株具有较高的同源性。联合应用青霉素、头孢曲松抗感染有效。结论该起人群流行疾病是一起由猪链球菌型所致感染性综合征,为人畜共患疾病。

Objective To study the explosive infectious disease occurred in some areas of Jiangsu Province from late summer to autumn 1998～1999.Methods We collected 27 cases and analyzed their epidemiologic and clinical features, appraised biochemical features of strain isolated from patient's blood or CSF, compared the homogeneity among 4 isolated streptococcus suis Ⅱfrom the patients and diseased pigs.Results All patients had the history of killing diseased pigs or saling pork of the diseased pigs.The onset of the illness was abrupt,toxaemia was severe with red maculopapule or petechia or ecchymosis,and the patients rapidly precipitated into shock and DIC.Menigeal reflex was positive in some cases,and during epidemic stage latter purulent meningitis occurred in the majority of the cases.WBC count increased obviously, liver and kidney damage occurred in the majority of the patients.Strain isolated from the patients was appraised as streptococcus suis Ⅱ by API-Step.There was a higher homogeneity in the strains of streptococcus suis Ⅱ isolated from the patients and diseased pigs.Combining large doses of penicillin G with ceftriaxone was effective in curing the patients with the disease. Conclusion The epidemical disease occurred in this district is infectious syndrome caused by streptococcus suis Ⅱ and is zoonosis.