对32例感染猪链球菌病的临床分析

Clinical analysis the infection of pig Streptococcus suis type 2 in 32 patients

目的观察成都地区32例人感染猪链球菌病患者的临床特征。方法收集患者流行病学、临床表现、细菌培养、毒力基因鉴定结果等并进行分析。结果6例患者血液及脑脊液的分离培养的细菌中,均含猪链球菌2型毒力基因;全部患者在发病前均以宰杀、加工等方式直接接触病、死猪史,25例(78.12%)患者皮肤有明显伤口。临床分型以脑膜炎型患者居多(65.6%,21例),其次为普通型(12.5%,4例)、混合型(15.6%,5例)、休克型(6.2%,2例);普通型、脑膜炎型预后良好;混合型预后较差,其总死亡率为6.25%(2/32)。结论患者通过直接接触病、死猪而受染猪链球菌2型,无第2代病例发生;青霉素和头孢菌素可作为首选治疗药物。

Objective To investigate clinical characteristics of 32 patients infected with Streptococcus suis type 2 in Chengdu local area. Methods All data concerning epidemiology, clinical behavior were collected. The bacteria culture, toxicity gene in the 32 patients were analyzed. Results S. suis type 2 toxicity gene was found in all the cultured bacteria separated from the blood and/or CSF of 6 patients. All patients had history of directly contact with ill and/or dead pig by chances such as slaughtering and/or prccessing pigs. Twenty -five patients（78.12% ）had visible skin wounds . Most of the patients could clinically classified as meningitis type patients （ 65. 6%, n = 21 ） ; the rest are normal type （ 12.5%, n = 4） ; the multiple type （ 15.6%, n = 5 ） ; shock type（6.2%, n = 2）. Normal type and meningitis type patients had good prognosis. While multiple type patients have bad prognosis. Overall mortality rate was 6.25%. Conclusion Patients were infected with S. suis type 2 by directly contacting with ill and/or dead pigs. No secondary patients were found. Penicillin and cephalosporins can be considered preferred theraputic medication.