南宁市儿童流感嗜血杆菌、肺炎链球菌和脑膜炎奈瑟菌所致脑膜炎流行病学特征分析

Epidemiological features of bacterial meningitis among children under 5 years old in Nanning

目的 了解广西南宁市 5岁以下儿童流感嗜血杆菌 (Hi)、肺炎链球菌 (Sp)和脑膜炎奈瑟菌 (Nm)所致脑膜炎流行病学特征 ,为制订该病的预防对策提供依据。方法 2 0 0 0年 11月至 2 0 0 2年 12月对广西南宁市市区、市郊 15个乡镇、武鸣县 10个乡镇和邕宁县 14个乡镇的凡符合“疑似脑膜炎筛检标准”的 5岁以下患儿进行以病原学为依据的细菌性脑膜炎流行病学监测。结果 共评估了12 72例疑似脑膜炎患儿 ,发现Hi脑膜炎 3例、Sp脑膜炎 4例 ,未发现Nm脑膜炎病例 ;Hi、Sp脑膜炎年均发病率分别为 0 98/10万、1.30 /10万 ;Hi和Sp脑膜炎病例分布于邕宁县和南宁市区 ;Hi、Sp脑膜炎平均发病年龄分别为 11 7、5 8月龄 ;发病季节较分散 ;临床症状体征均较重 ,Hi和Sp脑膜炎各有 1例并发症发生 ,Sp脑膜炎病死 1例 ,均无后遗症发生 ;所分离的Hi和Sp菌株有对青毒素和复方新诺明耐药的现象 ;确诊患儿绝大多数居住于农村 ,均未接种过相应的疫苗。结论 虽然本次监测南宁市 5岁以下儿童Hi、Sp和Nm所致脑膜炎发病率均较低 ,但除采取针对呼吸道传染病的预防措施外 ,仍主张采取针对性的疫苗接种。

Objective To determine the Epidemiological characteristics of meningitis caused by H.influenzae (Hi), S.pneumoniae (Sp) and N. meningitis (Nm) among children under 5 years, and to provide reference for developing preventive strategies. Methods Cases diagnosed bacteriologically were from the surveillance of suspected meningitis in children<5 years living in urban area and 15 townships of Nanning, 10 townships of Wuming County and 14 townships of Yongning County in Guangxi Province from November 2000 to December 2002. Results A total of 1 272 cases of suspected meningitis were found, of which three cases caused by Hi, four Sp and zero Nm. The annual incidences of Hi and Sp meningitis were 0.98 and 1.30 per 100 000 respectively. Cases of Hi and Sp meningitis were found in Yongning County and Nanning urban area and without relevant vaccination. The average ages of Hi and Sp meningitis cases were 11.7 and 5.8 months respectively. No distinct seasonal cluster observed. These cases had severe clinical symptoms and signs but without sequelae and two had complications and one died. Conclusion Although the incidence rate of Hi, Sp and Nm meningitis in children<5 years was low in Nanning, specific vaccines vaccination should strongly be recommended.