C群流行性脑脊髓膜炎53例临床分析

Clinical analysis of 53 cases with epidemic cerebrospinal meningitis group C

目的总结2003年以来C群流行性脑脊髓膜炎(流脑)的临床特征,为今后流脑防治工作积累经验。方法对53例C群流脑患者的临床资料进行回顾性分析。结果患者主要集中在青少年和成人,两者分别占49.1%(26例)和39.6%(21例),而婴幼儿则最少,只占1.9%(1例)。临床分型以普通型为主,占69.8%,暴发型只占30.1%。死亡4例(7.5%)。共分离出C群脑膜炎奈瑟球菌28株,药敏结果显示C群Nm对青霉素、头孢曲松、头孢噻肟等普遍敏感,而对复方新诺明、庆大霉素、环丙沙星等耐药率都在80%以上。结论C群感染者多见于青少年和成人。C群感染者病情重,病死率高。抗菌治疗以青霉素、头孢菌素类抗生素为佳。

Aim To investigate the clinical features of epidemic cerebrospinal meningitis group C in recent 3 years, aiming to develop the strategies for control ling this disease. Methods A retrospective analysis was conducted in 53 hospitalized patients with epidemic cerebrospinal meningitis group C from 2003 to 2006. Results The majority of 53 patients were juvenile and adult, accounting for 49.1% （26 cases） and 39.6% （21 cases） , respectively . However, the least rate of total cases were infant patients, only beingl. 9% （ 1 cases ）. The clinical features of most patients belonged to ＂common type＂（ 69.8% ） , followed by fulminant type（30.1% ）. Four cases（7.5 % ）died, all of whom were fulminant cases. Totally 28 strains of Neisseria meningitidis were isolated and the Isolates of N. menlngitidis group C were still highly sensitive to penicillin, cefriaxone and cefotaxime . However, the resistance rate of strains to trimeth-sulfa, centamicen and ciprofloxacin was above 80%. Conclusion Most of the patients infected by N. meningitidis group C are juvenile and adult. Penicillin and the third generation cephalosporins are still highly active against N. meningitidis group C.