2008/2009年度山东省流行性脑脊髓膜炎病原学监测资料分析

Analysis on Pathogen Surveillance Data of Epidemic Cerebrospinal Meningitis in Shandong Province,2008-2009

[目的]了解脑膜炎奈瑟菌菌群分布、变异及耐药情况，为流行性脑脊髓膜炎（流脑）防治工作提供科学依据。[方法]对2008／2009年度山东省流脑疑似病例及流脑监测点流行期检测资料进行分析。[结果]调查健康人群1097人。从咽拭子检出脑膜炎双球菌13人，带菌率为1．19％，分离菌株中，A群3株，B群1株，C群1株，W135群4，I群2株，X群2株。带菌率，15～19岁为5．77％，其他年龄为0．43％（P〈0．01）。检测10例流脑病例脑脊液（或血清），其密切接触者咽拭子30份，“两脑”项目哨点医院送检脑炎、脑膜炎疑似病例脑脊液（或血清）标本184份，RT—PCR检出l株A群菌（流脑病例）、3株C群菌（“两脑”病例）。用分离的9株菌株进行药敏试验，1株B群菌株对12种抗生素均敏感；其他8株对氨苄青霉素、阿齐霉素、美洛培能、头孢曲松、头孢噻肟、阿齐霉素、氯霉素、利福平、萘啶酸均敏感，对复方新诺明均耐药，对青霉素1株耐药．对环丙沙星6株耐药，对左氧氟沙星6株耐药。[结论]目前山东省流脑疫情以A群、C群为主，从健康人群中检出W135群菌株，部分菌株对常用抗菌药物表现耐药。

[Objective]To understand the distribution, variation and drug resistance of Neisseria meningitidis（Nm）, so as to provide scientific basis for its prevention and control. EMethods]Analysis was made on the surveillance data of suspected epidemic eerebrospinal meningitis（ECM） eases and Neisseria meningitides（Nm） carrier rate in Shandong Province during 2008 to 2009. [Results]l3 Nm strains were isolated from 1097 specimens with the rate of 1.19 %. The proportion of Nm serogroup A,B,C,W135,I,and X was 3,1,1,4,2,and 2. The carrier rate was 5.77% in 15-19 age group,and 0.43% in the other age groups（ P 〈0.01）. Cerebrospinal fluid （or serum） of 10 cerebrospinal meningitis eases were detected,30 throat swab in close contact, 184 specimens of cerebrospinal fluid （or serum） of encephalitis, meningitis suspected cases from ＂two meningitis ＂ project sentinel hospitals, 1 group A strain （meningitis eases）and 3 group C strains（ ＂two meningitis ＂ eases）were detected with RT- PCR. 9 isolated strains were conducted on sensitive test,a group B strains were sensitive to 12 antibiotics ; the other eight strains were all sensitive to ampicillin, azithromyein, eeftriaxone, cefotaxime, azithromyein, chloramphenicol, rifampin, nalidixic acid, were resistant to cotrimoxazole, 1 strain was resistant, 6 strains were resistant to eiprofloxae,and 6 strains were resistant to levofloxaein, [Conclusion]During 2008 to 2009, serogroup A and C are the dominant strains of ECM eases in Shandong province. Serogroup W135 is isolated in healthy groups and the resistant strains have been identified.