佛山市南海区首例B群流行性脑脊髓膜炎病例的流行病学调查分析

Epidemiological investigation of the first case of group B epidemic cerebrospinal meningitis in Nanhai District,Foshan City,Guangdong Province,China

目的对佛山市南海区首例B群流行性脑脊髓膜炎(简称流脑)病例的流行病学特点进行调查分析,为进一步完善流脑防控策略与措施提供科学依据。方法查阅病例病案,访视病例家属及其他相关知情人,并进行病例的流行病学个案调查。结果患儿邱某某,男性,1岁2个月,于2011年7月11日开始发病,因发热、皮疹就诊并住院治疗,经抗感染、对症支持治疗后好转出院;发病前无与同类患者接触史;家庭居住条件和卫生环境一般;实验室检测证实,该病例为B群脑膜炎奈瑟菌感染;药敏试验显示,病原菌株对替卡西林、哌拉西林、美罗培南、亚胺培南、氨曲南、头孢吡肟、头孢哌酮、头孢他啶、头孢曲松、环丙沙星、左氧氟沙星等均敏感,对复方新诺明、庆大霉素不敏感,对丁胺卡那霉素耐药;经采取综合预防控制措施,未出现二代病例。结论该病例确诊为佛山市南海区首例B群流脑病例,预防控制B群流脑的关键是采取以加强病原学检测、敏感药物使用为重点的综合防控措施。

Objective To investigate the epidemiological feature of the first case of group B epidemic cerebrospinal meningitis in Nanhai District,Foshan City,Guangdong Province,China,and provide a scientific basis for further perfection of measure to prevent and control the disease.Methods Individually epidemiological investigation was performed by viewing the medical records and consulting the families of the patient and other insiders.Results The male patient at age of 14 months was hospitalized due to fever and rash on July 11,2011,and was discharged from the hospital after anti-infectious therapy and symptomatic treatment.The patient who lived in ordinary residing and hygienic conditions had no history of exposure to the patients with the same disease.Laboratory test proved that the patient was infected with group B Neisseria meningitides.Drug-sensitivity test showed that the isolate from the patient was sensitive to ticarcillin（TiC）,piperacillin（PIP）,meropenem（MEM）,imipenem（IPM）,azthreonam（AZT）,cefepime（FEP）,cefoperazone（CFP）,ceftazidime（CAZ）,ceftriazone（CTR）,ciprofloxacin（CIP） and levofloxacin（LEV）,while was non-sensitive to compound sulfamethoxazole（COSMZ） and gentamicin,and was resistant to amikacin（AMK）.No the second generation of cases appeared since comprehensive measures were taken to prevent and control the disease.Conclusion The first case of group B epidemic cerebrospinal meningitis in Nanhai District,Foshan City was diagnosed.The key to prevent and control the disease was comprehensive measures focusing on strengthening of etiologic monitoring and application of effective drugs.