贵州省2007-2010年细菌性痢疾流行特征及病原分析

Epidemic Characteristics and Etiological Analysis of Bacillary Dysentery in Guizhou Province During the Period of 2007-2010

目的了解贵州省2007-2010年细菌性痢疾的流行特征和菌型分布,为制定防控策略提供依据。方法以2007-2010年来源于"中国疾病监测信息报告管理系统"的菌痢疫情为资料,分析菌痢的人群、地区、时间分布特征,并对146株菌痢菌株进行血清学分型和药敏试验。结果 2007-2010年贵州省共报告菌痢48 222例,平均发病率为31.92/10万,病死率为0.049%,总体发病呈逐年下降趋势。发病主要集中在0～5岁组,发病率为151.76/10万,其次为65岁以上组,发病率为36.66/10万。男性多于女性,男女性别比为1.5∶1;职业分布以农民最多占46.04%,其次为散居儿童和学生分别占29.73%、11.06%;年均发病率最高的地区是黔东南州,发病率为49.06/10万,其次是黔南和黔西南;贵州省菌痢有明显的季节性,5-9月为发病高峰。菌型分布以宋内为主,其次是福氏志贺菌。菌株的多重耐药严重,84.93%的菌株存在多重耐药。结论菌痢是贵州省主要的传染病之一,2007-2010年贵州省菌痢发病率呈逐年下降趋势,发病以婴幼儿和农民为主,流行菌株以宋内和福氏志贺菌为主,多重耐药现象严重。

Objective To study the epidemic characteristics and distribution of serotypings of bacillary dysentery in Guizhou Province during the periods of 2007 - 2010, and to provide reference for making prevention and control strategies. Methods The incidence data of bacillary dysentery from 2007 to 2010 were derived from the China Diseases Reporting Informa- tion System, and then the incidence, regional and temporal distribution features of the patients were analyzed. 146 strains of dys- entery - causing bacteria were conducted serological typing and drug sensitive test. Results A total of 48,222 cases of bacilla- ry dysentery were reported in Guizhou Province from 2007 to 2010, the annual average morbidity and fatality rates were 31.92/ 100,000 and 0. 049%, respectively. Th.e incidence in total showed a descending tendency. The cases were mainly concentrated on the age group of 0 - 5 years, with the incidence rate of 151.76/100,000, followed by the age group of 〉65 years, with the incidence rate of 36.66/100,000. Male patients were more than female patients, and the ratio of males to females was 1.5：1. Farmers were primarily affected, accounting for 46.04 %, followed by scattered children and students, accounting for 29.73 % and 11.. 06 % respectively. There was the highest annual average morbidity in Qian Dongnan Prefecture（49.06/100,000）, fol- lowed by Qian Nan and Qian Xinan. Seasonality of bacillary dysentery occurred in Guizhou Province was evident, peaking in May to September. Predominant serotyping was Shigella sonnei, followed by Shigella .flexneri. Multi - drug resistance of the strains isolated from bacillary dysentery cases was very serious, 84.93 % of the strain showed multi - drug resistance. Conclusions Bacillary dysentery was one of the major infectious diseases in Guizhou Province. The incidence showed a gradual decrease tenden- cy from 2007 to 2010. Infants and farmers were the high - risk population. The predominant serotypings were Shigella sonnei and Shigella yTeocneri, and multi - drug resistance was serious.