高原地区儿童脑炎脑膜炎症候群病原监测分析

Pathogen detection for syndromes of encephalitis and meningitis among child patients in plateau of Qinghai province from 2010 to 2011

目的了解高原地区脑炎脑膜炎症候群病例病原种类及其流行特征。方法收集2010年1月—2011年12月在青海省妇女儿童医院和青海红十字医院就诊的≤14岁脑炎脑膜炎症候群病例基本信息及临床信息,对所有脑脊液标本进行肺炎链球菌、脑膜炎奈瑟球菌等8种细菌的培养鉴定以及乙脑病毒等4种病毒的核酸检测。结果共有254例脑炎脑膜炎病例脑脊液标本进行了实验室检测,共检出阳性菌株21株,细菌检出率为8.27%;以金黄色葡萄球菌、结核杆菌检出率最高,各占整个阳性标本的23.81%;其次为大肠杆菌和隐球菌,各占阳性标本的19.05%;另检出肺炎链球菌和脑膜炎奈瑟球菌,分别占阳性标本的9.52%和4.76%;病毒核酸检测阳性19份,病毒检出率为7.48%,主要为肠道病毒,共15份,占整个阳性标本的78.95%,检出腮腺炎病毒和单纯疱疹病毒核酸阳性各2份,各占阳性标本的10.53%。结论高原地区脑炎脑膜炎症候群仍以细菌感染略占优势,而肠道病毒引起的脑炎也不容忽视。

Objective To study types and distributions of pathogens of encephalitis and meningitis syndromes among child cases in plateau of Qinghai province. Methods The information on age, gender, nationality, and clinical charasteristics were collected among the children under age of 14 years with syndromes of encephalitis and meningitis. Cerebrospinal fluid（CSF）specimen from the patients were detected for pathogens of Cryptococcus,Staphylococcus au- reus , S. pneumoniae , Colibacillus , H. influenzae tape b, N. meningitis, and Bacillus tuberculosis. Real-time （ RT ） -PCR method were used to detect Japanese encephalitis virus （JEV）, enterovirus （EV）, mumps virus （MV）, and herpes simplex virus type I ＋ II （ HSV I ＋ II）. Results Totally 254 cases were collected and the detection rate of bacterial was 8.27%. Major pathogens included Staphylococcus aureus and Bacillus tuberculosis, followed by Colibacillus, cryptococ- cus, S. pneumoniae, and N. meningitis. The detection rate of virus was 7.48 %. Totally 15 cases were enterovirus positive, accounting for 78.95% of positive samples. The mumps virus and herpes simplex virus were also detected from some ca- ses. Conclusion The bacterial were major pathogens for encephalitis and meningitis syndromes in plateau of Qinghai province, and the surveillance and control of enterovirus encephalitis should be strengthened.