2004—2014年宁波市细菌性痢疾流行特征及病原学分析

Epidemiological characteristics and pathogenicity of bacillary dysentery in Ningbo from 2004 to 2014

目的了解宁波市细菌性痢疾流行特征,为防控工作提供依据。方法采用SPSS 17.0和Excel2003软件,对宁波市2004-2014年细菌性痢疾疫情资料进行数据统计处理,采用Pearsonχ~2检验,P<0.05为差异有统计学意义,分离和收集志贺菌进行鉴定分型、耐药性和致病力检测。结果宁波市细菌性痢疾年发病率在1.78/10万~42.59/10万,平均为18.69/10万。全年均可发病,发病高峰为8~9月。志贺菌流行株以B群志贺菌为主,D群志贺菌为次,呈福氏2a血清型、福氏c亚型和宋内氏志贺菌格局。菌株耐药严重,多为多重耐药株;携带毒力基因种类多、毒性强。结论宁波市细菌性痢疾发病率逐年下降,已维持在较低水平,但菌株的血清型在转换,耐药性和毒力显示其有较强的致病性,引起暴发与流行的因素仍未改变,提示应加强细菌性痢疾的监测与防控。

Objective To discuss the epidemiological characteristics of bacillary dysentery in Ningbo and to pro- vide scientific evidence for disease prevention and control. Methods Epidemic data of bacillary dysentery in Ningbo from 2004 to 2014 were statistically analyzed by SPSS 17. 0 and Excel 2003 software. Strains of Sbigel- la were isolated for serotype identification, drug resistance and pathogenicity tests. Results The annual inci- dence of bacillary dysentery in Ningbo ranged from 1.78 to 42.59 per 100 000 populations with the average of 18.69. The peak season was in August and September although patients with bacillary dysentery could present throughout the year. Among the epidemic strains of Shigella, S. flexneri was found to be dominant, followed by S. sonnei. 2a subtype of S. flexneri was the most common one, followed by S. flexneri c subtype and S. sonnei subtype. Drug resistance of Shigella was very popular and most of the strains were multi-drug-resistant. Most of strains carried various virulence genes and were highly virulent. Conclusions The incidence of bacillary dysentery in Ningbo decreases year by year and remains at a low level. However, the serotypes of strains keep changing and become highly pathogenic, indicating that disease monitoring and control still need to be en- hanced.