贵州省2010-2015年细菌性痢疾流行病学特征分析

Epidemiological characteristics of bacillary dysentery in Guizhou Province from 2010 to 2015

目的了解贵州省细菌性痢疾(菌痢)的发病特征及流行趋势,为制订防治策略提供科学依据。方法对贵州省2010-2015年菌痢疫情资料进行描述性流行病学分析。结果 2010-2015年贵州省共报告菌痢病例34 580例,6年报告平均发病率为16.28/10万。发病率较高的地区依次为黔南州、黔西南州和安顺市。5~9月为发病高峰。男女发病比为1.45∶1,其中0~4岁和15~20岁组发病最多(占病例总数的55.70%)。职业分布以农民(46.06%)、散居儿童(32.24%)和学生(9.30%)为主。病原菌型监测显示,志贺菌总的阳性检出率为2.57%(97/3 778),以宋内志贺菌菌株为主,占91.75%(89/97)。志贺菌株的耐药情况较为普遍,菌株对环丙沙星和庆大霉素等药物敏感。2010-2015年通过电话、网络等共报告菌痢突发事件41起,事件集中发生在5~10月,36起发生在学校,32起可能为水源性暴发,易引起菌痢暴发疫情的病原是福氏志贺菌。结论贵州省菌痢发病呈下降趋势但仍是危害群众身体健康的重要疾病之一。重点加强学校、农村的防控工作,切实落实综合性防控措施,减少菌痢的危害。

Objective To analyze the epidemiological characteristics of bacillary dysentery and the problems in Guizhou Province so as to provide scientific basis for the formulation of strategies for the control and prevention. Methods Descriptive epidemiological analysis was conducted on the incidence data of bacillary dysentery reported in Guizhou Province from 2010 to2015. Results There were 34 580 cases reported in Guizhou Province from 2010 to 2015. The incidence rate was 16. 28/100000. The areas with higher incidence were successively Qiannan,Qianxi＇ nan and Anshun. The peak incidence was from May to September. Incidence ratio between males and females was 1. 45∶ 1,among which 0 - 4 years old and 15 - 20 years old groups had the most incidence（ accounting for 55. 70% of the total number of cases）. Occupation distribution is mainly based on farmers（ 46. 06%）,scattered children（ 32. 24%） and students（ 9. 30%）. The pathogenic type monitoring showed that the total positive detection rate of Shigella was 2. 57%（ 97/3 778）,and that of Shigella sonnei was the main strain,accounting for 91. 75%（ 89/97）. The drug resistance of Shigella strains is more common and the strains are sensitive to drugs such as ciprofloxacin and gentamycin. From 2010 to 2015,there were 41 reported bacteriophage emergencies by telephone and internet. The incidents occurred from May to October,36 occurred in schools,and 32 were likely to be water-borne outbreaks. Shigella flexneri is the pathogen that can cause outbreaks of bacillary dysentery. Conclusion The incidence of bacillary dysentery in Guizhou shows a downward trend,but it is still one of the important diseases that endanger people＇s health. In order to reduce the risk of bacillary dysentery disease,we should strengthen the prevention and control work in school and rural areas,and effectively implement comprehensive prevention and control measures.