济南市2012-2016年急性脑炎脑膜炎症候群监测病例的病原谱分析

Pathogen spectrum of acute meningitis and encephalitis syndrome cases in Jinan city during 2012-2016

目的分析济南市2012-2016年急性脑炎脑膜炎症候群(Acute meningitis and encephalitis syndrome,AMES)监测病例的病原谱。方法选择济南市6家监测医院,采集AMES病例的血清/脑脊液(CSF)标本,采用ELISA检测乙脑病毒(JEV)、水痘-带状疱疹病毒(VZV)、麻疹病毒(MV)、人类肠道病毒(HEV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)、风疹病毒(RV)和腮腺炎病毒(MuV)IgM抗体,采用PCR检测脑膜炎奈瑟菌(Nm)、肺炎链球菌(Sp)和b型流感嗜血杆菌(Hib)抗原,对数据进行描述性分析。结果 2012-2016年共报告AMES病例4 550例,其中4 122例血清/CSF标本JEV的IgM抗体阳性率为8.6%;3 750例血清标本HEV、HSV、MuV、VZV、MV、RV、CMV的IgM抗体阳性率分别为17.1%、22.0%、8.5%、0.1%、0.1%、0.5%、0.6%;2 864例CSF标本Nm、Sp、Hib的PCR抗原检测阳性率分别为2.3%、1.1%、0.1%。结论济南市2012-2016年AMES病例的优势致病原为HSV、HEV、JEV和MuV。

Objective To describe the pathogen spectrum of acute meningitis and encephalitis syndrome(AMES) cases in Jinan city during 2012-2016. Methods We selected six Jinan hospitals to obtain serum and/or cerebrospinal fluid(CSF) samples from AMES cases. We used ELISA to test for IgM antibodies to Japanese encephalitis virus(JEV),human enterovirus(HEV), herpes simplex virus(HSV), mumps virus(MuV), varicella-zoster virus(VZV), measles virus(MV), rubella virus(RV), and cytomegalovirus(CMV). We used PCR to test for Neisseria meningitides(Nm),Streptococcus pneumonia(Sp), and Haemophilus influenza type b(Hib). Data were analyzed with descriptive methods.Results A total of 4 550 AMES cases were reported in Jinan during 2012-2016. Among serum and/or CSF samples from4 122 cases, the positivity rate of IgM antibody to JEV was 8.6%;among serum samples from 3 750 cases, positivity rates to HEV, HSV, MuV, VZV, MV, RV, and CMV were 17.1%, 22.0%, 8.5%, 0.1%, 0.1%, 0.5%, and 0.6%, respectively;and among CSF samples f rom 2 864 cases, PCR-positive rates for Nm, Sp, and Hib were 2.3%, 1.1%, and 0.1%,respectively. Conclusion The predominant pathogens for AMES cases were HSV, HEV, JEV and MuV in Jinan during2012-2016.