【摘要】 目的了解细菌性脑膜炎发病、流行病学及病原学特征的变化趋势,为制定针对性的防控措施提供科学依据。方法 2007-2012年在广西贵港市及所辖市、县建立起以实验室检测为基础的脑膜炎症状监测系统。对符合筛检标准的病例进行流行病学调查,并采集脑脊液及血标本进行常规检查、细菌培养及聚合酶链反应(polymerase chain reaction,PCR)检测。结果共评估了2 493名病例,其中实验室确诊病例95例,临床诊断444例,可疑病例1 954例。确诊及临床诊断的细菌性脑膜炎年均发病率为2.63/10万;死亡21例,病死率为3.90%。发病年龄呈增高趋势,确诊及临床诊断病例年龄中位数为17岁。由真菌引起的感染增多,脑脊液及血培养阳性菌中新型隐球菌分别占42.55%(20/47)及16.36%(9/55);其次为猪链球菌,分别占14.89%(7/47)及7.27%(4/55)。用PCR方法检出脑膜炎奈瑟菌2株、流感嗜血杆菌2株及肺炎链球菌10株。结论细菌性脑膜炎的流行病学及病原谱发生了变化;敏感的症状监测系统加以实验室检测结果对脑膜炎的发现、防控及临床诊疗有较重要的意义。更多还原

【Abstract】 Objective To understand the changing trends of morbidity,epidemiologic and pathogenic characteristics of bacterial meningitis( BM),and to provide scientific basis for development of appropriate control measures. Methods A laboratory-based surveillance for meningitis was set up in Guigang City and its affiliated cities /counties between 2007 and 2012. Epidemiologic investigation was carried out on the cases meeting the screening criteria,with cerebrospinal fluid( CSF) and blood samples collected. Routine tests,bacterial culture and PCR were performed on the specimens. Results A total of 2 493 cases were evaluated,including 95 laboratory-confirmed cases,444 clinical cases and the remaining1945 suspected cases. The annual incidence of the confirmed and clinical cases was measured 2. 63 /100 thousands. Twenty-one cases died of meningitis and the mortality was 3. 90%. The median ages of patients with BM has a trend of increasing,which was found to be 17 years old in the confirmed and clinical cases under the surveillance system. Increase of infection of fungus was found,the predominant pathogens isolated from CSF and blood specimens were Cryptococcus neoformans,accounting for 42. 55%( 20 /47) and 16. 36%( 9 /55),respectively,Streptococcus suis for 14. 89%( 7 /47) and7. 27%( 4 /55),respectively. Two strains of Neisseria meningitides,2 of Haemophilus influenza and 10 of Streptococcus pneumonia were tested positively using the assay of PCR. Conclusions The epidemiological and pathogenic characteristics have changed. Laboratory-based syndromic surveillance is significant for disease control,clinical diagnosis and treatment for BM.更多还原