【摘要】 目的 对深圳市1例本地钩端螺旋体病患者进行现场流行病学调查分析，为城市钩端螺旋体病防控提供参考依据。方法 对2024年11月13日深圳市南山区上报的1例钩端螺旋体患者开展流行病学调查和实验室检测，对患者疑似暴露风险点开展鼠密度监测。采用荧光定量聚合酶链反应(polymerase chain reaction，PCR)检测方法对患者血液、尿液样本和所捕获鼠类的血液、肝脾肾组织、尿液样本以及溪水样本进行钩端螺旋体核酸检测。结果 患者早期症状不明显，发病后第6天因赫氏反应拟诊钩端螺旋体病疑似病例，后经宏基因组测序和核酸检测确诊为流感伤寒型钩端螺旋体病。经流行病学调查，患者发病前1个月内曾3次前往W景区徒步溯溪，其间被树枝划伤和戳伤，伤口浸泡溪水。调查组在W景区溪水两岸有效布笼203个，捕获老鼠19只，钩端螺旋体阳性率为36.84%(7/19)。未发现其他感染者。结论 此钩端螺旋体患者为本地感染病例证据较充分，推测感染地点为W景区，感染途径为伤口接触被患钩端螺旋体病的鼠类尿液污染的溪水。更多还原

【Abstract】 Objective To conduct a field epidemiological investigation and analysis on a local case of leptospirosis in Shenzhen,providing a reference for the prevention and control of leptospirosis in urban areas.Method An epidemiological investigation and laboratory testing were conducted on a leptospirosis case reported in Nanshan District,Shenzhen on November 13,2024,along with rodent density monitoring at potential exposure risk sites of the patient.Real-time PCR was used to detect Leptospira nucleic acid in the blood and urine samples of the case,as well as in the blood,liver,spleen,kidney tissue,and urine samples of the captured rodents,and in stream water samples.Result The early symptoms of the patient were not obvious.Six days after the onset of the disease,the patient was diagnosed as a suspected leptospirosis case based on Hirsch reaction,and then he was diagnosed as leptospirosis typhi by metagenomic next-generation sequencing and nucleic acid detection.According to the epidemiological investigation,the patient had gone to W scenic spot on foot and traced the creek three times one month before the onset of the disease,during which he was pierced by branches,and the wounds were soaked in creek water.The epidemiological investigation team set up 203 traps along both banks of the stream in the W scenic area and captured 19 rats.The positive rate of leptospira was 36.84%.No other infected persons were identified.Conclusion This patient with leptospirosis has sufficient evidence of local infection.The infection site was determined to be the W scenic area.The mode of infection is through contact with water contaminated by urine of rodents through wounds.更多还原