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目的分析细菌性痢疾(菌痢)疫情资料与监测数据,了解甘肃省菌痢的流行特征、菌群变迁、耐药状况,为国家菌痢监测方案提出改进建议。方法收集甘肃省2010-2014年“中国疾病预防控制信息系统”和国家监测点上报的菌痢数据,进行流行病学和病原学特征比较分析。结果 2010-2014年甘肃省共报告病例46866例,年均报告发病率36.27/10万,共采集便标本3686份,检出志贺菌256株,其中福氏志贺菌所占比例为84.38%,血清型以F2a型为主59.38%。脓血便的志贺菌检出率最高23.57%,福氏志贺菌对庆大霉素耐药性最小,宋内氏志贺菌对环丙沙星较敏感。0岁(婴儿)组志贺菌标本测阳性率最低5.06%,临床诊断漏诊率最高68%。结论甘肃省菌痢的优势菌型为F2a型,多重耐药严重,婴儿组临床诊断漏诊率偏高,应进一步完善菌痢诊断标准中婴儿组菌痢的病例定义。
Objective To analyze the epidemiological data and monitoring data of bacillary dysentery (bacillary dysentery), understand the epidemiological characteristics of bacillary dysentery, the change of flora and drug resistance in Gansu Province, and put forward some suggestions for the improvement of the monitoring program of bacillary dysentery in our country. Methods The data of bacillary dysentery reported from 2010-2014 in China, “Disease Prevention and Control Information System of China” and national monitoring sites were collected for comparative analysis of epidemiological and etiological characteristics. Results A total of 46,866 cases were reported in Gansu Province from 2010 to 2014, with an average annual incidence rate of 36.27 / 100 000. A total of 3686 samples of stool samples were collected and 256 strains of Shigella were detected, of which Shigella flexneri accounted for 84.38% The main type of F2a was 59.38%. The highest rate of Shigella was 23.57%. Shigella flexneri was the least resistant to gentamicin, and Shigella flexneri was more sensitive to ciprofloxacin. 0-year-old (infants) Shigella specimens positive rate of the lowest 5.06%, clinical diagnosis of missed diagnosis rate of up to 68%. Conclusions The dominant bacterium type of bacillary dysentery in Gansu province is F2a type. The multi-drug resistance is serious. The rate of misdiagnosis of clinical diagnosis in infants is high. The case definition of bacillary dysentery in the diagnostic criteria of bacillary dysentery should be further improved.