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目的分析学校发生的一起细菌性痢疾暴发疫情状况,并采用脉冲凝胶电泳(PFGE)方法对致病菌株进行同源性分析,为今后此类疫情的防控提供经验。方法开展现场流行病学调查,采用描述和分析流行病学的方法对暴发原因进行分析,同时开展病原学检测,运用PFGE对分离的菌株进行同源性分析。结果此次疫情波及2所学校,即A中学和B小学。共发现病例358例(疑似病例291例,确诊病例67例),其中A中学233例,罹患率为4.82%;B小学125例,罹患率为2.88%,均为学生。从37例患者的粪便中共检出20株宋内志贺菌;对23株宋内志贺菌进行PFGE分析,发现A中学和B小学的菌株分型为同一带型。饮用直饮水生水是该次疫情发生的主要危险因素(OR=2.04,95%CI=1.18~3.53),但不排除与相似症状病人接触和不洁的生活习惯是可能危险因素。结论在学校开学之际落实各项菌痢防控措施,提高学校卫生工作质量非常重要。
Objective To analyze the outbreak of bacillary dysentery in school and to analyze the homology of pathogenic bacteria by pulse gel electrophoresis (PFGE), which will provide experience for the prevention and control of such epidemic in the future. Methods An epidemiological investigation was conducted in the field. Epidemiology was used to describe the cause of the outbreak and the pathogenicity was tested. The isolates were analyzed by homology analysis using PFGE. As a result, the two outbreaks affected two schools, namely A Middle School and B Primary School. A total of 358 cases were found (291 suspicious cases, 67 confirmed cases), of which 233 cases of A secondary school, the attack rate was 4.82%; B primary 125 cases, the attack rate was 2.88%, were students. Twenty strains of Shigella sonnei were detected in feces of 37 patients. PFGE analysis of 23 strains of Shigella sonnei showed that the strains of A and B were classified into the same belt type. Drinking raw drinking water was the main risk factor of the outbreak (OR = 2.04, 95% CI = 1.18 ~ 3.53), but it did not rule out the contact and unclean habits of patients with similar symptoms were possible risk factors. Conclusion It is very important to implement various bacillary dysentery prevention and control measures at the school opening to improve the quality of school health work.