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[目的]分析上海市闵行区2005—2009年细菌性痢疾流行特征,探讨发病规律,为细菌性痢疾的防治提供依据。[方法]收集2005—2009年细菌性痢疾疫情数据进行描述性流行病学分析,并对2007—2009年检出的55株志贺菌进行血清学分型。[结果]闵行区2005—2009年细菌性痢疾发病率为5.43/10万~39.01/10万,年均发病率为19.06/10万,总体呈下降趋势。发病主要集中在5—10月,发病高峰期为9月,月均发病率达4.09/10万。0~4岁婴幼儿发病率最高,为189.38/10万。发病数居前三位的人群是散居儿童、学生和工人。55株痢疾杆菌分型结果,福氏志贺菌36株,占65.45%,宋内志贺菌19株,占34.55%,福氏志贺菌以F2 a、F4 c和F1 a为主。菌株对阿莫西林、头孢噻吩、头孢噻肟以及庆大霉素较敏感。[结论]闵行区近年来细菌性痢疾发病率明显下降。应在夏秋季将0~4岁组婴幼儿、散居儿童、学生和工人作为细菌性痢疾重点防治的对象。阿莫西林、头孢噻吩、头孢噻肟和庆大霉素可作为临床首选药物。
[Objective] To analyze the epidemic characteristics of bacterial dysentery in Minhang District of Shanghai from 2005 to 2009, and to explore the pathogenesis of bacterial dysentery and provide the basis for the prevention and treatment of bacterial dysentery. [Methods] The data of epidemic situation of bacillary dysentery from 2005 to 2009 were collected for descriptive epidemiological analysis. Serotypes of 55 strains of Shigella were detected in 2007-2009. [Result] The incidence of bacillary dysentery in Minhang District from 2005 to 2009 was 5.43 / 100,000 to 39.01 / 100,000 and the average annual incidence rate was 19.06 / 100,000, showing an overall downward trend. The incidence mainly concentrated in May-October, the peak incidence of September, the monthly average incidence of 4.09 / 100,000. 0 to 4-year-old infants the highest incidence of 189.38 / 100,000. The top three people affected by the disease are scattered children, students and workers. Among the 55 strains of Shigella dysenteriae, 36 strains of Shigella flexneri accounted for 65.45%, 19 strains of Shigella sonnei accounted for 34.55%, and Shigella flexneri was mainly F2a, F4c and F1a. The strains are more sensitive to amoxicillin, cefalotin, cefotaxime and gentamicin. [Conclusion] The incidence of bacillary dysentery in Minhang District decreased significantly in recent years. Should be in the summer and autumn 0 to 4-year-old group of infants, diasporas, students and workers as the focus of prevention and treatment of bacterial dysentery. Amoxicillin, cefalotin, cefotaxime and gentamicin can be used as clinical drug of choice.