2008-2019年杭州市非职业人群布鲁菌病流行病学特征分析

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目的:了解杭州市非职业人群布鲁菌病(简称布病)的流行病学特征,为非职业人群布病患者的诊断及提出下一步防控措施提供依据。方法:采用回顾性分析方法,收集2008-2019年杭州市报告的布病患者的基本信息、流行病学特征、临床特征及实验室检测资料。资料来源于杭州市疾病预防控制中心历年确诊布病病例的个案调查表及布病防治工作年报,分析其中非职业人群布病患者的流行病学特征、临床特征及诊断情况等。结果:2008-2019年杭州市共报告非职业人群布病患者76例,占总报告布病病例的34.23%(76/222)。76例非职业人群布病患者中,男性47例、女性29例,男女性别比为1.62∶1.00;年龄为(47.37 ± 16.04)岁,范围为6~84岁。3-5月是非职业人群布病发病的高峰期,占59.21%(45/76);主要感染途径是直接接触和消化道途径,占80.26%(61/76)。临床症状以发热[100.00%(76/76)]、多汗[73.68%(56/76)]、肌肉关节疼痛[69.74%(53/76)]为主;诊断时间为27(14,49)d,最长诊断时间为190 d,其中39例(51.32%,39/76)患者出现了误诊。经医院实验室全自动血培养仪常规培养提示疑似布鲁菌60株,经分型鉴定羊种布鲁菌54株,符合率为90.00%。2015-2019年患者血培养率(88.46%,46/52)明显高于2008-2014年(58.33%,14/24),差异有统计学意义(χn 2=8.968,n P < 0.05)。n 结论:2008-2019年杭州市非职业人群布病发病有季节性,感染方式多样,临床症状不典型、易误诊。高发季节对疑似布病患者开展血培养有利于布病的早期诊断。“,”Objective:To understand the epidemiological characteristics of brucellosis in non-occupational population reported in Hangzhou, and provide basis for diagnosis and further prevention and control of brucellosis in non-occupational population.Methods:The basic information, epidemiological characteristics, clinical characteristics and laboratory test data of brucellosis patients reported in Hangzhou from 2008 to 2019 were collected retrospectively. The data were obtained from the case questionnaire of confirmed brucellosis and annual report of brucellosis prevention and control work of Hangzhou Center for Disease Control and Prevention over the years. The epidemiological characteristics, clinical characteristics and diagnosis of brucellosis in non-occupational population were analyzed.Results:From 2008 to 2019, 76 cases of brucellosis in non-occupational population were reported in Hangzhou, accounting for 34.23% (76/222) of the total reported brucellosis cases. In the 76 cases of brucellosis in non-occupational population, there were 47 males and 29 females, the ratio of male to female was 1.62∶1.00; the age was (47.37 ± 16.04) years old, ranging from 6 to 84 years old. The peak incidence of brucellosis in non-occupational population was from March to May, accounting for 59.21% (45/76); the main routes of infection were direct contact and digestive tract, accounting for 80.26% (61/76). The main clinical symptoms were fever (100.00%, 76/76), hyperhidrosis (73.68%, 56/76) and muscle and joint pain (69.74%, 53/76); the diagnosis time was 27 (14, 49) d, and the longest diagnosis time was 190 d. Among them, 39 cases were misdiagnosed, accounting for 51.32% (39/76). Sixty suspected n Brucella strains were identified by routine culture of automatic blood culture apparatus in hospital laboratory, and 54 strains of n Brucella melitensis were identified by typing, with a coincidence rate of 90.00%. The blood culture rate of patients from 2015 to 2019 (88.46%, 46/52) was significantly higher than that from 2008 to 2014 (58.33%, 14/24), the difference was statistically significant (χn 2=8.968, n P < 0.05).n Conclusions:From 2008 to 2019, the onset of brucellosis in non-occupational population is seasonal in Hangzhou, the infection mode is diverse, the clinical symptoms are not typical, and it is easy to be misdiagnosed. Blood culture for suspected brucellosis patients in high incidence season is conducive to the early diagnosis of brucellosis.
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