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目的分析武威市2004-2013年细菌性痢疾流行病学及病原学特征,为细菌性痢疾的防控提供科学依据。方法采用描述流行病学方法对武威市2004-2013年细菌性痢疾监测数据、菌型检测和药敏试验结果进行分析。结果武威市2004-2013年细菌性痢疾的总发病率为35.45/10万,其中男性为43.35/10万,女性为27.12/10万,男性发病明显高于女性,差异有统计学意义(P<0.05),总体发病率有下降趋势;发病集中在每年的7-9月,具有明显的季节性;5岁以下儿童发病率最高,为204.93/10万,农民、学生也是高发人群,其发病占所有发病的30.46%和15.53%;三县一区间的发病率有统计学意义差异(P<0.05);武威市以B群福氏志贺菌为主要菌群,优势菌群发生频繁的变迁;流行菌株普遍耐药,对四环素、利福平、阿莫西林、氨苄西林、复方新诺明和荼啶酸六种抗菌素的耐药率在74%以上,环丙沙星、头孢噻吩和头孢噻肟钠耐药率上升较缓慢,庆大霉素的耐药率逐年下降。结论 2004-2013年武威市细菌性痢疾的发病有下降趋势,但是流行菌株处于动态变化之中,且耐药性普遍,因此细菌性痢疾的防控形势依然严峻。
Objective To analyze epidemiological and etiological characteristics of bacterial dysentery in Wuwei City from 2004 to 2013 and provide a scientific basis for the prevention and control of bacterial dysentery. Methods Descriptive epidemiological methods were used to analyze the data of bacillary dysentery in Wuwei city from 2004 to 2013, the results of bacteriological test and drug susceptibility test. Results The total incidence of bacillary dysentery in Wuwei City in 2004-2013 was 35.45 / 100 000, of which 43.35 / 100000 for males and 27.12 / 100000 for females, the incidence was significantly higher in males than in females (P < 0.05). The overall incidence rate showed a decreasing trend. The incidence was concentrated in July-September of each year, with obvious seasonality. The highest incidence of children under 5 years old was 204.93 / 100000. The incidence of peasants and students was also high All incidences were 30.46% and 15.53% respectively. The incidence rates of three counties and one interval were statistically different (P <0.05). The dominant flora of Shigella flexneri B was the main group in Wuwei city, The epidemic strains were generally drug-resistant. The resistance rates to tetracycline, rifampicin, amoxicillin, ampicillin, cotrimoxazole, and sulfinic acid were above 74%. Ciprofloxacin, cefalotin and cefotaxime Sodium resistance rate increased more slowly, gentamicin resistance rate decreased year by year. Conclusion The incidence of bacterial dysentery in Wuwei City in 2004-2013 is on the decline. However, the prevalence of bacterial dysentery is in a dynamic state and the drug resistance is common. Therefore, the prevention and control of bacterial dysentery are still serious.