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目的分析急性细菌性脑膜炎(Acute Bacterial Meningitis,ABM)哨点监测及病原学监测结果,了解山东省ABM流行特征。方法对6所哨点医院监测的ABM病例开展流行病学调查,采用细菌培养、乳胶凝集、实时荧光定量-聚合酶链反应等方法对病例标本进行常见病原菌检测,并通过Epi Info 2003、SPSS 13.0等软件对数据进行分析。结果 2006-2012年共报告ABM病例309例,男女性别比为1.81∶1,以儿童、学生和农民为主。其中实验室确诊病例61例,脑膜炎奈瑟菌(Neisseria meningitidis,Nm)感染32例(B群2例,C群19例,W135群2例,不可分群9例),患者年龄主要为7~44岁(24例,75.00%),职业以学生和农民居多,4、5月为发病高峰期(15例,46.88%);肺炎链球菌(Streptococcus pneumoniae,Sp)感染29例,以婴幼儿和老年人为主(18例,62.07%);未检出流感嗜血杆菌(Haemophilus influenzae,Hi)。病例转归总体良好,痊愈或好转者占87.05%,实验室确诊ABM病例疗程显著低于非实验室确诊病例(t=2.762,P=0.006)。结论山东省哨点监测发现的ABM首要致病原是Nm,Sp次之,建议根据疾病的流行特征及病原谱分布,对ABM的防控策略做相应调整。病原体的检出对疾病治疗具有促进作用,需要进一步加强病原学监测。
Objective To analyze the results of sentinel surveillance and etiological surveillance of acute bacterial meningitis (ABM) and to understand the epidemiological characteristics of ABM in Shandong Province. Methods Epidemiological investigation of ABM surveillance in 6 sentinel hospitals was carried out. Bacterial culture, latex agglutination and real-time fluorescence quantitative polymerase chain reaction were used to detect common pathogens in case samples. Epi Info 2003, SPSS 13.0 Software such as data analysis. Results A total of 309 ABM cases were reported from 2006 to 2012, with a sex ratio of 1.81:1, mainly children, students and peasants. Among them, 61 cases were diagnosed in laboratory and 32 cases were Neisseria meningitidis (2 cases in group B, 19 cases in group C, 2 cases in group W135 and 9 cases insensible in group) 44 years old (24 cases, 75.00%), occupations were mostly students and peasants, peak incidence in April and May (15 cases, 46.88%); Streptococcus pneumoniae (Sp) infection in 29 cases, The elderly mainly (18 cases, 62.07%); no detection of Haemophilus influenzae (Hi). The cases were generally good, accounting for 87.05% of the patients were cured or improved. The course of laboratory diagnosis of ABM was significantly lower than that of non-laboratory confirmed cases (t = 2.762, P = 0.006). Conclusion The main pathogen of ABM detected by sentinel surveillance in Shandong Province is Nm and Sp. It is suggested that the strategy of ABM should be adjusted according to the prevalence of disease and the distribution of pathogen spectrum. The detection of pathogens can promote the treatment of diseases, and the etiological monitoring needs to be further strengthened.