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目的:及时全面了解、掌握广西桂林市及其辖区伤寒主要流行菌型变化动态和传染源。方法:在广西桂林市及其辖区7个县开展伤寒监测,监测内容包括对发热疑似病人进行病原学、血清学检测;对密切接触者、病人病后带菌调查;水体及疫点环境调查。选取桂林市10家医院作为哨点医院。结果:2002年8个监测点发病数为2371例,占广西病例总数的56.17%,发病率为0.066%。哨点医院病原学监测3724份标本,分离出阳性菌382株,阳性率10.26%,甲型副伤寒沙门氏菌占95.29%,伤寒沙门氏菌仅占4.45%。监测点血培养总阳性率14.83%,甲型副伤寒沙门氏菌占97.64%,伤寒沙门氏菌占2.36%;粪培养总阳性率0.76%,均为甲型副伤寒沙门氏菌。结论:该地区流行的主要菌型仍然以甲型副伤寒沙门氏菌为主,传染源仍广泛存在,防治形势仍不容乐观。提示防控策略应从过去的接种伤寒疫苗为主转向加强监测,有效控制传染源,提高饮食、饮用水安全。
OBJECTIVE: To make timely and comprehensive understanding of the dynamics and source of infection of the major epidemic strains of typhoid fever in Guilin, Guangxi. Methods: Typhoid fever surveillance was carried out in 7 counties in Guilin, Guangxi and its jurisdiction. The monitoring included etiological and serological detection of suspected feverish patients; investigation of the carriage of bacteria and bacteria in close contact with patients; Select Guilin 10 hospitals as sentinel hospitals. Results: The incidence of infectious diseases in 8 monitoring sites in 2002 was 2371 cases, accounting for 56.17% of the total cases in Guangxi with a prevalence of 0.066%. Sentinel etiology of 3724 samples were observed, isolates of 382 positive bacteria, the positive rate of 10.26%, Salmonella paratyphi 95.29%, Salmonella typhi accounted for only 4.45%. The total positive rate of blood culture in monitoring point was 14.83%, Salmonella paratyphi A was 97.64%, Salmonella typhi was 2.36%, and total positive rate of fecal culture was 0.76%. All of them were Salmonella paratyphi A CONCLUSION: Salmonella paratyphi A is still the predominant strain in the area, and the source of infection is still widespread. The situation of prevention and treatment is still not optimistic. It is suggested that the prevention and control strategies should shift from the past vaccination of typhoid fever mainly to strengthening monitoring, effectively controlling sources of infection, and improving the safety of diet and drinking water.