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目的了解沧州市2000—2013年的健康人群流行性脑脊髓膜炎(简称流脑)带菌率和菌型分布变迁状况,为提出新的免疫策略,制定有效的防控措施,控制暴发提供依据。方法每年在流脑流行前期(12月至1月)、流行期(3月)和流行后期(5月),采用分层随机抽样方法,采集0~6、7~12、13~17和18岁以上4个不同年龄组的咽拭子标本,进行健康人群流脑带菌调查和分析。依据WS 295-2008《流行性脑脊髓膜炎诊断标准》进行脑膜炎奈瑟菌分离培养和鉴定,数据用SPSS 17.0软件包统计分析。结果 2000—2013年连续14年监测的4 865人中,检出带菌者232人,总带菌率为4.77%。其中2000和2003年带菌率最高,为9.09%;2013年最低,为0.42%。共检出流脑菌群11群,分别为A、B、C、D、X、Y、29E、W135、H、I和K群。其中以B群检出率最高,为1.19%;其次Y群,为1.09%,A和C群的检出率分别为0.60%和0.25%;检出率最低的是W135群(0.14%)。13~17岁组带菌率最高,为6.63%;其次是0~6和7~12岁组,分别为4.10%和4.06%;最低的是18岁以上组,为3.09%。4个年龄组带菌率比较,差异有统计学意义(χ2=20.83,P<0.01)。结论连续14年的监测结果表明,沧州市健康人群流脑带菌率呈现下降趋势,特别是2008年以后下降更为明显,反映了多年来沧州市对流脑监测和疫苗接种工作的重视。13~17岁组带菌率最高,提示今后要加强该年龄组人群的监测、预防接种以及健康教育工作。带菌者中检出了致病菌株,且检出率高于其他菌群,提示今后A+C流脑疫苗仍应在沧州市继续推广应用。
Objective To understand the prevalence and distribution of epidemic cerebrospinal meningitis (CSF) in healthy population from 2000 to 2013 in Cangzhou City, and to provide evidences for proposing new immunization strategies, formulating effective prevention and control measures and controlling outbreaks. Methods The stratified random sampling method was used to collect 0 ~ 6, 7 ~ 12, 13 ~ 17 and 18 per year in pre-epidemic phase (December to January), epidemic period (March) and late epidemic period (May) Throat swab specimens from 4 different age groups over the age of 4 were investigated and analyzed. Neisseria meningitidis was isolated and identified according to WS 295-2008 “Diagnostic criteria of epidemic cerebrospinal meningitis”. The data were analyzed by SPSS 17.0 software package. Results Of the 4 865 persons monitored for 14 consecutive years from 2000 to 2013, 232 carriers were detected with a total carrier rate of 4.77%. Among them, the highest rate was 9.09% in 2000 and 2003; the lowest in 2013 was 0.42%. A total of 11 meningococcal groups were detected, which were A, B, C, D, X, Y, 29E, W135, H, I and K, respectively. Among them, the detection rate of group B was the highest (1.19%), followed by group Y (1.09%), the detection rates of groups A and C were 0.60% and 0.25%, respectively. The lowest detection rate was W135 group (0.14%). The highest incidence rate was 6.63% in the group of 13 to 17 years old, followed by the groups of 0 to 6 and 7 to 12 years old, which were 4.10% and 4.06% respectively; the lowest was 18 years old and over, which was 3.09%. The incidence of infection in 4 age groups was statistically significant (χ2 = 20.83, P <0.01). Conclusion The monitoring results for 14 consecutive years show that the incidence of endemic encephalo-vaginal infection in healthy population in Cangzhou shows a declining trend, especially after 2008, which reflects the attention paid to the monitoring and vaccination of convective cerebrospinal fluid in Cangzhou City over the years. 13 to 17 years old group had the highest rate of carrier, suggesting that in the future to strengthen the monitoring of the age group, vaccination and health education. Detected in carriers of pathogenic strains, and the detection rate is higher than other bacteria, suggesting that future A + C meningitis vaccine should continue to promote the use of Cangzhou City.