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目的探讨四川省2005年7月下旬至8月上旬83例猪链球菌病患者的临床特征。方法收集83例住院患者资料,包括病原学、流行病学、临床表现、细菌学检查、毒力基因鉴定结果、药敏试验等,进行分析。结果(1)从病死猪心血培养物和肝组织培养物分离到的细菌与从死亡患者脾组织培养物、患者血、脑脊液培养物分离到的细菌,经鉴定均含猪链球菌Ⅱ型的毒力基因猪链球菌Ⅱ型荚膜多糖基因(cps2A),溶菌酶释放相关蛋白基因(sly),溶血素基因(sly),且高度同源;来自人、猪的猪链球菌Ⅱ型对四环素、链霉素耐药,来自人的两株菌对环丙沙星中介。(2)83例患者均有宰杀、肢解病死猪和猪血浆成份(血、组织液)直接接触史,皮肤有可见伤口者,感染率高。(3)临床分为普通型、脑膜炎型、休克型、混合型四型。(4)普通型脑膜炎型预后良好,休克型、混合型预后相对较差,与本病相关的总死亡率是14·50%(12/83)。结论(1)猪链球菌Ⅱ型是本次猪链球菌病病原体,传染源是患病死亡的猪。(2)主要传播途径是直接接触病死猪的血浆成份,无第二代患者产生。(3)重症患者早期就诊是提高存活率重要措施。(4)重视抗菌药物在家畜、家禽中的合理应用。
Objective To investigate the clinical features of 83 cases of Streptococcus suis in Sichuan from late July to early August 2005. Methods The data of 83 inpatients including etiology, epidemiology, clinical manifestation, bacteriological examination, virulence gene identification and susceptibility testing were collected and analyzed. Results (1) Bacteria isolated from necrosis porcine blood cultures and liver tissue cultures and those isolated from the cultures of dead spleens, patient blood and cerebrospinal fluid, were identified as containing both S. suis type II The gene encoding Streptococcus suis type Ⅱ capsular polysaccharide (cps2A), lysine release related protein (sly), hemolysin gene (sly), and highly homologous; human, pig Streptococcus suis type Ⅱ tetracycline, Streptomycin-resistant, two strains from human to ciprofloxacin intermediates. (2) 83 patients were slaughtered, dead pigs and swine mucosa were directly contacted with history of plasma components (blood, tissue fluid), the skin was visible wounds, the infection rate is high. (3) Clinical divided into ordinary type, meningitis type, shock type, mixed type four. (4) The common meningitis type has a good prognosis. The shock type and mixed type have a relatively poor prognosis. The total mortality rate associated with this disease is 14.5% (12/83). Conclusion (1) Streptococcus suis type Ⅱ is the pathogen of Streptococcus suis, the source of infection is the death of pigs. (2) The main route of transmission is direct contact with the plasma components of diseased pigs, with no second-generation patients. (3) Early treatment of critically ill patients is an important measure to improve the survival rate. (4) attach importance to the rational use of antibacterial drugs in livestock and poultry.