应用预防医学
應用預防醫學
응용예방의학
Journal of Applied Preventive Medicine
2015年
5期
281-285
,共5页
梁大斌%林玫%董柏青%王鸣柳%曾竣%廖和壮%权怡%景怀琦
樑大斌%林玫%董柏青%王鳴柳%曾竣%廖和壯%權怡%景懷琦
량대빈%림매%동백청%왕명류%증준%료화장%권이%경부기
脑膜炎%症状监测%病原谱
腦膜炎%癥狀鑑測%病原譜
뇌막염%증상감측%병원보
meningitis%syndromic surveillance%bacterial spectrum
目的:了解广西脑膜炎症状监测病例的临床特点、就诊情况及病原谱,为制定防控策略提供科学依据。方法在广西2市2县建立脑膜炎症状监测系统,对符合筛查标准的病例进行调查,采集脑脊液、血液进行常规及细菌病原学检查。结果2009年2月—2014年12月共监测1661例脑膜炎症候群病例,其中临床诊断病例占16.98%(282例),实验室确诊病例占4.58%(76例)。358例确诊及临床诊断病例的年龄中位数是26岁(5天~86岁),成人及儿童分别占40.22%(144例)及59.78%(214例);脑脊液蛋白质及葡萄糖指标检出异常的比例成人组均高于儿童组(P均小于0.05)。发病-就诊间隔天数中位数(P25-P75)为0.00天(0.00—3.00天)。儿童组及成人组检出较多的病原菌分别为肺炎链球菌(21.88%)及新型隐球菌(38.64%)。此外,还检出较为少见的脑膜炎奈瑟菌B群2例,伤寒沙门菌和非伤寒沙门菌各1例。结论症状监测有利于及时发现脑膜炎病例。成人脑膜炎病例有增多趋势,应引起重视。对不同人群的防控措施及临床治疗应有针对性。
目的:瞭解廣西腦膜炎癥狀鑑測病例的臨床特點、就診情況及病原譜,為製定防控策略提供科學依據。方法在廣西2市2縣建立腦膜炎癥狀鑑測繫統,對符閤篩查標準的病例進行調查,採集腦脊液、血液進行常規及細菌病原學檢查。結果2009年2月—2014年12月共鑑測1661例腦膜炎癥候群病例,其中臨床診斷病例佔16.98%(282例),實驗室確診病例佔4.58%(76例)。358例確診及臨床診斷病例的年齡中位數是26歲(5天~86歲),成人及兒童分彆佔40.22%(144例)及59.78%(214例);腦脊液蛋白質及葡萄糖指標檢齣異常的比例成人組均高于兒童組(P均小于0.05)。髮病-就診間隔天數中位數(P25-P75)為0.00天(0.00—3.00天)。兒童組及成人組檢齣較多的病原菌分彆為肺炎鏈毬菌(21.88%)及新型隱毬菌(38.64%)。此外,還檢齣較為少見的腦膜炎奈瑟菌B群2例,傷寒沙門菌和非傷寒沙門菌各1例。結論癥狀鑑測有利于及時髮現腦膜炎病例。成人腦膜炎病例有增多趨勢,應引起重視。對不同人群的防控措施及臨床治療應有針對性。
목적:료해엄서뇌막염증상감측병례적림상특점、취진정황급병원보,위제정방공책략제공과학의거。방법재엄서2시2현건립뇌막염증상감측계통,대부합사사표준적병례진행조사,채집뇌척액、혈액진행상규급세균병원학검사。결과2009년2월—2014년12월공감측1661례뇌막염증후군병례,기중림상진단병례점16.98%(282례),실험실학진병례점4.58%(76례)。358례학진급림상진단병례적년령중위수시26세(5천~86세),성인급인동분별점40.22%(144례)급59.78%(214례);뇌척액단백질급포도당지표검출이상적비례성인조균고우인동조(P균소우0.05)。발병-취진간격천수중위수(P25-P75)위0.00천(0.00—3.00천)。인동조급성인조검출교다적병원균분별위폐염련구균(21.88%)급신형은구균(38.64%)。차외,환검출교위소견적뇌막염내슬균B군2례,상한사문균화비상한사문균각1례。결론증상감측유리우급시발현뇌막염병례。성인뇌막염병례유증다추세,응인기중시。대불동인군적방공조시급림상치료응유침대성。
Objectives To understand the clinical features, health seryices-seeking and bacterial spectrum in cases with meningitis syndromes,and to provide scientific evidence for development of control strategies. Methods A syndromic surveillance system for meningitis was set up to evaluate cases meeting the screening criteria in 2 cities and 2 counties of Guangxi.The cerebrospinal fluid (CSF) and blood specimens were collected for routine tests and bacterial culture to elucidate bacterial etiology. Results During February 2009 to December 2014, a total of 1661 cases with meningitis syndrome were evaluated, of those, 282 (16.98%) were clinical diagnosis cases and 76(4.58%) were laboratory-confirmed cases. The median age of 358 clinical diagnosis and confirmed cases was 26 years (5d-86y). Adult cases accounted for 40.22%(144) and children cases for 59.78%(214). Abnormal CSF protein and glucose were observed more frequently in adults than children (P<0.05) .The median intervals (P25-P75) between onset of illness and seeing a doctor were 0 days (0-3) in cases enrolled. Streptococcus pneumonia (7 cases, 21.88% ) and Crytococcus neoformans(17cases, 38.64% )were the most common pathogens causing meningitis in children and adults, respectively. And rarely detected pathogens such as Neisseria meningitidesgroup B(2) Salmonella typhi(1), and non-typhi salmonella(1)were isolated in this surveillance. Conclusions Syndromic surveillance is helpful for timely detecting cases with meningitis. Increased cases of meningitis were observed in adults, which should gain more at tention. Effective control and treatment strategies should be taken according to different population.