| 谢娜,符文慧,朱兵清,王童敏,陈涛,朱帕尔古丽·哈那西,徐丽,邵祝军,崔燕.新疆维吾尔自治区1960-2019年流行性脑脊髓膜炎流行病学及病原学特征分析[J].中华流行病学杂志,2021,42(6):1037-1043 |
| 新疆维吾尔自治区1960-2019年流行性脑脊髓膜炎流行病学及病原学特征分析 |
| Epidemiological and Etiologic characteristics of Meningococcal meningitis in Xinjiang Uygur Autonomous Region,1960-2019 |
| 收稿日期:2020-11-18 出版日期:2021-06-29 |
| DOI：10.3760/cma.j.cn112338-20201118-01336 |
| 中文关键词: 流行性脑脊髓膜炎 脑膜炎奈瑟菌 血清群 克隆群 流行病学特征 |
| 英文关键词: Meningococcal meningitis Neisseria meningitides Serogroup Clonal complex Epidemiological characteristic |
| 基金项目:新疆维吾尔自治区自然科学基金（2018D01C088） |
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| 目的 了解新疆维吾尔自治区（新疆）流行性脑脊髓膜炎（流脑）的流行病学和病原学特征。方法 资料来源于中国疾病预防控制信息系统和新疆CDC保存的1960-2019年流脑发病数据，分析其流行病学特征。采用分离培养和荧光PCR对临床标本进行检测，并开展健康人群带菌调查。采用玻片凝集和荧光PCR方法检测菌株的血清群，采用多位点序列分型（multi-locus sequence typing，MLST）方法检测脑膜炎奈瑟菌（Nm）菌株分子分型特征。结果 1960-2019年新疆流脑年发病率为0.02/10万~81.32/10万，病死率为1.05%~20.78%。喀什地区、阿克苏地区、乌鲁木齐市、昌吉回族自治州与和田地区发病数位居前5位。1990年以前，病例和密切接触者均以A群为主（81.82%）；1990年以后，出现B、C、W和Y群病例（14.00%），密切接触者没有明显优势的血清群，B、A、W、Y、C群分别为23.28%、18.53%、15.52%、9.91%、7.33%。健康人群带菌率为15.50%，16~岁带菌率最高（25.53%），菌株主要血清群为B（52.11%）、W（20.66%）、C（12.21%）和Y（9.39%）。MLST分子分型结果显示，新疆Nm菌株主要克隆群为ST-4821、ST-175和ST-5克隆群，病例Nm菌株以ST-5和ST-4821克隆群为主。结论 1960-2019年新疆流脑发病率存在地区差异，健康人群带菌率高，Nm菌株血清群正在发生变迁。应在重点地区加强流脑疫情的防控，防止流脑的暴发流行。 |
| 英文摘要: |
| Objective To understand the epidemiological and etiologic characteristics of meningococcal meningitis in Xinjiang Uygur Autonomous Region (Xinjiang). Methods The epidemiological data about the meningococcal meningitis cases in Xinjiang from 1960 to 2019 were collected from the China information system for disease control and prevention and the Center for Disease Control and Prevention of Xinjiang. The epidemiological characteristics were analyzed. Clinical specimens from suspected cases were cultured and tested by real-time PCR method. A survey on the carriage rate of Neisseria meningitides (Nm) in the healthy population was performed. The serogroups of isolates were determined by serum-agglutination and PCR methods. Multi-locus sequence typing was used for subtyping the isolates. Results The incidence rates of meningococcal meningitis in Xinjiang from 1960 to 2019 were 0.02/100 000-81.32/100 000, with the mortality as 1.05%-20.78%. The five districts with the most cases were Kashi prefecture, Aksu prefecture, Urumqi city, Changji Hui autonomous prefecture, and Hotan prefecture. Before 1990, serogroup A (81.82%) was the commonest group for cases and contacts. After 1990, 14.00% of the cases were caused by serogroups B, C, W, and Y. There was no predominant serogroup for contacts with serogroups B, C, W, Y, and C accounting for 23.28%, 18.53%, 15.52%, 9.91% and 7.33% respectively. The general Nm carriage rate was 15.50%, with the population of 16-20 years age group having the highest rate (25.53%). Serogroups B (52.11%), W (20.66%), C (12.21%), and Y (9.39%) occupied 52.11%, 20.66%, 12.21% and 9.39% respectively. The commonest clonal lineages of Nm isolates were ST-4821, ST-175, and ST-5 clonal complexes, while the ST-5 and ST-4821 clonal complexes were the major ones for invasive strains. Conclusions There appeared regional differences in the incidence rates of Xinjiang meningococcal meningitis, and the carriage rate of Nm was high. The serogroups have been changing. It is necessary to strengthen the prevention and control of meningococcal meningitis to prevent any potential outbreak. |
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