新疆维吾尔自治区2004-2014年细菌性痢疾流行概况及耐药分析

张建; 马合木提; 夏依旦; 木塔力甫; 木合亚提; 李方; 顾本思; 李新兰

Abstract

张建,马合木提,夏依旦,木塔力甫,木合亚提,李方,顾本思,李新兰.新疆维吾尔自治区2004-2014年细菌性痢疾流行概况及耐药分析[J].Chinese journal of Epidemiology,2016,37(11):1526-1530

新疆维吾尔自治区2004-2014年细菌性痢疾流行概况及耐药分析

Epidemiology and etiology of bacillary dysentery in Xinjiang Uigur Autonomous Region, 2004-2014

Received:June 27, 2016

DOI：10.3760/cma.j.issn.0254-6450.2016.11.018

KeyWord: 菌痢发病率血清分型耐药率

English Key Word: Bacillary dysentery Incidence Serotyping Drug resistant rate

FundProject:国家科技重大专项（2013ZX10004202-001）

Author Name	Affiliation	E-mail
Zhang Jian	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China
Mahemuti	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China	396658883@qq.com
Xiayidan	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China
Mutalifu	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China
Muheyati	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China
Li Fang	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China
Gu Bensi	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China
Li Xinlan	Xinjiang Uigur Autonomous Region Center for Disease Control and Prevention, Urumqi 830002, China

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Abstract:

目的了解新疆维吾尔自治区（新疆）细菌性痢疾（菌痢）的流行概况及病原特征。方法采用描述性流行病学方法，对2004-2014年新疆菌痢的发病资料、菌型监测、药敏试验等进行分析。结果 2004-2014年新疆共报告菌痢123 238例，年发病率波动在25.91/10万～76.04/10万之间，年病死率在0.00～46.90/10万之间。东疆地区的发病率高于其他地区。7-9月为发病高峰。男性发病率高于女性。各年龄组中以<5岁组发病率最高。职业分布中以散居儿童最高，其次是农民和学生。福氏志贺菌是优势菌群，其中F2a最多。流行菌株对链霉素、青霉素、强力霉素及四环素等抗生素等高度耐药，对青霉素、四环素、强力霉素和链霉素耐药率逐年上升，且多重耐药现象严重，耐5种抗生素的菌株达71.43%。结论 2004-2014年新疆菌痢发病率保持平稳下降的趋势，但是个别地区的发病率仍然高于全国平均水平，应该对重点地区、重点人群、高发季节采取有针对性的措施。耐药及多重耐药现象严重，给防治工作带来了一定难度，该疾病仍然是新疆传染病防治的重点。

English Abstract:

Objective To understand the epidemiological and etiological characteristics of bacillary dysentery in Xinjiang Uigur Autonomous Region (Xinjiang) during 2004-2014, and provide evidence for the prevention and control of bacillary dysentery. Methods Descriptive epidemiological analysis was conducted by using the incidence data of bacillary dysentery in Xinjiang during 2004-2014 and the serotyping and the antibiotic susceptibility test of the pathogens isolated were performed. Results A total of 123 238 cases of bacillary dysentery were reported in Xinjiang from 2004 to 2014. The average annual incidence of bacillary dysentery ranged from 25.91 per 100 000 to 76.04 per 100 000 and the average annual mortality ranged from 0.00 to 46.90 per 100 000. The incidence of bacillary dysentery was higher in eastern Xinjiang than other areas. The incidence peak was during July-September. The incidence of bacillary dysentery in males was higher than that in females. The incidence was highest in infants and young children under five years old. Most cases were children outside child care settings, farmers and students. Shigella flexneri was the predominant pathogen and F2a was the most frequently detected subtype. The isolated strains were highly resistant to streptomycin, penicillin, doxycycline and tetracycline. The resistant rates to penicillin, tetracycline, doxycycline and streptomycin increased with year. Up to 71.43% of the strains were resistant to more than five antibiotics. Conclusion The incidence of bacillary dysentery was in decrease in Xinjiang from 2004 to 2014, but in some area, the incidence of bacterial dysentery was higher than national average level. It is necessary to strengthen the surveillance and conduct targeted prevention and control in areas and population at high risk and in season with high incidence. The serious drug resistance and multi drug resistance of the pathogens have posed challenge to the prevention and treatment of bacillary dysentery in Xinjiang.

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