广西南宁地区5岁以下儿童细菌性脑膜炎流行病学监测研究.docVIP

广西南宁地区5岁以下儿童细菌性脑膜炎 的流行病学监测研究 董柏青 唐振柱 林玫 （广西疾病预防控制中心 530021） [摘 要] 目的 分析南宁地区5岁以下儿童细菌性脑膜炎的发病率、流行特征、病原谱、后遗症等的特点。方法 采取以监测区域所有医院、卫生院及村卫生室为监测单位，以人口为基数的流行病学监测方法，以符合筛选标准的病例作为研究病例；采集脑脊液（CSF）和血液标本，按照统一规程进行病原学分离和临床诊断。结果 在26个月监测期内，在5岁以下儿童中共收集到符合筛检标准的研究病例1272例，其中临床诊断病例265例，临床诊断病例年均发病率为86.36/10万，病原确诊细菌性脑膜炎病例38例，年均发病率为12.38/10万。确诊病例的病原谱以葡萄球菌为主,次为大肠埃希氏菌和肺炎双球菌；月龄分布以1个月以下年龄组为最高，次为1-12个月龄组，1-24月龄组是Sp和Hi所致脑膜炎的高发年龄组；并发症和后遗症发生率分别为13.16%和0.00%，病死率18.42%。实验室分别从1193份血培养标本和1211份CSF培养标本中分离出40株和23株Hi、Sp等致病菌，但均未分离到脑膜炎奈瑟菌（Nm）。结论 首次证实广西存在流感嗜血杆菌所致脑膜炎，年均发病率为0.98/10万，处于较低发病水平；确诊细菌性脑膜炎年均发病率12.38/10万，是当前危及儿童健康的重要问题；确诊细菌性脑膜炎的病原谱以葡萄球菌主。 [关键词] 流感嗜血杆菌 细菌性脑膜炎 流行病学 监测 Epidemiologic Surveillance for bacterial meningitis in children under 5 years of age in Nianning district, Guangxi province DONG Baiqing*, TANG Zhenzhu, LIN Mei, LI Cuiyun, TAN Dongmei, LIANG Dabin, LIAO Hezhuang, LIU Xianzhi, QUAN Yi, FANG Jinsong, WU Xinghua, QIN Weiwen, Kilgore PE, Xu Zhiyi,.Kennedy, WA Clemens JD. *Guangxi Autonomous Region Center for Disease Prevention and Control, Nanning 530021, China Corresponding author: DONG Bai=ping. Email: dbp666@163.net [Abstract] Objective To characterize the incidence, epidemiologic features, etiologic agents and sequelae of bacterial meningitis in children under 5 years of age in Nanning, Guangxi. Methods A population-based surveillance was conducted to evaluate children with signs and symptoms of meningitis. All hospitals, township health centers and village clinics in the surveillance area were structured to participate in the case referral and evaluation. Cerebrospinal fluid (CSF) and blood specimens were obtained and processed using standardized microbiologic methods. Results During the 26-month surveillance period, among the children under 5 years old, a total of 1,272 cases who meet the screening criteria of meningitis were evaluated. 265 of 1272 cases were identified as clinically diagnosed meningitis, with incidence rate of 86.36 per 100,000 population, and the annual i