摘要
目的分析H ib（b型流感嗜血杆菌）脑膜炎病例的特征。方法采用前瞻性观察研究的方法,2007年5月至2009年12月期间,在随机抽取的4个县（市）、区的6所各级各类医院中主动开展脑炎、脑膜炎症状监测,对收集到的血、脑脊液标本进行H ib细菌培养和RT-PCR检测。结果首次在河北省检出5例H ib脑膜炎病例,均为612月龄的农村婴儿,发病季节为秋冬季,无H ib疫苗接种史,标本采集前1周均使用了抗生素。首次就诊与最后就诊的时间间隔较长。临床症状、实验室检测结果趋向不典型。预后良好,无并发症和后遗症。结论建议对临床诊断为细菌性脑膜炎的患儿采集脑脊液优先开展细菌培养,有条件的情况下进行RT-PCR检测。建议在全国大范围开展急性脑炎/脑膜炎症状监测,在此基础上开展巢式病例对照研究以较为准确的评估其感染状况、危险因素和疾病负担,探讨其纳入免疫规划的可行性。
Objective To analyze the epidemiological characteristics,clinical features and laboratory detection results of haemophilus influenzae type b（Hib）.meningitis cases.Methods The active surveillance of encephalitis and meningitis was conducted in 6 hospitals in 4 randomly selected counties（district） in Hebei from May 2007 to December 2009.The blood and cerebrospinal fluid（CSF） samples were collected to conduct Hib culture and RT-PCR detection.Results Five cases of Hib meningitis were detected for the first time in Hebei,the incidence was about 0.36/lakh.The cases mainly occurred in Autumn and Winter and all were infants age 6-12 months in rural area,who were without Hib vaccination history and had taken antibiotics 1 week before sample collecting.The interval between initial medical seeking and final medical seeking was long.Their clinical symptoms and laboratory detection results were atypical.The cases were all had good prognosis and without sequela.Conclusion It is suggested to take samples from the children diagnosed as bacterial meningitis to conduct bacterial culture and conduct RT-PCR when it is possible,and it is suggested to conduct intensive surveillance of acute encephalitis and meningitis symptoms in China,and on the basis of the surveillance,nested case-control study should be conducted to evaluate the Hib infection status,risk factors and diseases burden accurately and feasibility of inclusion of Hib vaccine into EPI program.
出处
《疾病监测》
CAS
2011年第3期208-210,共3页
Disease Surveillance
基金
WHO/卫生部流行性脑脊髓膜炎和流行性乙型脑炎等疾病监测合作项目(2007-2009年)~~
关键词
B型流感嗜血杆菌
脑膜炎
症状监测
流行病学特征
临床特点
实验室检测
haemophilus influenzae type b
meningitis
symptom surveillance
epidemiological characteristics
clinical feature
laboratory detection
