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目的通过对湖南省2010~2013年霍乱监测结果分析和评价,了解湖南省霍乱流行状况,为进一步采取预防控制措施提供依据。方法收集全省2010~2013年常规开展内、外环境监测资料和发生疫情后开展病例搜索,采集相关外环境标本检测、感染的危险因素调查资料以及开展霍乱弧菌菌株血清学型别、药敏实验、霍乱毒素基因和脉冲场凝胶电泳检测分子生物学监测资料。结果湖南省2010~2013年共发生15起霍乱疫情,报告病例28例,发现带菌者13例;常规外环境监测样品142 047份,检出霍乱弧菌阳性170份,阳性率为0.12%,其中水产品样62 753份,阳性167份,阳性率为0.27%;药敏实验显示霍乱弧菌对诺氟沙星、环丙沙星、丁胺卡那霉素和阿莫西林克拉维酸钾敏感,对复方新诺明的耐药;对185株霍乱弧菌进行CT毒素基因检测,96株阳性;霍乱弧菌PFGE同源性比较,省内分离的菌株PFGE同源性基本一致,与上海市、浙江省、四川省分离的霍乱菌株PFGE具有同源性。结论湖南省霍乱感染途径主要是食用了受污染的水产品,应加强对水产品的监管和食用指导。
Objective To analyze and evaluate the results of cholera surveillance in Hunan Province from 2010 to 2013 to understand the epidemic situation of cholera in Hunan Province and provide evidence for further prevention and control measures. Methods The routine surveillance data of internal and external environment of the whole province from 2010 to 2013 were collected and the case search was conducted after the outbreak of the epidemic. The survey data about the detection and infection of external environmental specimens and the serological types of Vibrio cholerae strains were collected. Experiments, cholera toxin genes and pulsed-field gel electrophoresis detection of molecular biology monitoring data. Results A total of 15 cholera epidemic cases were reported in Hunan from 2010 to 2013, of which 28 cases were reported and 13 carriers were found. Of 142 047 routine external environmental monitoring samples, 170 were positive for Vibrio cholerae, with a positive rate of 0.12%, of which, 62,753 aquatic samples were positive, with 167 positives, the positive rate was 0.27%. The susceptibility test showed that Vibrio cholerae was sensitive to norfloxacin, ciprofloxacin, amikacin and amoxicillin potassium clavulanate , Resistant to cotrimoxazole; CTV toxin gene was detected in 185 strains of Vibrio cholerae, 96 were positive; Comparison of PFGE homology of Vibrio cholerae and isolates from other provinces were basically the same, , Zhejiang Province, Sichuan Province isolates of cholera strains PFGE homology. Conclusion The pathogen of cholera infection in Hunan Province is mainly the consumption of contaminated aquatic products. Supervision and guidance of aquatic products should be strengthened.