目的了解济南市细菌性痢疾的流行特征及菌型变迁,为制定防制策略提供科学依据。方法采用描述流行病学方法对2004—2013年济南市细菌性痢疾病例及菌痢菌型分布数据做回顾性分析。结果 2004—2013年济南市共报告细菌性痢疾例14 496例,年均发病率为22.95/10万。全年均可发病,具有明显的季节性,5~9月份为流行高峰期,共报告病例11 580例,占总病例数的79.88%。发病率由高到低依次为城区(槐荫、天桥、市中和历下)、城乡结合部(历城、长清)、郊县(章丘、平阴、济阳和商河),差异有统计学意义(χ2=2663.615,P=0.00)。各年龄组均有病例发生,发病年龄主要集中在0~4岁、20~30岁、10~20岁年龄组,分别占所有发病总人数的27.16%、17.47%和11.82%。菌痢男性年发病率为25.77/10万,女性发病率为20.08/10万,发病率男性高于女性(χ2=212.378,P=0.00)。以0~5岁年龄组病例数最多;职业分布以散居儿童、学生和农民为主,散居儿童居共报告病例3 761例,占发病总数的25.95%,居首位。2004—2012年共分离鉴定志贺菌株827株,其中B群622株占75.21%,为优势菌群;其次是D群184株占22.25%;A群11株占1.33%;C群最少10株占1.21%。福氏志贺菌检出率逐渐下降,而宋内氏志贺菌逐渐上升,且福氏志贺菌优势菌型也在不断变化。结论济南市菌痢发病率维持在较低水平,但因为流行因素广泛存在,流行菌型不断变迁,防控形势依然严峻。 Objective To understand the epidemiological characteristics and bacteriological changes of bacterial dysentery in Ji’nan City and to provide a scientific basis for formulating control strategies. Methods Descriptive epidemiological methods were used to analyze the distribution of bacillary dysentery and bacillary dysentery in Jinan City from 2004 to 2013. Results A total of 14 496 cases of bacterial dysentery were reported in Jinan from 2004 to 2013, with an average annual incidence of 22.95 / 100 000. It can be affected throughout the year, with obvious seasonal characteristics. It was the peak season from May to September. A total of 11 580 cases were reported, accounting for 79.88% of the total cases. The morbidity from high to low was in urban areas (Huaiyin, flyover, city and under the calendar), urban-rural combination (Licheng, Changqing), suburbs (Zhangqiu, Pingyin, Jiyang and Shanghe) There was statistical significance (χ2 = 2663.615, P = 0.00). The incidence of all cases occurred in all age groups, the age of onset mainly in 0 to 4 years old, 20 to 30 years old, 10 to 20 age group, accounting for 27.16%, 17.47% and 11.82% of the total number of all cases. The annual incidence of bacillary dysentery was 25.77 / 100 000, the incidence of female was 20.08 / 100 000, the incidence of male was higher than that of female (χ2 = 212.378, P = 0.00). The number of cases in the age group 0 to 5 was the largest. Occupational distribution was dominated by scattered children, students and peasants. A total of 3 761 cases of scattered children were reported, accounting for 25.95% of the total number of cases, ranking the first place. A total of 827 Shigella strains were isolated and identified from 2004 to 2012, of which 622 strains of Group B accounted for 75.21% of the total, which was the predominant flora. Next were 184 strains of D group, accounting for 22.25%, 11 strains of A group accounting for 1.33%, and 10 of C groups Accounting for 1.21%. The detection rate of Shigella flexneri gradually decreased, while the Shigella sonnei gradually increased, and the dominant bacteria of Shigella flexneri were also constantly changing. Conclusions The incidence of dysentery in Jinan remains at a low level. However, due to the prevalence of epidemic factors and the continuous change of epidemic bacteria, the situation of prevention and control is still grim.