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目的描述人感染猪链球菌病死亡病例特征,探讨预防死亡发生的重点人群及其指示指标。方法采用统一问卷开展人感染猪链球菌病流行病学调查;以存活病例为对照分析死亡病例的人口统计学特征、临床特征及危险因素暴露情况。结果人感染猪链球菌病病死率最高的人群是40～49岁年龄组(病死率29.73%),97.37%的死亡病例有中毒性休克表现。死亡病例发病至入院平均间隔为0.76天,平均病程为2.11天,病程进展较存活病例更快。死亡病例中皮肤瘀点(斑) (73.68%)、腹泻(50.0%)、呼吸困难(21.05%)、眼结膜充血(34.21%)等临床表现较存活病例常见, 肝、肾功能损伤较存活病例严重。死亡病例的平均潜伏期、危险因素暴露率与存活病例相比差异无统计学意义(P>0.05)。结论早期预防休克是减少猪链球菌感染死亡的关键,40岁以上病例是预防死亡的重点人群。对病例开展肝、肾功能指标监测可有效反映疾病进展与结局。
Objective To describe the characteristics of human death from streptococcus suis infection and to explore the key population for prevention of death and its indication. Methods The epidemiological survey of human swine streptococcal infection was carried out by using a unified questionnaire. The demographic characteristics, clinical features and exposure of risk factors of death cases were analyzed with survival cases. Results The highest case fatality rate of people infected with streptococcus suis was 40-49 years old (case fatality rate 29.73%), and 97.37% of the death cases had toxic shock. The average time between death and hospitalization was 0.76 days, with an average course of 2.11 days. The course of disease progression was faster than that of the surviving cases. The clinical manifestations such as skin petechia (73.68%), diarrhea (50.0%), dyspnea (21.05%) and conjunctival hyperemia (34.21%) were more common than the surviving cases, serious. There was no significant difference in the average incubation period and the risk of death between the two groups (P> 0.05). Conclusion Early prevention of shock is the key to reduce the death of Streptococcus suis infection, the over 40-year-old cases are the key population to prevent death. Carrying out the monitoring of liver and kidney function indicators in patients can effectively reflect the progress and the outcome of the disease.