2000--2013年沧州市健康人群流行性脑脊髓膜炎带菌监测结果

目的了解沧州市2000--2013年的健康人群流行性脑脊髓膜炎（简称流脑）带菌率和菌型分布变迁状况，为提出新的免疫策略，制定有效的防控措施，控制暴发提供依据。方法每年在流脑流行前期（12月至1月）、流行期（3月）和流行后期（5月），采用分层随机抽样方法，采集0～6、7～12、13～17和18岁以上4个不同年龄组的咽拭子标本，进行健康人群流脑带菌调查和分析。依据WS295-2008《流行性脑脊髓膜炎诊断标准》进行脑膜炎奈瑟菌分离培养和鉴定，数据用SPSS17．0软件包统计分析。结果2000--2013年连续14年监测的4865人中，检出带菌者232人，总带菌率为4．77％。其中2000和2003年带菌率最高，为9．09％；2013年最低，为0．42％。共检出流脑菌群11群，分别为A、B、C、D、X、Y、29E、W135、H、I和K群。其中以B群检出率最高，为1．19％；其次Y群，为1．09％，A和c群的检出率分别为0．60％和0．25％；检出率最低的是W135群（0．14％）。13～17岁组带菌率最高，为6．63％；其次是0～6和7—12岁组，分别为4．10％和4．06％；最低的是18岁以上组，为3．09％。4个年龄组带菌率比较，差异有统计学意义（χ2=20．83，P〈0．01）。结论连续14年的监测结果表明，沧州市健康人群流脑带菌率呈现下降趋势，特别是2008年以后下降更为明显，反映了多年来沧州市对流脑监测和疫苗接种工作的重视。13—17岁组带菌率最高，提示今后要加强该年龄组人群的监测、预防接种以及健康教育工作。带菌者中检出了致病菌株，且检出率高于其他菌群，提示今后A＋C流脑疫苗仍应在沧州市继续推广应用。

Monitoring results of epidemic cerebrospinal meningitis pathogen among healthy population in Cangzhou from 2000-2013

[ Objective ] To understand the germ-carrying rate and bacteria type distribution of epidemic cerebrospinal meningitis among healthy population in Cangzhou from 2000-2013, provide basis for putting forward new immune strategy, developing effective prevention and control measures and controlling the outbreak. [ Methods ] In the early epidemic period （ December to January）, epidemic period （March） and later epidemic period （May）, the throat swab specimens of 0-6 years old group, 7-12 years old group, 13-17 years old group and above 18 years old group were selected by stratified random sampling method to carry out the investigation and analysis of epidemic cerebrospinal meningitis pathogen among healthy population. According to the WS 295-2008 ＂epidemic cerebrospinal meningitis diagnosis standard＂, the neisseria meningitidis was isolated and identified. The data were analyzed by SPSS 17.0 software. [ Results ] A total of 4 865 people were monitored from 2000-2013, 232 people carried the germ, the germcarrying rate was 4.77%. Which in 2000 and 2003 the germ-carrying rate was the highest with 9.09%, in 2013 was the lowest with 0.42%. 11 groups of meningococcus were detected, which were A, B, C, D, X, Y, 29E, W135, H, I and K group. The B group had the highest detection rate with 1.19%, followed by Y group was 1.09%, A group and C group were 0.6% and 0.25%, W135 group was the lowest with 0.14%. The germ-carrying rate of 13-17 years old group was the highest with 6.63%, followed by 0-6 years old and 7-12 years old group with 4.10% and 4.06% respectively, 18 years old group was the lowest with 3.09%. The difference of germ-carrying rate in four age groups was statistically significant （ X2 = 20. 83, P 〈 0. 001 }. [ Conclusion] 14 years monitoring results show that the germ-carrying rate of epidemic cerebrospinal meningitis among healthy pop- ulation in Cangzhou shows a downward trend, especially after 2008 decreased obviously, which reflect the attention of Cangzhou to epidemic cerebrospinal meningiti