湖南省2010～2013年霍乱监测结果分析

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。

Monitoring results of cholera in Hunan from 2010 to 2013

Objective To analyze the results of cholera monitoring in Hunan province from 2010 to 2013 and provide the scientific basis for cholera control and prevention . Methods The data of case-based surveillance and the environmental monitoring of cholera from 2010 to 2013 were collected. After chlolera outbreak, the case surveys were conducted and the specimens were collected. The serological detection, susceptibility testing, cholera toxin gene testing and PFGE were carried out. Results The 15 cholera outbreaks were reported in Hunan province from 2010 to 2013, 28 cases and 13 carriers were detected. Results of routine monitoring showed that 170 of 142 047 samples were positive with the positive rate of 0.12%, 167 of 62 753 aquatic product samples were positive with the positive rate of 0.27%. Drug sensitivity test showed that the Vibzio choleta stains were sensitive to norfloxacin, ciprofloxacin, amikacin and amoxicillin clavulanate, but resistant to cotrimoxazole. The detection of CT toxin gene showed 96 of 185 strains were positive. The PFGE showed the strains were basically same in Hunan province, and the strains in Hunan Province were homologous with those in Shanghai, Zhejiang and Sichuan. Conclusion The contaminated aquatic product were main cause of cholera outbreak in Hunan province. The supervision of aquatic products and guidance of consumption be strengthened.