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宝鸡市314例布鲁氏菌病病例的流行病学特征分析及菌株种型鉴定

Epidemiological characteristics and species type identification of 314 cases of brucellosis in Baoji City

摘要目的:了解宝鸡市人间布鲁氏菌病(简称布病)流行特征,并对布鲁氏菌菌株进行种型鉴定,为全市布病的精准防控提供科学依据。方法:采用回顾性分析方法,对2009—2022年中国疾病预防控制信息系统中报告的宝鸡市人间布病病例进行描述性流行病学分析。应用细菌学培养、血清凝集、生化试验、噬菌体裂解及PCR方法对分离菌株及核酸进行综合鉴定。结果:2009—2022年,宝鸡市共报告人间布病314例,年均发病率为0.62/10万。不同年份发病率比较,差异有统计学意义(χ 2 = 51 748 520.36, P < 0.001)。病例男女性别比为3.30 ∶ 1.00(241 ∶ 73)。年龄分布在2 ~ 84岁,中位数为50岁;其中病例集中在30 ~ 59岁组(206例,65.61%),其次为60 ~ 84岁组(80例,25.48%)和2 ~ 29岁组(28例,8.92%)。4—8月为发病高峰,共205例,占65.29%。全市报告病例波及213个乡镇,乡镇数量从2009年的1个上升到2022年的29个。病例的发病-确诊时间间隔中位数为11 d;不同性别、职业、地区间发病-确诊时间间隔比较,差异均无统计学意义(均 P > 0.05)。共分离10株布鲁氏菌菌株,经BCSP31-PCR均鉴定为布鲁氏菌属,经AMOS-PCR均鉴定为羊种布鲁氏菌;经综合鉴定,4株为羊种3型,3株为羊种变异型,3株为羊种1型。 结论:宝鸡市布病疫情总体呈波动上升趋势,流行范围逐渐扩大,感染菌株均为羊种布鲁氏菌。

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abstractsObjective:To learn about the epidemic characteristics of human brucellosis in Baoji City, and to identify brucellosis strains, so as to provide scientific basis for precise prevention and control of brucellosis in the city.Methods:A retrospective analysis method was used to conduct a descriptive epidemiological analysis of brucellosis cases in Baoji City reported in the China Disease Prevention and Control Information System from 2009 to 2022. Bacteriology culture, serum agglutination, biochemical test, phage cleavage and PCR were used to identify the isolates and nucleic acids, respectively.Results:From 2009 to 2022, a total of 314 cases of human brucellosis were reported in Baoji City, with an average annual incidence rate of 0.62/100 000, The incidence rate of different years was compared, the difference was statistically significant (χ 2 = 51 748 520.36, P < 0.001). The gender ratio of male to female was 3.30 ∶ 1.00 (241 ∶ 73). The age distribution ranged from 2 to 84 years old, with a median of 50 years old. The cases were concentrated in the 30 - 59 age group (206 cases, 65.61%), followed by the 60 - 84 age group (80 cases, 25.48%) and the 2 - 29 age group (28 cases, 8.92%). The peak of incidence was from April to August, with a total of 205 cases, accounting for 65.29%. Cases were reported in 213 townships, with the number of townships increasing from 1 in 2009 to 29 in 2022. The median time interval between onset and diagnosis of the case was 11 days. There was no significant difference in the time interval between onset and diagnosis among different genders, occupation and regions ( P > 0.05). A total of 10 strains of Brucella were isolated and identified as Brucella genus by BCSP31-PCR, and as Brucella melitensis by AMOS-PCR. After comprehensive identification, 4 strains were Brucella melitensis 3, 3 strains were mutant Brucella melitensis, and 3 strains were Brucella melitensis 1. Conclusion:The epidemic of brucellosis in Baoji City shows a fluctuating upward trend, with the epidemic scope gradually expanding, and the infected strains are all Brucella melitensis.

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