Dong Baiqing, Liang Dabin, Lin Mei, Wang Mingliu, Zeng Jun, Liao Hezhuang, Zhou Lingyun, Huang Jun, Wei Xiaolin, Zou Guanyang, Jing Huaiqi
Department of Emergency Response, Guagnxi Zhuang Autonomous Region Health Bureau, Nanning, Guangxi, China.
Divsion of Bacterial Infectious Disease Control, Guagnxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi, China.
PLoS One. 2014 Oct 31;9(10):e110876. doi: 10.1371/journal.pone.0110876. eCollection 2014.
Under the existing national surveillance system in China for selected infectious diseases, bacterial cultures are performed for only a small percentage of reported cases. We set up a laboratory-based syndromic surveillance system to elucidate bacterial etiologic spectrum and detect infection by rare etiologies (or serogroups) for five core syndromes in the given study area.
Patients presenting with one of five core syndromes at nine sentinel hospitals in Guagnxi, China were evaluated using laboratory-based syndrome surveillance to elucidate bacterial etiologies. We collected respiratory and stool specimens, as well as CSF, blood and other related samples for bacterial cultures and pulse field gel electrophoresis (PFGE) assays.
From February 2009 to December 2011, 2,964 patients were enrolled in the study. Etiologies were identified in 320 (10.08%) patients. Streptococcus pneumonia (37 strains, 24.18%), Klebsiella pneumonia (34, 22.22%), Pseudomonas aeruginosa (19, 12.42%) and Haemophilus influenza (18, 11.76%) were the most frequent pathogens for fever and respiratory syndrome, while Salmonella (77, 81.05%) was most often seen in diarrhea syndrome cases. Salmonella paratyphi A (38, 86.36%) occurred in fever and rash syndrome, with Cryptococcus neoformans (20, 35.09%), Streptococcus pneumonia (5, 8.77%), Klebsiella pneumonia (5, 8.77%),streptococcus suis (3, 5.26%) and Neisseria meningitides group B (2, 3.51%) being the most frequently detected in encephalitis-meningitis syndrome. To date no pathogen was isolated from the specimens from fever and hemorrhage patients.
In addition to common bacterial pathogens, opportunistic pathogens and fungal infections require more attention. Our study contributes to the strengthening of the existing national surveillance system and provides references for other regions that are similar to the study area.
在中国现行的全国部分传染病监测系统中，仅对一小部分报告病例进行细菌培养。我们建立了一个基于实验室的症状监测系统，以阐明细菌病因谱，并检测给定研究区域内五种核心症状的罕见病因（或血清群）感染情况。
在中国广西的九家哨点医院，对出现五种核心症状之一的患者进行基于实验室的症状监测，以阐明细菌病因。我们收集了呼吸道和粪便标本，以及脑脊液、血液和其他相关样本进行细菌培养和脉冲场凝胶电泳（PFGE）分析。
2009年2月至2011年12月，共有2964例患者纳入研究。320例（10.08%）患者确定了病因。肺炎链球菌（37株，24.18%）、肺炎克雷伯菌（34株，22.22%）、铜绿假单胞菌（19株，12.42%）和流感嗜血杆菌（18株，11.76%）是发热和呼吸道症状最常见的病原体，而沙门菌（77株，81.05%）在腹泻症状病例中最常见。甲型副伤寒沙门菌（38株，86.36%）出现在发热和皮疹症状中，新型隐球菌（20株，35.09%）、肺炎链球菌（5株，8.77%）、肺炎克雷伯菌（5株，8.77%）、猪链球菌（3株，5.26%）和B群脑膜炎奈瑟菌（2株，3.51%）是脑炎-脑膜炎症状中最常检测到的病原体。迄今为止，发热和出血患者的标本中未分离出病原体。
除常见细菌病原体外，机会性病原体和真菌感染需要更多关注。我们的研究有助于加强现有的国家监测系统，并为与研究区域相似的其他地区提供参考。
