Streeton C L, Hanna J N, Messer R D, Merianos A
National Centre for Epidemiology and Population Health, Australian National University, Canberra.
J Paediatr Child Health. 1995 Jun;31(3):245-8. doi: 10.1111/j.1440-1754.1995.tb00795.x.
To describe an epidemic of acute post-streptococcal glomerulonephritis (APSGN) that occurred in Aboriginal children in three remote Aboriginal communities in Far North Queensland between July and October, 1993.
Children at the communities aged between 2 and 14 years were screened so as to identify all cases of APSGN. Parenteral penicillin was administered to all 583 children who presented for the screening procedure.
APSGN was diagnosed in 58 (10%) of the 583 children. A further 142 (24%) children had microscopic haematuria. Children aged 5-8 years had the highest APSGN attack rate, and the highest prevalence of microscopic haematuria. Of all 583 children, 34% had skin sores, and group A streptococci (GAS) were isolated from 71% of the skin swabs. The prevalence of both skin sores and GAS were greater in the children with APSGN, and in those with microscopic haematuria, than in children with normal urine. A marked decline in the number of cases of APSGN occurred after the mass administration of penicillin.
The epidemic of APSGN was associated with GAS skin infections. The mass use of penicillin may have had an effect in reducing the transmission of the nephritogenic strain of GAS. Microscopic haematuria was a significant finding in many of the children, and further prospective studies are required to understand the significance of this finding.
描述1993年7月至10月间在昆士兰远北地区三个偏远原住民社区的原住民儿童中发生的急性链球菌感染后肾小球肾炎（APSGN）疫情。
对社区中年龄在2至14岁的儿童进行筛查，以确定所有APSGN病例。对前来接受筛查的583名儿童均给予了青霉素注射。
583名儿童中有58名（10%）被诊断为APSGN。另有142名（24%）儿童有镜下血尿。5至8岁的儿童APSGN发病率最高，镜下血尿患病率也最高。在所有583名儿童中，34%有皮肤溃疡，71%的皮肤拭子中分离出A组链球菌（GAS）。与尿液正常的儿童相比，APSGN患儿和镜下血尿患儿的皮肤溃疡和GAS患病率更高。在大规模注射青霉素后，APSGN病例数显著下降。
APSGN疫情与GAS皮肤感染有关。青霉素的大规模使用可能对减少致肾炎性GAS菌株的传播起到了作用。镜下血尿在许多儿童中是一个重要发现，需要进一步的前瞻性研究来了解这一发现的意义。
