超强台风"摩羯"登陆文昌后特殊病原菌感染的流行病学特征及其耐药性
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R181.3*2

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海南省自然科学基金项目(825RC872);海南省人民医院国家自然科学基金培育530工程面上项目(2022MSXM09)


Epidemiological characteristics and antimicrobial resistance of special pathogenic infection following super typhoon "Yagi" landfall in Wenchang
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    摘要:

    目的 研究超强台风"摩羯"灾后文昌地区特殊病原菌感染的流行病学特征,为灾区感染性疾病的诊治和防控提供依据。方法 回顾性分析台风登陆前(2024年8月6日—9月5日)、后(2024年9月6日—10月5日)组及历史同期组(A2023、B2022、C2021、D2020、E2019,2019—2023年每年9月6日—10月5日)共7个组9种人兽共患病原菌和条件致病菌感染患者的临床特征和病原菌数据,比较分析患者的流行病学特征、病原菌分布及菌株耐药性等。结果 台风登陆后组检出26例感染患者,整体感染率高于除B2022组外的所有组(均P<0.05)。病例主要分布于沿海地区;感染途径以医院外为主(88.5%);男性占80.8%,农民占53.9%,69.2%的病例在台风后10 d内发生。感染部位以多部位合并感染、血流感染和软组织感染为主。主要病原菌对常用抗菌药物保持较高敏感性。临床初始经验性抗菌药物使用准确率偏低(登陆后45.5% VS 既往同期62.8%)。临床治愈率降至76.9%, 病死率升至7.7%。假鼻疽伯克霍尔德菌和肾脏钩端螺旋体感染者病死率分别为25.0%、50.0%。结论 台风灾后特殊病原菌感染显著增加且预后较差,建议重视血培养和分子生物学检测,以实现早期诊断和精准治疗,完善防控措施并提高临床经验性用药的准确性。

    Abstract:

    Objective To study the epidemiological characteristics of special pathogenic infection in Wenchang area following the super typhoon "Yagi" disaster, and provide basis for the diagnosis, treatment, prevention and control of infectious diseases in disaster-affected areas. Methods Clinical characteristics and pathogenic data of 7 groups of patients infected with 9 species of zoonotic pathogens and opportunistic pathogens were analyzed retrospectively. The 7 groups included: pre-typhoon landfall group (August 6 to September 5, 2024), post-typhoon landfall group (September 6 to October 5, 2024), and groups in the past years of the same period (A2023, B2022, C2021, D2020, E2019, September 6 to October 5 of each year in 2019-2023). Epidemiological characteristics of patients as well as distribution and resistance of pathogens were compared and analyzed. Results In post-typhoon landfall group, 26 patients were infected. The overall infection rate of the post-typhoon landfall group was higher than all groups except B2022 group (all P<0.05). The infected cases mainly distributed in coastal areas. The main route of infection was outside the hospital (88.5%). Male accounted for 80.8%, agricultural workers accounted for 53.9%, and 69.2% of the cases occurred within 10 days after the typhoon. The major infection sites were multiple site co-infection, bloodstream infection, and soft tissue infection. The main pathogens maintained high sensitivity to commonly used antimicrobial agents. The accuracy of clinical initial empirical antimicrobial use was relatively low (45.5% in post-typhoon landfall group vs 62.8% in the groups of the same period in the past). The clinical cure rate decreased to 76.9%, and mortality increased to 7.7%. The mortality of patients infected with Burkholderia pseudomallei and kidney infected with Leptospira were 25.0% and 50.0%, respectively. Conclusion After typhoon disaster, special pathogen infection significantly increases and the prognosis is poor. It is recommended to emphasize blood culture and molecular biology testing to facilitate early diagnosis and precise treatment, optimize prevention and control measures, and enhance the accuracy of clinical empirical medication.

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陈净,苏秀莹,田佳,等.超强台风"摩羯"登陆文昌后特殊病原菌感染的流行病学特征及其耐药性[J]. 中国感染控制杂志,2025,24(8):1033-1041. DOI:10.12138/j. issn.1671-9638.20252075.
CHEN Jing, SU Xiuying, TIAN Jia, et al. Epidemiological characteristics and antimicrobial resistance of special pathogenic infection following super typhoon "Yagi" landfall in Wenchang[J]. Chin J Infect Control, 2025,24(8):1033-1041. DOI:10.12138/j. issn.1671-9638.20252075.

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  • 收稿日期:2025-01-21
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  • 在线发布日期: 2025-08-19
  • 出版日期: 2025-08-28