Epidemiologic Features Of Bacillary Dysentery During 1990～2009 In Zhengzhou City

Bacillary dysentery is a very significant etiopathogenisis of infectious diarrhea. Presently it is still a very important problem of public health in the world especially in developing counties. The incidence rate of bacillary dysentery was ranked as the first place among infectious diseases of class A and class B. The ranking was slowing down in recent years, but mobility is still high. The route of transmission of bacillary dysentery, which is with hyperinfection, is fece-mouth transmission. The patients, infected with bacillary dysentery, show a relative short duration of immunity, and the whole population is susceptible. Furthermore, there are not specified measures for prevention and immunity control; the treatment is only performed with antibiosis and fluid replacement, which brings the patient a certain complaint and therapeutics burden. The pathogenic bacteria are different in different period and antibiotic abusage in the last decades, which makes the drug fast very severity and impacts on prevention and clinical treatment of bacillary dysentery.ObjectiveBecause incidence rates of bacillary dysentery are different in different districts in China and there is lack of general and systematic research on epidemiologic feature of bacillary dysentery and etiology monitoring in Zhengzhou, we don't know situation of variation of predominant epidemic strain and we want make a further identify the situation of drug fast. We have performed with a retrospective analysis of mobility of bacillary dysentery in the recent twenty years and have grasped bacterium dysentery, understood the incidence of major characteristics of bacterium dysentery, so useful information can be provided for control of bacterium dysentery. Moreover, prospective etiology population monitoring from 2005 to 2008 has been made and we have made a preliminary research on distribution features of microbial population of Shigella, serum type and drug fast spectacle, which provides rational administration for the clinical treatment of bacillary dysentery in Zhengzhou and foundation for further research on drug fast mechanism of bacillary dysentery and carrying out others relative researches. Data and MethodsIn order to provide useful information for the control of bacillary dysentery, bacillary dysentery incidence and the main character of bacillary dysentery incidence must be understood. The incidence of bacillary dysentery outbreak reporting data of Zhengzhou City from 1990 to 2009 has been collected, cleaned up and summarized. All data create database in the type of excel and the descriptive research method was used to analyze the distribution of bacillary dysentery in Zhengzhou City; In accordance with the "National bacillary dysentery monitoring program" and "people of bacillary dysentery infection surveillance programs in Henan Province" the bacillary dysentery has been monitored at national-level monitoring points in Zhengzhou City and the result has been cleaned up and counted, using statistical software for data SPSS 11.0 chi-square test or rank sum test and other statistical analysis. ResultsThere were reported of 83993 cases of bacillary dysentery from 1990 to 2009, the average incidence rate of bacillary dysentery was 66.26 per 100,000 per year and incidence rate was fluctuated between 26.57 per 100,000 and 128.25 100,000. There were two mobility peaks, but the tendency was descending. The mobility was demonstrated obviously peak in summer and autumn, and the cases were collected in June and September, which was accounted of 69.15 percent of all cases in one year. The mobility was obviously higher in the city than that in the county. The most mobility was in children, accounted of 31.08 percent, the second was aged 20 -29 years population and aged 30-39 years population, accounted of 14.56 and 11.50 percent, respectively. We have concluded that the mobility of old person with age over 58 was steady ascending from the data on mobility in recent three years. The mobility of scattered children was ranked first place, which accounted of 28.59 percent, and the mobility of farm workers was added, the proportion was prominence.1938 stool specimens collected from patients with diarrhea disease were enrolled from 2005 to 2008.146 strains of Shigella were separated and the detection was 7.35 percent. And 121 strains of Shigella flexneri, accounted of 82.88 percent, 25 strains of Shigella sonnei, accounted of 17.12 percent. Subtype F4c,Fla and F2a were the major serological type,proportion was 43.80 percent,23.97 percent and 22.31 percent.Construction of microbial population was no significant difference in the female and the male. Isolated strain was demonstrated mainly bloody purulent stool, accounted of 70.55 percent, secondly was abdominal pain(67.81%). The results showed drug resistance rate of Shigella to Nalidixic Acid and Tetracycline was 100 percent, drug resistance to Ampicillin, Rifampicin, Trimethoprim+Sulfamethoxazole, Chloramphenicol was severity, drug resistance was 95.56%,91.11%,77.78% and 74.44%.There was no drug resistance to bacillosporin B and Nitrofurantoin. Among of 90 strains Shigella,37 was drug fast strains, multidrug resistant rate was 100%,which were majority of 5 to 7 kinds of antibacterial agent strains,accounted of 68.89%,the most was resistant to 12 kinds of drug. ConclusionFrom the monitored data of 20 years it is demonstrated that the mobility of bacillary dysentery is steady descending but still in the high level, and the distribution varied in different period. Through several years of pathogenic bacteria monitoring it is showed that strains of drug-resistance bacteria are different with those in the past and multidrug resistant situation is very severity, which can used to evaluate the burden of diseases and make a further emphasis and regulation on monitoring of bacillary dysentery and to conduct a research on drug fast mechanism and to provided real guide of data for clinical rationale administration.