目的 调查新疆伊犁地区农村居住儿童媒介传播立克次体感染状况。方法 2012年8-11月选择伊犁州伊宁市、巩留县及昭苏县农村6~12岁儿童为调查对象,采集血液标本。采用WHO推荐的微量间接免疫荧光方法(m-IFA),对7种媒介传播立克次体进行血清IgG抗体检测,比较每种立克次体抗体阳性率在3个调查点间及2个年龄组间的差异。结果 本次调查共检测7种立克次体IgG抗体,平均每种病原体检测血清246份,共检测血清1 722份。结果显示蜱传西伯利亚立克次体、嗜单核细胞埃立克体、嗜吞噬细胞无形体、贝氏苛柯斯体人群抗体阳性率分别为37.4%(92/246)、29.3%(72/246)、15.4%(38/246)和12.6%(31/246)。蚤传汉赛巴尔通体、莫氏立克次体及螨传恙虫病东方体抗体阳性率分别为15.8%(39/246)、5.7%(14/246)和11.8%(29/246)。同一病原体在男女性别、3个调查点及2个年龄组间阳性率差异无统计学意义(P>0.05)。结论 新疆伊犁地区农村儿童普遍存在媒介传播立克次体感染状况,加强临床诊断及鉴别诊断、对急性不明原因发热儿童在高度怀疑立克次体感染情况下,经验性抗立克次体治疗具有重要临床意义。

Objective To better understand the situation of rickettsiae infection in agrarian children in Yili prefecture, Xinjiang Uygur Autonomous Region. Methods A total of 1 722 serum samples were collected from children aged from 6-12 years old in rural areas of Yining city, Gongliu county and Zhaosu county from August to November, 2011. Indirect immunofluorescencs antibody assay proposed by WHO was used to detect tick born Rickettsia sibirica, Ehrlichua chaffeensis, Anaplasma phagocytophilum, Coxiella burnetii and flea born Rickettsia typhi, Bartonella henselae and mite born Orientia tsutsugamushi respectively. Results A high prevalence of tick borne rickettsiae including R. sibirica, E. chaffeensis, A. phagocytophilum and C. burnetiiwere detected in 37.4% (92/246) and 29.3% (72/246), 15.4% (38/246) and 12.6% (31/246), respectively. A significant seroprevalence were detected in 15.8% (39/246) of B. henselae, 5.7% (14/246) of R. typhi, and 11.8% (29/246) of O. tsutsugamushi, respectively. Conclusion A highly seroprevalences of vector-born rickettsiae were demonstrated in agrarian children in Yili prefecture, Xinjiang Uygur Autonomous Region. Differential diagnoses of patients with unknown febrile diseases and empirical anti-rickettsia antibiotics treatment of patients with suspected rickettsia infection were needed in the local areas.