Bacterial etiologies of five core syndromes: laboratory-based syndromic surveillance conducted in Guangxi, China

PLoS One. 2014 Oct 31;9(10):e110876. doi: 10.1371/journal.pone.0110876. eCollection 2014.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / growth & development
  • Bacteria / isolation & purification*
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / etiology*
  • Child
  • Child, Preschool
  • China / epidemiology
  • Culture Techniques
  • Epidemiological Monitoring*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Laboratories*
  • Male
  • Middle Aged
  • Syndrome
  • Young Adult

Grants and funding

BQD received funding by the Chinese Center for Disease Control and Prevention (2009ZX10004203-003) (http://www.chinacdc.cn/). The Chinese Center for Disease Control and Prevention played a role in study design. ML received the funding by the Department of Science and Technology of the Guangxi Zhuang Autonomous Region, China (2012GXNSFAA053159) (http://www.gxst.gov.cn/). The Department of Science and Technology of Guangxi has no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.