2016—2018年白银市食源性疾病主动监测病原学及流行病学特征分析  

Epidemiologic and etiologic characteristics of foodborne diseases active surveillance in Baiyin City,2016-2018

作　　者：李梅基[1] 张小梅[1] 强丽红 陈安明[1] 张景辉[1] 王彦博[1] 卢旭升[1] 仇文轩[1] LI Meiji;ZHANG Xiaomei;QIANG Lihong;CHEN Anming;ZHANG Jinghui;WANG Yanbo;LU Xusheng;QIU Wenxuan(Baiyin Center for Disease Control and Prevention,Gansu Baiyin 730900,China)

机构地区：[1]白银市疾病预防控制中心,甘肃白银730900

出　　处：《中国食品卫生杂志》2020年第1期72-76,共5页Chinese Journal of Food Hygiene

摘　　要：目的了解甘肃省白银市食源性腹泻患者中沙门菌、志贺菌、副溶血性弧菌和致泻大肠埃希菌(diarrheagenic Escherichia coli,DEC)的病原学和流行病学特征。方法对2016—2018年白银市食源性疾病主动监测腹泻患者的粪便标本进行沙门菌、志贺菌、副溶血性弧菌和DEC 4种病原菌的分离、生化鉴定、血清学分型、药物敏感性试验和脉冲场凝胶电泳(PFGE)分型。结果从1003份粪便标本中共分离到300株致病菌,总检出率为29.9%。DEC的检出率最高(29.1%,292/1003),其次是沙门菌和志贺菌,副溶血性弧菌未检出。1003例患者中男女比例为1.3∶1,女性患者致病菌检出率(31.8%,136/428)高于男性(28.5%,164/575);19~59岁和≤5岁年龄组的检出率较高,分别为31.5%(76/241)和30.6%(188/615)。致病菌的检出主要在第二季度和第三季度。7株沙门菌经PFGE分型后分为6种带型,存在1次聚集。沙门菌对四环素的耐药率最高达85.7%(6/7),多重耐药株有6株;1株福氏志贺菌2a型是七重耐药菌株;292株DEC均对亚胺培南敏感,对头孢他啶、头孢西丁、氯霉素、环丙沙星的敏感率均>80%,对氨苄西林的耐药率最高(80.8%,236/292),多重耐药菌株占75.3%(220/292)。结论2016—2018年白银市食源性疾病主动监测中DEC检出率最高,19~59岁年龄组致病菌检出率最高,存在明显的季节特征,第二季度和第三季度为主要流行季节,菌株的耐药性较强,耐药谱广。Objective To study the epidemiologic and etiologic characteristics of Salmonella,Shigella,Vibrio parahemolyticus,diarrheagenic Escherichia coli(DEC)from foodborne diarrhea patients in Baiyin.Methods Stool samples were collected from foodborne disease patients in Baiyin during 2016-2018 and pathogenic bacteria strains were isolated and identified by biochemical characteristics,serotyping,drug resistance test and pulsed-field gel electrophoresis(PFGE).Results A total of 300 strains were isolated from 1003 stool samples,the overall positive rate was 29.9%and the positive rate of DEC was the highest(29.1%,292/1003),followed by that of Salmonella and Shigella,and Vibrio parahemolyticus were not detected.Totally 1003 foodborne disease cases were reported and the ratio of male and female was1.3∶1,the detection rate of pathogenic bacteria in female patients(31.8%,136/428)was higher than male patients(28.5%,164/575),the patients were mainly adults aged 19-59 years and young children under 5 years old,and the positive rate was 31.5%(76/241)and 30.6%(188/615).Pathogenic bacteria strains were isolated mainly in the second and third quarter of the year.PFGE result indicated that 7 isolates belonged to 6 types,and there was one aggregation phenomenon.Salmonella had high resistant rate to tetracycline(85.7%,6/7),it was found that 6 strains were multi-drug resistant.Shigella flexneri 2 a subtype was resistant to 7 drug.292 strains of DEC were sensitive to imipenem,and the drug sensitive rates of ceftazidime,cefoxitin,chloramphenicol and ciprofloxacin were greater than 80%,the resistance rate to ampicillin was the highest(80.8%,236/292),the multi-resistance to three or more antibiotics was75.3%(220/292).Conclusion In the active etiological surveillance for foodborne diseases in Baiyin during 2016-2018,the detection rate of DEC was the highest.Pathogenic bacteria strains were isolated mainly in adults aged 19-59 years.The season specific characteristics of pathogenic bacteria was observed,and the infections mainly occurred in th

关 键 词：食源性疾病 主动监测 致病菌 流行病学 病原学 特征 沙门菌 志贺菌 副溶血性弧菌 致泻大肠埃希菌 

分 类 号：R155.3[医药卫生—营养与食品卫生学] R181.3[医药卫生—公共卫生与预防医学]