2013-2015年上海市普陀区869例成人腹泻患者病原监测结果  

Etiological surveillance for 869 cases of adult patients with diarrhea in Putuo district of Shanghai, 2013- 2015

作　　者：唐海丰[1] 李勇[1] 顾文超[1] 黄文静[1] 李晓君[1] 后永春[1] 张宇艳[1] 

机构地区：[1]上海市普陀区疾病预防控制中心,上海200333

出　　处：《现代预防医学》2016年第12期2255-2258,共4页Modern Preventive Medicine

摘　　要：目的了解上海市普陀区成人腹泻病例的流行病学特征和病原谱构成,为制定有针对性的预防和控制措施提供依据。方法依托上海市建立的腹泻病监测网络,对普陀区哨点监测医院肠道门诊腹泻病例按10:1抽样间隔进行调查,并采集粪便标本进行细菌培养和病毒检测。结果从869例病例粪便标本中检出至少1种病原体阳性者544例,阳性率为62.60%。细菌阳性率为19.22%,主要为致泻性大肠埃希氏菌(66例)、副溶血性弧菌(40例)、空肠弯曲菌(34例)。病毒阳性率为32.68%,主要为诺如病毒(173例)、轮状病毒(71例)。有93例病例为多重感染,阳性率10.70%。病原体检出率呈现明显的夏季高峰和秋冬季高峰,夏季细菌阳性率高于病毒,秋冬季病毒阳性率高于细菌,差异均有统计学意义(P<0.05)。呕吐频次均数病毒阳性组(1.11次/d)高于细菌阳性组(0.50次/d),差异有统计学意义(P<0.05)。结论上海市普陀区成人腹泻病原谱较为广泛,有鲜明的季节流行特征,应针对不同季节加强相应病原体的监测和防控。Objective The aim of this study was to understand the pathogen spectrum and epidemiological characteristics of adult diarrhea cases from 2013 to 2015 in Putuo district of Shanghai, in order to provide the scientific evidence for prevention and control measures. Methods The survey was conducted on the basis of Shanghai diarrhea surveillance network. The adult diarrhea cases seeking medical care were sampled by ratio of 10：1. And stool samples were collected from them for pathogen isolation. Results Among 869 stool samples detected, 544 were positive for at least one pathogen （62.60%）. The positive rate for bacteria was 19.22%, mainly diarrheagenic Escherichia coli （66 cases）, Vibrio parahaemolyticus （40 cases） and Campylobacterjejuni （34 cases）. The positive rate for virus was 32.68%, mainly norovirus （40 cases） and rotavirus （40 cases）. 93 cases were multiple infections （10.70%）. The positive rates peaked obviously in summer and during autumn- winter. The positive rate of bacteria was higher than that of virus in summer, and the positive rate of virus was higher than that of bacteria during autumn-winter.The differences were statistically significant （P〈0.05）.The frequency of vomiting in virus positive group （1.11 times a day） was higher than that in bacteria positive group （0.50 times a day）, and the difference had statistically significance （P〈0.05）. Conclusion The pathogen spectrum of adult diarrhea was relatively wide in Putuo district of Shanghai and the seasonality of the incidence was obvious. Specific etiological surveillance and control strategies should be strengthened according to pathogenic factors in different seasons.

关 键 词：成人腹泻 流行病学 病原谱 监测 

分 类 号：R181.22[医药卫生—流行病学]