2011-2013年上海西区哨点医院成人急性腹泻细菌感染的病原学分析  

Etiological analysis of acute infectious diarrhea in adults of west district sentinel hospital of Shanghai in 2011-2013

作　　者：沈思兰 李颖[2] 史慧晶 刘岩红 张万菊[3] 何静[3] 朱绍琴 胡芸文[3] 钱方兴 

机构地区：[1]上海市同仁医院感染科,上海200336 [2]上海市长宁区疾病预防控制中心传染病防治科,上海200336 [3]上海市公共卫生临床中心病原体检测与生物安全部,上海201508

出　　处：《中华医院感染学杂志》2016年第22期5100-5103,共4页Chinese Journal of Nosocomiology

基　　金："十二五"国家卫生科技重大基金资助专项(2012ZX10004-211);上海市公共卫生三年行动计划重点学科建设传染病与卫生微生物学基金资助项目(15GWZK0102)

摘　　要：目的 了解上海市西区哨点医院成人急性腹泻病细菌感染的菌群分布及变化趋势,有针对性地进行急性腹泻病的预防控制。方法 选取2011年1月-2013年12月上海西区哨点医院肠道门诊未使用抗菌药物的急性腹泻患者2 091例,采集粪标本进行培养并分离常见肠道致病细菌（副溶血弧菌、大肠埃希菌、沙门菌属、空肠弯曲菌和志贺氏菌属）,由长宁区疾病预防控制中心对各医院分离的阳性菌株进行复核并保存。结果 671例患者粪便培养阳性,阳性率达32.1%,培养出病原菌671株,居前是副溶血弧菌、大肠埃希菌、沙门菌属和志贺菌属,其所占比例分别为33.8%、22.1%、21.5%和10.3%;其中,大肠埃希菌主要为肠产毒性大肠杆菌（ETEC）,占74.3%（110/148）;沙门菌属以肠炎沙门氏菌最为常见,占44.4%（64/144）;志贺氏菌属以宋氏志贺菌为主,占84.1%（58/69）;21-30岁患者的病原菌检出率最高,达（29.5%）;各季节病原菌检出以7-9月份最多,占68.70%（461/671）。结论 上海市西区成人急性腹泻患者有明显的季节性,青年为主,大肠埃希菌感染呈上升趋势,应主动对重点人群有针对性地开展有效的腹泻病预防控制工作。OBJECTIVE To understand the distribution of pathogens causing acute infectious diarrhea in adults of west district sentinel hospital of Shanghai and analyze the change trend so as to put forward targeted prevention and control measures of the acute diarrhea .METHODS A total of 2 091 patients with acute diarrhea who were not treated with antibiotics in diarrhea outpatient department of west district sentinel hospital of Shanghai from Jan 2011 to Dec 2013 were enrolled in the study ,then the stool specimens were collected to culture and isolate the common species of intestinal tract pathogenic bacteria （Vibrio parahaemolyticus ,Escherichia coli ,Salmonella , Campylobacter jejuni ,and Shigella） ,and the isolated positive strains were identified and preserved by center for disease control and prevention of Changning district .RESULTS The stool specimens were cultured positive in 671 patients ,with the positive rate 32 .1% .Totally 671 strains of pathogens were isolated;the V .parahaemolyticus , E .coli ,Salmonella ,and Shigella were dominant among the pathogens ,accounting for 33 .8% ,22 .1% ,21 .5% , and 10 .3% ,respectively ;the enterotoxigenic E .coli was dominant among the E .coli strains ,accounting for 74 . 3% （110/148）;the Salmonella Enteritidis was the most common species of Salmonella ,accounting for 44 .4%（64/144）;the Shigellasonnei was dominant among the Shigellaspp ,accounting for 84 .1% （58/69） .The isola‐tion rate of pathogens was highest （29 .5% ） in the patients aged from 21 to 30 years old （198/671）;68 .70%（461/671） of the pathogens were isolated in July‐September .CONCLUSION The adults with acute diarrhea in the western district of Shanghai show remarkable seasonal character ,and the young patients are dominant .The inci‐dence of E .coli infection shows an upward trend .It is necessary to actively conduct the targeted prevention and control of the diarrhea in the key population .

关 键 词：感染性腹泻 细菌 流行病学特征 

分 类 号：R516.1[医药卫生—内科学]