我国2012-2015年门诊腹泻患者中致泻性大肠埃希菌流行特征分析  

Epidemiological characteristics of diarrheagenic Escherichia coil among diarrhea outpatients in China, 2012-2015

作　　者：张子科 赖圣杰[2] 余建兴[2] 杨婉琪[2] 王鑫 景怀琦 李中杰[2] 杨维中[2] 

机构地区：[1]浙江大学医学院附属第一医院检验科浙江省临床体外诊断技术研究重点实验室,杭州310003 [2]中国疾病预防控制中心传染病预防控制处传染病监测预警中国疾病预防控制中心重点实验室,北京102206 [3]传染病预防控制所应急实验室

出　　处：《中华流行病学杂志》2017年第4期419-423,共5页Chinese Journal of Epidemiology

基　　金：国家科技重大专项（2012ZX10004-201）;中国疾病预防控制中心传染病监测预警重点实验室项目

摘　　要：目的 了解我国门诊腹泻患者中致泻性大肠埃希菌（DEC）流行特征。方法 2012－2015年在27省（直辖市、自治区）170家医院门、急诊中开展腹泻病监测，收集腹泻病例的临床和流行病学资料，同时采集粪便标本，送往92家网络实验室开展DEC检测。结果 在46 721例腹泻监测病例中，DEC的总检出率为7.7%，且各地区检出率存在较大差异。在2 982例（6.4%）报告了PCR菌型鉴定分类信息的DEC阳性病例中，肠集聚性黏附大肠埃希菌（EAEC）是最主要的类型（1 205例，40.4%），其次是肠致病性大肠埃希菌（EPEC）（815例，27.3%）和肠产毒性大肠埃希菌（ETEC）（653例，21.9%）。整体分析，25～34岁青壮年、暖温带地区和黏液便的DEC检出率较高，检出率分别为10.1%、11.1%和9.4%。DEC的季节性发病特征明显，各菌型的流行高峰均在夏季。结论 DEC是我国腹泻病门诊重要病原体之一，流行菌型以EAEC、EPEC和ETEC为主，不同地区、不同年龄人群、不同季节的流行特征存在差异。Objective To understand the epidemiological characteristics of diarrheagenic Escherichia （E.） coli （DEC） among diarrhea outpatients in China. Methods Diarrhea surveillance program was conducted in outpatient and emergency departments from 170 hospitals that under the sentinel programs in 27 provinces, from 2012-2015. Clinical and epidemiological data regarding diarrhea patients were collected, with fecal specimens sampled and tested for DEC in 92 network-connected laboratories. Results Among all the 46 721 diarrhea cases, 7.7% of them appeared DEC positive in those with geographic heterogeneity. In 2 982 cases （6.4%） with available data on PCR subtypes of DEC, enteroaggregative E. coli （EAEC, 1 205 cases, 40.4%） appeared the most commonly seen pathogens, followed by enteropathogenic E. coli （EPEC, 815 cases, 27.3%）, and enterotoxigenic E.coli （ETEC, 653 cases, 21.9%）. The highest positive rate of DEC was observed in outpatients of 25-34 years old （10.1%）, living in the warm temperate zones （11.1%）, and with mucous-like stool （9.4%）. The positive rate of DEC showed a strong seasonal pattern, with peaks in summer, for all the subtypes. Conclusions DEC seemed easy to be detected among diarrhea outpatients in China, with EAEC, EPEC and ETEC the most commonly identified subtypes. Epidemiological characteristics regarding the heterogeneities of DEC appeared different, in regions, age groups and seasons. Long-term surveillance programs should be strengthened to better understand the epidemiology of DEC, in China.

关 键 词：腹泻病 哨点监测 致泻性大肠埃希菌 季节性 

分 类 号：R181.3[医药卫生—流行病学]