2015至2017年天津市急性腹泻患者病原谱及其流行特征  

Pathogenic spectrum and epidemiological characteristics of diarrhea patients in Tianjin during 2015-2017

作　　者：高璐[1] 李佳萌[1] Gao Lu;Li Jiameng

机构地区：[1]天津市疾病预防控制中心传染病控制室,300011

出　　处：《中华传染病杂志》2019年第4期209-213,共5页Chinese Journal of Infectious Diseases

基　　金：天津市疾病预防控制中心科技基金项目(CDCKY1705).

摘　　要：目的了解天津市急性腹泻患者病原谱和流行特征。方法采集2015至2017年监测点医院1536例腹泻患者的粪便标本,病毒核酸鉴定采用实时PCR法,细菌培养应用选择性培养基,药物敏感试验采用临床实验室标准化协会推荐的Kirby-Bauer纸片扩散法。统计学分析采用χ2检验。结果1536例腹泻患者的粪便标本中,1种细菌阳性标本109份(7.10%),1种病毒阳性标本171份(11.13%);混合感染标本20份(1.30%),其中病毒合并细菌感染8份,病毒双重感染12份。腹泻患者标本的病原总检出率为19.53%。诺如病毒、副溶血性弧菌、轮状病毒、沙门菌、星状病毒和札如病毒的检出率位居前六位。细菌检出时间分布曲线呈单峰,主要为8月,病毒检出时间分布曲线呈双峰,为5~6月和11~12月。腹泻患者年龄>30岁组细菌检出率为9.82%(75/764),年龄<30岁组为5.44%(42/772),差异有统计学意义(χ^2=10.451,P<0.01);年龄<25岁病毒检出率为17.83%(112/628),年龄≥25岁为10.02%(91/908),差异有统计学意义(χ^2=19.755,P<0.01)。沙门菌、志贺菌和副溶血性弧菌对氨苄西林有不同程度耐药。结论急性腹泻患者的肠道细菌和病毒的检出季节分布明显不同,呈现"细菌单峰,病毒双峰"的趋势。细菌感染30岁以上人群,而病毒感染25岁以下人群。腹泻的主要病原为诺如病毒、副溶血性弧菌、轮状病毒。Objective To investigate the pathogenic spectrum and epidemiological characteristics of acute diarrhea patients in Tianjin.Methods A total of 1 536 stool samples of diarrhea patients were collected from hospitals between 2015 and 2017.Viral nucleic acids were detected by real-time polymerase chain reaction.Selective medium was used to culture bacteria.Drug susceptibility tests were performed by Kirby-Bauer disk diffusion method recommended by the Association for Standardization of Clinical Laboratories.χ^2 test was used for statistical analysis.Results In the stool samples of 1 536 cases of diarrhea,one enteric bacterium was detected in 109 samples with the positive rate of 7.10%,one enterovirus was detected in 171 samples with the positive rate of 11.13%,mixed infection was detected in 20 samples with positive rate of 1.30%,including 8 samples with enteric bacterium and enterovirus and 12 samples with double enterovirus.The total detection rate of diarrhea cases was 19.53%.Norovirus,vibrio parahaemolyticus,rotavirus,Salmonella,stellate virus and sapovirus ranked the top six in the detection rate.The total detection rate curve of bacteria showed a single peak,mainly in August,while the total detection rate curve of the virus showed a double peak,which was from May to June and from November to December.The positive rate of bacteria in patients aged over 30 years old was 9.82%(75/764),while that in those aged less than 30 years old was 5.44%(42/772).The difference was statistically significant(χ2=10.451,P<0.01).The positive rate of viral pathogen in patients aged no less than 25 years old was 10.02%(91/908),while that in those aged less than 25 years old was 17.83%(112/628).The difference was statistically significant(χ^2=19.755,P<0.01).Salmonella,Shigella and vibrio parahaemolyticus were resistant to ampicillin in varying degrees.Conclusions The positive rate curves of bacteria and virus are obviously different,showing a trend of"bacterial single peak and viral double peak".Bacteria mainly infect people aged ov

关 键 词：腹泻 人群监测 病原谱 

分 类 号：R574.62[医药卫生—消化系统]