2013-2018年北京市顺义区哨点医院腹泻病例中致泻性大肠埃希菌流行特征分析  

Epidemiological characteristics of diarrheagenic Escherichia coli among diarrhea outpatients in Shunyi district of Beijing,2013-2018

作　　者：冯冉[1] 甄国新[2] 李颖[3] 张爽[3] 冀国强[1] 高彭[2] 马红梅[3] Feng Ran;Zhen Guoxin;Li Ying;Zhang Shuang;Ji Guoqiang;Gao Peng;Ma Hongmei(Emergency Office,Center for Disease Control and Prevention in Shunyi District of Beijing,Beijing 101300,China;Department of Nutrition and Food Hygiene,Center for Disease Control and Prevention in Shunyi District of Beijing,Beijing 101300,China;Microbiological laboratory,Center for Disease Control and Prevention in Shunyi District of Beijing,Beijing 101300,China)

机构地区：[1]北京市顺义区疾病预防控制中心应急办公室,北京101300 [2]北京市顺义区疾病预防控制中心营养与食品卫生科,北京101300 [3]北京市顺义区疾病预防控制中心微生物检验科,北京101300

出　　处：《首都医科大学学报》2020年第6期991-996,共6页Journal of Capital Medical University

摘　　要：目的了解北京市顺义区腹泻病例中致泻性大肠埃希菌(diarrheagenic Escherichia coli,DEC)的流行特征,为顺义区DEC引起的腹泻防控工作提供科学依据。方法收集2013至2018年北京市顺义区2家哨点医院肠道门诊腹泻患者临床和流行病学资料,采集粪便标本进行DEC检测,数据采用SPSS 25.0和Excel 2010进行流行病学分析。结果2068例腹泻监测病例中检出DEC 182例(8.80%),检出率由高到低依次为肠产毒性大肠埃希菌(enterotoxigenic E.coli,ETEC)(111例,5.37%)、肠致病性大肠埃希菌(enteropathogenic E.coli,EPEC)(45例,2.18%)、肠集聚性大肠埃希菌(enteroaggregative E.coli,EAEC)(27例,1.31%)(各类型DEC检出数相加大于阳性例数是由于混合感染者分别计算到各类型引起),且不同户籍、不同性别、不同年龄的检出率差异无统计学意义。DEC的季节性发病特征明显,各菌型的流行高峰均在夏季,主要表现为ETEC(χ^2=76.591,P<0.001)和EAEC(χ^2=10.204,P<0.05);本市患者EPEC(χ^2=12.243,P<0.001)和EAEC(χ^2=7.947,P<0.01)阳性检出率高;不同年龄EAEC检出率差异有统计学意义(χ^2=17.171,P<0.05)。发热、恶心、腹痛、脱水症状对DEC检出率无影响,但无呕吐症状病例DEC检出率高(χ^2=7.099,P<0.01),主要体现为ETEC(χ^2=15.073,P<0.001);伴发热与无发热组EAEC检出率差异有统计学意义(χ^2=4.951,P<0.05)。结论北京市顺义区DEC流行的优势菌型主要为ETEC、EPEC和EAEC,季节性发病特征明显,夏季应加强DEC引起腹泻的防控工作。Objective To understand the epidemiological characteristics of diarrheagenic Escherichia coli(DEC)among diarrhea outpatients in sentinel hospitals in Shunyi District of Beijing,and to provide evidences for the prevention and treatment control of diarrhea.Methods C1 inical and epidemiological data regarding from diarrhea patients from 2 sentinel surveillance hospitals from 2013 to 2018 were collected,with fecal specimens sampled and tested for DEC.The descriptive epidemiological statistical analysis was performed with SPSS 25.0 and Excel 2010.Results Among all the 2068 diarrhea cases,182 cases(8.80%)appeared DEC positive,which included the PCR subtypes enterotoxigenic E.coli(ETEC)(111 cases,5.37%),enteropathogenic E.coli(EPEC)(45 cases,2.18%),and enteroaggregative E.coli(EAEC)(27 cases,1.31%).Epidemiological characteristics regarding the heterogeneities of DEC showed no difference in regions,gender and age groups(P>0.05).The positive rate of DEC showed an obvious seasonal distribution,which reached the peaks in summer for all the subtypes,especially,the ETEC(χ^2=76.591,P<0.001)and EAEC(χ^2=10.204,P<0.05).The positive rates of EPEC(χ^2=12.243,P<0.001)and EAEC(χ^2=7.947,P<0.01)in local people were higher.The detection rate of EAEC showed significant difference in different ages(χ^2=17.171,P<0.05).Fever,nausea,abdominal pain and dehydration had no effect on the detection rate of DEC,but the detection rate of DEC in patients with vomiting,mainly in ETEC(χ^2=15.073,P<0.001),was high(χ^2=7.099,P<0.01).There was significant difference in the detection rate of EAEC between febrile group and non febrile group(χ^2=4.951,P<0.05).Conclusion ETEC,EPEC and EAEC were the predominant bacterial types of DEC in Shunyi.The seasonal characteristics of DEC was obvious,and thus the prevention and control of diarrhea caused by DEC should be strengthened in summer.

关 键 词：腹泻 致泻性大肠埃希菌 流行特征 

分 类 号：R181.3[医药卫生—流行病学]