北京市密云区腹泻相关病原流行特征及腹泻病原菌耐药谱研究  

Epidemiological characteristics of diarrhea pathogens and drug resistance of diarrhea-related bacteria in diarrheal patients in Miyun district,Beijing

作　　者：张巍巍 冯宝立 王金龙 韩雅俊 何广学[1] Zhang Weiwei;Feng Baoli;Wang Jinlong;Han Yajun;He Guangxue(Chinese Center for Disease Control and Prevention,Beijing 102206,China;Miyun District Center for Disease Control and prevention of Beijing,Beijing 101500,China)

机构地区：[1]中国疾病预防控制中心,北京102206 [2]北京市密云区疾病预防控制中心,北京101500

出　　处：《疾病监测》2021年第4期381-386,共6页Disease Surveillance

摘　　要：目的通过检测北京市密云区哨点医院门诊就诊腹泻患者粪便中的腹泻相关病原,了解其流行情况及腹泻病原菌的耐药特征,为感染性腹泻的防治提供病原学依据。方法收集2014—2019年密云区医院和密云中医院2个监测哨点的腹泻患者粪便标本,采用培养分离方法鉴定腹泻病原菌并检测其耐药谱,同时采用实时荧光定量聚合酶链式反应方法检测腹泻相关病毒。结果共收集1870份腹泻患者粪便样本,分离腹泻病原菌267株,其中沙门菌84株,弧菌属52株,致泻性大肠埃希菌111株,气单胞菌10株,弯曲菌8株,志贺菌2株。1870份样本中,腹泻病毒检测阳性的样本314份,其中诺如病毒GⅡ型、GⅠ型、轮状病毒、腺病毒、札如病毒核酸阳性的样本分别为204、28、61、17、4份。腹泻病原菌和病毒阳性样本共577份(30.86%)。≤14岁年龄组阳性率最高,为43.95%。腹泻相关病原在第三季度(7—9月)检出率最高,6年平均检出率为40.26%。腹泻相关病毒在第一(1—3月)和第四季度(10—12月)的检出率较高,6年平均检出率分别为18.86%、23.63%。分离的菌株中,84.52%的沙门菌和87.39%的致泻性大肠埃希菌有抗药性,36.90%的沙门菌和36.94%的致泻性大肠埃希菌为多重耐药菌株。结论在北京市密云区,引起腹泻的病原构成多样,且多重耐药严重,应加强病原监测,促进多部门多领域协同合作,加强药物管理和合理使用,采取有效措施防控耐药发生。Objective To understand the infection status of pathogenic bacteria and drug resistance characteristics in diarrhea patients in Miyun district,Beijing,and provide evidence for the prevention and treatment of infectious diarrhea.Methods The stool samples were collected from two sentinel hospitals in Miyun(Miyun District Hospital and Miyun Traditional Chinese Medicine Hospital)from 2014 to 2019.Pathogenic bacteria were identified by culture and isolation and drug resistances were analyzed.Diarrhea related viruses were also detected by real-time PCR.Results From 2014 to 2019,a total of 1870 stool samples were collected.And 267 strains of bacteria(84 Salmonella strains,52 Vibrio strains,111 Escherichia coli strains,10 Aeromonas strains,8 Campylobacter strains,2 Shigella strains)were isolated.And 314 samples were positive with viruses(204 with norovirus GⅡ,28 with norovirus GⅠ,61 with rotavirus,17 with adenovirus,4 with zaravirus).The highest positive rate was in age group≤14 years(43.95%).The highest annual detection rate of diarrhea pathogens was in the third quarter,with an average positive rate of 40.26%in six years.The annual detection rate of diarrhea related viruses were higher in the first and fourth quarters,with an average positive rate of 18.86%and 23.63%respectively in six years.The drug resistance rates of Salmonella and diarrheagenic E.coli were 84.52%and 87.39%respectively.36.90%of Salmonella strains and 36.94%of diarrheagenic E.coli strains were multidrug resistant.Conclusion In Miyun district,the composition of pathogens causing diarrhea tends to be diversified.Multidrug resistance of bacteria is serious.It is necessary to strengthen the pathogen surveillance,promote collaborations of multidisciplinary to response together,strengthen the management and rational use of drugs,and take effective measures to prevent and control the occurrence of drug resistance.

关 键 词：腹泻 致泻病原菌 腹泻相关病毒 多重耐药 

分 类 号：R211[医药卫生—中医学] R373