基于三个城市抗生素相关性腹泻主要病原菌的分布情况调查  

Investigation on the distribution of main pathogens of antibiotic-associated diarrhea in three cities

作　　者：贾筱溪 李文革[2] 孙文魁[3] 袁齐武 王媛媛 张文竹[2] 卢金星[2] 杨彬[3] 黎明[4] 吴媛[2] 马超锋 JIA Xiao-xi;LI Wen-ge;SUN Wen-kui;YUAN Qi-wu;WANG Yuan-yuan;ZHANG Wen-zhu;LU Jin-xing;YANG Bin;LI Ming;WU Yuan;MA Chao-feng(Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 710000;State Key Laboratory Infections Disease Prevention and Control,National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206;Shandong Center for Disease Control and Prevention,Jinan,Shandong 250014;Chengdu Center for Disease Control and Prevention,Chengdu,Sichuan 610041;Xi9an Center for Disease Control and Prevention,Xi'an,,Shaanxi 710000,China)

机构地区：[1]陕西中医药大学,陕西咸阳710000 [2]中国疾病预防控制中心传染病预防控制所,传染病预防控制国家重点实验室,北京102206 [3]山东省疾病预防控制中心,山东济南250014 [4]成都市疾病预防控制中心,四川成都610041 [5]西安市疾病预防控制中心,陕西西安710000

出　　处：《热带医学杂志》2021年第5期549-551,595,共4页Journal of Tropical Medicine

基　　金：国家科技重大专项(2018ZX10733402)。

摘　　要：目的了解山东省安丘、泰安市和四川省成都市常见抗生素相关性腹泻(AAD)的4种病原菌(艰难梭菌、产气荚膜梭菌、金黄色葡萄球菌、沙门氏菌)感染情况,为进一步开展我国抗生素相关性腹泻的检测监测提供流行病学资料。方法2017-2018年,收集3个试点城市819例抗生素相关性腹泻患者的腹泻样本,对4种病原菌进行检测,对患者的病例资料进行统计分析。结果819份腹泻样本的4种病原菌阳性率为49.8%(408/819);其中产气荚膜梭菌的阳性率33.5%(274/819)高于其它病原菌;门诊腹泻病例4种病原菌的阳性率68.0%(282/415)高于住院病例31.2%(126/404),两者差异有统计学意义(χ^(2)=110.675,P<0.05);各年龄组阳性率之间的差异有统计学意义(χ^(2)=48.138,P<0.05),31<41岁(62.8%)、1<11岁(60.0%)、11<21岁(60.0%)3个年龄组的阳性率较其它年龄组更高。结论3个试点城市抗生素相关性腹泻人群中检测结果以产气荚膜梭菌为主,金黄色葡萄球菌和艰难梭菌次之,与已报道的病原菌分布比例略有差异,未来需要开展更大范围的流行病学调查,明确我国抗生素相关性腹泻的病原谱特征。Objective To describe the distribution and features of 4 common antibiotic-associated diarrhea(AAD)pathogens(Clostridium difficile,Clostridium perfringens,Staphylococcus aureus,Salmonella)in three selected cities,Chengdu of Sichuan province and Anqiu and Tai.an of Shandong province,which providing epidemiological data for further detection and monitoring of antibiotic-associated diarrhea in China.Methods A total of 819 diarrhea samples were collected from these three cities in 2017-2018;of which,these 4 pathogens were detected and analyzed.Results 49.8%(408/819)feces samples were positive for the 4 pathogens.The isolation rate of C.perfringens was highest 33.5%(274/819),followed by S.aureus and C.difficile.The positive rate of out-patient was significantly higher than that of hospitalized cases[68.0%(282/415)vs.31.2%(126/404)](χ^(2)=110.675,P<0.05).The positive rates among different age groups also showed statistical significant differences(χ^(2)=48.138,P<0.05).The positive rates of 31-<41 years old(62.8%),1-<11 years old(60.0%),11-<21 years old(60.0%)were higher than other age groups.Conclusions In the three pilot cities,C.perfringens was the main pathogen,followed by S.aureus and C.difficile,which was slightly different from the reported distribution proportion of pathogens.In future,a wider range of epidemiological investigation should be needed to clarify the pathogen characteristics of AAD in China.

关 键 词：抗生素相关性腹泻 艰难梭菌 产气荚膜梭菌 金黄色葡萄球菌 

分 类 号：R574.62[医药卫生—消化系统]