2018—2020年苏州市5岁以下儿童感染性腹泻病原学及流行特征分析  

Etiology and epidemic characteristics of infectious diarrhea in childrenunder 5 years old in Suzhou in 2018-2020

作　　者：包林[1] 王迪 崔家瑞 陈海燕[2] 崔朋伟[1] 陈立凌[1] BAO Lin;WANG Di;CUI Jia-rui;CHEN Hai-yan;CUI Peng-wei;CHEN Li-ling(Suzhou Municipal Center for Disease Control and PreventionSuzhou,Jiangsu 215004,China;Children′s Hospital Affiliated to Suzhou University,Suzhou,Jiangsu 215004,China)

机构地区：[1]江苏省苏州市疾病预防控制中心,江苏苏州215004 [2]苏州大学附属儿童医院,江苏苏州215025

出　　处：《公共卫生与预防医学》2022年第2期52-56,共5页Journal of Public Health and Preventive Medicine

基　　金：苏州市医学重点学科项目[流行病学(Szxk201516)];医疗健康大数据在疾病预防中运用的关键技术性研究(GSWS2019024);基于医疗健康大数据的传染病监测与预警关键技术研究(SS202073)。

摘　　要：目的了解苏州市儿童感染性腹泻病原学和流行特征,为精准防控提供依据。方法对2018—2020年在苏州市某国家级哨点监测医院开展感染性腹泻病原主动监测,对病例完成流行病学调查并采集粪便标本,对所有标本进行5种病毒和6类细菌检测和分型(群)。结果共纳入感染性腹泻病例999例,病原检出率为36.34%,病毒检出率为31.41%,细菌检出率为6.31%,多病原混合感染检出率为4.8%。检出率排前3位的病原体是轮状病毒17.92%、诺如病毒12.51%和沙门菌3.4%。轮状病毒腹泻和诺如病毒腹泻均高发于7~24月龄儿童,分别于冬季和冬春季形成发病高峰。细菌性腹泻未见明显季节和年龄组分布特征。多病原混合感染以病毒-病毒为主,轮状病毒G9[P]8占绝对优势,诺如病毒以2型占绝对优势。结论2018—2020年苏州地区5岁以下儿童感染性腹泻主要由病毒引起,其中轮状病毒和诺如病毒为本地的优势病原体,病毒性腹泻具有明显的人群分布和季节性特征。细菌性腹泻的优势病原体是沙门菌和致泻性大肠埃希菌,须在全年全年龄段加强防控。Objective To investigate the etiology and epidemic characteristics of infectious diarrhea in children in Suzhou,and to provide a basis for accurate prevention and control.Methods Active surveillance of infectious diarrhea pathogens was carried out in a national sentinel surveillance hospital in Suzhou from 2018 to 2020.Epidemiological investigation was completed and stool samples were collected.All samples were detected and classified for 5 viruses and 6 types of bacteria.Results A total of 999 cases of infectious diarrhea were included,the detection rate of pathogen was 36.34%,virus was 31.41%,bacteria was 6.31%,and multi-pathogen mixed infection was 4.8%.The top three pathogens were rotavirus(17.92%),norovirus(12.51%)and Salmonella(3.4%).Both rotavirus diarrhea and norovirus diarrhea occurred most frequently in children aged 7-24 months,with peak incidence in winter and early spring.There was no obvious seasonal and age distribution of bacterial diarrhea.The multi-pathogen mixed infection was mainly virus-virus.G9[P]8 was the dominant genotype of rotavirus,while type 2 was the dominant type of norovirus in the cases of infectious diarrhea.Conclusion Infectious diarrhea in children under 5 years old in Suzhou area from 2018 to 2020 is mainly caused by viruses,among which rotavirus and norovirus are the dominant pathogens.Viral diarrhea has obvious population distribution and seasonal characteristics.The dominant pathogens of bacterial diarrhea are Salmonella and diarrheagenic Escherichia coli.

关 键 词：儿童 感染性腹泻 病原学 流行特征 

分 类 号：R181[医药卫生—流行病学]