2017—2019年北京市海淀区感染性腹泻监测结果分析  

Analysis on monitoring results of infectious diarrhea in Haidian District, Beijing from 2017 to 2019

作　　者：韩思媛[1] 刘方遥[1] 吕冰[2] 高志勇[2] 白婧[1] 刘伟[1] 邵云平[1] 郭黎[1] HAN Si-yuan;LIU Fang-yao;LYU Bing;GAO Zhi-yong;BAI Jing;LIU Wei;SHAO Yun-ping;GUO Li(Bejing Haidian District Center for Disease Control and Prevention,Bejing 100094,China;不详)

机构地区：[1]北京市海淀区疾病预防控制中心,北京100094 [2]北京市疾病预防控制中心

出　　处：《医学动物防制》2022年第10期936-941,共6页Journal of Medical Pest Control

基　　金：国家“十三五”科技重大专项(2018ZX10714002-003-002)。

摘　　要：目的 了解2017—2019年北京市海淀区感染性腹泻流行病学特征、临床特点、病原体分布和耐药性情况,为感染性腹泻的防控和临床诊治提供科学依据。方法 采集2017—2019年北京市海淀区哨点医院肠道门诊患者便样本,收集流行病学和临床资料。采用分离培养法鉴定病原菌及检测其耐药谱,采用实时荧光定量PCR(real-time PCR)检测相关病毒。结果 1 010份监测样本中,细菌阳性251份,阳性率为24.85%,主要为致泻性大肠埃希菌,占54.18%(136份),沙门菌占17.53%(44份),副溶血性弧菌占16.33%(41份)。其中355份监测样本中,病毒阳性112份,阳性率为31.55%,主要为诺如病毒,占65.18%(73份);轮状病毒占25.00%(28份)。细菌性腹泻主要发生在夏季,病毒性腹泻常流行于冬春季。发热、便红细胞、白细胞升高为细菌性腹泻患者的临床特征,而恶心、呕吐在病毒性腹泻患者中较多出现。药敏试验显示,致泻性大肠埃希菌和沙门菌均对氨苄西林耐药,对头孢他啶、亚胺培南、头孢西丁、庆大霉素较敏感,耐药率分别为86.76%、88.64%,其中多重耐药菌率分别为87.50%、77.27%。结论 2017—2019年北京市海淀区感染性腹泻有明显的流行病学和临床特征,应有针对性地加强防控。不同病原菌的耐药性不同,应加强监测,为临床用药予以指导。Objective To provide scientific basis for prevention and control of intestinal infectious diseases as well as clinical diagnosis and treatment by understanding the epidemiologic features, clinical features, pathogen distribution and drug resistance in Haidian District, Beijing from 2017 to 2019.Methods Stool samples as well as epidemiological and clinical data from outpatients of sentinel hospitals in Haidian District, Beijing from 2017 to 2019 were collected.The isolation culture method was applied to identify pathogenic bacteria and test the drug resistant spectrum, and related viruses were detected by real-time PCR.Results A total of 251 strains of bacteria with a positive rate of 24.85% were found in 1 010 monitored samples, and diarrheogenic Escherichia coli(DEC) dominated, accounting for 54.18%(136 cases),Salmonella accounted for 17.53%(44 cases),Vibrio parahaemolyticus accounted for 16.33%(41 cases).In the 355 monitored samples, 112 positive viruses with the positive rate of 31.55% were found, Norovirus dominated, accounting for 65.18%(73 cases);and Rotaviruses accounted 25.00%(28 cases).Bacterial diarrhea mainly occurred in summer, and viral diarrhea was normally epidemic in winter and spring.Fever, elevated red or white blood cells were clinical features of bacterial infection, while nausea and vomiting frequently attacked patients suffering from viral diarrhea.The drug sensitivity test showed that both DEC and Salmonella were resistant to ampicillin, and sensitive to ceftazidime, imipenem, cefoxitin and gentamicin.The drug resistant rate of DEC and Salmonella were 86.76% and 88.64% respectively, and had the multi-drug resistant rate of 87.50% and 77.27%,respectively.Conclusion Infectious diarrhea in Haidian District, Beijing during the period from 2017 to 2019 exhibits evident epidemiologic and clinical features, and targeted prevention and control should be strengthened.The drug resistance of different pathogenic bacteria varies, so the monitoring should be strengthened, and clinical strategies of anti

关 键 词：感染性腹泻 细菌 病毒 耐药性 流行病学特征 临床特点 监测 分析 

分 类 号：R442.2[医药卫生—诊断学]