湖南省2017-2021年食源性疾病主动监测病原学及流行特征分析  

Analysis of the etiology and epidemiological characteristics of active surveillance of foodborne diseases in Hunan Province,2017-2021

作　　者：郑美惠 赖天兵[2] 贾华云[2] 让蔚清[1] 梁进军[2] 段宏波[2] 吴诗蓝 ZHENG Mei-hui;LAI Tian-bing;JIA Hua-yun;RANG Wei-qing;LIANG Jin-jun;DUAN Hong-bo;WU Shi-lan(School of Public Health,University of South China,Hengyang,Hunan 421001,China;不详)

机构地区：[1]南华大学公共卫生学院,湖南衡阳421001 [2]湖南省疾病预防控制中心食品安全监测科,湖南长沙410005

出　　处：《现代预防医学》2023年第7期1327-1332,共6页Modern Preventive Medicine

基　　金：湖南省自然科学基金(2021JJ70086)。

摘　　要：目的了解湖南省食源性疾病病原体的流行病学特征及血清型分布,为精准防控食源性疾病提供参考依据。方法收集湖南省18家哨点医院2017—2021年食源性疾病主动监测病例信息,并采集粪便/肛拭子标本进行特定病原体检测,不同特征病原体检出情况的比较采用χ^(2)检验。结果共采集粪便或肛拭子标本12579例,病原体总检出率为21.26%;其中沙门菌的阳性检出率为8.68%,诺如病毒8.52%、致泻大肠埃希菌4.35%、副溶血性弧菌0.66%、志贺菌0.06%。从季节分布看,除志贺菌外的3种食源性致病菌在三季度的检出率最高(P<0.001),诺如病毒在一季度的检出率最高(χ^(2)=250.915,P<0.001)。沙门菌中以鼠伤寒沙门菌占比最大,为63.34%,感染多发生于5岁以下儿童;诺如病毒在5~17岁年龄组检出率最高,感染型别以诺如病毒Ⅱ型为主,占68.53%。病原体阳性病例的常见可疑暴露食品是粮食类及其制品(占15.77%)、肉与肉制品和水果类及其制品(占14.91%);家庭自制(占34.35%)和散装(占24.52%)是可疑食品的主要加工及包装方式。结论沙门菌和诺如病毒是引起湖南省食源性腹泻病的主要病原体,具有明显季节性,儿童和青少年高发,应继续加强主动监测工作,对重点人群开展优势菌种的食品安全知识宣讲。Objective To understand the epidemiological characteristics and serotype distribution of foodborne disease pathogens in Hunan Province,to provide a reference for accurate prevention and control of foodborne diseases.Methods Information on active surveillance cases of foodborne diseases from 2017 to 2021 from 18 sentinel hospitals in Hunan Province were collected,and fecal/anal swab specimens were collected for specific pathogen testing.Comparison of the detection of different characteristic pathogens was performed using theχ^(2) test.Results A total of 12579 fecal or anal swab specimens were collected,with a total pathogen detection rate of 21.26%,including Salmonella(8.68%),Norovirus(8.52%),Diarrheagenic Escherichia coli(DEC)(4.35%),Vibrio parahaemolyticus(0.66%),and Shigella(0.06%).In terms of seasonal distribution,the three foodborne pathogenic bacteria except Shigella had the highest detection rate in the third quarter(P<0.001),and that of Norovirus was the highest in the first quarter(χ^(2)=250.915,P<0.001).Salmonella Typhimurium accounted for the largest proportion(63.34%)in Salmonella,which mainly occurred in children under 5 years old.Norovirus had the highest detection in the age group of 5 to 17 years,and the main viral pathogen was GⅡ(68.53%).Positive cases of common pathogens suspected exposure was food grains and their products(15.77%),meat and meat products,and fruits and their products(14.91%).Homemade(34.35%)and bulk suspicious food(24.52%)was the main processing and packaging methods.Conclusion Salmonella and Norovirus are the main pathogens causing infectious diarrhea in Hunan Province,with obvious seasonality and high incidence in children and adolescents.Active surveillance should be continued,and food safety knowledge publicity of dominant bacteria should be promoted in key populations.

关 键 词：食源性疾病 病原体 检出率 血清型 

分 类 号：R155.5[医药卫生—营养与食品卫生学]