2017-2020年江苏省感染性腹泻病原谱分析  

Pathogenic spectrum of infectious diarrhea in Jiangsu province from 2017 to 2020

作　　者：艾静[1] 李楚楚 嵇红[1] 秦圆方[1] 张雪峰[1] 程晓庆 付建光[1] Ai Jing;Li Chuchu;Ji Hong;Qin Yuanfang;Zhang Xuefeng;Cheng Xiaoqing;Fu Jianguang(Institute of Acute Infectious Disease Prevention and Control,Jiangsu Provincial Center for Disease Control and Prevention,National Health Commission Key Laboratory of Intestinal Pathogenic Microbiology,Nanjing 210009,China)

机构地区：[1]江苏省疾病预防控制中心急性传染病防制所、国家卫生健康委肠道病原微生物重点实验室,南京210009

出　　处：《国际病毒学杂志》2025年第1期7-11,共5页International Journal of Virology

摘　　要：目的基于江苏省感染性腹泻主动监测系统,掌握本省感染性腹泻病原谱,明确感染差异,为制定防控策略提供依据。方法2017—2020年收集门诊和住院腹泻患者粪便标本送检,对主要引起腹泻的5种病毒和6种细菌进行病原学检测,了解疾病病原谱和不同人群流行特征。结果本研究共纳入腹泻病例8801例,病毒性病原体检出率远高于细菌性病原体,在11种病原体中轮状病毒检出率最高(9.62%),其次为诺如病毒(8.84%),细菌性病原体中致泻性大肠埃希菌检出率最高(2.16%),其次为沙门菌(2.09%)。病毒性病原体检出率呈现随年龄增长下降的趋势,细菌性病原体这一趋势不明显。5岁以下儿童为感染性腹泻的重点防控人群。副溶血弧菌在门诊病例的检出率高于5岁以下住院病例,且有统计学差异,其它大部分病原体住院病例检出率高于门诊病例。城市和农村之间病原谱存在差异。门诊和住院人群在轮状病毒主要基因型分布上较为相似,均以G9P[8]型为主。诺如病毒基因型分布在两类人群中有一定差异,但均以GII.4[P31]型为优势流行株。门诊病例中的GII.6[P7]和GII.17[P17]基因型占比显著高于住院病例。结论目前感染性腹泻的人群防控应以病毒性病原体为主,但致泻性大肠埃希菌和沙门菌等细菌类病原体感染也不容忽视。监测和重点防控的人群可侧重于5岁以下住院儿童。关注肠道腺病毒、副溶血弧菌和志贺菌等在农村人群的感染情况。Objective To understand the pathogenic spectrum of diarrhea in our province and study the differences in infections based on Jiangsu Provincial Active Surveillance System for Infectious Diarrhea,so as to provide a basis for formulating prevention and control strategies.MethodsFrom 2017 to 2020,fecal samples were collected from diarrhea patients in the outpatient and inpatient sections for the detection of five viral and six bacterial pathogens causing diarrhea and for understanding the pathogen spectrum and epidemic characteristics in different populations.ResultsA total of 8801 cases of diarrhea were enrolled in the study.The detection rate of viral pathogens was much higher than that of bacterial pathogens.Among the 11 pathogens,the detection rate of rotavirus was the highest(9.62%),followed by norovirus(8.84%).Among bacterial pathogens,the detection rate of diarrheal Escherichia coli was the highest(2.16%),followed by salmonella(2.09%).The detection rates of viral pathogens showed a trend of decreasing along with increment of age while the trend was not so obvious for bacterial pathogens.Children under 5 years old were the key population for the prevention and control of infectious diarrhea.The detection rate of Vibrio parahaemolyticus in outpatient cases was higher than that in hospitalized cases under 5 years old,and the difference was statistically significant.For other pathogens,the detection rate was higher in hospitalized cases than that in outpatient cases.There were differences between the pathogen spectrums in urban and rural areas.For the rotavirus,the distribution of main genotypes among outpatient cases was similar to that of inpatient cases,with G9P[8]as the dominant type in both groups.The two groups had different genotype distributions of norovirus but the same dominant genotype,GII.4[P31].The proportion of genotypes GII.6[P7]and GII.17[P17]in outpatient cases were significantly higher than that in hospitalized cases.ConclusionsCurrently,the prevention and control of infectious diarrhea should f

关 键 词：感染性腹泻 病原谱 监测 流行病学 

分 类 号：S85[农业科学—兽医学]