天津地区腹泻患儿病原体感染情况和流行病学特征分析

Analysis of epidemiological characteristics and pathogen infection in children with diarrhea in Tianjin

目的了解天津地区腹泻患儿病原体的感染情况和流行病学特征。方法收集2017年8月至2018年7月天津市儿童医院1466例腹泻患儿粪便标本,对所有标本进行5种肠道相关病原体(诺如病毒、轮状病毒、艰难梭菌毒素、腺病毒和星状病毒)检测。结果所检1466份标本中,627份标本肠道病原体核酸检测为阳性,阳性率为42.8%。其中,诺如病毒检出率最高,为26.3%,其次依次为轮状病毒(15.3%)、艰难梭菌毒素(4.6%)、腺病毒(4.1%)和星状病毒(1.84%),感染存在明显季节性。不同性别之间患儿5种病原体阳性检出率相似,不同年龄之间只有诺如病毒和轮状病毒的阳性检出率有统计学意义(P<0.05)。混合感染共110例,以诺如病毒和轮状病毒混合感染最为常见,共37例。结论天津地区婴幼儿感染性腹泻病原谱复杂多样,主要病原体为诺如病毒和轮状病毒。

Objective To understand the pathogen infection and epidemiological characteristics of children with diarrhea in Tianjin.Methods Stool samples from 1466 children with diarrhea in Tianjin Children's Hospital from August 2017 to July 2018 were collected,and all samples were tested for five intestinal-related pathogens(norovirus,rotavirus,Clostridium difficile toxin,adenovirus,and astrovirus).Results Among the 1466 samples,627 samples were positive for nucleic acid detection of intestinal pathogens,with a positive rate of 42.8%.The detection rate of norovirus was the highest(26.3%),followed by rotavirus(15.3%),Clostridium difficile toxin(4.6%),adenovirus(4.1%),and astrovirus(1.84%).The infection has obvious seasonality.The positive detection rates of the five pathogens were similar among children of different sexes,and only the positive detection rates of norovirus and rotavirus were statistically significant among different ages(P<0.05).There were 110 cases of mixed infection,and the mixed infection of norovirus and rotavirus was the most common,with a total of 37 cases.Conclusions The pathogen spectrum of infant infectious diarrhea in Tianjin is complex and diverse,and the main pathogens are norovirus and rotavirus.