上海市浦东新区5岁以下儿童腹泻病病原谱监测分析

Surveillance and analysis on diarrheal disease pathogen spectrum among children under 5 years old in Pudong New Area of Shanghai City

[目的]了解上海市浦东新区5岁以下儿童腹泻病的病原谱构成、病原特征,为制定预防控制措施提供依据。[方法]对2012年2月—2013年1月浦东新区人民医院、儿童医学中心2家监测点医院的619例腹泻患儿进行个案调查,同时采集粪便标本进行肠道致病菌和病毒的检测。[结果]诺如病毒、轮状病毒、肠道腺病毒、扎如病毒、星状病毒的检出率分别为11.95%、7.27%、2.91%、1.45%、0.97%;致泻性大肠埃希菌、非伤寒沙门菌、弯曲菌、嗜水气单胞菌、志贺菌、小肠结肠炎耶尔森菌的检出率分别为5.65%、2.42%、0.81%、0.65%、0.48%、0.32%。病毒检出率8月至次年的3月为27.70%,高于其他月份的18.48%(χ2=7.18,P<0.05);细菌检出率4—10月为15.34%,远高于其他月份的3.15%(χ2=31.22,P<0.05)。[结论]诺如病毒为浦东新区5岁以下儿童病毒性腹泻的最主要病原,致泻性大肠埃希菌为细菌性腹泻的最主要病原。细菌性腹泻的防控应以夏秋季为重点,病毒性腹泻应以全年为重点。

[Objective] To investigate the pathogen spectrum and characteristics of diarrheal disea-ses among children under five and to provide the basis for prevention and control measures . [ Methods] From February 2012 to January 2013, a total of 619 cases from 2 sentinel hospitals were collected for case survey .From them were collected stool specimens for detection of enteric pathogenic bacteria and virus nu-cleic acids. [Results] The virus detection rate was norovirus （11.95%）, rotavirus（7.27%）, enteric adenovirus（2.91%）, saporovirus（1.45%） and astrovirus（0.97%）.The bacteria detection rate was E. coli（5.65%）, nontyphoidal salmonella （2.42%）, campylobacter （0.81%）, aeromonas hydrophila （0.65%）,shigella（0.48%） and yersinia enterocolitica （0.32%）.The virus detection rate was 27.70%from August to next March, which showed higher than that of other months （18.48%） （χ2 =7.18,P 〈0.05）.The bacteria detection rate was 15.34%from April to October, showing higher than the rate of oth-er months（3.15%）（χ2 =31.22,P〈0.05）. [Conclusion] Norovirus is the main pathogen for viral diarrheal diseases in children under five and E .coli is the main pathogen of bacterial diarrheal diseases . All study results suggested that summer and autumn should be as the focus time in prevention and control of bacterial diarrhea , while those of viral diarrhea should cover the whole year .