儿童感染性腹泻病原学研究

Etiology of infectious diarrhea in children

目的研究儿童感染性腹泻病原学组成与流行病学特征.方法按<临床检验操作规程>定点逐月检测0～6岁腹泻患儿大便标本中轮状病毒、痢疾杆菌、致病性大肠埃希菌(EPEC)与沙门菌,并分析病历.结果全年共检测693份标本,检出病原326份,检出率为47.0%;轮状病毒、EPEC、痢疾杆菌及沙门菌的检出率依次为30.2%,8.4%、7.2%与1.3%;轮状病毒与细菌性病原构成比为64.1:35.9;轮状病毒以秋冬季(10、11月与次年1、2月)、水样便标本、2岁以内年龄组以及人工和混合喂养婴儿检出率较高;细菌性病原以夏秋季(6～10月)与脓血便检出率较高;痢疾菌群中以福氏菌占优势(70%),次为宋内杆菌(28.0%);EPEC菌型复杂,共检出11个'O'群;检出的沙门菌有4种,即阿哥纳、德尔串、鼠伤寒与肠炎血清型.结论开展儿童感染性腹泻病原学研究能即时发现病原,并为制定防治对策提供依据.

Objective To study the pathogen and epidemiological characteristics of infectious diarrhea in children. Methods The fecal specimens taken from diarrheal infants aged O to 6 years were examined according to “Operating rules of Clinical identification”. Results Pathogenic organisms were-detected in 326 from the total 693 of fecal specimens with a positive rate 47. 0%. The detection rate of rotavirus ,pathogenic Escherichia coil（EPEC）, Shigella dysenteriae and Salmonella was 30. 2%, 8. 4%, 7. 2% and 1. 3% respectively. The ratio of rotavirus to other bacterial pathogens was 64.1 ： 35.9. The rotavirus infection was found more often in egg-like specimens,autumn and winter（January,February,October and November） ,diarrheal infants within 2 years old and infants fed by food or food together with mother milk. Bacterial pathogens were dominant in purulence specimens and in summer and autumn （from June to October）. In the genus of Shigella dysenteriae,S. Flexneri predominated （70%） and S. sonnei next （28. 0%）. The type of EPEC was complex and 11 of “O” types were detected. The four serotypes in Salmonella were S. derby,S, agona,S, typhimurium and S. entertidis. Conclusion The research on etiology of infectious diarrhea in childreu could find pathogen in time and facillitate the process of its protection and treatment.