成都地区婴幼儿腹泻病原微生物感染及控制对策

Pathogenic microorganism infection and preventive measure of infant and preschool children with diarrhea in Chengdu

目的了解成都地区婴幼儿腹泻病原微生物的感染特点,探讨预防感染的控制措施。方法随机收集2004年4月～2005年3月0～6岁门诊腹泻患儿粪便标本,进行常规细菌培养,筛检致病菌,同时采用免疫胶体金方法进行轮状病毒、腺病毒的检测。结果在收集的207份腹泻患儿的粪便标本中,病毒检测阳性85例(41.1%),其中轮状病毒阳性76例(36.7%),腺病毒阳性6例(2.9%),轮状病毒和腺病毒同时阳性3例(1.4%);检出致病菌24例(11.6%),主要以沙门菌为主(6.3%)、其次为志贺菌(2.9%)、致病性大肠埃希菌(1.4%),未发现病毒和细菌同时感染。结论成都地区轮状病毒感染是导致婴幼儿腹泻的主要原因,同时,细菌感染引起的腹泻也占了一定比例。因此,对出现在夏秋季及有不洁饮食的婴幼儿腹泻应注意细菌学监测,对出现在秋冬季婴幼儿腹泻应加强轮状病毒感染的检测,便于及时发现和及早治疗感染。同时,研制一种安全有效的疫苗将对预防和控制婴幼儿腹泻的发生起重要作用。

Objective To investigate the characteristics of pathogenic microorganism infection in infant and preschool children with diarrhea in Chengdu for finding the preventive measures. Methods Stool samples collected randomly from outpatients with diarrhea under 6 years old, from April 2004 to March 2005, were cultured and identified for pathogenic bacteria, and rotavirus and adenovirus antigens were detected by VIKIA Rota-Adeno. Results Among 207 samples, the viruses were detected in 85 samples, the positive rate of rotavirus and adenovirus infection were 36.7%（76/207） and 2.9%（6/207）, respectively. Both adenovirus and rotavirus were detected positive in three samples, and the positive rate was 1.4% （3/207）. Pathogenic bacteria were detected in 24 samples, including Salmonella, Shigella and pathogenic E.coli, the positive rate were 6.3%（13/207）, 2.9%（6/207）, 1.4%（3/207）, respectively. Conclusions Rotavirus infection is a major factor leading to infant and preschool children with diarrhea in Chengdu while diarrhea caused by pathogenic bacteria were found in some cases. To diagnose and treat early, we should emphasize pathogenic bacteria survey for infant and preschool children who haven＇t a right food sanitation in autumn-summer, and rotavirus detection for the diseased children in winter-autumn,and it is important to make a safe and effective vaccine to prevent and control the occurrence of diarrhea in infant and preschool children.