上海市黄浦区沙门氏菌感染特征及主要血清型分析

Analysis on epidemiologic characteristics of Salmonella infection and serotype distribution in Huangpu District,Shanghai

目的了解上海市黄浦区沙门氏菌感染病例的流行病学特征,菌型分布和发病的潜在危险因素。方法对3家区监测点医院开展腹泻病人监测,对符合沙门氏菌监测对象定义的病例留便进行血清型检测,并每月采集食品样本开展沙门氏菌血清分型检测。结果 2008-2011年黄浦区腹泻病例中沙门菌检出率平均为3.30%(287/8 695),略高于上海市平均水平(3.13%)。检出病例以男性为主,主要检出时间为5～10月,血清分型以肠炎(32.06%)和鼠伤寒(14.98%)为优势菌种。食品监测提示动物肉类在夏季每月均有沙门菌检出,其中7月最高(22.50%),8月次之(18.75%),血清分型以伦敦、猪霍乱和德比沙门菌为主。单因素分析结果显示,饮用生水、一周内可疑饮食史、前一周聚餐史为主要危险因素;多因素Logistic回归结果显示,一周内可疑饮食史为主要危险因素(P<0.001),65.02%的患者发病前一周有不洁饮食史。结论黄浦区腹泻病人中的沙门菌平均检出率高于上海市平均水平,因此应加强预防控制,做好食品监测并加强食品卫生管理和安全管理的宣传教育。

Objective To understand and analyze the epidemiologic and etiologic characteristics of Salmonella infection of Shanghai Huangpu District, and to investigate the risk factors. Methods 3 sentinel hospitals were assigned to collect epidemiological data and stool samples of diarrhea patients. The different samples of common food were also collected for laboratory testing. Case-control study was conducted to find out risk factors of Salmonella infection. Results The average Salmonella detection rate for diarrhea patients was 3.30% （287/8 695） in Huangpu District in 2008-2011, which was higher than that in Shanghai （3.13%）. Of 287 Salmonella cases, the sex ratio was 1.52 ： 1 and most of them were found between May to October annually. Salmonella enteritis （32.06%） and Salmonella typhimurium （ 14.98% ） were the dominant serotypes. Salmonella was detected in animal meat in summer, with the highest rate （22.50%） in July followed by in August （18.75%）. The major serotypes were London, Choleraesuis and Derby. Multivariate analysis indicated that suspicious dietary history within a week was the main risk factor （P〈0.001）. Conclusions The average Salmonella detection rate for diarrhea patients in Huangpu District was higher than that in Shanghai. Food safety and health education should be strengthened for control and prevention of Salmonella infection.