2012年5—12月上海市感染性腹泻细菌和病毒病原学监测结果分析

Bacteriological and virological surveillance for infectious diarrhea in Shanghai,May-December,2012

目的了解2012年5—12月上海市感染性腹泻的病原谱和流行病学特征。方法随机抽取6所不同级别医院,对在其肠道门诊就诊的感染性腹泻病例按一定的抽样间隔进行调查,并采集粪便标本,进行细菌培养和病毒检测。结果从1001例病例粪便标本中检出阳性465例,检出率为46.45%。检出细菌7种、病毒5种。细菌检出率为12.09%,主要为副溶血性弧菌(61例)、沙门菌(35例)。病毒检出率为32.07%,主要为诺如病毒(262例)、轮状病毒(40例)。阳性例数呈较明显的夏季高峰和秋冬季高峰。465例阳性病例的平均年龄为(44.20±17.56)岁,病原阳性组和阴性组的年龄构成差异无统计学意义(P>0.05)。细菌阳性组中有腹痛和发热症状的构成比均高于病毒阳性组,有呕吐和恶心症状的构成比均低于病毒阳性组;细菌阳性组发病前5天有聚餐史和外出史的构成比均高于病毒阳性组,二组有宠物接触史的比例均高于阴性组,上述差异均有统计学意义(P<0.05)。结论上海地区腹泻病原谱较为广泛,季节高峰较为明显,应针对各病原检出率的差异在不同季节开展相应的防控措施。

Objective To understand the pathogen spectrum and epidemiological characteristics of infectious diarrhea in Shanghai from M ay to December,2012. Methods A regular sampling survey w as conducted among the infectious diarrhea cases seeking medical care in 6 hospitals at different levels randomly selected in Shanghai,and stool samples w ere collected from these cases for bacteriological and virological detections. Results Among 1001 stool samples detected,465 w ere pathogen positive（ 46. 45%）. Seven kinds of bacteria,including Vibrio parahemolyticus（ 61 cases）and Salmonella（ 35 cases）,and 5 kinds of viruses,including norovirus（ 262 cases） and rotavirus（ 40 cases）,w ere detected. The bacterium positive rate w as 12. 09% and the virus positive rate w as 32. 07%. The positive detection rate w as obviously higher in summer than that in autumn and w inter. The average age of 465 positive cases w ere 44. 20 ±17. 56 years. The difference in age distribution betw een positive cases and negative cases w as not statistically significant（ P〉0. 05）. More cases had abdominal pain and fever in bacteria positive group than in virus positive group,but less cases had nausea and vomiting in bacteria positive group than in virus positive group. M ore cases had dining together or travel history 5 days before onset in bacteria positive group than in virus positive group,and more cases had pet exposure in bacteria or virus positive group than in bacteria or virus negative group. All the differences w ere all statistically significant（ P〈0. 05）. Conclusion The pathogen spectrum of infectious diarrhea w as w ide and related seasonality w as obvious in Shanghai. It is necessary to take pathogen and season specific prevention and control measures.