银川地区儿童急性腹泻病原学及相关影响因素

Acute diarrhea in children in Yinchuan:Etiology and related factors

目的:研究儿童急性腹泻病病原学分布特点及病因相关因素分析,为临床合理治疗提供依据.方法:采集2012-04/2013-04就诊的腹泻患儿的新鲜粪便进行细菌培养,同时采用RTPCR技术进行轮状病毒、诺如病毒、扎如病毒、星状病毒及肠道腺病毒检测.同期针对患儿发病相关因素进行问卷调查及分析.结果:286份粪便样本中共检测细菌和病毒208例,检出率72.73%;病毒阳性172例,阳性率60.14%,其中轮状病毒84例(29.34%)、诺如病毒62例(21.77%),扎如病毒14例(4.90%)、星状病毒27例(9.44%),肠道腺病毒21例(7.34%).细菌培养致病菌36例,检出率为12.58%,分别为沙门氏菌、志贺氏菌、金黄色葡萄球菌、致病性大肠埃希菌及白色念珠菌.未检出细菌和病毒78例(27.28%).急性腹泻病与多种因素(年龄、季节、喂养方式、发病诱因及母亲文化程度)具有相关性.结论:银川地区儿童急性腹泻病以病毒感染为主,轮状病毒、诺如病毒为主要致病菌,目前存在不合理使用抗生素情况.各型腹泻病发病与不同因素有相关性.

AIM：To investigate the etiology and related factors for acute diarrhea in children,in order to provide a reasonable basis for clinical treatment of this disease.METHODS：Fresh fecal samples were collected from children with acute diarrhea who visited from April 2012 to April 2013.Bacterial culture of these samples were performed,and RT-PCR was used for detection of rotavirus,norovirus,sappovirus,astrovirus and intestinal adenovirus.A questionnaire survey was also performed to analyze the related factors for acute diarrhea in children.RESULTS：Of 286 stool samples detected,bacteria or viruses were detected in 208（72.73%）.There were 172（60.14%） viruspositive samples,of which 84（29.34%） were positive for rotavirus,62（21.77%） positive for norovirus,14（4.90%） for sappovirus,27（9.44%）for astrovirus,and 21（7.34%） for intestinal adenovirus.Bacterial pathogens were detected in 36（12.58%） samples,including Salmonella,Shigella,Staphylococcus aureus,Escherichia coli and Candida albicans.Both bacteria and viruses were not detected in 78（27.28%） cases.Acute diarrheal disease was related to a variety of factors including age,season,feeding pattern,predisposing factors and mother education.CONCLUSION：Acute diarrhoea in children is mainly caused by viral infections,with rotavirus and norovirus as the main pathogens.