2014年上海市宝山区腹泻病监测结果分析

Surveillance results of diarrhea in Baoshan District,Shanghai City,2014

目的了解上海市宝山区腹泻病流行特征和病原谱分布,为制定防控措施提供科学依据。方法 2014年上海市宝山区2家在监测点肠道门诊对腹泻病病例进行监测,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。对检测阳性的细菌菌株进行抗生素耐药实验。结果 2014年两家监测点医院共监测到腹泻病2 486例,腹泻病发病呈明显季节性。380例病例的粪便标本开展病原学检测,179例病例标本病原检出阳性,检出率为47.11%;检出细菌5种、病毒4种;细菌检出率为14.74%(56/380),主要为致泻性大肠杆菌(32例,占57.14%)、沙门菌(10例,占17.86%)和副溶血型弧菌(10例,占17.86%);病毒检出率为37.11%(141/380),主要为诺如病毒(98例,占69.50%)、轮状病毒(20例,占14.18%)。夏季以细菌感染为主,冬春季以病毒感染为主。4种细菌对抗生素都有不同程度耐药。结论2014年上海市宝山区腹泻病病原谱较为广泛,季节高峰较为明显,应该在不同季节根据不同病原流行情况开展针对性防控措施。

Objective To investigate the epidemic features and pathogen spectrum distribution of diarrhea cases in Baoshan District, Shanghai City so as to provide scientific evidence for developing prevention and control measures. Methods Surveil- lance on diarrhea was conducted in intestinal outpatient departments of 2 sentinel hospitals in Baoshan District, Shanghai City in 2014. Diarrhea cases were selected according to a certain sampling interval, and stool samples were collected for bacteriological and virological detections. Strains of pathogenic bacteria detected in stool culture were subject to antibiotic resistance test. Re- sults A total of 2,486 cases of diarrhea were detected in 2 sentinel hospitals in 2014. The prevalence of diarrhea showed notable seasonal variation. Among 380 stool samples detected, 179 （47.11% ） were pathogen positive. The detection rates of bacteria and viruses were 14.74 % （56/380）and 37.11% （141/380）respectively. Five kinds of bacteria including Escherichia coli（ n = 32, 57.14% ）, Salmonella （n = 10, 17.86% ） and Vibrio parahaemolyticus （n = 10, 17.86% ） and four kinds of viruses, mainly norovims （n= 98, 69.50% ） and rotavirus （n = 20, 14.18% ）, were detected. In summer, most of the cases were in- fected with bacteria, but in winter and spring with viruses. The four kinds of bacteria had varying degrees of resistance to common antibiotics. Conclusions The pathogen spectrum of infectious diarrhea is wide and the related seasonality is obvious in Baoshan District, Shanghai City in 2014. It is necessary to take specific prevention and control measures based on different sea- sons and various pathogens.