上海市综合性医院腹泻患者隐孢子虫感染状况调查

Investigation on Cryptosporidium infections in diarrhea patients from the general hospitals in Shanghai

目的了解上海市综合性医院腹泻患者隐孢子虫感染情况,为防控隐孢子虫病提供科学依据。方法选择上海市3所综合性医院肠道门诊,2013—2015年期间采集门诊腹泻患者新鲜粪便,采用病原学的改良抗酸染色法和检测粪抗原的免疫层析试剂条法进行检测,以了解腹泻患者隐孢子虫感染状况,并对感染特征进行分析。结果检测腹泻患者粪便样本2 817份,检出隐孢子虫病原学阳性37份,总阳性率为1.31%。3所医院腹泻患者病原学阳性率间差异无统计学意义(P>0.05),隐孢子虫阳性者性别、年龄和文化程度分布差异均无统计学意义(P均>0.05),职业以外来务工人员阳性率较高。6—9月为发病高峰,夏季明显高于冬季(P<0.05)。各类性状粪便隐孢子虫阳性率差异无统计学意义(P>0.05)。有腹痛、恶心、呕吐、发热和不洁食物史者分别为67.57%、21.62%、18.92%、16.22%、51.35%。试剂条法检测隐孢子虫粪抗原阳性率为2.59%。结论春末和夏秋季是隐孢子虫感染高发季节,应加强监测。联合应用多种检测方法能提高隐孢子虫检出率。

Objective To understand the status of Cryptosporidium infections in diarrhea patients from the general hospitals of Shanghai, we will provide the evidence for the prevention measures. Methods The gastroenterology clinics from three general hospitals in Shanghai were selected, and the fresh feacal specimens of diarrhea patients were collected from 2013 to 2015, and examined by parasitological detection approach by modified acid-fast staining method and feacal antigen-based detection approach by dipstick of immunochromatography, in order to understand the status of Cryptosporidium infections in diarrhea patients, and analyze the infection features. Results Among 2 817 fecal samples detected, 37 positive samples were detected parasitologically with 1.31% of general positive rate. There were no any statistically significant difference in positive rates among three hospitals（P〉0.05）, nor in sex, age, occupation and literature levels（P〉0.05）, while the infection rate of migrated population from other regions was higher. It was found the peak of incidence occurred from June to September, and the positive rate was higher in summer than that in winter（P〈0.05）. There was no any statistically difference in Cryptosporidium positive rates among various feacal specimens with different patterns（P〉0.05）. About 67.57%, 21.62%, 18.92%, 16.22%,51.35% of patents complained with abdominal pain, nausea, vomiting, fever, and the history to eat un- healthy food,respectively. While about 2.59% of specimens were positive in feacal antigen detection by dipstick approach. Conclusion The highly peak for the Cryptosporidium infections occurred in the season of summer and autumn which need to strength the surveillance. The detection rate to identify Cryptosporidium parasites can be was improved when integration of multi-detection methods in detection of Cryptosporidium.