大连市560例急性结膜炎患者病原学及流行病学特征分析

Analysis on etiological and epidemiological characteristics of 560 acute conjunctivitis patients in Dalian

目的了解大连市急性结膜炎病原谱构成、临床及流行病学特征。方法2017年7月至2019年6月,在大连市3家医院眼科采集急性结膜炎患者眼拭子标本各2份,1份采用real-time PCR方法进行病毒核酸检测,另1份进行标准细菌培养、鉴定。结果560份急性结膜炎患者眼拭子样本中,265份检测到致病病原,总阳性率为47.32%。其中219份为腺病毒阳性,包括腺病毒3型52份、8型109份、19/37型47份、3和8型双阳性1份及未分型10份。其余46份标本为细菌感染,其中表皮葡萄球菌检出最多(11例),其次是金黄色葡萄球菌(9例)及沙门菌属(6例)。未检测到肠道病毒通用型。不同性别和年龄组腺病毒阳性率差异有统计学意义,男性多于女性,15~44岁年龄组阳性率最高。结论2017—2019年大连市引起结膜炎的主要病原为腺病毒,其中腺病毒8型最多,其次是3型和19/37型,应在日后的监测中引起重视。

Objective To understand the pathogenic spectrum as well as the clinical and epidemiological characteristics of acute conjunctivitis in Dalian.Methods From July 2017 to June 2019,two conjunctival swabs were collected from each patient with acute conjunctivitis in outpatients of three hospitals in Dalian.One swab sample was used for nucleic acid detection of adenovirus and intestinal virus by real-time PCR methods.The other swab sample was used for standard bacterial culture and identification.Results A total of 560 samples from acute conjunctivitis patients were collected.Pathogenic agents were detected in 265 samples,with an overall positive rate of 47.32%.For the positive samples,219 were positive for adenovirus,including 52 for adenovirus type 3,109 for type 8,47 for type 19/37,1 for type 3 and 8 at the same time,and 10 for ungenotyped.The remaining 46 samples were positive for bacteria.Staphylococcus epidermidis was the most detected(11 cases),followed by Staphylococcus aureus(9 cases)and Salmonella(6 cases).Enterovirus was not detected.The differences in the positive rates of adenovirus by genders and age groups were statistically significant.There were more male patients than females,and the positive rate was the highest in the 15-44 years old group.Conclusions The main pathogen of acute conjunctivitis was adenovirus from 2017 to 2019 in Dalian.Adenovirus type 8 was the most common type,followed by adenovirus type 3 and type 19/37.Surveillance should focus on such viruses in the future.