2016-2018年上海市奉贤区腹泻病流行特征

Epidemiological characteristics of diarrhea in Fengxian district of Shanghai from 2016 to 2018

目的了解2016-2018年上海市奉贤区腹泻病的流行特征、病原谱及不同致病菌的耐药情况。方法选择上海市成人腹泻病综合监测哨点医院奉贤区平安社区卫生服务中心,根据其肠道门诊就诊量,按照1∶5的抽样间隔机械抽取就诊的初诊腹泻病例进行采样并开展病原学检测、临床特征及流行病学调查。结果共监测腹泻病例927例,病原总检出率为51.21%,其中细菌、病毒检出率分别为33.82%、26.57%。轮状病毒A组阳性率50岁以上年龄组显著高于小年龄组,差异有统计学意义(P<0.05)。夏季以细菌为优势病原菌,冬季以病毒为优势病原菌。非伤寒沙门氏菌对头孢噻肟、四环素和复方新诺明耐药性较高;副溶血性弧菌对头孢呋辛耐药性较高;肠聚集性大肠杆菌(EAggEC)和产肠毒素型大肠杆菌(ETEC)对头孢噻肟耐药性较高。结论2016-2018年奉贤区腹泻病病原检出率较高,细菌性腹泻及病毒性腹泻呈现一定的季节性变化。不同菌株对几种头孢类抗生素、四环素及复方新诺明存在较高耐药性,需要引起重视,临床上要合理使用抗生素。

Objective To investigate the epidemiological characteristics and pathogenic spectrum of infectious diarrhea cases in Fengxian district of Shanghai from 2016 to 2018,and analyze the drug resistance of different enteropathogenic bacteria.Methods Shanghai Ping’an District Pingan Community Health Service Center for Adult Diarrhea Surgery Sentinel Hospital was selected for the study.According to the amount of intestine outpatient visits,the newly diagnosed diarrhea cases were taken at a sampling interval of 1:5 for sampling and carry out pathogenic detection,clinical characteristics and epidemiological investigation.Results A total of 927 adults with diarrhen were surveyed;the overall pathogen detection rate was 51.21%;the positive rate for bacterium was 33.82%and for virus was 26.57%.The infection rate of rotavirus group A was highest in people who was over 50 years old(P<0.05).The predominant pathogen was bacterium and virus in winter.Non-typhoid Salmonella was more resistant to cefotaxime,tetracycline and trimethoprim.Vibrio parahaemolyticus was more resistant to cefuroxime.Enteroaggregative Escherichia coli(EAggEC)and enterotoxigenic Escherichia coli(ETEC)were more resistant to cefotaxime.Conclusion The detection rate of diarrhea in Fengxian district was high from 2016 to 2018.Bacterial diarrhea and viral diarrhea showed some seasonal changes.The drug resistance of some enteropathogenic bacteria to cephalosporin,cotrimoxazole and tetracycline was very high.This phenomenon needed to be taken seriously.Antibiotics should be used reasonably in the clinic.