2015年~2019年顺义区感染性腹泻监测病例细菌性病原谱监测结果分析

Analysis of the Surveillance Results of Bacterial Pathogen Spectrum of Infectious Diarrhea Surveillance Cases in Shunyi District from 2015 to 2019

目的了解北京市顺义区2015年~2019年感染性腹泻病原菌谱构成、流行特征,为本地区感染性腹泻的防控提供依据。方法选取2015年~2019年北京市顺义区3家哨点医院以呕吐或腹泻等消化道症状为主诉就诊的肠道门诊病例为研究对象,采集粪便标本,开展志贺菌、沙门菌、致泻性大肠埃希菌、副溶血弧菌和霍乱弧菌、弯曲菌等病原菌检测,分析其时间、年龄分布以及采样时间和患者临床表现等对标本阳性检出率的影响。结果2015年~2019年共检测样本1856份,总阳性率为28.83%,其中双重、多重感染阳性率为2.10%;2016年~2018年感染性腹泻病原菌谱中副溶血性弧菌所占比例最大,分别为9.16%、9.49%、9.78%;2015年和2019年致泻性大肠埃希菌所占比例最大,为6.82%和12.71%;肠道致病菌的人群分布主要集中在11~50岁,其中41~50岁年龄段阳性率最高(35.68%);病原菌的检出具有季节性,6~10月份检出率较高,8月份达到高峰;采样时间早的标本阳性检出率较高(χ^(2)=6.476,P<0.05);不同性别、临床表现的患者标本阳性检出率比较,差异无统计学意义(P>0.05)。结论2015年~2019年北京市顺义区细菌性腹泻病原菌谱构成存在一定差异,季节性特征明显,检出阳性率影响因素复杂。持续开展感染性腹泻监测病例细菌性病原谱监测工作对感染性腹泻防控具有重要意义。

Objective To understand the composition and epidemiological characteristics of infectious diarrhea pathogens in Shunyi District,Beijing from 2015 to 2019,and provide a basis for the prevention and control of infectious diarrhea in this area.Methods From 2015 to 2019,three sentinel hospitals in Shunyi District,Beijing,were selected as the research objects of intestinal outpatients with gastrointestinal symptoms such as vomiting or diarrhea as the main complaint.Stool specimens were collected and tested for pathogenic bacteria such as Shigella,Salmonella,diarrheal Escherichia coli,Vibrio parahaemolyticus,Vibrio cholerae,Campylobacter,etc.The influence of its time,age distribution,sampling time and patient clinical manifestations on the positive detection rate of specimens was analyzed.Results From 2015 to 2019,a total of 1856 samples were tested,with a total positive rate of 28.83%,of which the positive rate for double and multiple infections was 2.10%;From 2016 to 2018,Vibrio parahaemolyticus accounted for the largest proportion in the spectrum of infectious diarrhea pathogens,9.16%,9.49%,and 9.78%respectively;in 2015 and 2019,the proportion of diarrheal Escherichia coli was the largest,which was 6.82%and 12.71%;The population distribution of intestinal pathogens was mainly concentrated in the 11-50 years old,and the positive rate of 41-50 years old was the highest(35.68%);The detection of pathogenic bacteria was seasonal,the detection rate was higher from June to October,and reached the peak in August;the positive detection rate of specimens with early sampling time was higher(χ^(2)=6.476,P<0.05);There was no statistically significant difference in the positive detection rate of patients with different genders and clinical manifestations(P>0.05).Conclusion From 2015 to 2019,there are certain differences in the composition of the pathogenic bacteria spectrum of bacterial diarrhea in Shunyi District,Beijing,with obvious seasonal characteristics and complex factors affecting the positive rate of detection.Continuous monitoring of the bacterial pathogen spectrum of infectious diarrhea cases is of great significance to the prevention and control of infectious diarrhea.