2015-2019年北京市海淀区感染性腹泻病原菌监测结果

Pathogenic surveillance results of infectious diarrhea in Haidian District of Beijing from 2015-2019

目的分析2015—2019年北京市海淀区感染性腹泻监测病例粪便中肠道致病菌分布及流行特征。方法采集2015—2019年北京市海淀区肠道门诊腹泻监测病例的粪便标本,检测5种致泻性大肠埃希菌、沙门菌、副溶血弧菌和志贺菌等常见肠道致病菌。采用χ2检验比较不同时间、年龄组和性别间的肠道致病菌检出率。结果 2015—2019年共采集2 104份粪便标本,肠道致病菌检出率为19.30%。致病菌检出每年集中在夏季6—8月;2015—2019年致病菌检出率分别为8.61%(57/662)、19.55%(69/353)、23.27%(84/361)、25.07%(96/383)和28.99%(100/345),呈逐年上升趋势,差异有统计学意义(χ^(2)=73.673,P<0.01)。黏液脓血便(5.28%)、脱水(2.28%)是常见肠道致病菌感染的重要临床特征。检出的肠道致病菌主要为致泻性大肠埃希菌(53.20%)、沙门菌(21.18%)和副溶血弧菌(17.00%)。致泻性大肠埃希菌以肠聚集性大肠埃希菌(44.44%)和肠产毒性大肠埃希菌(41.67%)为主,沙门菌以肠炎沙门菌(50.00%)最为常见,副溶血弧菌血清型分布以O3:K6型(68.12%)为优势血清型。结论 2015—2019年北京市海淀区腹泻监测病例中检出的肠道致病菌主要为致泻性大肠埃希菌,其次是沙门菌和副溶血弧菌。致病菌检出具有明显的夏季特征和临床特点,青年干部职员和中学及大学学生是防控重点人群。要持续加强肠道传染病病原菌监测工作,有针对性的开展肠道传染病防控工作。

Objective To analyze the distribution and epidemiological characteristics of the intestinal pathogenic bacteria in the feces of infectious diarrhea surveillance cases in Haidian District of Beijing from 2015-2019. Methods From 2015-2019,stool samples were collected from intestinal out-patient diarrhea surveillance cases in Haidian District of Beijing for the detection of five intestinal pathogenic bacteria,including five kinds of Diarrheagenic Escherichia coli(DEC),Salmonella,Vibrio parahaemolyticus and Shigella. χ2 test was used to compare the detection rates of intestinal pathogens in diarrhea cases with different time,gender and age. Results From 2015-2019,a total of 2104 stool samples were collected,and the detection rate of intestinal pathogenic bacteria was 19.30%. The pathogenic bacteria detection peaked in the summer from June to August every year. From 2015-2019,the detection rate of pathogenic bacteria was respectively 8.61%(57/662),19.55%(69/353),23.27%(84/361),25.07%(96/383)and 28.99%(100/345),showing an increasing trend year by year,and the difference was statistically significant (χ^(2)=73.673,P<0.01).Mucous pus and blood stool(5.28%) and dehydration(2.28%) were the important clinical features of common intestinal pathogenic bacteria infection. The main intestinal pathogens detected were DEC(53.20%),Salmonella(21.18%)and Vibrio parahaemolyticus(17.00%). The DEC was mainly Enteroaggregative E. coli(EAEC)(44.44%),and Enterotoxigenic E.coli(ETEC)(41.67%).Salmonella Enteritis( 50. 00 %) was the most common Salmonella. The predominant serotype of Vibrio parahaemolyticus was O3:K6(68.12%). Conclusion From 2015-2019,the main intestinal pathogenic bacteria in diarrhea surveillance cases in Haidian District of Beijing is DEC,followed by Salmonella and Vibrio parahaemolyticus. The pathogenic bacteria show obvious summer features and clinical characteristics. Young cadres and employees,and students of middle schools and universities are key groups for prevention and control. It is necessary to continue to strengthen the intestinal bacteria surveillance and conduct targeted prevention and control of intestinal infectious diseases.