上海青浦区2015-2019年成人腹泻病监测分析

Analysis of Adult Diarrheal Disease Surveillance in Qingpu District of Shanghai from 2015 to 2019

目的了解上海市青浦区2015—2019年成人腹泻病监测的病原谱和流行病学特征,为腹泻病防控提供科学依据。方法以2015—2019年在复旦大学附属中山医院青浦分院肠道门诊就诊的成人腹泻病例为监测对象,以1:8的抽样间隔采集粪便标本,按照监测方案要求进行相关的细菌分离培养和病毒检测并进行分析。结果青浦区2015—2019年5年间就诊的成人腹泻病例数逐年增加。就诊病例高峰在夏季(6—8月)。从1832例病例中检出929例病原体阳性,检出率为50.71%。在929例阳性标本中共包含1069株菌毒株。单一细菌感染的为512例,检出率为27.95%,主要包括副溶血性弧菌215例、致泻性大肠埃希菌184例、沙门氏菌80例。单一病毒感染的为282例,检出率为15.39%,主要包括诺如病毒GⅡ型158例和轮状病毒A组42例。细菌在夏季(6—8月)检出率最高;病毒在冬季(12—2月)检出率最高。结论青浦区腹泻病病原体检出情况呈现明显的季节性分布,副溶血性弧菌、致泻性大肠埃希菌、诺如病毒GII型是本区的优势病原体。针对病原谱分布和流病特征可对居民开展有针对性的健康教育策略,并采取相应的干预措施,降低传染病发病风险。

Objective To understand the pathogen spectrum and epidemiological characteristics of adult diarrheal disease surveillance in Qingpu District from 2015 to 2019,and to provide the scientific basis for the prevention and control of diarrheal diseases in the jurisdiction.Methods From 2015 to 2019,adults with diarrhea who visited the intestinal outpatient department of Zhongshan Hospital Affiliated to Fudan University in Qingpu District,Qingpu Branch were selected as monitoring objects.Fecal samples were collected at a sampling interval of 1:8,and relevant bacterial isolation and culture,virus detection and analysis were conducted.Results The number of adult diarrhea cases in the 5 years from 2015 to 2019 increased year by year.The peak of medical cases is in summer(June August).A total of 929 pathogen positive cases were detected from 1832 cases,and the detection rate was 50.71%.A total of 1069 bacterial strains were contained in 929 positive specimens.A total of 512 cases were single bacterial infection with the detection rate of 27.95%,and conclude mainly 215 cases of Vibrio parahaemolyticus,184 cases of diarrhea-causing Escherichia coli,and 80 cases of Salmonella.A total of 282 cases were single virus infection with the detection rate of 15.39%,conclude mainly 158 cases of Norovirus GⅡand 42 cases of rotavirus A group.The detection rate of bacteria was the highest in summer(June-August),and the detection rate of virus was the highest in winter(December-February).Conclusion The detection of diarrheal disease pathogens in Qingpu District showed an obvious seasonal distribution.Vibrio parahaemolyticus,diarrhea-causing Escherichia coli,and Norovirus GII were the dominant pathogens in Qingpu District.Targeted health education strategies can be carried out for residents based on the distribution of pathogen spectrum and the characteristics of epidemiological diseases,and corresponding intervention measures can be taken to reduce the risk of infectious diseases.