2021年北京市大兴区感染性腹泻病原菌监测结果分析

Analysis of monitoring results of infectious diarrhea in Daxing District of Beijing in 2021

目的了解北京市大兴区腹泻患者病原谱情况,为肠道传染病的防控及临床治疗提供依据。方法收集大兴区两家哨点医院腹泻患者的粪便标本进行肠道致病菌及肠道病毒的分离培养鉴定,并对分离到的致病菌开展血清分型、脉冲场凝胶电泳分型(PFGE)及药敏实验。结果共检测粪便标本440份,检出肠道致病菌66株(15.00%),肠道病毒12株(10.26%)。肠道致病菌男女检出率差异有统计学意义(P<0.05),肠道病毒男女检出率差异无统计学意义(P>0.05);不同年龄及职业人群肠道致病菌和病毒检出率差异均无统计学意义(P>0.05)。致泻性大肠埃希菌、沙门菌、副溶血性弧菌除对阿米卡星100.00%敏感外,对其他抗生素耐药率不同,但均没有发现对某一抗生素完全耐药的菌株。PFGE试验得到的带型较分散,呈多态性。结论北京市大兴区腹泻患者感染病原菌种类较多,PFGE带型呈高度多态性,对多种抗生素耐药,应继续加强监测,并在临床治疗时合理使用抗生素。

Objective To understand pathogenic spectrum of diarrhea patients in Daxing District,Beijing,and to provide basis for prevention and control of intestinal infectious diseases and clinical treatment.Methods Stool samples of diarrhea patients were collected from two sentinel hospitals in Daxing District to isolate and culture intestinal pathogenic bacteria and intestinal virus,and the isolated pathogenic bacteria were analyzed by serotyping,pulsed-field gel electrophoresis and antibiotics susceptibility test.Results A total of 440 fecal samples were tested,66 strains(15.00%)of enteric pathogenic bacteria and 12strains(10.26%)of enteric viruses were detected.The detection rate of intestinal pathogenic bacteria between male and female was statistically significant(P<0.05),and the detection rate of enterovirus between male and female was not statistically significant(P>0.05).There was no statistical significance on the differences in the detection rate of ernterogenic bacteria and enteroviruses on ages and occupations(P>0.05).The results of drug resistance test showed that Salmonella,Vibrio parahaemolyticus and pathogenic Escherichia coli were 100.00%sensitive to amikacin,but their drug resistance rates were different to other antibiotics,and no strain was found to be completely resistant to one antibiotic.PFGE analysis showed that PFGE patterns were scattered and showed polymorphism.Conclusion The pathogenic bacteria of diarrhea patients are diverse in Daxing District,and PFGE patterns is highly polymorphic and resistant to multiple antibiotics.Monitoring should be strengthened and antibiotics should be used rationally in clinical treatment.