甘肃省主要食源性致病菌感染流行特征和风险评估

Epidemiological characteristics and risk assessment of major foodborne pathogens in Gansu province

目的 掌握甘肃省沙门菌、志贺菌、致泻性大肠埃希菌(diarrheagenic Escherichia coli, DEC)引起食源性疾病的感染流行特征,开展风险评估。方法 采集腹泻≥3次/d的就诊患者信息和粪便样本,进行沙门菌、志贺菌、DEC检测。结果 沙门菌、志贺菌、DEC总体感染率分别为1.53%(95%CI:1.33%~1.73%)、0.64%(95%CI:0.46%~0.71%)、3.60%(95%CI:3.33%~3.86%)。沙门菌、志贺菌和DEC感染率分别在3~<6、6~<15、15~<25岁年龄组中最高。不同年龄、性别人群中致病菌感染率不同,3~<6岁年龄组男性患儿沙门菌和DEC感染率最高,3~<6岁女性患儿志贺菌感染率最高。DEC感染有明显季节性,夏秋季有持续高峰期,沙门菌和志贺菌全年最高峰分别在9、10月。报告的可疑暴露食品种类、食品包装方式、食品来源地不同,致病菌感染率不同。结论 甘肃省志贺菌、DEC流行水平较高,沙门菌较低,流行高峰期与其他地区有差异。不同性别、年龄组人群不同致病菌感染率不同,3~<6岁学龄前儿童是3种致病菌感染的重点人群。散装食品消费可能导致更高的致病菌感染风险,来自超市的食品消费引起致病菌感染的风险较低。

Objective To understand the epidemic characteristics of foodborne diseases caused by Salmonella, Shigella and Escherichia coli in Gansu province, and to conduct risk assessment. Methods The general information and fecal samples of patients with diarrhea ≥3 times/d were collected, and Salmonella, Shigella, diarrheagenic Escherichia coli(DEC) were detected. Results The overall positive rates of Salmonella, Shigella, and DEC were 1.53%(95%CI:1.33%-1.73%), 0.64%(95%CI:0.46%-0.71%) and 3.60%(95%CI:3.33%-3.86%), respectively.The positive rates of Salmonella, Shigella and DEC were the highest in preschool children aged 3-<6 years, in school-age children aged 6-<15 years, and in adolescents aged 15-<25 years.The infection rates of foodborne pathogens varied in different age groups and gender groups.Boys aged 3-<6 years had the highest infection rate of Salmonella and Escherichia coli, while girls with the same age had the highest infection rate of Shigella.The seasonal peak of DEC infection was in summer and autumn, while the infection of Salmonella and Shigella peaked in September and October.The infection rate of foodborne pathogens also varied with reported suspicious exposed food types, food packaging methods and food sources. Conclusions The epidemic levels of Shigella and DEC are relatively high while Salmonella is relatively low in Gansu province.Preschool children aged 3-<6 years are more vulnerable to three common foodborne pathogen infections.Consuming unpacked food is related to high risk of pathogen infection.