2018-2021年北京市门头沟区哨点医院腹泻病例中致泻大肠埃希菌流行特征分析

Epidemiological characteristics of diarrheagenic Escherichia coli in sentinel hospitals of Mentougou district of Beijing,2018-2021

目的了解北京市门头沟区腹泻病例中的致泻大肠埃希菌(diarrheagenic Escherichia coli,DEC)的流行特征及规律,为疾病的防控工作提供科学依据。方法收集2018-2021年北京市门头沟区2家食源性疾病哨点医院的腹泻病例样本,通过实时荧光定量聚合酶链反应(PCR)的方法进行鉴定,采用SPSS 22.0进行数据分析。结果2018-2021年共收集1214件样本,阳性110件,检出率为9.06%,检出前三位的是产肠毒素大肠埃希菌(enterotoxigenic E.coli,ETEC)、肠道聚集性大肠埃希菌(enteroaggregative E.coli,EAEC)和肠道致病性大肠埃希菌(enteropathogenic E.coli,EPEC)。经统计学分析,不同年度间的检出率差异有统计学意义(χ^(2)=24.984,P<0.001),新冠疫情期间DEC检出率明显下降。DEC主要发生在夏季(χ^(2)=19.796,P<0.001),以本市患者为主(χ^(2)=10.709,P=0.001),不同性别和年龄的检出率间差异无统计学意义。恶心、呕吐、发热、脱水和腹痛症状均不是影响检出率的关键因素,粪便性状组间检出率差异有统计学意义(χ^(2)=25.081,P<0.001)。结论致泻大肠埃希菌主要发生在夏季,人群普遍易感,夏季应加强DEC引起腹泻疫情的防控工作。

Objective To understand the epidemiological characteristics and regularity of diarrheagenic Escherichia coli(DEC)in diarrhea cases in Mentougou district of Beijing,and provide scientific basis for disease prevention and control.Methods Diarrhea case samples from two sentinel hospitals of food-borne diseases in Mentougou district,Beijing from 2018 to 2021 were collected and identified by real-time fluorescence quantitative PCR.Analysis was conducted using SPSS 22.0.Results A total of 1214 samples were collected from 2018 to 2021,of which 110 were positive,with a detection rate of 9.06%.Enterotoxigenic E.coli(ETEC),enteroaggregative E.coli(EAEC)and enteropathogenic E.coli(EPEC)ranked the top three pathogenic bacterias.The detection rate of DEC was significantly different between years(χ^(2)=24.984,P<0.001),and the detection rate of DEC decreased significantly during COVID-19.DEC mainly occurred in summer(χ^(2)=19.796,P<0.001),and was mainly in local patients(χ^(2)=10.709,P=0.001).There were no significant differences in the detection rates of different genders and ages.Nausea,vomiting,fever,dehydration and abdominal pain were not the key factors affecting the detection rate,while the detection rates of fecal traits between groups were statistically significant(χ^(2)=25.081,P<0.001).Conclusions Diarrheagenic Escherichia coli mainly occurs in summer,and the population is generally vulnerable to infection.The measures to prevent and control of diarrhea diseases caused by DEC should be strengthened in summer.