2017—2021年安徽省食源性腹泻病例病原学分析

Etiological analysis of foodborne diarrhea cases in Anhui Province from 2017 to 2021

目的分析安徽省2017—2021年食源性腹泻病例病原学特征,为制定相关防控措施提供依据。方法采用横断面研究方法,收集2017—2021年安徽省22家食源性疾病病原学监测医院上报被采集肛拭子/粪便的腹泻病例信息,并按要求对采集的患者标本开展病原学检测。分类资料采用χ^(2)_(趋势)或χ^(2)进行组间比较。结果2017—2021年共采集标本15484份,病原体总检出率为23.75%(3678/15484)。其中,诺如病毒检出率最高,为10.01%(1550/15484);其次是沙门菌(6.16%,954/15484)、致泻大肠埃希菌(6.10%,944/15484)、副溶血性弧菌(1.66%,257/15484)、志贺菌(1.00%,155/15484)。不同年份(χ_(2)_(趋势)=11.249,P<0.05)和不同季度(χ^(2)_(趋势)=146.119,P<0.05)病原体的检出率,均差异有统计学意义。各年龄段人群中,年龄<11岁患者的病原体检出率最高(30.29%,1123/3708);学生的病原体检出率较高。可疑暴露食品前3位分别是肉类及其制品(17.62%,648/3678)、粮食及其制品(15.17%,558/3678)和多种食品(13.78%,507/3678)。可疑暴露场所主要是家庭(69.93%,2572/3678)。结论安徽省食源性腹泻病例病原体主要为诺如病毒和沙门菌,总检出率呈逐季度上升趋势,主要可疑暴露食品和场所分别为肉类及其制品和家庭。需要针对不同人群、季节、暴露食品和场所,制定不同的食源性疾病防控措施。

Objective To provide the basis for formulating relevant prevention and control measures,the etiological characteristics of foodborne diarrhea cases in Anhui Province from 2017 to 2021 were analyzed.Methods This crosssectional study method was conducted from 2017 to 2021 and included data from diarrhea cases in 22 foodborne disease etiology-monitoring hospitals,Anhui Province.Anal swabs or feces were taken from all cases of diarrhea and the samples were tested for etiology as required.Data were processed withχ^(2)_(trend) test orχ^(2)trend test.Results A total of 15484 specimens were collected from 2017 to 2021,and the total detection rate of pathogens was 23.75%(3678/15484).The detection rate of Norovirus,Salmonella,diarrheagenic Escherichia coli,Vibrio parahaemolyticus,and Shigella were 10.01%(1550/15484),6.16%(954/15484),6.10%(944/15484),1.66%(257/15484),and 1.00%(155/15484),respectively.The detection rate of pathogens in different years(χ^(2)_(trend)=11.249,P<0.05)and different quarters(χ^(2)trend=146.119,P<0.05)had statistical significance.Among all age groups,the pathogen detection rate of patients under 11 years old was the highest(30.29%,1123/3708).The pathogen detection rate of students was higher.The top three foods with suspected exposure were meat and its products(17.62%,648/3678),grain and its products(15.17%,558/3678),and multiple foods(13.78%,507/3678).The site with largest number of suspected exposure cases was the household(69.93%,2572/3678).Conclusion The primary pathogenic bacteria of foodborne diarrhea cases in Anhui province were Norovirus and Salmonella and the total detection rate increased quarter by quarter.The major suspected exposed foods and places were meat and its products and households,respectively.Different foodborne disease prevention and control measures need to be developed for different populations,quarters,exposed foods,and places.