2020—2022年广州市婴幼儿食源性疾病流行病学及病原学分析

Characteristics pathogens of foodborne diseases in children aged 0-3 years in Guangzhou city,2020-2022:an analysis of sentinel surveillance data

目的分析广东省广州市婴幼儿食源性疾病流行病学和病原学特征,为婴幼儿食源性疾病防控提供数据支持。方法对收集的2020—2022年广州市食源性疾病监测医疗机构接诊并上报的1270例婴幼儿食源性疾病病例信息和4种常见食源性致病菌(沙门菌、志贺菌、副溶血性弧菌、致泻大肠埃希菌)的检测结果进行分析。结果1270例婴幼儿食源性疾病病例的发病高峰期在每年夏秋季。病例临床主要表现为腹泻(85.0%)、发热(50.0%)、呕吐(33.5%)、腹痛(12.8%)、恶心(6.1%)等症状,其中腹泻类型以水样便为主(74.8%),平均腹泻6.0次/d,呕吐3.0次/d;发热体温平均39.0℃。可疑食物以婴幼儿食品为主,主要原材料是粮食类及其制品。40.8%的病例检出致病菌,主要为沙门菌(99.6%),少量为致泻大肠埃希菌(0.4%)。婴儿组(<1岁)沙门菌检出率(58.4%)显著高于幼儿组(1~3岁)(32.3%)(P<0.001)。广州的食源性沙门菌血清型呈多样化分布,鼠伤寒沙门菌变种1,4,[5],12:i:-是优势血清型(68.2%),其次为肠炎沙门菌(9.7%)、斯坦利沙门菌(3.3%)、罗森沙门菌(2.7%)。这4种沙门菌血清型其毒力存在差异,表现为感染鼠伤寒沙门菌变种1,4,[5],12:i:-的发热概率高于感染罗森沙门菌(P=0.004),感染肠炎沙门菌的发热概率高于感染罗森沙门菌(P=0.002)。结论根据广州婴幼儿食源性疾病流行病学和病原学特征,应从保障食品安全、开展针对性问诊、加强目标致病菌监测、拓展宣传教育等方面强化该特殊人群的食源性疾病防控工作。

Objective To analyze the epidemiological characteristics and pathogens of foodborne diseases among children aged 0-3 years in Guangzhou city,Guangdong province,to provide data for the prevention and control of diseases in the population.Methods Medical records and detection results of four common foodborne pathogens(Salmonella,Shigella,Vibrio parahaemolyticus,and enteropathogenic Escherichia coli)were obtained from 1270 foodborne illness cases aged 0-3 years reported by 289 sentinel hospitals in Guangzhou city from 2020 to 2022,and descriptive statistics were performed on the collected data.Results The majority of cases occurred during the summer and fall seasons each year.The proportion of cases with the following clinical symptoms was 85.0%for diarrhea with 3 to 8 episodes and an average of 6.0 per day(74.8%with watery stools),50.0%for fever with an average temperature of 39.0℃,33.5%for vomiting with 2 to 5 episodes and an average of 3.0 per day,12.8%for abdominal pain,and 6.1%for nausea.The reported suspect foods implicated in the incidence of illness were mainly cereals and their products.Pathogens associated with the illnesses of the cases were detected in 40.8%of the cases,predominantly Salmonella(99.6%),with a small percentage of enteropathogenic Escherichia coli(0.4%).The detection rate of Salmonella in cases less than one year of age was 58.4%,significantly higher than in cases 1-3 years of age(32.3%)(P<0.001).The dominant serotype of Salmonella detected in the cases was Salmonella Typhimurium variant 1,4,[5],12:i:-(68.2%),followed by Salmonella Enteritidis(9.7%),Salmonella Stanley(3.3%),and Salmonella Rissen(2.7%).Four serotypes of Salmonella with different virulence were detected.For example,infections with Salmonella Typhimurium variant 1,4,[5],12:i:-had a higher probability of fever than those with Salmonella Rissen(P=0.004),and the probability of fever in cases infected with Salmonella Enteritidis was higher than that in cases infected with Salmonella Rissen(P=0.002).Conclusion Based on the epidemiological and pathogenic characteristics of foodborne diseases in children aged 0-3 years Guangzhou city,it is recommended to strengthen the prevention and control of foodborne diseases in this special population by ensuring food safety,conducting targeted consultations,strengthening target pathogen surveillance,and expanding publicity and education.