2016-2018年北京市通州区感染性腹泻细菌病原谱监测分析

Surveillance for pathogen spectrum of infectious diarrhea in Tongzhou district of Beijing, 2016–2018

目的了解北京市通州区感染性腹泻细菌多病原监测中致病菌的病原谱,为细菌性感染性腹泻的防控提供依据。方法收集2016—2018年北京市通州区哨点医院肠道门诊腹泻患者监测病例粪便标本,采用血清分型、毒力基因等方法对沙门菌、副溶血弧菌、致泻性大肠埃希菌进行分子生物学鉴定,并分析其流行特征。结果收集粪便标本1 269例,分离致病菌298株,检出率为23.48%,不同年龄组病例致病菌检出率差异有统计学意义(χ2=33.584,P<0.001)。阳性菌株中致泻性大肠埃希菌检出最多(46.98%),以肠道集聚性大肠埃希菌和产肠毒素大肠埃希菌为主;其次为副溶血弧菌(24.50%)和沙门菌(19.46%)。细菌流行的季节性比较明显,以夏秋季为主。沙门菌血清型以肠炎沙门菌和鼠伤寒沙门菌为主,副溶血弧菌血清型以O3∶K6为主。结论 2016—2018年北京市通州区感染性腹泻致病菌以致泻性大肠埃希菌为主,副溶血弧菌和沙门菌感染也是腹泻常见病原菌。应加强感染性腹泻致病菌常规监测,在流行季节做好重点人群健康宣教工作,同时进一步加强危险因素调查及其防控。

Objective To understand the bacterial pathogen spectrum of infectious diarrhea in Tongzhou district of Beijing from 2016 to 2018,and provide evidence for the prevention and control of bacterial infectious diarrhea.Methods Stool samples were collected from intestinal outpatient diarrhea patients of two sentinel hospitals of Tongzhou district for detection of related pathogenic bacteria.The molecular biology identification of Salmonella,Vibrio parahaemolyticus and diarrheagenic Escherichia coli was carried out according to serotype and virulence gene,and the epidemic characteristics were analyzed.Results A total of 298 strains of pathogenic bacteria were isolated from 1 269 stool samples with a detection rate of 23.48%.The detection rates of pathogenic bacteria in different age groups were statistically significant(χ2=33.584,P<0.001).Among the positive strains,diarrheagenic E.coli was predominant(140/298,46.98%),mainly EAEC and ETEC,followed by V.parahaemolyticus(73/298,24.50%)and Salmonella(58/298,19.46%).The seasonality of bacteria spread was obvious,mainly in summer and autumn.The major Salmonella serotype were S.Enteritis and S.Typhimurium.The serotype of V.parahaemolyticus was mainly O3:K6.Conclusion From 2016 to 2018,pathogenic bacteria of infectious diarrhea in Tongzhou district were mainly diarrheagenic E.coli,V.parahaemolyticus and Salmonella were also the common pathogens of infectious diarrhea.It is necessary to strengthen the routine surveillance for pathogens of infectious diarrhea and health education in population at high risk,and risk factor investigation and prevention and control should be further strengthened.