| 2013～2014年深圳市腹泻疾病的病原学分析研究 |
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| 引用本文： | 文明明,韩美玲,李卫宁,李迎慧,张海龙,杨 虹.2013～2014年深圳市腹泻疾病的病原学分析研究[J].现代检验医学杂志,2016,0(3):143-146. |
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| 作者姓名： | 文明明 韩美玲 李卫宁 李迎慧 张海龙 杨 虹 |
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| 作者单位： | 1.北京大学深圳医院检验科,广东深圳 518036; 2.深圳市疾病预防控制中心,广东深圳 518020 |
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| 摘 要： | 目的 分析北京大学深圳医院2013～2014年门急诊腹泻患者肠道病原菌的分布情况,为临床诊断和治疗提供参考依据; 同时了解沙门菌检测方法改进的成效。方法 2013～2014年间,在北京大学深圳医院门急诊采集了1719名腹泻患者的粪便标本,进行致泻性大肠埃希菌、沙门菌、志贺菌、弧菌的分离培养、鉴定和血清分型; 对其中451份水样便标本进行轮状病毒、诺沃克病毒、星状病毒和肠道腺病毒的荧光PCR检测。沙门菌检测由标本直接接种改为用增加亚硒酸盐胱氨酸增菌液(SC)增菌培养,分析两种方法检出率的统计学差异。结果 在1 719份粪便标本中,共检出肠道病原菌143株阳性率为8.3%(143/1 719)],其中沙门菌76株,占53.1%(76/143); 致泻性大肠埃希菌46株,占32.2%(46/143),包括肠产毒性大肠埃希菌(ETEC)25株、肠致病性大肠埃希菌(EPEC)12株、肠黏附性大肠埃希菌(EAEC)8株和肠侵袭性大肠埃希菌(EIEC)1株; 副溶血弧菌19株,占13.3%(19/143); 志贺菌2株,占1.4%(2/143)。检测到两种病原菌(沙门菌+EPEC)混合感染病例一例。在451份水样便标本中,有189份检出一种或两种肠道病毒,阳性率为41.9%(189/451),其中诺沃克病毒91份,占48.1%(91/189),轮状病毒79份,占41.8%(79/189),星状病毒10份,占5.3%(10/189)和肠道腺病毒9份,占4.8%(9/189)。有4份标本同时检出轮状病毒和诺沃克病毒,有1份标本同时检出星状病毒和诺沃克病毒; 检出致病菌和病毒混合感染10例。沙门菌检测方法改进后阳性率由0.6%(17/2 627)提高到4.4%(76/1 719),χ2=67.2,P<0.01,差异具有统计学意义。结论 腹泻病原微生物类型复杂多样,临床应重视和加强腹泻病原微生物的常规检验,改进检测方法,降低漏检率,对完善当前腹泻病的病因诊断和治疗有重要参考意义。
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| 关 键 词： | 腹泻病 沙门菌 致泻性大肠埃希菌 副溶血弧菌 诺沃克病毒 轮状病毒 |
Etiology of Diarrheal Disease Years in Shenzhen from 2013 to 2014 |
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| WEN Ming-ming,HAN Mei-ling,LI Wei-ning,LI Ying-hui,ZHANG Hai-long,YANG Hong.Etiology of Diarrheal Disease Years in Shenzhen from 2013 to 2014[J].Journal of Modern Laboratory Medicine,2016,0(3):143-146. |
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| Authors: | WEN Ming-ming HAN Mei-ling LI Wei-ning LI Ying-hui ZHANG Hai-long YANG Hong |
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| Affiliation: | 1.Department of Clinical Laboratary,the Shenzhen Hospital of Peking University,
Guangdong Shenzhen 518036,China;
2.Shenzhen Center for Disease Control and Prevention,Guangdong Shenzhen518020,China |
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| Abstract: | Objective Through the analysis of the pathogensdistribution of out-patient department and emergency department patients withdiarrhea from Shenzhen Hospital of Peking University in 2013～2014,so as to provide reference for the clinical diagnosis and treatment of diarrhea disease.While understanding the improved Salmonella detection results.MethodsVaried pathogenic bacteria were isolated and identified from 1 719 diarhea stool samples of native Shenzhen Hospital of Peking University from 2013 to 2014 through enrich culture,separate culture,biochemistry,serology etc.Pathogenic virus were tested for 451 watery stool specimens by fluorescence PCR.Analyzed statistical differences between the direct inoculation and selenite cystine broth enrichment for Salmonella.Results Picked out 143 disease germs from 1 719 examples diarrhea patient's stool samples,among which there were 25 strains of ETEC,12 strains of EPEC,8 strains of EAEC,1 strains of EIEC,19 strains of Vibrio parahemolyticus,76 strains Salmonella,2 strains Shigella and 0 strain of Vibrio cholera.There were 10 samples with two disease germs timely.Picked out 189 disease viruses from 451 examples diarrhea patient's stool without disease germs,among which there were 79Rotavirus positive,91 Norwalk virus positive,9 Adenoviruspositive,10 Astrovirus positive.There were 4 samples with Rotavirus and Norwalk virus timely.After Salmonella ways to improve the positive rate of 0.6%(17/2 627)increased to 4.4%(76/1 719),χ2=67.2,P<0.01,the difference was statistically significant.Conclusion The detectable rate of Salmonella and Norwalk virus was the majority, and the clinic enhance the test of the diarrhea pathogenic microorganism,including the improvement of detection method,to reduce the missing rate of them,to provide the scientific basis for the diagnostical therapectic measures. |
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