2015—2019年北京市食源性致泻大肠埃希氏菌感染病例流行特征分析

目的分析2015—2019年北京市食源性致泻大肠埃希氏菌(diarrheagenic Escherichia coli,DEC)感染病例的流行病学特征和发病规律,为制定相应的防控策略与措施提供科学依据。方法收集2015—2019年北京市36家食源性疾病主动监测医院腹泻病例的粪便或肛拭子标本及其个人信息,采用χ^(2)检验对率或构成比进行比较。结果共收集27619份病例标本,其中有2485份为DEC阳性病例,检出率为9.00%,不同分型中肠产毒性大肠埃希菌检出率最高,为3.10%,其次为肠聚集性大肠埃希菌,检出率为3.02%。不同年龄组DEC检出率差异有统计学意义(χ^(2)=32.923,P<0.001),20~39岁年龄组DEC检出率最高,为9.81%,40~59岁年龄组感染肠产毒性大肠埃希菌高于其他年龄组,0~5岁年龄组肠致病性大肠埃希菌的检出率最高。时间分布上,第三季度为高发期,不同季度间DEC检出率差异有统计学意义(χ^(2)=606.032,P<0.001)。空间分布上,远郊的DEC检出率最高,且城区、近郊和远郊的DEC检出率差异有统计学意义(χ^(2)=28.034,P<0.001),肠产毒性大肠埃希菌的检出主要分布在城区和近郊,肠聚集性大肠埃希菌主要分布在远郊。结论2015—2019年北京市食源性DEC的检出率呈逐年上升趋势,应在夏秋高发季节针对重点人群积极开展防控工作。

Epidemic characteristics of cases of food-borne diarrheagenic Escherichia coli infection in Beijing, 2015-2019

Objective To analyze the epidemiological characteristics and incidence regularity of cases of food-borne diarrheagenic Escherichia coli (DEC) infection in Beijing from 2015 to 2019, and to provide a scientific basis for development of corresponding prevention and control strategies and measures. Methods We collected stool or anal swab samples and epidemiological information of diarrhea patients in 36 active surveillance hospitals of food-borne diseases in Beijing from 2015 to 2019. Chi-square test was used to compare the rates or proportions. Results A total of 27,619 samples were collected, of which 2,485 were positive for DEC, with the detection rate of 9.00%. The detection rate of enterotoxigenic Escherichia coli (ETEC) was the highest (3.10%), followed by enteroaggregative Escherichia coli (EAEC) (3.02%). There was a statistically significant difference in the detection rate of DEC among different age groups (χ²=32.923, P<0.001). The detection rate of DEC was found to be the highest in the group aged 20-39 years (9.81%). The infection rate of ETEC in the group aged 40-59 years was higher than those in other age groups, and the detection rate of enteropathogenic Escherichia coli (EPEC) was the highest in the group aged 0-5 years. Temporal distribution displayed that the third quarter was the peak period, and the difference in the detection rate of DEC among different quarters was statistically significant (χ²=606.032,P<0.001). Spatial distribution revealed that the detection rate of DEC in exurbs was found to be the highest, with statistically significant differences among urban areas, suburbs and exurbs (χ²=28.034, P<0.001). ETEC detected was mainly distributed in urban areas and suburbs, whereas EAEC detected was mainly distributed in exurbs. Conclusion The detection rate of food-borne DEC in Beijing from 2015 to 2019 showed an upward trend year by year. Prevention and control work should be actively carried out among key groups in summer and autumn with high incidence.