湖州地区食源性腹泻病例监测病原构成研究

目的调查了解湖州地区食源性腹泻患者病原构成情况,促进临床对聚集性疾病识别能力提高,为食源性疾病的预防、控制及治疗提供合理的临床依据及指导。方法回顾性分析湖州地区某医院就诊的食源性腹泻患者1614例临床资料,对所有患者进行粪便标本采集,并对所有粪便标本实施微生物学检测,检测粪便中具体食源性致病菌感染情况,对患者的临床资料及实验室检查结果进行记录并分析,观察并比较所有食源性腹泻检出食源性致病菌患者年龄、性别分布情况,同时观察病原菌检出集中季节及爆发年份。结果收集的1614例粪便标本中检测出食源性致病菌171例,占10.59%;在检出食源性致病菌为阳性的171例标本中以沙门菌、肠集聚性大肠埃希菌、肠毒素性大肠埃希菌及肠致病性大肠埃希菌为主,其占比分别为43.27%、16.96%、12.87%、11.70%。男性患者粪便标本中病菌检出率为10.69%(91/851),女性患者检出率为10.48%(80/763),男性与女性患者的检出情况比较,差异无统计学意义(P0.05)。婴幼儿患者致病菌检出率较成年患者低,差异有统计学意义(P0.05);夏秋季节食源性腹泻患者食源性致病菌检出率高于春冬季节,差异有统计学意义(P0.05);2016年检出率高于2015年,差异有统计学意义(P0.05)。结论湖州地区食源性腹泻患者食源性致病菌以沙门菌感染为主,夏秋季节为主要爆发季节,应加强对食品的监管,同时针对高发人群进行积极的食品安全教育,避免食源性疾病集中爆发。

Study on the pathogen composition and case-based surveillance of foodborne diarrhea in Huzhou area

Objective To investigate the pathogenic composition of patients with food-borne diarrhea in Huzhou area,promote the clinical identification ability of cluster disease,and to provide reasonable clinical evidence and guidance for the prevention,control and treatment of food-borne diseases.Methods The clinical data of 1614 patients with foodborne diarrhea in a hospital in Huzhou were retrospectively analyzed.Faecal specimens of all patients were collected.Microbiological tests were performed on all fecal specimens to detect specific food-borne pathogen infections in feces.The clinical data and laboratory test results of patients were recorded and analyzed.The age and gender distribution of patients with detected food-borne pathogens in all foodborne diarrhea patients.The detection concentrate season and outbreak year of pathogens were observed.Results 171 cases of food-borne pathogens were detected in the 1614 fecal specimens collected,accounting for 10.59%.Salmonella,intestinal-collective E.coli,enterotoxigenic E.coli and enteropathogenic E.coli were dominated in 171 specimens with positive food-borne pathogens,accounting for 43.27%,16.96%,12.87%and 11.70%,respectively.The detection rate of germs in the stool samples of male patients was 10.69%(91/851)and that of female patients was 10.48%(80/763).There was no significant difference in the detection between male and female patients(P>0.05).The detection rate of pathogenic bacteria in infants and young children was lower than that in adult patients,and the difference was significant(P<0.05).The detection rate of food-borne pathogenic bacteria in food-borne diarrhea patients in summer and autumn was higher than that in spring and winter,and the difference was statistically significant(P<0.05).The detection rate in 2016 was higher than that in 2015,and the difference was statistically significant(P<0.05).Conclusion Foodborne pathogens in food-borne diarrhea patients in Huzhou area are mainly Salmonella.As the summer and autumn are the main outbreak seasons,food supervision should be strengthened,and active food safety education should be conducted for high-incidence groups to avoid the outbreak of food-borne diseases.