云南战区腹泻病原菌监测及流行病学特征研究

目的对云南战区腹泻病原菌进行监测,掌握其腹泻病原谱的构成和流行病学特征,为军队和地方腹泻病的防控及诊治提供重要依据。方法采集监测点肠道门诊腹泻患者新鲜粪便标本,按统一制定的监测方案,操作规程检测志贺菌、沙门菌、致泻性大肠埃希菌（EIEC、ETEC、EPEC、EHEC、EAggEC）、小肠结肠炎耶尔森菌、空肠弯曲菌、霍乱弧菌、副溶血弧菌、气单胞菌、类志贺邻单胞菌以及其它肠道病原菌。结果从588例腹泻患者粪便标本中检出各类病原菌220株,检出率为37.41%。其中肺炎克雷伯菌居首位（6.80%）、费劳地枸橼酸菌次之（5.95%）、居第三位的是志贺菌（4.25%）、列第四位的是奇异变形菌和阴沟肠杆菌（3.23%）、排第五至第七位的分别是产酸克雷伯菌（2.89%）、侵袭性大肠杆菌（2.21%）和气单胞菌（1.53%）。不同年龄组检出率为29.11%～48.34%之间,其中36～45岁年龄组检出率最高,男女性别间差异无统计学意义（P〉0.05）。病原检出率5、8、9月份较高。结论通过对腹泻病原菌监测,了解腹泻病原菌的组成,建立病原谱,掌握其流行病学特征,为军队和地方腹泻病的研究、防控、流行病学调查等提供重要参考资料。

Surveillance of diarrheal bacteria and their epidemiological chracteristics in Yunan military area

Aim To monitor the diarrheal pathogens and investigate their epidemiological characteristics in Yunan Province for offer evidence of control activities.Methods Fresh stool samples were collected from outpatients and the pathogens of Shigella,Salmonella,diarrheogenic Escherichia coli,Yersinia enterocolitica,Campylobacter jejuni,Vibrio cholerae,Vibrio parahaemolyticus,Aeromonas,Plesimonas shigelloides and other intestinal pathogens were detected accoding to the uniform monitoring scheme and procedures.Results Totally 220 strains were detected from 588 diarrheal outpatients with positive rate of 37.4%,including Klebsiella pneumoniae ranking the first,followed by Citrobacter freundii（5.95）,Shigella（94.25%）,proteus mirabilis and Aerobacter cloacae（3.23%）,Klebsiella oxytoca（2.89%）,Enteroinvasive E.coli,EIEC（2.21%） and Aeromonas（1.53%）.The detection rate in different age groups were in the range of 29.11%~48.34%,being higher in the age groop of from 16 yers to 45 years and highest in the age groups of 36 years to 445 years.There was no differences between sexes in positive rate（P0.05）.May,August and September were the months with higher positive rate.Conclusion The list of diarrheal pathogens and the characteristic of the pathogens to have provided important rinformation for control of the pathogens