南京市主要细菌性病原体食源性疾病负担研究

目的 研究南京市主要细菌性病原体致食源性疾病负担,提出食源性疾病监测策略。方法 根据南京市11个区17家食源性疾病哨点医院主动监测和食源性疾病负担调查结果,结合各主要细菌性病原体的食源性比例等各项乘数,获得人群中各主要细菌性病原体的发病率及疾病负担。结果 2015年全市共采集1 208份食源性疑似病例生物标本,检出非伤寒沙门氏菌31株、副溶血性弧菌20株、致泻大肠埃希氏菌15株,检出率分别为2.57%、1.66%、2.56%;全市疾病负担调查3 600人,急性胃肠炎的月患病率为3.9%,年发病率为0.55次/人年;推算出南京市非伤寒沙门氏菌食源性感染发病率为1 292/10万,0~4岁年龄组发病率最高(3 481/10万);副溶血性弧菌食源性感染发病率为619/10万,15~24岁年龄组发病率最高(2 076/10万),致泻性大肠埃希氏菌的食源性感染发病率为1 653/10万,5~14岁年龄组发病率最高(5 263/10万)。结论 南京市非伤寒沙门氏菌、副溶血性弧菌、致泻性大肠埃希氏菌感染负担较重,儿童非伤寒沙门氏菌和致泻性大肠埃希氏菌、青壮年副溶血性弧菌的感染负担尤为突出,针对不同人群加强相应病原体的监测,同时应进一步完善相关监测及研究,为制定相应的风险控制措施提供科学依据。

Burden of foodborne illness caused by the major bacterial pathogens infections,Nanjing

Objective To study the burden of food-borne illness caused by the major bacterial pathogens infections in Nanjing,and to provide information for strategies of foodborne illness surveillance.Methods Based on the active surveillance system established in 17 hospitals from 11 districts and population-based household survey results,multipliers,such as the proportion of foodborne ones in major bacterial pathogens,were used to estimate the incidence and burden of food-borne illness caused by the major bacterial pathogens.Results A total of 1208 stool or rectal swab specimens were collected from suspected food-borne cases.31 non-typhoidal Salmonella strains,20 Vibrio parahaemolyticus strains and 15 diarrheagenic Escherichia coli strains were identified,and the positive rate were 2.57%,1.66%,and 2.56%,respectively.3600 persons enrolled in the household survey.The adjusted monthly prevalence of AGI was 3.9% with 0.55 time per person per year.It was estimated that the incidence of foodborne infection caused by non-typhoidal Salmonella was 1292/100,000,and the incidence in 0-4 year group was estimated as the highest (3481/100,000).The incidence of foodborne infection caused by Vibrio parahaemolyticus was 619/100,000 and the incidence in 15-24 year group was estimated as the highest (2076/100,000).The incidence of foodborne infection caused by diarrheagenic Escherichia coli was 1653/100,000,with the incidence in 5-14 year group estimated as the highest (5263/100,000).Conclusion It indicates that non-typhoidal Salmonellosis,Vibrio parahaemolyticus and diarrheagenic Escherichia coli present major public health burden in Nanjing．The findings highlight the surveillance for both non-typhoidal Salmonella and diarrheagenic Escherichia coli infections in children group,also the surveillance of Vibrio parahaemolyticus infection in the young group.Relevant departments should further research and strengthen the related surveillance to provide scientific basis for the corresponding risk control measures．