2015-2016年度龙山县感染性腹泻病原学监测结果分析

目的了解2015-2016年度龙山县感染性腹泻病例的病原学特征,为制定相应的防控措施提供科学依据。方法2015年5月-2017年4月,收集在龙山县哨点医院就诊的符合纳入标准的腹泻病例相关信息,采集粪便标本进行肠道致病菌及病毒检测,并进行数据分析。结果共调查并检测264例感染性腹泻病例,检出阳性病例98例,总感染率为37. 1%。2015、2016年度感染率分别为45. 0%、30. 6%,差异有统计学意义(χ~2=5. 851,P=0. 016)。细菌、病毒的感染率分别为13. 3%、25. 4%,差异有统计学意义(χ~2=12. 443,P<0. 001)。共分离出致病菌35株,阳性率为13. 3%,以沙门菌为主(74. 3%);共分离出病毒78株,阳性率为29. 5%,以诺如病毒为主(61. 5%),细菌、病毒病原谱构成差异均有统计学意义(χ~2=36. 260,P<0. 001;χ~2=11. 957,P=0. 008)。不同性别病原检出阳性率及病原谱构成差异无统计学意义(P> 0. 05);青少年组、壮年组和老年组病毒检出阳性率分别为45. 2%、19. 2%、10. 8%,差异有统计学意义(χ~2=24. 175,P<0. 001)。各年龄组细菌检出阳性率及细菌、病毒病原谱构成差异均无统计学意义(P>0. 05)。7-9月份细菌检出阳性率高,检出沙门菌22份,占总数的84. 6%; 11月-次年3月病毒检出阳性率高,诺如病毒春秋季感染较多,共检出36份,占总数的75%,轮状病毒感染呈现秋冬季高峰特点,共检出9份,占总数的60%。结论 2015-2016年度龙山县腹泻病例的主要病原是沙门菌、诺如病毒和A组轮状病毒,且具有明显的季节流行特征。

Pathogenic monitoring of infectious diarrhea in Longshan County, 2015-2016

Objective To investigate the pathogenic characteristics of infectious diarrhea cases in Longshan County during 2015-2016, and to provide a scientific basis for formulating corresponding prevention and control measures. Methods We collected the information about diarrhoea cases meeting the inclusion criteria in the sentinel hospitals in Longshan County from May 2015 to April 2017. The fecal specimens were collected for detection of intestinal pathogenic bacteria and viruses, and then the data were analyzed. Results A total of 264 infectious diarrhea cases were investigated and detected. 98 cases were positive, with the total infection rate of 37.1%. The annual infection rates in 2015 and 2016 were 45% and 30.6% respectively, showing a statistically significant difference (χ²=5.851, P=0.016). The infection rates of bacteria and viruses were 13.3% and 25.4% respectively, with a statistically significant difference (χ²=12.443, P<0.001). A total of 13.3% (35/264) strains of pathogenic bacteria were isolated, and most of them were Salmonella (74.3%). A total of 29.5% (78/264) strains of viruses were isolated, and most of them (61.5%) were norovirus. The pathogenic spectrums of bacteria and viruses showed statistically significant differences (χ²=36.260, P<0.001; χ²=11.957, P=0.008). No statistically significant difference was found in the positive rate of pathogen detection and the pathogenic spectrums between genders (P>0.05). The positive detection rates of viruses in the youth group, the prime-aged group and the elderly group were 45.2%, 19.2% and 10.8% respectively, with statistically significant differences(χ²=24.175, P<0.001). No statistically significant differences were observed in the positive rate of bacterial detection and the pathogenic spectrums of bacteria and viruses among different age groups (all P>0.05). The positive rate of bacteria detected in July-September was high, and 22 Salmonella-positive samples were detected, accounting for 84.6% of the total. The positive rate of virus detection was found to be higher in November to March next year. A total of 36 norovirus-positive samples were detected in springand autumn, accounting for 75% of the total. Rotavirus infection presented peak characteristics in autumn and winter, and a total of 9 rotavirus-positive samples were detected, accounting for 60% of the total. Conclusions The main pathogens of the diarrhea cases occurred in Longshan County during 2015-2016 were Salmonella, norovirus and group A rotavirus, and the distribution of the cases showed obvious seasonal epidemic characteristics.