甘肃省2009-2018年腹泻症候群监测病例病原学分析

  目的   了解甘肃省腹泻症候群病原谱分布与流行特征。   方法   采集甘肃省2009-2018年哨点医院腹泻症候群监测病例的粪便标本, 以实时荧光链式反应检测病毒核酸, 以分离培养法检测细菌。   结果   4 406例标本中检出1 547例阳性病例, 病原阳性率35.11%。其中1 281例检出病毒, 病毒阳性率47.20%;287例检出细菌, 细菌阳性率8.57%。病原谱前五位是轮状病毒(46.04%)、星状病毒(13.37%)、诺如病毒(13.15%)、志贺菌(9.90%)和腺病毒(7.81%)。轮状病毒、诺如病毒、星状病毒、志贺菌与非伤寒沙门菌在各年龄段感染情况的差异具有统计学意义(均有P < 0.05)。11月到次年3月病毒阳性率较高, 6-8月细菌阳性率较高。各病原流行季节不同, 四季都以轮状病毒感染为主。   结论   甘肃省腹泻症候群病例病原谱较广泛, 病毒性腹泻更常见, 发病具有明显的季节高峰。加强持续性监测可掌握病原特征与流行趋势, 有助于对重点人群采取针对性与季节性防控措施。

Etiological analysis of surveillance cases of diarrhea syndrome in Gansu Province from 2009 to 2018

Objective To understand pathogenic distribution and epidemiological characteristics of diarrhea syndrome in Gansu Province.Methods Fecal specimens from diarrhea syndrome surveillance cases at sentinel hospitals in Gansu Province from 2009 to 2018 were collected,and virus nucleic acids were detected by real-time fluorescent chain reaction,and bacteria were detected by isolation culture.Results 1547 positive cases were detected from 4406 stool specimens with the positive rate of 35.11%.Among the positive samples,1281 cases were positive for virus with the positive rate of 47.20%;287 cases were positive for bacteria with the positive rate of 8.57%.Top five of pathogenic spectrum were rotavirus(46.04%),astrovirus(13.37%),norovirus(13.15%),Shigella(9.90%)and adenovirus(7.81%).In different age groups,statistically significant differences were found in the positive rates of rotavirus,norovirus,astrovirus,Shigella and non-typhoid Salmonella(all P<0.05).The positive rate of virus was higher from November to March of next year,and the positive rate of bacteria was higher from June to August.The epidemic seasons of pathogens were different,of which rotavirus was dominating in four seasons.Conclusions The pathogenic spectrum of diarrhea is wide relatively in Gansu Province,and viral diarrhea is more common,with obvious seasonal peak.Continuous monitoring should be strengthened to grasp characteristics and epidemic trends of pathogens,and it is helpful to take targeted and seasonal preventive measures in population at high risk.