天津市2018—2020年腹泻症候群病原菌检测结果分析

目的 为了解天津市细菌性腹泻病原谱构成,探讨近年来天津市主要病原菌的变异和流行变迁规律,为细菌性腹泻诊断和防控提供科学依据。方法 采集2018—2020年天津市哨点医院细菌性腹泻症候群患者标本826份,开展多种肠道致病菌检测,并对优势菌进行PFGE（pulsed-field gel electrophoresis）分子分型分析。结果 天津市细菌性腹泻病病原谱前三位的分别为：沙门菌（5.69%）、致泻性弧菌（2.66%）、嗜水气单胞菌（1.09%）。沙门菌可分为14个血清型,其中肠炎沙门菌为优势血清型（占44.68%）,其次为鼠伤寒沙门菌（占19.15%）。2018—2019年的沙门菌流行趋势较为平缓,2020年则呈双峰分布。2018—2019年7—8月为副溶血性弧菌检出阳性高峰期,2020年全年均未检出副溶血性弧菌。46株沙门菌成功分型,得到33种PFGE带型,菌株间相似度在51.7%~100.0%,其中PT22、PT24、PT25为优势型。结论 沙门菌是天津市2018—2020年细菌性腹泻病的主要致病菌。分子分型结果呈现多样性。为有效防控细菌感染性腹泻,应针对重点区域、重点人群和高发季节采取有效防控措施。

Pathogen detection results of bacterial diarrhea syndrome in Tianjin, 2018-2020

Objective To understand the composition of bacterial diarrhea pathogens in Tianjin, explore the variation and prevalence of major pathogens in Tianjin in recent years, and we provide scientific basis for the diagnosis, prevention and control of bacterial diarrhea. Methods We collected 826 specimens of bacterial diarrhoeal syndrome from Tianjin Sentinel Hospital from 2018 to 2020, tested a variety of intestinal pathogenic bacteria, and molecular typing analysis of PFGE (pulsed-field gel electrophoresis) was performed on the dominant bacteria. Results The top three bacterial diarrhoea pathogens were Salmonella (5.69%), V. parahaemolytica (2.66%) and Aeromonas hydroophilic (1.09%). Salmonella could be classified into 14 serotypes, of which Salmonella enteritis was the dominant serotype (44.68%), followed by Salmonella Typhimurium (19.15%). Salmonella trends were relatively flat in 2018 to 2019, with a bimodal distribution in 2020. July to August in 2018-2019 were the peaks of positive V. parahaemolytes, and no V. parahaemolytes was detected in 2020. Forty-six Salmonella strains were successfully typed with 33 PFGE band types, with interstrain similarity of 51.7%-100.0%, of which PT22, PT24, PT25 were the dominant types. Conclusions Salmonella and Vibrio parahaemolyticus are the main pathogens of bacterial diarrhoea disease in Tianjin from 2018 to 2020. Molecular typing results show diversity. In order to effectively prevent and control bacterial infectious diarrhea, effective prevention and control measures should be taken for key areas, key groups and high-incidence seasons.