2014年上海市宝山区腹泻病监测结果分析

目的 了解上海市宝山区腹泻病流行特征和病原谱分布,为制定防控措施提供科学依据.方法 在监测点肠道门诊对腹泻病病例进行监测,按一定的抽样间隔进行调查,并采集粪便标本,进行细菌培养和病毒检测.对检测阳性的细菌菌株进行抗生素耐药实验.结果 2014年两家监测点医院共监测到腹泻病2486例,腹泻病发病呈明显季节性.380例病例的粪便标本开展病原学检测,179例病例标本病原检出阳性,检出率为47.11%; 检出细菌5种,病毒4种; 细菌检出率为14.74%(56/380),主要为致泻性大肠杆菌(32例,占57.14%) ,沙门氏菌(10例,占17.86%)和副溶血型弧菌(10例,占17.86%); 病毒检出率为37.11%(141/380),主要为诺如病毒(98例,占69.50%),轮状病毒(20例,占14.18%).夏季以细菌感染为主,冬春季以病毒感染为主.4种细菌对抗生素都有不同程度耐药.结论 宝山区腹泻病病原谱较为广泛,季节高峰较为明显,应该在不同季节根据不同病原流行情况开展针对性防控措施.

Analysis of pathogen spectrum surveillance of diarrheal patients in Baoshan District,Shanghai, 2014

Objective To describe the epidemiological and pathogen features of diarrheal patients in Baoshan District,then put forward preventive and treatment work of enteric infectious disease．Methods Disease surveillance was conducted in the intestinal outpatient of monitoring hospital．The diarrhea cases were randomly selected,and stool samples were collected from these cases for bacteriological and virological detections．Pathogenic bacteria of stool positive culture were tested against antimicrobial agents．Results A total of 2486 cases of diarrhea disease were detected in two monitoring hospitals, 2014. The incidence rates showed notable seasonal variation. Among 380 stool samples detected, 179 were pathogen positive (47.11%). Four kinds of bacteria, including Escherichia coli (61 cases, 57.14%), Salmonella (10 cases, 17.68%), Escherichia coli (10 cases, 17.68%) and four kinds of viruses, including norovirus (98 cases, 69.50%) and rotavirus (20 cases, 14.18%), were detected. The bacterium positive rate was 14.74% and the virus positive rate was 37.11%. The most of cases in summer were infected by bacterial, winter and spring by virus infection. Four types of bacteria had varying degrees of resistance to common antibiotics. Conclusions The pathogen spectrum of infectious diarrhea was wide and related seasonality was obvious in Baoshan District, Shanghai. It was necessary to take pathogen and season specific prevention and control measures.