2009年北京市昌平区细菌性痢疾监测结果分析

目的了解北京市昌平区腹泻病例流行病学特征,评价细菌性痢疾的诊断符合情况,降低临床诊断误诊率。方法按照卫生行业标准(WS287-2008)对昌平区312例腹泻病例进行个案调查,对患者粪便样本进行痢疾志贺菌培养。结果检出痢疾志贺菌38份,检出率为12.18%(38/312),其中细菌性痢疾临床诊断病例中志贺菌检出率为17.19%(22/128),感染性腹泻病例中志贺菌检出率为12.80%(16/125)。农民工、农民的检出率较高;有发热、粘液便、脓血便等典型症状的腹泻病例样本检出率高;散居儿童临床诊断病例诊断符合率低。结论细菌性痢疾的临床误诊率较高,应逐步提高实验室诊断比例。

Surveillance of shigellosis in Changping district of Beijing,2009

Objective To understand the epidemiological features of diarrhea cases,evaluate the clinical diagnosis of shigellosis in Changping district and reduce the misdiagnosis. Methods A total of 312 diarrhea cases were surveyed individually and the shigellosis strains in their stool samples were cultured and identified according to the national hygiene criteria （WS 287-2008）. Results Thirty eight samples from diarrhea cases were detected to be positive for Shigella,the total positive rate was 12.18%,The positive rate among diagnosed shigellosis patients was 17.19% （22/128）,and the positive rate among infectious diarrhea patients was 12.80% （16/125）. The positive rate among migrant worker and famer was higher than others,and the positive rate among the patient with the classical symptom such as fever,mucous stool,bloody purulent stool was higher than others. The accuracy of clinical diagnosis for children outside child care settings was low. Conclusion The clinical misdiagnosis rate of shigellosis was high,the laboratory confirmation should be strengthened.