田祎, 钱海坤, 吕冰, 曲梅, 霍达, 张新, 黄瑛, 王全意, 贾蕾. 2015-2018年北京市肠道门诊成年人急性细菌性腹泻监测结果分析[J]. 疾病监测, 2020, 35(5): 411-415. DOI: 10.3784/j.issn.1003-9961.2020.05.010
引用本文: 田祎, 钱海坤, 吕冰, 曲梅, 霍达, 张新, 黄瑛, 王全意, 贾蕾. 2015-2018年北京市肠道门诊成年人急性细菌性腹泻监测结果分析[J]. 疾病监测, 2020, 35(5): 411-415. DOI: 10.3784/j.issn.1003-9961.2020.05.010
Yi Tian, Haikun Qian, Bing Lyu, Mei Qu, Da Huo, Xin Zhang, Ying Huang, Quanyi Wang, Lei Jia. Surveillance results of acute bacterial diarrhea in adult patients visiting enteric disease clinics in Beijing, 2015–2018[J]. Disease Surveillance, 2020, 35(5): 411-415. DOI: 10.3784/j.issn.1003-9961.2020.05.010
Citation: Yi Tian, Haikun Qian, Bing Lyu, Mei Qu, Da Huo, Xin Zhang, Ying Huang, Quanyi Wang, Lei Jia. Surveillance results of acute bacterial diarrhea in adult patients visiting enteric disease clinics in Beijing, 2015–2018[J]. Disease Surveillance, 2020, 35(5): 411-415. DOI: 10.3784/j.issn.1003-9961.2020.05.010

2015-2018年北京市肠道门诊成年人急性细菌性腹泻监测结果分析

Surveillance results of acute bacterial diarrhea in adult patients visiting enteric disease clinics in Beijing, 2015–2018

  • 摘要:
    目的分析2015 — 2018年北京市肠道门诊成年人急性细菌性腹泻的流行病学特征、临床特征,以及粪便病原谱变化。
    方法2015年1月至2018年12月,在北京市每个区按月采集急性腹泻患者粪便标本,收集临床和流行病学资料,检测粪便标本中霍乱弧菌、志贺菌、沙门菌等肠道致病菌。 使用单变量logistic回归分析影响肠道致病菌阳性的流行病学和临床因素,采用多变量logistic回归对混杂因素进行调整。 使用描述性统计分析病原谱变化。
    结果2015 — 2018年,共采集监测样本13 126份,其中肠道致病菌阳性标本2 689份,检出率为20.49%。 每年肠道致病菌检出高峰集中在7 — 9月。 年龄、居住地和季节为肠道致病菌感染的相关流行病学因素。 不同年份肠道致病菌检出率差异有统计学意义。 体温≥38.5 ℃、腹痛、恶心、呕吐、脱水为肠道致病菌阳性的相关临床因素;腹泻6~10次/d与3~5次/d相比,前者肠道致病菌检出率高;临床诊断为感染性腹泻者相对于诊断为非感染性腹泻者,前者检出率高。 2015 —2018年,检出的肠道致病菌主要为肠致病性大肠埃希菌、沙门菌和副溶血弧菌,但不同年份分布不同。
    结论2015 — 2018年北京市肠道门诊成年人急性细菌性腹泻致病菌主要为肠致病性大肠埃希菌、沙门菌和副溶血弧菌,其检 出有明显流行病学和临床特征,应有针对性地加强防控。

     

    Abstract:
    ObjectiveTo analyze the epidemiological and clinical characteristics, and pathogen spectrum changes in adult patients visiting enteric disease clinics due to acute bacterial diarrhea in in Beijing from 2015 to 2018.
    MethodsFrom January 2015 to December 2018, the clinical and epidemiological data of the acute diarrheal cases and their stool samples were collected in Beijing. The samples were tested for Vibrio cholerae, Shigella, Salmonella and other intestinal bacteria. Univariate logistic regression analysis was conducted to analyze the epidemiological and clinical factors for the positivity of bacterial infection, and multivariate logistic regression was used to adjust confounding factors. Descriptive analysis was used to identify the pathogen spectrum changes.
    ResultsFrom 2015 to 2018, a total of 13 126 samples were collected, of which 2 689 were bacteria-positive (20.49%). The annual positive detection peaked from July through September. The related epidemiological factors of intestinal bacterial infection included age, residence and season. The differences in positive rate of bacterial infection among years were significant. Fever (≥38.5 ℃), abdominal pain, nausea, vomiting were the clinical symptoms of intestinal bacterial infection. Diarrhea of 6–10 times per day was associated with higher positive detection rate compared with 3–5 times per day. Cases diagnosed as infectious diarrhea had higher positive detection rate than the ones diagnosed as non-infectious diarrhea. From 2015 to 2018, the major intestinal bacteria detected were Escherichia coli, Salmonella and V. parahaemolyticus, but the distribution of pathogen spectrum varied with years.
    ConclusionFrom 2015 to 2018, the major intestinal bacteria detected in adults in Beijing were E. coli, Salmonella and V. parahaemolyticus. Specific prevention and control measures shall be strengthened for intestinal bacterial diarrhea with certain epidemiological and clinical characteristics.

     

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