沈隽卿, 张月娟, 袁国平, 金凯, 茅俭英, 彭真真, 朱倩如, 杨兴堂, 许学斌. 2010-2014年上海市宝山区沙门菌监测分析及能力评估[J]. 疾病监测, 2016, 31(7): 546-553. DOI: 10.3784/j.issn.1003-9961.2016.07.005
引用本文: 沈隽卿, 张月娟, 袁国平, 金凯, 茅俭英, 彭真真, 朱倩如, 杨兴堂, 许学斌. 2010-2014年上海市宝山区沙门菌监测分析及能力评估[J]. 疾病监测, 2016, 31(7): 546-553. DOI: 10.3784/j.issn.1003-9961.2016.07.005
SHEN Jun-qing, ZHANG Yue-juan, YUAN Guo-ping, JIN Kai, MAO Jian-ying, PENG Zhen-zhen, ZHU Qian-ru, YANG Xing-tang, XU Xue-bin. Performance of Salmonella surveillance in Baoshan district, Shanghai[J]. Disease Surveillance, 2016, 31(7): 546-553. DOI: 10.3784/j.issn.1003-9961.2016.07.005
Citation: SHEN Jun-qing, ZHANG Yue-juan, YUAN Guo-ping, JIN Kai, MAO Jian-ying, PENG Zhen-zhen, ZHU Qian-ru, YANG Xing-tang, XU Xue-bin. Performance of Salmonella surveillance in Baoshan district, Shanghai[J]. Disease Surveillance, 2016, 31(7): 546-553. DOI: 10.3784/j.issn.1003-9961.2016.07.005

2010-2014年上海市宝山区沙门菌监测分析及能力评估

Performance of Salmonella surveillance in Baoshan district, Shanghai

  • 摘要: 目的 评估基层公共卫生机构基于实验室监测腹泻病例和食源性沙门菌的能力。方法 2010-2014年,遴选辖区内2家临床医院和固定农贸市场、大型超市和自然水体等进行连续性主动监测和环境背景监测。分析沙门菌的年度流行曲线和菌型特征,回顾性评估监测系统中流行病学和实验室的能力。结果 2010-2014年,监测病例和食源环境沙门菌阳性率为6.9%(269/3898)和5.3%(99/1885)。标本量最多的21~60岁组阳性率(6.2%,168/2714)显著低于标本量最少的12岁组(40.6%,39/96),确诊病例男女性别比为1.3:1。食源带菌以猪肉最高(26.2%,44/168),其次为禽肉:鸡肉(7.8%,9/116)和鸭肉(14.3%,4/28)。人源的优势型依次为鼠伤寒、肠炎、婴儿、汤卜逊和山夫登堡沙门菌,食源菌型较人源更具多样性。人源菌株耐药特征稳定,对环丙沙星和头孢菌素的耐药率低,食源株的耐药率略高于人源,但有下降趋势。监测数据中2010年和2011年较其后的几年更能体现真实的沙门菌年度流行特征。结论 上海市宝山区的沙门菌病例以青壮年居多,食源暴露以肉制品最高,流行曲线真实但存在偏倚,应加强监测过程的分段评估和质量控制。基层公共卫生机构开展食源性主动监测需投入更多人力、物力,建议借助国家网络实验室平台集成暴发应对和分子分型的能力建设。

     

    Abstract: Objective To evaluate the performance of laboratory based foodborne Salmonella surveillance and diarrhea cases in Baoshan district, Shanghai. Methods Two hospitals, selected farm produce markets/supermarkets and natural water were used to carry out continuous active surveillance and environment background surveillance from 2010 to 2014. The annual Salmonella infection epidemiologic curve and type characteristics were analyzed. Results From 2010 to 2014, Salmonella positive rates in foodborne infection cases and foodborne environment samples were 6.9% (269/3898) and 5.3% (99/1885) respectively. The Salmonella positive rate in group 21-60 years (6.2%, 168/2714) was significant lower than in age group 12 years (40.6%, 39/96). The male to female ratio of the confirmed infection cases was 1.3:1. In food samples, 26.2% of pork specimens were Salmonella positive, followed by chicken meat (7.8%, 9/116) and duck meat (14.3%, 4/28). The predominate human sourced serotypes were S. Typhimurium, S. Enteritidis, S. Infantis, S.Thompson and S. Sanftenberg, which were less diverse than those from food products. Antibiotic resistance characteristics of human sourced isolates were stable, which had less resistance to ciprofloxacin and cephalosporin. The foodborne Salmonella isolates were relatively more resistant to common antibiotics than human sourced isolates, but it showed downtrend in recent years. The surveillance data during 2010-2011 reflected the epidemiologic pattern of Salmonella infection more accurately than data from other years. Conclusion Most Salmonella infection cases were young adults in Baoshan. The animal products were highly contaminated with Salmonella. The epidemiologic curves of Salmonella infection were reliable, but bias existed. The quality control and evaluation should be strengthened in surveillance. More investment should be given to local health facilities to conduct active foodborne infection surveillance, and the capability for outbreak response and pathogen molecular subtyping should be strengthened by using national laboratory network platform.

     

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