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目的了解上海市西区哨点医院成人急性腹泻病细菌感染的菌群分布及变化趋势,有针对性地进行急性腹泻病的预防控制。方法选取2011年1月-2013年12月上海西区哨点医院肠道门诊未使用抗菌药物的急性腹泻患者2 091例,采集粪标本进行培养并分离常见肠道致病细菌(副溶血弧菌、大肠埃希菌、沙门菌属、空肠弯曲菌和志贺氏菌属),由长宁区疾病预防控制中心对各医院分离的阳性菌株进行复核并保存。结果 671例患者粪便培养阳性,阳性率达32.1%,培养出病原菌671株,居前是副溶血弧菌、大肠埃希菌、沙门菌属和志贺菌属,其所占比例分别为33.8%、22.1%、21.5%和10.3%;其中,大肠埃希菌主要为肠产毒性大肠杆菌(ETEC),占74.3%(110/148);沙门菌属以肠炎沙门氏菌最为常见,占44.4%(64/144);志贺氏菌属以宋氏志贺菌为主,占84.1%(58/69);21~30岁患者的病原菌检出率最高,达(29.5%);各季节病原菌检出以7~9月份最多,占68.70%(461/671)。结论上海市西区成人急性腹泻患者有明显的季节性,青年为主,大肠埃希菌感染呈上升趋势,应主动对重点人群有针对性地开展有效的腹泻病预防控制工作。
Objective To understand the distribution and trend of bacterial population of bacterial infection in adult acute diarrhea in sentinel hospital in Western Shanghai and to prevent and control acute diarrhea. Methods A total of 2 091 cases of acute diarrhea patients who did not use antibiotics in the outpatient department of sentinel hospital in Shanghai Western Hospital from January 2011 to December 2013 were selected and their fecal specimens were collected for culture and isolation of common intestinal pathogenic bacteria (Vibrio parahaemolyticus, Escherichia coli, Salmonella, Campylobacter jejuni, and Shigella). The positive isolates isolated from hospitals in Changning District Center for Disease Control and Prevention were reviewed and stored. Results 671 cases of fecal culture positive, the positive rate of 32.1%, 671 strains of pathogens were cultured, living in front of Vibrio parahaemolyticus, Escherichia coli, Salmonella and Shigella, the proportion was 33.8% Escherichia coli accounted for 74.3% (110/148). Salmonella was the most common type of Salmonella enteritis, accounting for 44.4% (64 / 144). Shigella was mainly Shigella spp., Accounting for 84.1% (58/69). The highest detection rate of pathogens was found in 21 ~ 30 years old (29.5%). July to September up, accounting for 68.70% (461/671). Conclusions Adult patients with acute diarrhea in western Shanghai have obvious seasonal, young and predominant infections. Escherichia coli infection is on the rise. Active prevention and control of diarrhea should be carried out in targeted groups.