论文部分内容阅读
目的了解上海市青浦区副溶血性弧菌腹泻病感染状况和疾病负担。方法 2015年1月至2016年12月,选择上海市青浦区某三级医院所有初诊疑似细菌性腹泻病例为研究对象,采集粪便标本进行肠道多病原分离,对实验室诊断为副溶血性弧菌的食源性腹泻病例通过入户调查方式了解其医疗费用。结果 6 129例腹泻患者中,确诊为细菌性腹泻患者1 092例(17.82%,1 092/6 129),其中646例检出副溶血性弧菌,分离率为10.54%,578例为单一感染(9.43%),68例为混合感染(1.10%);95.50%的副溶血性弧菌菌株携有直接溶血素基因(tdh);流行峰值7—8月,病例以40~60岁年龄组和农民较常见;混合感染以感染副溶血性弧菌和沙门菌最常见,与单一感染相比,发热率差异有统计学意义(χ~2=8.003,P<0.05)。副溶血性弧菌阳性病例直接医疗费用为(338.75±191.45)元,直接非医疗费用(59.83±74.94)元;农村患者的直接医疗费用和间接非医疗费用均高于城市(P<0.05);治疗中抗生素使用比率较高,且使用抗生素的直接医疗费用高于不使用抗生素组(t=2.531,P<0.05)。结论副溶血性弧菌腹泻病例症状较轻,发病率较高,存在一定混合感染;农民的疾病负担较重。应强化重点人群卫生知识宣传,提倡就近治疗和优化诊疗方式,以降低经济负担。
Objective To understand the infection status and disease burden of Vibrio parahaemolyticus diarrhea in Qingpu District of Shanghai. Methods From January 2015 to December 2016, all the newly diagnosed cases of suspected bacterial diarrhea in a tertiary hospital in Qingpu District, Shanghai were selected as the research object. Stool specimens were collected for pathogenicity separation of multiple pathogenic bacteria. Bacterial food-borne diarrhea cases through the home survey to understand their medical costs. Results Among 6 129 diarrhea patients, 1092 (17.82%, 1092/612) were diagnosed as bacterial diarrhea. Among them, 646 cases were found to have Vibrio parahaemolyticus, the isolation rate was 10.54%, and 578 cases were single infection (9.43%), and 68 were mixed infections (1.10%). 95.50% strains of Vibrio parahaemolyticus carried the direct hemolysin gene (tdh); the peak prevalence was from July to August, Peasants were more common. Vibrio parahaemolyticus and Salmonella were most commonly infected with mixed infection, and the difference was statistically significant (χ ~ 2 = 8.003, P <0.05) compared with single infection. The direct medical costs of Vibrio parahaemolyticus positive cases were (338.75 ± 191.45) yuan, and the direct non-medical expenses were 59.83 ± 74.94 yuan. The direct medical costs and indirect non-medical expenses of rural patients were higher than those of cities (P <0.05). The rate of antibiotic use was higher in treatment, and the direct medical costs of using antibiotics were higher than those without antibiotics (t = 2.531, P <0.05). Conclusion The symptoms of Vibrio parahaemolyticus diarrhea are mild and the incidence is high, and there is a certain mixed infection. The disease burden of peasants is heavier. The publicity of health knowledge of key people should be strengthened to promote the nearest treatment and optimize the treatment methods to reduce the economic burden.