CAJ | 학술논문

目的了解2013年8月至2014年7月上海市腹泻病例的病原谱和流行病学特征.方法随机抽取23所不同级别医院,对在其肠道门诊就诊的腹泻病例按一定的抽样间隔进行调查,并采集粪便标本,进行细菌培养和病毒检测.结果从3 467例病例粪便标本中检出至少1种病原体阳性者1 561例,阳性率为45.02％.检出细菌6种、病毒5种.细菌阳性率为13.46％,主要为副溶血性弧菌(172例)、沙门菌(143例);病毒阳性率为27.75％,主要为诺如病毒(471例)、轮状病毒(312例).阳性例数呈较明显的夏季高峰和秋冬季高峰,秋冬季病毒阳性率高于细菌,夏季细菌阳性率高于病毒,差异均有统计学意义(P＜0.05).分层分析显示,病毒阳性组中,各年龄组均以11月至次年2月阳性数构成比最高,但各年龄组阳性数构成比差异无统计学意义(P＞0.05).细菌阳性组中,各年龄组均以6-9月阳性数构成比最高,且各年龄组阳性数构成比差异有统计学意义(P＜0.05).发热比例细菌阳性组(19.06％)高于病毒阳性组(10.91％),差异有统计学意义(P＜0.05).结论上海地区腹泻病原谱较为广泛,季节高峰明显,应针对重点人群在不同季节对病原体加强相应的监测与防控.
목적 료해2013년8월지2014년7월상해시복사병례적병원보화류행병학특정.방법 수궤추취23소불동급별의원,대재기장도문진취진적복사병례안일정적추양간격진행조사,병채집분편표본,진행세균배양화병독검측.결과 종3 467례병례분편표본중검출지소1충병원체양성자1 561례,양성솔위45.02％.검출세균6충、병독5충.세균양성솔위13.46％,주요위부용혈성호균(172례)、사문균(143례);병독양성솔위27.75％,주요위낙여병독(471례)、륜상병독(312례).양성례수정교명현적하계고봉화추동계고봉,추동계병독양성솔고우세균,하계세균양성솔고우병독,차이균유통계학의의(P＜0.05).분층분석현시,병독양성조중,각년령조균이11월지차년2월양성수구성비최고,단각년령조양성수구성비차이무통계학의의(P＞0.05).세균양성조중,각년령조균이6-9월양성수구성비최고,차각년령조양성수구성비차이유통계학의의(P＜0.05).발열비례세균양성조(19.06％)고우병독양성조(10.91％),차이유통계학의의(P＜0.05).결론 상해지구복사병원보교위엄범,계절고봉명현,응침대중점인군재불동계절대병원체가강상응적감측여방공.
Objective To understand the pathogen spectrum and epidemiological characteristics of diarrhea cases in Shanghai from August 2013 to July 2014.Methods The survey was conducted in 23 hospitals at different levels randomly selected in Shanghai,the diarrhea cases seeking medical care in these hospitals were sampled,and stool samples were collected from them for pathogen isolation.Results Among 3 467 stool samples detected,1 561 were positive for at least 1 pathogen (45.02％).A total of 6 kinds of bacteria and 5 kinds of viruses were detected.The positive rate for bacterium was 13.46％,mainly Vibrio parahaemolyticus (172 cases) and Salmonella (143 cases).The positive rate for virus was 27.75％,mainly Norovirus (471 cases) and Rotavirus (312 cases).The positive rates peaked obviously in summer and during autumn-winter.The positive rate of virus was higher than that of bacterium during autumn-winter,and the positive rate of bacterium was higher than that of virus in summer,the differences were statistically significant (P＜0.05).Stratified analysis showed the constituent ratio of virus positive samples during November-February was highest among all age groups,however,the difference was not statistically significant (P＞0.05).The constituent ratio of bacterium positive samples during June-September was highest in all age groups,the difference was statistically significant (P＜0.05).The proportion of the cases with fever in bacterium positive group (19.06％) was higher than those in virus positive group (10.91％),the difference had statistically significance (P＜0.05).Conclusion The pathogen spectrum of diarrhea was relatively wide in Shanghai and the seasonality of the incidence was obvious.Specific etiological surveillance and control strategies should be strengthened among risk groups in different seasons.