2013—2016年青海省婴幼儿食源性腹泻流行病学特征及病原研究

目的 分析青海省婴幼儿食源性腹泻的流行病学特征,为青海省婴幼儿食源性腹泻防控提供参考依据。方法 收集2013年1月—2016年12月,在青海省13家哨点医院就诊的以腹泻为主诉的婴幼儿(<4岁)食源性腹泻病例信息,并采集粪便或肛拭子标本进行4种致病菌(沙门菌、志贺菌、副溶血性弧菌、致泻大肠埃希菌)及诺如病毒的常见病原体的检测。结果 共监测3 068例婴幼儿食源性腹泻病例,腹泻性状以水样便为主,54.66%(1 677/3 068)的病例伴有发热；共检出病原体150例,检出率为4.89%(150/3 068),其中以志贺菌检出率最高(2.36%,72/3 049),其次是沙门菌(2.11%,64/3 035)和诺如病毒(1.02%,10/983)；婴幼儿食源性腹泻的发生呈较明显的夏秋季高峰；婴儿组病原体的检出率高于幼儿组；乳类食品为首位原因食品。结论 青海省婴幼儿食源性腹泻的主要优势致病菌为志贺菌和沙门菌,并有诺如病毒检出,应加强对目标病原的持续监测,开展婴幼儿食源性腹泻知识宣传教育并有效防控。

Epidemiological analysis and research on pathogen spectrum among children of foodborne acute diarrhea in Qinghai Province during 2013-2016

Objective To analyze the epidemiological feature of foodborne acute diarrhea among children in Qinghai, and to provide references for foodborne acute diarrhea control and prevention. Methods Suspected foodborne acute diarrhea cases during 2013-2016 were collected from 13 sentinel hospitals of Qinghai among children aged less than 4 years and feces or swab samples were collected for pathogenic analysis. Four kinds of bacteria (Shigella spp., Salmonella spp., diarrheagenic E.coli and Vibrio parahaemolyticus) and one kind of viruses (Norovirus) were detected. Results A total of 3 068 foodborne acute diarrhea among children aged less than 4 years were enrolled. The main character of feces was watery stool, and 54.66% (1 677/3 068) had fever. There were 150 positive cases, and the total positive rate was 4.89% (150/3 068). The highest positive rate was Shigella spp., which was 2.36% (72/3 049), followed by Salmonella spp. of 2.11% (64/3 035), and the positive rate of Norovirus was 1.02% (10/983). The foodborne acute diarrhea among children was mainly occurred during the summer and autumn. The positive rate of infants (<1) was higher than that of infants (1-3). Milk products were the main suspected food. Conclusion The main pathogen was Shigella spp. and Salmonella spp. among children of in Qinghai Province, and Norovirus was also detected. It was necessary to strengthen the surveillance capacity and the publicity of foodborne acute diarrhea knowledge among children,also to carry out more effective preventive and control measures.