2015至2019年上海某区致泻性大肠埃希菌感染性腹泻的流行特征分析

Epidemiological characteristics of diarrheagenic Escherichia coli infectious diarrhea in a district of Shanghai from 2015 to 2019

摘要:

目的：了解上海市某区2015至2019年致泻性大肠埃希菌引起感染性腹泻的流行状况与特征，为防控感染性腹泻提供参考。方法：收集2015至2019年上海市青浦区某三级医院初诊为疑似细菌性腹泻，经实验室诊断分离出致泻性大肠埃希菌的病例监测数据，采用描述性流行病学方法分析其流行特征。结果：2015至2019年从4 494份患者粪便或肛拭标本中检出513例致泻性大肠埃希菌，检出率为11.42%，主要为产毒性大肠埃希菌（66.08%，339例），其次为黏附性大肠埃希菌（18.91%，97例）和致病性大肠埃希菌（14.42%，74例）；2015至2019年致泻性大肠埃希菌检出率分别为9.10%、11.35%、16.57%、10.30%和10.67%，差异有统计学意义（?字2=116.962，P＜0.001）；其引起的感染性腹泻常见于夏秋季节，腹泻症状以水样便为主（87.13%，447例），部分伴随腹痛、恶心、呕吐或发热等，其中86.16%为单一感染，混合感染组的发热率和腹痛率均低于单一感染组，差异有统计学意义（发热： ?字2=4.936，P=0.026；腹痛： ?字2=17.079，P＜0.001）；不同年龄组检出率差异有统计学意义（ ?字2=40.672，P＜0.001），以21~30岁组检出率最高（15.97%）；干部职员（17.48%）、医务人员（18.18%）和教师（18.60%）等职业检出率较高，不同职业检出率差异有统计学意义（ ?字2=23.554，P=0.001）。结论：上海市青浦地区致泻性大肠埃希菌检出率较高，以产毒性大肠埃希菌为主，呈现当地流行特征，以工人群体为主，年龄组、各种职业间检出率差异有统计学意义，监测其流行状况与特征，可有效为防控致泻性大肠埃希菌引起感染性腹泻提供科学数据。

Abstract:

Objective：To investigate the prevalence and characteristics of infectious diarrhea caused by diarrheagenic Escherichia coli（E. coli） from 2015 to 2019 in a district of Shanghai，and to provide reference for prevention and control of infectious diarrhea. Methods：The surveillance data of the newly diagnosed suspected bacterial diarrhea in a tertiary hospital in Qingpu District of Shanghai from 2015 to 2019 were collected，and the epidemiological characteristics were analyzed by descriptive epidemiological method. Results：From 2015 to 2019，among the 4 494 patients’ stool or anal swab specimens，513 cases of diarrheagenic E. coli were detected，with the detection rate of 11.42%，and the mainly was enterotoxigenic E. coli（66.08%，339 cases），followed by enteroaggregative E. coli（18.91%，97 cases） and enteropa-thogenic E. coli（14.42%，74 cases）. The detection rate of diarrheagenic E. coli from 2015 to 2019 respectively was 9.10%，11.35%，16.57%，10.30% and 10.67%，and the differences among years were statistically significant（ ?字2=116.962，P<0.001）. The infectious diarrhea caused by diarrheagenic E. coli was commonly to see in summer and autumn. The main diarrhea symptom was watery stool（87.13%，447 cases），and some were accompanied with abdominal pain，nausea，vomiting or fever，among which 86.16% was single infection. The fever rate and abdominal pain rate of composite infection group were lower than those of single infection group，with statistical significance（fever： ?字2=4.936，P=0.026；abdominal pain： ?字2=17.079，P＜0.001）. There was significant difference in the detection rate among different age groups（ ?字2=40.672，P<0.001），with the highest detection rate in 21-30-year-old group（15.97%）. The detection rate of cadre staff（17.48%），medical staff（18.18%） and teachers（18.60%） was relatively high，with significant differences among the detection rate among different occupations（ ?字2=23.554，P=0.001）. Conclusion：The detection rate of diarrheagenic E. coli in Qingpu is quite high，mainly enterotoxigenic E. coli，showing local epidemic characteristics，mainly found in workers，and the differences among different ages and occu－pations are statistical significant. To survey its prevalence and characteristics can effectively provide scientific data for the prevention and control.