2015-2017年深圳市福田区致泻性大肠杆菌监测结果分析
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摘要
目的了解深圳市福田区致泻性大肠杆菌(DEC)在腹泻人群中的流行特征,为制定防控措施提供科学依据。方法通过哨点医院收集2015-2017年腹泻门诊标本1 268份,采用分离培养和PCR相结合的方法鉴定致泻性大肠杆菌,用SPSS 19.0对结果进行统计分析。结果共50例患者分离出DEC,2015、2016、2017年分别为22、15、13例,DEC分离率分别为3.4%、5.6%、3.8%,不同年份的分离率差异无统计学意义(χ~2=2.449,P=0.294)。其中2例患者分别为肠致病性大肠埃希菌(EPEC)和肠凝聚型大肠埃希菌(EAEC)、EPEC和肠毒素型大肠埃希菌(ETEC)合并感染。共52株DEC,EPEC和ETEC是主要的检出型别,分别占DEC的38.5%(20/52)和36.5%(19/52),其次为EAEC、肠侵袭型大肠埃希菌(EIEC)和肠出血性大肠埃希菌(EHEC),所占比例分别为15.4%、7.7%和1.9%。5-10月的分离率为6.1%,明显高于其他月份(1.5%),差异有统计学意义(P<0.05)。10～19岁、≥下年龄组的分离率分别为7.7%、4.9%和4.2%。结论 EPEC和ETEC是福田区DEC感染的主要型别,5-10月份是感染的高发时间,0～5岁和60岁以上人群是DEC感染的高发人群。
Objective To understand the epidemiological character of diarrheagenic Escherichia coli(DEC) in Futian district of Shenzhen and thus provide the basis for prevention and control of diarrheal disease. Methods A total of 1 268 stool samples were collected from diarrhea patients by sentinel hospitals during 2015 and 2017. DEC isolates were cultured and identified by PCR method. The results were analyzed by SPSS 19.0 software package. Results Fifty DEC strains(3.9%) were isolated and two co-infections were found. The prevalence in 2015, 2016 and 2017 were 3.4%, 5.6% and 3.8%, respectively. No significant difference was observed in the prevalence between different years(2.449, P=0.294).Enteropathogenic E.coli(EPEC) and Enterotoxigenic E.coli(ETEC) constituted 38.5% and 36.5% of the isolates,respectively, which was followed by Enteroaggregative E.coli(EAEC), Enteroinvasive E.coli(EIEC), and Enterotoxigenic E.coli(EHEC). The detection rates during May to October were significantly higher than those in other months(P<0.05). The detection rates in the age group of 10～19 years,≥60 years and <5 years old were 7.7%, 4.9% and 4.2%, respectively.Conclusions EPEC and ETEC were the predominant pathotypes of DEC in Futian district. From May to October were the prevalent months of DEC and age groups of 0～5 years and over 60 years old were the main groups at high risk.
Objective To understand the epidemiological character of diarrheagenic Escherichia coli(DEC) in Futian district of Shenzhen and thus provide the basis for prevention and control of diarrheal disease. Methods A total of 1 268 stool samples were collected from diarrhea patients by sentinel hospitals during 2015 and 2017. DEC isolates were cultured and identified by PCR method. The results were analyzed by SPSS 19.0 software package. Results Fifty DEC strains(3.9%) were isolated and two co-infections were found. The prevalence in 2015, 2016 and 2017 were 3.4%, 5.6% and 3.8%, respectively. No significant difference was observed in the prevalence between different years(2.449, P=0.294).Enteropathogenic E.coli(EPEC) and Enterotoxigenic E.coli(ETEC) constituted 38.5% and 36.5% of the isolates,respectively, which was followed by Enteroaggregative E.coli(EAEC), Enteroinvasive E.coli(EIEC), and Enterotoxigenic E.coli(EHEC). The detection rates during May to October were significantly higher than those in other months(P<0.05). The detection rates in the age group of 10～19 years,≥60 years and <5 years old were 7.7%, 4.9% and 4.2%, respectively.Conclusions EPEC and ETEC were the predominant pathotypes of DEC in Futian district. From May to October were the prevalent months of DEC and age groups of 0～5 years and over 60 years old were the main groups at high risk.
引文
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[11]Qadri F,Svennerholm A-M,Faruque A,et al.Enterotoxigenic Escherichia coli in developing countries:epidemiology,microbiology,clinical features,treatment,and prevention[J].Clinl Microbiol Rev,2005,18(3):465-483.
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[2]Shen H,Zhang J,Li Y,et al.The 12 Gastrointestinal Pathogens Spectrum of Acute Infectious Diarrhea in a Sentinel Hospital,Shenzhen,China[J].Front Microbiol,2016,7:1926.
[3]Chen QL,Shi X,Li Y,et al.Rapid genetic typing of diarrheagenic Escherichia coli using a two-tube modified molecular beacon based multiplex real-time PCR assay and its clinical application[J].Ann Clin Microbiol Antimicrob,2014,13:30.
[4]李迎慧,邱亚群,冼慧霞,等.深圳市腹泻人群致泻性大肠埃希菌流行及病原特征研究[J].中华流行病学杂志,2016,37(1):115-118.
[5]陈辉,李博,鞠长燕,等.深圳市南山区2013-2014年感染性腹泻病原体监测结果[J].中国热带医学,2015,15(7):839-841.
[6]蔡妙森,许少坚,李贻汉,等.2014-2015年深圳市龙华新区感染性腹泻病原体监测结果分析[J].热带医学杂志,2016,16(11):1455-1457.
[7]Fischer Walker CL,Sack D,Black RE.Etiology of diarrhea in older children,adolescents and adults:a systematic review[J].PLoS Negl Trop Dis,2010,4(8):e768.
[8]贺连华,吴平芳,刘涛,等.深圳市熟食中食源性致病菌污染状况的调查研究[J].中国热带医学,2005,5(2):357-358.
[9]Croxen MA,Law RJ,Scholz R,et al.Recent advances in understanding enteric pathogenic Escherichia coli[J].Clin Microbiol Rev,2013,26(4):822-880.
[10]Canizalez-Roman A,Flores-Villase?or HM,Gonzalez-Nu?ez E,et al.Surveillance of Diarrheagenic Escherichia coli strains isolated from diarrhea cases from children,adults and elderly at northwest of Mexico[J].Front Microbiol,2016,7:1924.
[11]Qadri F,Svennerholm A-M,Faruque A,et al.Enterotoxigenic Escherichia coli in developing countries:epidemiology,microbiology,clinical features,treatment,and prevention[J].Clinl Microbiol Rev,2005,18(3):465-483.
[12]Harrington SM,Dudley EG,Nataro JP.Pathogenesis of enteroaggregative Escherichia coli infection[J].FEMS Microbiol Lett,2006,254(1):12-18.