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目的了解甘肃省武威市腹泻症候群病例的病原构成及其流行特点,为腹泻的预防控制提供科学依据。方法采集2012年1月─2014年12月武威市凉州区2所哨点医院门诊、急诊就诊的腹泻患者粪便标本,用细菌培养法检测肠道细菌(沙门氏菌、志贺氏菌、致泻性大肠埃希菌、霍乱弧菌、副溶血弧菌),用ELISA、PCR和RT-PCR法检测肠道病毒(轮状病毒、诺如病毒、星状病毒、肠道腺病毒、札如病毒)。结果共收集粪便标本212份,检出阳性标本150份、病原体7种,阳性检出率为70.75%;病原谱构成分别为沙门氏菌9份(6.00%)、志贺氏菌7份(4.67%)、A组轮状病毒57份(38.00%)、诺如病毒29份(19.33%)、札如病毒8份(5.33%)、肠道腺病毒26份(17.33%)、星状病毒14份(99.33%);57份A组轮状病毒阳性标本中,病毒毒株G血清分型以G9、G3为主,P基因型分型以P[8]为主;男、女病原检出阳性率差异无统计学意义(χ2=0.01,P>0.01);发病年龄以3岁以下组为主,占83.02%(176/212),病原体的阳性检出率为63.68%(135/212),与其他年龄组相比差异有统计学意义(χ2=26.03,P<0.05);2─7月、10─12月为病原阳性检出较高的月份。结论2012─2014年甘肃省武威市腹泻症候群病例监测的主要病原体为沙门氏菌和A组轮状病毒,婴幼儿是高发人群,扩大病原监测范围和加强感染性腹泻的防治仍是今后工作的重点。
Objective To understand the pathogenic constitution and epidemiological characteristics of diarrhea syndrome in Wuwei City, Gansu Province, and provide a scientific basis for the prevention and control of diarrhea. Methods Stool samples of diarrhea patients from outpatient and emergency department of 2 sentinel hospitals in Liangzhou District of Wuwei City from January 2012 to December 2014 were collected. Bacterial culture was used to detect intestinal bacteria (Salmonella, Shigella, diarrhea Escherichia coli, Vibrio cholerae and Vibrio parahaemolyticus). The enteroviruses (rotavirus, Norovirus, Astrovirus, Enteric virus and Zarvirus) were detected by ELISA, PCR and RT-PCR. . Results A total of 212 samples of stool samples were collected, including 150 positive samples and 7 pathogens. The positive detection rate was 70.75%. The pathogen spectrum consisted of 9 (6.00%) Salmonella, 7 (4.67%) Shigella, 57 cases (38.00%) of group A rotavirus, 29 cases (19.33%) of Norovirus, 8 cases (5.33%) of Sapporo virus, 26 cases (17.33%) of intestinal adenovirus and 14 cases 99.33%). Among the 57 samples of group A rotavirus positive, G9 and G3 were the main serotypes of the virus strains. The genotype of P was P [8]. The positive rate of male and female pathogens The difference was not statistically significant (χ2 = 0.01, P> 0.01). The age of onset was less than 3 years old, accounting for 83.02% (176/212), and the positive rate of pathogens was 63.68% (135/212) There was significant difference between the other age groups (χ2 = 26.03, P <0.05). In the months from July to October, the month from October to December was the highest positive. Conclusions The main pathogens of the surveillance of diarrheal syndrome in Wuwei City, Gansu Province, between 2012 and 2014 are the Salmonella and A group rotavirus. Infants and young children are high risk population. It is still the focus of future work to expand the scope of pathogen surveillance and to prevent and control infectious diarrhea.