安徽省儿童医院2016—2...1年住院腹泻患儿病原学监测_张蔷.pdf

中国国境卫生检疫杂志2023年2月第46卷第1期Chinese Frontier Health Quarantine Feb.2023，Vol 46，No.1Etiological surveillance of children with diarrhea hospitalized in AnhuiChildrens Hospital from 2016 to 2021ZHANG Qiang，DENG FangDepartment of Infectious Diseases，Anhui Childrens Hospital，Hefei，Anhui 230001，ChinaAbstract：ObjectiveTo investigate the etiological surveillance results of children with diarrhea hospitalized in AnhuiChildrens Hospital.MethodsThe fecal samples of 1 334 children with diarrhea hospitalized in Anhui ChildrensHospital from 2016 to 2021 were detected using traditional method，the nucleic acids of pathogens（Salmonella，Diarrheagenic Escherichia coli，Shigella，Yersinia enterocolitica，Plesiomonas shigelloides，Rotavirus，Norovirus，Sapovirus，Adenovirus，Astrovirus）were detected by Real-time PCR reaction（PCR）.Then the distribution characteristics ofpathogenic bacteria in hospitalized children with diarrhea were analyzed in terms of onset year，age，gender，livingenvironment and onset season.ResultsFrom 2016 to 2021，a total of 770 pathogenic strains were detected in1 334 fecal samples of 1 334 children，with a detection rate of 57.72%，including 290 strains of pathogenic bacteria（21.74%）and 480 strains of virus（35.98%）.The most detected pathogenic bacteria were Salmonella（7.35%）anddiarrheagenic Escherichia coli（7.12%），while the most detected viruses were rotavirus（17.32%）and norovirus（10.72%）.The pathogen detection rate was the highest in 2017（66.10%）and the lowest in 2021（50.38%）.Therewas an downward trend over time in the detection rate of pathogenic bacteria in hospitalized children with diarrhea.The detection rates of pathogenic bacteria，viruses and total pathogens were statistically different in children withdiarrhea in different age groups（P0.05），with the highest detection rate of pathogenic bacteria in children aged 11-14 years（30.45%）and the highest detection rate of viruses in children aged 0-5 years（43.37%）.The detection疾病监测安徽省儿童医院 20162021 年住院腹泻患儿病原学监测张蔷，邓芳安徽医科大学附属省儿童医院（安徽省儿童医院）感染科，安徽 合肥230001摘要：目的调查安徽省儿童医院住院腹泻患儿病原学监测结果。方法采用传统法检测安徽省儿童医院20162021年1 334例住院腹泻患儿粪便细菌，实时荧光PCR检测病原体核酸（包括沙门菌、致泻性大肠杆菌、志贺菌、小肠结肠炎耶尔森菌、类志贺邻单胞菌、轮状病毒、诺如病毒、札如病毒、腺病毒、星状病毒），并分析不同年份、年龄、性别、居住地及不同季节的住院腹泻患儿病原菌分布特点。结果20162021年共收集病例1 334例，在1 334份粪便标本中检出770株病原微生物，检出率为57.72%，其中致病菌290株（21.74%），病毒480株（35.98%）。检出率最高的致病菌为沙门菌（7.35%）和致泻性大肠杆菌（7.12%），检出率最高的病毒是轮状病毒（17.32%）和诺如病毒（10.72%）。2017年病原菌检出率最高，为66.10%，2021年病原菌检出率最低，为50.38%，随时间的推移，住院腹泻患儿病原菌检出率下降。不同年龄段腹泻儿童病原菌、病毒及总病原体检出率差异均有统计学意义（P0.05）。不同居住环境腹泻患儿致病菌、病毒及总病原菌检出率比较，差异均无统计学意义（P0.05）。不同季节腹泻患儿致病菌、病毒及总病原体检出率差异均有统计学意义（P0.05）and different living environments（P0.05）.The detection rates of pathogenic bacteria，viruses and total pathogens showed statistical difference in diarrhea children in different onset seasons，with higherdetection rate of pathogenic bacteria in summer and autumn than in spring and winter（30.04%，32.76%vs.18.78%，14.55%）and higher detection rate of viruses in winter than in the other three seasons（47.19%vs.29.10%，30.45%，29.74%）.ConclusionFrom 2016 to 2021，the pathogens detected in the fecal samples of hospitalized diarrheachildren in Anhui Childrens Hospital were mainly viruses.Viruses detection rates were high in diarrhea childrenaged 0-5 years and bacteria detection rates were high in diarrhea children aged 11-14 years.With age，the overalldetection rate of pathogens in diarrhea children decreased.Keywords：Childhood diarrheal disease；Pathogen；Drug sensitivity test；Drug resistance表120162021年腹泻住院患儿病原体构成n（%）Tab.1Pathogens of hospitalized children with diarrhea from 2016 to 2021 n（%）年份Year例数No.cases病原菌Pathogenic bacteria病毒Virus总检出率Totaldetec-tion rate沙门菌致泻性大肠杆菌志贺菌小肠结肠炎耶尔森菌类志贺邻单胞菌合计轮状病毒诺如病毒札如病毒腺病毒星状病毒合计201621120（9.48）16（7.58）7（3.32）7（3.32）6（2.84）56（26.54）37（17.54）23（10.90）6（2.84）5（2.37）6（2.84）77（36.49）133（63.03）201723619（8.05）16（6.78）7（2.97）7（2.97）4（1.69）53（22.46）50（21.19）33（13.98）6（2.54）9（3.81）5（2.12）103（43.64）156（66.10）75中国国境卫生检疫杂志2023年2月第46卷第1期Chinese Frontier Health Quarantine Feb.2023，Vol 46，No.1表3不同性别腹泻患儿病原体构成n（%）Tab.3Pathogens of diarrhea children of different gender n（%）性别Gender例数No.cases病原菌Pathogenic bacteria病毒Virus总检出率Totaldetec-tion rate沙门菌致泻性大肠杆菌志贺菌小肠结肠炎耶尔森菌类志贺邻单胞菌合计轮状病毒诺如病毒札如病毒腺病毒星状病毒合计男67650（7.40）50（7.40）20（2.96）19（2.81）11（1.63）150（22.19）123（18.20）74（10.95）19（2.81）19（2.81）16（2.37）251（37.13）401（59.32）女65848（7.29）45（6.84）18（2.74）18（2.74）11（1.67）140（21.28）108（16.41）69（10.49）17（2.58）21（3.19）14（2.13）229（34.80）369（56.08）合计1 33498（7.35）95（7.12）38（2.85）37（2.77）22（1.65）290（21.74）231（17.32）143（10.72）36（2.70）40（3.00）30（2.25）480（35.98）770（57.72）2值0.1630.7841.435P值0.6860.3760.2312.2不同年龄段腹泻患儿病原体构成不同年龄组的腹泻儿童病原菌、病毒及总病原体检出率差异有统计学意义（P0.05）。见表3。表2不同年龄段腹泻患儿病原体构成n（%）Tab.2Pathogens of children with diarrhea at different ages n（%）年龄（岁）Age（years）例数No.cases病原菌Pathogenic bacteria病毒Virus总检出率Totaldetec-tion rate沙门菌致泻性大肠杆菌志贺菌小肠结肠炎耶尔森菌类志贺邻单胞菌合计轮状病毒诺如病毒札如病毒腺病毒星状病毒合计0564139（6.08）37（5.77）15（2.34）13（2.03）9（1.40）113（17.63）132（20.59）82（12.79）23（3.59）24（3.74）17（2.65）278（43.37）391（61.00）61042732（7.49）32（7.49）12（2.81）13（3.04）7（1.64）96（22