2013—2015年上海市腹泻病综合监测结果分析

发布时间：2018-04-27 00:01

本文选题：腹泻病 + 监测模式　；参考：《中国公共卫生》2017年10期

【摘要】：目的探索临床诊疗与公共卫生充分结合的腹泻病监测新模式,动态掌握上海市腹泻病病原谱与流行病学变化特征。方法 2013年7月—2015年6月,按照现况研究样本量公式和概率比例规模(PPS)方法进行样本量计算和分配。通过医生问询收集监测病例临床特征和流行病学信息并录入开发的信息化系统。监测系统共登记初诊腹泻病例58 336例,采样病例共6 543例。进行11种细菌分离和5种病毒核酸检测,对阳性细菌株进一步进行药敏检测。结果成功构建"市级疾病预防控制中心-区级疾病预防控制中心-监测医院"三位一体的监测网络,内容覆盖腹泻病例的临床、流行学和病原学特征,并进行网络信息化系统管理。从6 543例病例粪便标本中检出至少1种病原体阳性者3 059例,阳性率为46.75%。共检出7种细菌、5种病毒。细菌阳性率为12.07%(790/6 543),主要为副溶血性弧菌(256例)、致泻性大肠埃希菌239例、沙门氏菌(209例)。病毒阳性率为30.46%,主要为诺如病毒(1 172例)、轮状病毒(546例)。病毒阳性数呈较明显的夏季高峰和秋冬季高峰,秋冬季病毒阳性率(52.54%,1 295/2 465)高于细菌(3.57%,88/2 465),夏季细菌阳性率(21.31%,541/2 539)高于病毒(10.05%,255/2 539),差异均有统计学意义(P0.05)。结论上海探索性构建了"一份标本、多种监测"的腹泻病综合监测的新模式,通过网络平台实现临床和公共卫生的信息化联接,基本掌握本市腹泻的病原谱和流行病学特征。该模式适用于特大型城市的腹泻病动态监测。
[Abstract]:Objective to explore a new surveillance model of diarrhoeal diseases combined with clinical diagnosis and treatment and public health, and to dynamically understand the spectrum and epidemiological characteristics of diarrhoeal diseases in Shanghai. Methods from July 2013 to June 2015, sample size formula and probabilistic proportional scale (PPS) method were studied to calculate and distribute the sample size. The information of clinical features and epidemiology of monitored cases was collected and recorded in the information system developed by doctor inquiry. A total of 58,336 cases of newly diagnosed diarrhea and 6,543 cases of sampled diarrhea were registered by the surveillance system. Eleven kinds of bacteria were isolated and 5 kinds of viral nucleic acid were detected. Results A trinity surveillance network was successfully constructed, which covers the clinical, epidemiological and etiological characteristics of diarrhea cases, including the city level disease prevention and control center, the district disease prevention and control center and the surveillance hospital. And carries on the network information system management. 3 059 of 6 543 fecal specimens were positive for at least one pathogen, and the positive rate was 46. 75%. A total of 7 kinds of bacteria and 5 kinds of viruses were detected. The positive rate of bacteria was 12.070.The positive rate was 790% 6543%, including 256 cases of Vibrio parahaemolyticus, 239 cases of cathartic Escherichia coli and 209 cases of salmonella. The positive rate of virus was 30.46%, mainly 1 172 cases of norovirus and 546 cases of rotavirus. The positive rate of virus in autumn and winter was significantly higher than that in summer and autumn and winter. The positive rate of virus in autumn and winter was higher than that in bacteria 3.5788 / 2 465). The positive rate of bacteria in summer was 21.31% 541% 2 539) higher than that of virus 10.05% 2555% 2 539 (P 0.05). Conclusion A new model of comprehensive surveillance of diarrhoeal diseases based on "one specimen, multiple surveillance" has been constructed in Shanghai. The information connection between clinical and public health can be realized through the network platform, and the pathogeny spectrum and epidemiological characteristics of diarrhea in this city can be basically grasped. The model is suitable for dynamic surveillance of diarrhoeal diseases in large cities.
【作者单位】：上海市疾病预防控制中心;
【基金】：上海市第四轮公共卫生三年行动计划重点学科“传染病与卫生微生物学”(15GWZK0101) 上海市第四轮公共卫生三年行动计划高端海外研修团队培养计划(GWTD2015S02)
【分类号】：R181.3

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