Zhang Z K, Lai S J, Yu J X, Yang W Q, Wang X, Jing H Q, Li Z J, Yang W Z
Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Key Laboratory of Clinical in Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou 310003, China; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease.
Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Apr 10;38(4):419-423. doi: 10.3760/cma.j.issn.0254-6450.2017.04.002.
To understand the epidemiological characteristics of diarrheagenic (DEC) among diarrhea outpatients in China. Diarrhea surveillance program was conducted in outpatient and emergency departments from 170 hospitals that under the sentinel programs in 27 provinces, from 2012-2015. Clinical and epidemiological data regarding diarrhea patients were collected, with fecal specimens sampled and tested for DEC in 92 network-connected laboratories. Among all the 46 721 diarrhea cases, 7.7 of them appeared DEC positive in those with geographic heterogeneity. In 2 982 cases (6.4) with available data on PCR subtypes of DEC, enteroaggregative (EAEC, 1 205 cases, 40.4) appeared the most commonly seen pathogens, followed by enteropathogenic (EPEC, 815 cases, 27.3), and enterotoxigenic (ETEC, 653 cases, 21.9). The highest positive rate of DEC was observed in outpatients of 25-34 years old (10.1), living in the warm temperate zones (11.1), and with mucous-like stool (9.4). The positive rate of DEC showed a strong seasonal pattern, with peaks in summer, for all the subtypes. DEC seemed easy to be detected among diarrhea outpatients in China, with EAEC, EPEC and ETEC the most commonly identified subtypes. Epidemiological characteristics regarding the heterogeneities of DEC appeared different, in regions, age groups and seasons. Long-term surveillance programs should be strengthened to better understand the epidemiology of DEC, in China.
为了解中国腹泻门诊患者中致泻性大肠埃希菌(DEC)的流行病学特征。2012年至2015年,在27个省份的170家哨点医院的门诊和急诊科开展了腹泻监测项目。收集腹泻患者的临床和流行病学数据,在92个联网实验室采集粪便标本并检测DEC。在所有46721例腹泻病例中,7.7%的病例DEC检测呈阳性,且存在地域异质性。在2982例(6.4%)有DEC PCR亚型可用数据的病例中,肠集聚性大肠埃希菌(EAEC,1205例,40.4%)是最常见的病原体,其次是肠致病性大肠埃希菌(EPEC,815例,27.3%)和产肠毒素性大肠埃希菌(ETEC,653例,21.9%)。DEC阳性率在25 - 34岁的门诊患者中最高(10.1%),居住在暖温带地区的患者中阳性率为(11.1%),粪便呈黏液样便的患者中阳性率为(9.4%)。所有亚型的DEC阳性率均呈现强烈的季节性模式,夏季为高峰。在中国腹泻门诊患者中似乎很容易检测到DEC,其中EAEC、EPEC和ETEC是最常见的亚型。DEC在地区、年龄组和季节方面的异质性流行病学特征有所不同。在中国应加强长期监测项目,以更好地了解DEC的流行病学情况。