Jia L, Lyu B, Tian Y, Zhang X, Liu Z C, Peng H, Li H J, Zhen B J, Wang X L, Huang Y, Qu M, Wang Q Y
Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China.
Department of Infectious Disease and Endemic Disease Control, Changping District Center for Disease Control and Prevention, Beijing 102200, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Feb 10;40(2):165-169. doi: 10.3760/cma.j.issn.0254-6450.2019.02.008.
To analyze the pathogenic surveillance programs and related factors on bacillary dysentery in Beijing, 2008-2017, to provide evidence for the practices of diagnosis, treatment and prevention of the disease. Analysis was conducted on surveillance data of bacillary dysentery, collected from the surveillance areas of national bacillary dysentery in Beijing. positive rate of stool samples were used as the gold standard while detection rate of , diagnostic accordance rate and resistance were computed on data from the surveillance programs. Chi-square test was used to compare the rates and unconditional logistic regression was used to analyze the related factors of infection. Both the reported incidence rate on bacillary dysentery and detection rate of in diarrhea patients showed significantly decreasing trend, from 2008 to 2017. The accordance rate of bacillary dysentery was only 7.80% (111/1 423). was the most frequently isolated strain (73.95%, 159/215) followed by . Results from the multivariate logistic regression of positive rate revealed that among those patients who were routine test of stool positive . routine test of stool positive (=1.863, 95: 1.402-2.475), onset from July to October . other months'time (=7.271, 95: 4.514-11.709) temperature ≥38 ℃ temperature <38 ℃(=4.516, 95: 3.369-6.053) and age from 6 to 59 years old . other ages (=1.617, 95: 1.085-2.410), presenting higher positive detection rates of from the stool tests. The resistant rates on ampicillin and nalidixic acid were 97.57% (201/206) and 94.90% (186/196), both higher than on other antibiotics. The resistant rates on ciprofloxacin (16.33%, 32/196), ofloxacin (9.57%, 11/115) and on amoxilin (15.05%, 31/206) were relatively low. The resistant rate appeared higher on than on . The proportion of strains with resistance on 3 more drugs, was 30.00%(21/70). The diagnostic accordance rate of bacillary dysentery in Beijing was low, with severe resistance of . Our findings suggested that clinicians should take multiple factors into account in their practices about epidemiological history, clinical symptom and testing results for diarrhea patients.
分析2008 - 2017年北京市细菌性痢疾的病原学监测方案及相关因素，为该病的诊断、治疗和预防提供依据。对北京市国家细菌性痢疾监测地区收集的细菌性痢疾监测数据进行分析。以粪便样本阳性率为金标准，计算监测方案数据中的检出率、诊断符合率和耐药率。采用卡方检验比较率，采用非条件logistic回归分析感染的相关因素。2008 - 2017年，北京市细菌性痢疾报告发病率和腹泻患者中细菌性痢疾的检出率均呈明显下降趋势。细菌性痢疾的符合率仅为7.80%（111/1423）。福氏志贺菌是最常分离出的菌株（73.95%，159/215），其次是宋内志贺菌。志贺菌属阳性率的多因素logistic回归结果显示，在粪便常规检测阳性的患者中，粪便常规检测阳性（=1.863，95%：1.402 - 2.475）、7 - 10月发病（相对于其他月份时间，=7.271，95%：4.514 - 11.709）、体温≥38℃（相对于体温<38℃，=4.516，95%：3.369 - 6.053）以及年龄6 - 59岁（相对于其他年龄，=1.617，95%：1.085 - 2.410）的患者，粪便检测中志贺菌属的阳性检出率较高。氨苄西林和萘啶酸的耐药率分别为97.57%（201/206）和94.90%（186/196），均高于其他抗生素。环丙沙星（16.33%，32/196）、氧氟沙星（9.57%，11/115）和阿莫西林（15.05%，31/206）的耐药率相对较低。宋内志贺菌的耐药率高于福氏志贺菌。对3种及以上药物耐药的菌株比例为30.00%（21/70）。北京市细菌性痢疾的诊断符合率较低，志贺菌属耐药严重。我们的研究结果表明，临床医生在对腹泻患者进行诊疗时应综合考虑流行病学史、临床症状和检测结果等多方面因素。
