Wang J, Sun H, Qi L, Shi X H, Zhou Y, Min K Y, Duan R, Wang X, Wang L J
Dongcheng District Center for Disease Control and Prevention, Beijing 100009, China.
Dongcheng District Center for Maternal and Child Health Care and Family Planning Service, Beijing 100061, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Oct 6;53(10):1027-1031. doi: 10.3760/cma.j.issn.0253-9624.2019.10.014.
To illuminate the epidemic characteristics of Yersiniosis among children in the central city of Beijing and the accuracy of current clinical diagnosis towards Yersiniosis. Etiological surveillance of diarrheal patients, a total of 3 493 cases, was performed in a children hospital in central area of Beijing from 2011 to 2018 continuously. Collected the epidemiological and clinical information of the cases, analyzed the clinical and etiological diagnosis for Yersiniosis and bacterial dysentery and compared the distribution of Yersiniosis cases with the different symptoms. A total of 3 493 acute diarrhea cases distributed from the age of 6 months to 13 years old, ((25), (75)) was 1.50 (0.75, 3.17) years old. The 28 cases were isolated Yersinia enterocolitica (isolation rate of 0.80%) and they could be diagnosed as Yersiniosis by etiology. The isolation peaked in May and February. A total of 85.71% (24/28) of Yersiniosis cases were under 5-year old. The children of 3-4 age group had the highest isolation rate (1.52%) while the rate (0.18%) of 0-1 age group was the lowest (=0.025). The Yersinia enteroclitica isolation rates of diarrheal patients with the symptoms including mucus feces, fever, white blood cell (WBC) and red blood cell (RBC) in feces were higher than the patients without these symptoms (>0.05). The 9 of 28 Yersiniosis cases by etiology diagnosis were clinical diagnosed as bacillary dysentery. The infants and young children under 5-year old were the main population of Yersiniosis adolescent patients under 14-year old. The typical symptoms characterized with mucus stool, fever, WBC and RBC by routine microscopic examination. The preliminary clinical diagnosis of Yersiniosis is easily confused with bacterial dysentery.
为阐明北京市中心城区儿童耶尔森菌病的流行特征及目前临床诊断对耶尔森菌病的准确性。对某儿童医院2011年至2018年连续收治的3493例腹泻患者进行病因学监测。收集病例的流行病学和临床信息,分析耶尔森菌病和细菌性痢疾的临床及病因诊断,并比较耶尔森菌病病例不同症状的分布情况。共3493例急性腹泻病例,年龄分布在6个月至13岁,((25),(75))为1.50(0.75,3.17)岁。分离出28株小肠结肠炎耶尔森菌(分离率0.80%),经病因学可诊断为耶尔森菌病。分离高峰在5月和2月。85.71%(24/28)的耶尔森菌病病例年龄在5岁以下。3~4岁年龄组儿童分离率最高(1.52%),而0~1岁年龄组最低(0.18%)(P=0.025)。粪便有黏液、发热、粪便白细胞(WBC)和红细胞(RBC)等症状的腹泻患者小肠结肠炎耶尔森菌分离率高于无这些症状的患者(P>0.05)。28例经病因学诊断为耶尔森菌病的病例中,9例临床诊断为细菌性痢疾。5岁以下婴幼儿是14岁以下青少年耶尔森菌病患者的主要人群。典型症状为黏液便、发热,粪便常规镜检可见WBC和RBC。耶尔森菌病的初步临床诊断易与细菌性痢疾混淆。