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目的比较旅行者腹泻(traveler’s diahrrea,TD)病原体的区域间差异,以期为预防和治疗提供依据。方法检索1973年至今发表于Pubmed(Medline)和中国知网的TD相关文献,对TD发生次数、人数、病原体、区域等因素进行整理及分析。结果经统计,肠产毒性大肠杆菌(Enterotoxic escherichia coli,ETEC)为最常见病原体,占总TD发病人数的30.86%(1 944/6 300),其中拉丁美洲、非洲和南亚阳性率最高,分别占该区域TD总数的33.59%(1 109/3 302)、31.22%(385/1233)和30.42%(223/733)。其余较高的病原体为肠黏附性大肠杆菌(Enteroadherent Escherichia coli,EAEC)和诺如病毒(Norovirus,NV)。ETEC、EAEC、肠致病性大肠杆菌(Enteropathogenic Escherichia coli,EPEC)、肠出血性大肠杆菌(Enterohemorrhagic Escherichia coli,EHEC)、弯曲杆菌、志贺氏菌、沙门氏菌、气单孢菌、毗邻单胞菌、非霍乱弧菌、贾第鞭毛虫、隐孢子虫、阿米巴原虫的感染均有地区间差异。结论TD的病原体存在地区间差异,了解该差异对TD的预防和治疗具有一定指导意义。
Objective To compare the regional differences of traveler’s diahrrea (TD) pathogens in order to provide the basis for prevention and treatment. Methods The related articles of TD published in PubMed (Medline) and China Knitting Network since 1973 were retrieved and analyzed. The number of TDs, number of people, pathogens, regions and other factors were sorted out and analyzed. Results Enterotoxic escherichia coli (ETEC) was the most common pathogens, accounting for 30.86% (1 944/6 300) of the total number of patients with TD. The highest positive rate was found in Latin America, Africa and South Asia, accounting for 33.59% (1 109/3 302), 31.22% (385/1233) and 30.42% (223/733) of the total TDs in the region. The remaining higher pathogens were Enteroadhesive Escherichia coli (EAEC) and Norovirus (NV). ETEC, EAEC, Enteropathogenic Escherichia coli (EPEC), Enterohemorrhagic Escherichia coli (EHEC), Campylobacter, Shigella, Salmonella, Aeromonas, , Non-Vibrio cholerae, Giardia, Cryptosporidium, and Amoeba were all inter-regional differences. Conclusions There are inter-regional differences in pathogen of TD. To understand the difference is of guiding significance in the prevention and treatment of TD.