目的了解苏州市食源性疾病医院监测点病例监测流程和各环节对监测结果的影响,探讨医院食源性疾病的监测工作模式和流程。方法苏州市内25家食源性疾病医院监测点进行问卷调查、医生访谈、现场观察,分析急性胃肠炎病例监测流程对监测病例率和阳性率的影响。结果符合监测定义的病例主要有急性胃肠炎、肠道感染、腹泻3种诊断。25家医院中64.0%具有粪便培养检验能力。接诊急性胃肠炎病例的医疗部门主要有肠道门诊、(消化)内科门诊、儿科门诊、急诊4个部门。4个部门的医生平均每人每天接诊病例数为44人。临床医生认为腹泻可能由食源性引起的比例为35.0%。医院内部食源性疾病监测工作有病例筛选和样本筛选2种模式。工作流程可分为病例信息采集、标本采集、送样检验3个环节。2013年度急性胃肠炎病例采集率为6.7%。阳性率为15.1%。一级医院、护士和检验的病例信息采集率高,定专人负责、检验人员采样、专人送样样本采集率高;肠道门诊、内科急诊和护士采样的样本存放在专用管中的以及专人送样的阳性率高。结论符合定义病例的实际人数较上报人数多,大医院的急性胃肠炎就诊病例平均数远多于小医院,临床医生负担重。医院食源性疾病病例监测模式和监测流程应结合医院实际情况而定。建立长效管理机制,调动医院参与监测的人员积极性。疾控机构也应整合各条线的监测任务,应用信息化手段有利于提高监测工作效率。 Objective To understand the monitoring procedures and the impact of various links on monitoring results of foodborne disease hospital surveillance stations in Suzhou City and to explore the monitoring mode and flow of the hospital foodborne diseases. Methods Twenty-five food-borne diseases monitoring stations in Suzhou were surveyed by questionnaires, interviews with doctors and observation on site. The impact of the monitoring procedure of acute gastroenteritis on surveillance rate and positive rate was analyzed. Results In line with the definition of monitoring the main cases of acute gastroenteritis, intestinal infection, diarrhea, three kinds of diagnosis. Of the 25 hospitals, 64.0% had fecal culture tests. The medical departments that receive acute gastroenteritis cases mainly include four departments of gut clinic, internal medicine clinic (outpatient), pediatric clinic and emergency department. The average number of admissions per day per doctor per day for 4 departments is 44. Clinicians think that diarrhea may be caused by food-borne ratio of 35.0%. Hospital-based foodborne disease surveillance has two cases of screening and screening samples. Workflow can be divided into case information collection, specimen collection, sample inspection 3 links. 2013 cases of acute gastroenteritis cases collected was 6.7%. The positive rate was 15.1%. First-class hospitals, nurses and test cases of high rate of collection of information, set the person responsible for the inspection staff sampling, sample collection high sample collection rate; gut clinic, medical emergency and nurse samples stored in a dedicated tube and sent Like the positive rate. Conclusion The actual number of eligible patients is higher than the reported number. The average number of acute gastroenteritis cases in large hospitals is far more than that of small hospitals, and the clinicians are overburdened. Hospital foodborne illness case monitoring mode and monitoring process should be combined with the actual hospital conditions. Establish a long-term management mechanism to mobilize the enthusiasm of the hospital staff involved in monitoring. Disease control agencies should also integrate the monitoring tasks of each line, the application of information technology will help improve the efficiency of monitoring.