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目的了解云南省昆明市肠致病性大肠杆菌(enteropathogenic Escherichia coli,EPEC)的流行特征,为我国EPEC感染引起的腹泻提供科学依据。方法在云南省昆明市4家哨点医院收集腹泻病例粪便样本1 121份,非腹泻人群粪便样本319份,进行细菌培养,选择单个菌落,提取DNA,并采用荧光定量PCR检测EPEC,同时使用结构化问卷收集研究对象基本信息。结果 EPEC在腹泻病例中的检出率高于非腹泻研究对象中的检出率(5.53%,1.88%,χ~2=7.36,P<0.05)。EPEC的检出率在不同年龄组腹泻病例中有统计学差异(χ~2=17.27,P<0.05),其中在2—5岁腹泻病例最高(12.12%,16/132);EPEC的检出率在腹泻病例中有明显的季节分布趋势(χ~2=12.82,P<0.05),其中EPEC在夏季最高(9.00%,18/200),冬季最低(3.05%,12/394)。EPEC阳性的腹泻病例水样便占61.3%(38/62),出现脱水症状占12.9%(8/62)。结论 EPEC是昆明市人群腹泻的重要细菌性病原体之一,且EPEC感染以5岁以下儿童为主,EPEC感染容易造成脱水。
Objective To understand the epidemiological characteristics of enteropathogenic Escherichia coli (EPEC) in Kunming, Yunnan province and to provide a scientific basis for diarrhea caused by EPEC infection in China. Methods A total of 1 121 cases of stool samples and 319 stool samples of non-diarrhea patients were collected from 4 sentine hospitals in Kunming, Yunnan Province. Bacteria were cultured and single colonies were selected for DNA extraction. EPEC was detected by real-time PCR. The questionnaire collected the basic information of the research object. Results The detection rate of EPEC in diarrhea cases was higher than that in non-diarrhea subjects (5.53%, 1.88%, χ ~ 2 = 7.36, P <0.05). The detection rate of EPEC was significantly different among diarrhea patients of different age groups (χ ~ 2 = 17.27, P <0.05), of which the highest incidence was found in diarrhea patients aged 2-5 years (12.12%, 16/132) In the diarrhea cases, there was a significant seasonal distribution trend (χ ~ 2 = 12.82, P <0.05). Among them, EPEC was the highest in summer (9.00%, 18/200) and lowest in winter (3.05%, 12/394). Water samples of EPEC positive diarrhea accounted for 61.3% (38/62), dehydration symptoms accounted for 12.9% (8/62). Conclusion EPEC is one of the important bacterial pathogens of diarrhea in Kunming. EPEC infection is mainly in children under 5 years of age, and EPEC infection easily causes dehydration.