20142023年浙江省海宁市食源性疾病病原体感染特征分析

Analysis of foodborne diseases pathogen infection characteristics in Haining City, Zhejiang Province from 2014 to 2023

  • 摘要:
    目的 分析浙江省海宁市食源性疾病主动监测病原体的流行特征,为食源性疾病及暴发事件的预防及调查提供依据。
    方法 收集2014—2023年海宁市哨点医院报告食源性疾病患者信息,并采集其粪便或肛拭子进行相关病原体检测。采用χ2检验比较不同组别的病原体检出率差异,采用多因素logistic回归分析病原体检出的危险因素。
    结果 2014—2023年间共检测样本5 814份,阳性检出率15.36%,其中诺如病毒检出率4.95%,致泻性大肠埃希菌检出率4.49%,沙门菌检出率3.59%,副溶血性弧菌检出率2.22%,志贺菌检出率0.11%。阳性检出率呈现出以诺如病毒为主的3—4月份小高峰和以细菌为主的7—9月大高峰的季节特征;病原体检出率最高的 3种人群为工人、脑力劳动者和其他人群。多因素logistic回归显示,年龄、季节和就诊前服用抗生素是病原体检出的显著影响因素(P<0.05)。就诊前服用抗生素组总病原体检出风险较未服用者降低(OR=0.29,95%CI:0.15~0.49);诺如病毒在学龄前年龄组(OR=0.19,95%CI:0.04~1.00)、夏秋季(OR值范围为0.23~0.41)及服用抗生素组(OR=0.42,95%CI:0.15~0.92)检出风险降低,在青年组检出风险增加(OR=1.40,95%CI:1.05~1.88);致泻性大肠埃希菌在夏季(OR=1.82,95%CI:1.30~2.60)检出风险升高;沙门菌检出风险在老龄组和夏季增加(OR值范围为1.44~2.21),在青年组、冬季和服用抗生素组降低(OR值范围为0.22~0.65);副溶血性弧菌检出风险在夏秋季增加(OR值范围1.80~1.90),在中小学生组和冬季降低(OR值范围为0.10~0.32)。
    结论 海宁市食源性疾病流行病原体检出处于较高水平,年龄、季节和就诊前服用抗生素是病原体检出的独立影响因素。提示在进行食源性暴发事件现场调查时可依据发生时间、病例年龄分布等特征提出针对性的致病因子假设。

     

    Abstract:
    Objective To analyze the epidemiological characteristics of pathogens in foodborne disease cases in Haining City, Zhejiang Province, and to provide a basis for the prevention and investigation of foodborne diseases and outbreak events.
    Methods Information on foodborne disease patients from 2014 to 2023 was collected, and stool or anal swab samples were tested for relevant pathogens. The χ2 test was used to compare the differences in pathogen detection rates among different groups, and multivariate logistic regression analysis was used to analyze the risk factors for pathogen detection.
    Results A total of 5 814 samples were tested, with a positive detection rate of 15.36%. The detection rates were 4.95% for norovirus, 4.49% for Escherichia coli, 3.59% for Salmonella, 2.22% for Vibrio parahaemolyticus, and 0.11% for Shigella. The positive detection rates showed seasonal characteristics, with a minor peak in March-April dominated by norovirus and a major peak in July-September dominated by bacteria. The three groups with the highest detection rates were workers, white-collar workers and other groups. Multivariate logistic regression analysis showed that age, season, and antibiotic use before consultation were significant influencing factors for pathogen detection (P<0.05). Total pathogen detection risk was lower in the group that took antibiotics before visiting the clinic compared to those who did not (OR=0.29, 95%CI: 0.15‒0.49). The detection risk for norovirus was lower in the preschool age group (OR=0.19, 95%CI: 0.04‒1.00), in summer and autumn (OR range 0.23‒0.41), and in the group taking antibiotics (OR=0.42, 95%CI: 0.15‒0.92), but higher in the adolescent group (OR=1.40, 95%CI: 1.05‒1.88). The detection risk for enteropathogenic Escherichia coli was higher in summer (OR=1.82, 95%CI: 1.30‒2.60). The detection risk for Salmonella increased in the elderly group and in summer (OR range 1.44‒2.21), but decreased in the adolescent group, in winter, and in the group taking antibiotics (OR range 0.22‒0.65). The detection risk for Vibrio parahaemolyticus increased in summer and autumn (OR range 1.80‒1.90), but decreased in the primary and secondary school student group and in winter (OR range 0.10‒0.32).
    Conclusion The prevalence of foodborne disease pathogens in Haining City is relatively high. Age, season, and antibiotic use before consultation are independent influencing factors for pathogen detection. These findings suggest that specific hypotheses regarding pathogenic factors can be proposed based on the time of occurrence and the age distribution of cases during field investigations of foodborne outbreaks.

     

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