上海市嘉定区腹泻患者中金黄色葡萄球菌感染及肠毒素基因携带情况分析

陈培超; 黄强; 程芳洲; 陈慧娟; 马智琪; 孙攀; 彭谦

doi:10.19428/j.cnki.sjpm.2024.24156

上海市嘉定区腹泻患者中金黄色葡萄球菌感染及肠毒素基因携带情况分析

Analysis of Staphylococcus aureus infection and enterotoxin gene carriage in diarrhoeal patients in Jiading District， Shanghai

摘要

摘要:
目的了解上海市嘉定区腹泻患者中金黄色葡萄球菌的感染状况，分析腹泻患者菌株中肠毒素基因携带情况。
方法于2021—2023年对上海市嘉定区1家哨点医院肠道门诊和9个不同街镇的社区卫生服务中心的腹泻患者的肛拭子样本进行金黄色葡萄球菌检测，并检测5种肠毒素（SE）毒力基因SEA、SEB、SEC、SED、SEE。
结果共收集到1 080份肛拭样品，81份样品中检出金黄色葡萄球菌，检出率为7.50%，2021—2023年腹泻患者中金黄色葡萄球菌检出率相近。男女金黄色葡萄球菌检出率差异无统计学意义（χ²=0.821，P=0.365）。婴幼儿腹泻患者的金黄色葡萄球菌检出率最高（29.51%），4~<31岁人群检出率为14.06%，年龄≥31岁人群金黄色葡萄球菌检出率为2.99%。嘉定区不同街镇间患者金黄色葡萄球菌检出率差异有统计学意义（χ²=66.134，P<0.05）。SEA、SEB、SEC、SED、SEE基因携带率分别为13.58%、14.81%、11.11%、7.41%、0。
结论嘉定区腹泻患者金黄色葡萄球菌的流行率较稳定且有明显的地域特征，儿童和青少年是高风险人群。以SEB基因为主，其次为SEA。

Abstract:
Objective To investigate the prevalence of Staphylococcus aureus in patients with diarrhea,and to analyze the genes carriage of enterotoxin in the strains of these patients in Jiading District, Shanghai.
Methods From 2021 to 2023, anal swabs of diarrhea outpatients from one sentinel hospital and nine community health service centers in different townships in Jiading District, Shanghai, were tested for Staphylococcus aureus, from which five enterotoxin virulence genes such as SEA, SEB, SEC, SED, and SEE were tested simultaneously.
Results A total of 1 080 anal swabs were collected, 81 of which were tested positive for S. aureus, with a detection rate of 7.50%, and the detection rate of S. aureus was similar in patients with diarrhea from 2021‒2023. There was no statistically significant difference in detection rates between males and females (χ²=0.821, P=0.365). S. aureus detection rate was highest in infants and young children with diarrhea (29.51%), followed by 14.06% in the people aged between 4‒<31 years, and 2.99% in those aged ≥31 years. Significant differences were observed in the detection rate of S. aureus in the diarrhoeal patients from different townships of Jiading District(χ²=66.134,P<0.05). The carriage rates of the 5 enterotoxin genes, namely SEA, SEB, SEC, SED, SEE, were 13.58%, 14.81%, 11.11%, 7.41%, and 0, respectively.
Conclusion The prevalence of S. aureus among the patients with diarrhea in Jiading District is relatively stable but with distinct geographical patterns. Children and adolescents are high-risk groups. SEB were the dominant gene, followed by SEA.

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