20162024年浙江省温州市食源性副溶血性弧菌流行特征及耐药性研究

Epidemiological characteristics and antimicrobial resistance analyses of foodborne Vibrio parahaemolyticus in Wenzhou City of Zhejiang Province from 2016 to 2024

  • 摘要:
    目的 分析2016—2024年温州市食源性疾病监测中副溶血性弧菌流行状况、血清型和耐药特征,为副溶血性弧菌感染的预防控制提供科学依据和数据支持。
    方法 采集2016—2024年温州市各级医疗机构食源性疾病监测中以呕吐、腹泻为主要症状并伴有食用可疑食物史的就诊患者的粪便或肛拭子样本45 980例,进行细菌分离鉴定和药敏试验,并通过“国家食源性疾病监测报告系统”收集病例相关信息。采用Cochran⁃Mantel⁃Haenszel列联表卡方检验进行组间检出率分析。
    结果 共收集45 980例疑似样本,经检测副溶血性弧菌阳性2 821例,总检出率为6.14%。比较不同人群检出率发现,20~39岁青壮年(8.57%,1 603/18 697)和农民、工人检出率最高(7.93%,994/12 537);比较不同季节检出率发现,6—10月份检出率较高(5.12%、9.04%、15.04%、14.68%、7.80%),其中8月份检出率最高。分析可疑食物的采样结果发现,水产品及其制品占比最高(42.86%)。进食场所方面,家庭占44.53%(1 257/2 821)。2016—2020年总体以O3:K6血清型为主(28.82%,813/2 821),其次为O10:K4(28.25%,797/2 821)和O4:KUT(23.61%,666/2 821)。耐药特征方面,副溶血性弧菌对头孢唑啉的耐药率最高,为84.15%(393/467),多重耐药率为6.21%(29/467)。
    结论 2016—2024年温州地区疑似食源性疾病患者在6—10月夏秋季出现副溶血性弧菌感染高峰,20~39岁青壮年和农民、工人是副溶血性弧菌感染防控的重点人群,副溶血性弧菌优势血清型由O3:K6变为O10:K4,副溶血性弧菌对头孢唑啉耐药性较高。要加强对优势血清型流行情况的监测,关注副溶血性弧菌的耐药性变化,加强对重点人群的健康宣教以及对水产品及其制品等高风险食品的监管检查。

     

    Abstract:
    Objective To analyze the epidemiological status, serotypes, and drug resistance characteristics of Vibrio parahaemolyticus in foodborne disease surveillance in Wenzhou from 2016 to 2024, and to provide scientific evidence and data support for the prevention and control of Vibrio parahaemolyticus infections.
    Methods A total of 45 980 stool or anal swab samples were collected from patients with vomiting and diarrhea as the main symptoms and a history of consuming suspicious food at medical institutions at all levels in Wenzhou from 2016 to 2024. Isolation, identification, and drug susceptibility testing were performed. Case information was collected through the National Foodborne Disease Surveillance Reporting System. The Cochran-Mantel-Haenszel (CMH) chi-square test was used to analyze the detection rates among groups.
    Results Among the 45 980 suspected samples, 2 821 were positive for Vibrio parahaemolyticus, with an overall detection rate of 6.14%. A comparison of detection rates across different population groups revealed that the highest rates were found among adults aged 20‒39 (8.57%, 1 603/18 697) and among farmers and workers (7.93%, 994/12 537). A comparison of detection rates across different seasons revealed that the detection rates were higher from June to October (5.12%, 9.04%, 15.04%, 14.68%, and 7.80%, respectively), peaking in August. Analyses of the sampling results for suspect foodstuffs revealed that aquatic products and their derivatives accounted for the highest proportion (42.86%). Regarding the setting of food consumption, the household accounted for 44.53% (1 257/2 821). From 2016 to 2020, the predominant serotype was O3:K6 (28.82%, 813/2 821), followed by O10:K4 (28.25%, 797/2 821) and O4:KUT (23.61%, 666/2 821). In terms of drug resistance, the resistance rate to cefazolin was the highest at 84.15% (393/467), and the multi-drug resistance rate was 6.21% (29/467).
    Conclusion From 2016 to 2024, patients with suspected foodborne illnesses in Wenzhou City experienced a peak in Vibrio parahaemolyticus infections during the summer and autumn months (June to October). Young adults aged 20‒39, as well as farmers and manual workers, were the key target groups for the prevention and control of Vibrio parahaemolyticus infections. The predominant serotype of Vibrio parahaemolyticus shifted from O3:K6 to O10:K4. Vibrio parahaemolyticus exhibited a high level of resistance to cefazolin. It is essential to strengthen surveillance of the epidemiological trends of the predominant serotype, monitor changes in the antibiotic resistance of Vibrio parahaemolyticus, enhance health education for key populations, and intensify regulatory inspections of high-risk foods such as aquatic products and their derivatives.

     

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