目的 了解浦东新区幼托儿童细菌和病毒感染性腹泻流行特征,为幼托儿童感染性腹泻病的防控提供科学依据。方法 依托6家医院,按照1∶5~1∶20不等的抽样间距,采集儿童腹泻初诊病例粪便标本并收集流行病学资料,开展细菌和病毒检测分析。结果 381例粪便标本中,细菌和病毒阳性检出率60.89%,民办幼儿园病例阳性检出率高于公办幼儿园(χ²=6.53,P＜0.05)。单纯细菌阳性检出率10.24%,主要为致泻性大肠埃希菌;单纯病毒阳性检出率33.33%,主要为诺如病毒和轮状病毒;混合感染阳性检出率17.59%,主要为2种病毒混合感染。单纯细菌感染夏季高,单纯病毒感染冬春季高(χ²=34.00,P＜0.05)。单纯病毒和细菌感染病例中,出现呕吐症状的构成比分别为42.06%和17.95%,病毒组高于细菌组(χ²=7.48,P＜0.05)。结论 上海市浦东新区幼托儿童感染性腹泻病原中细菌和病毒季节高峰明显,民办幼托机构儿童感染较重,应针对不同季节和不同人群开展防控措施。

Objective To analyze the epidemjological characteristics of bacterial and viral infectious diarrhea of kindergarten children in Pudong New Area. Methods Relying on 6 hospitals, the stool samples and epidemiological data of diarrhea cases in kindergarten children were collected according to the sampling distance of 1∶5~1∶20, and the stool samples were used to test for bacteria and viruses, at the meantime the epidemiological data was for epidemiology analysis. Results Among 381 stool samples detected, 232 (60.89%)were bacterial and viral pathogen positive, the positive rate in private kindergartens was higher than that in public kindergartens(χ²=6.53,P＜0.05).The bacterium positive rate was 10.24%, and the main pathogen was pathogenic Escherichia coli; The virus positive rate was 33.33%, and the main pathogens were norovirus and rotavirus. The cross infection positive rate was 17.59%, mainly were combined with 2 viruses. In summer, the bacterium positive rate was higher than virus, but the virus positive rate was higher in winter and spring(χ²=34.00,P＜0.05). More cases had vomiting in virus positive group (42.06%) than in bacterium positive group (17.95%). Conclusions The bacterial and viral pathogen spectrum of infectious diarrhea is related to season obviously in Pudong New Area kindergarten children, and children in private kindergarten are risk groups. It is necessary to carry out prevention and control measures for different seasons and groups.