文献类型：期刊文献

中文题名：广州市5岁以下腹泻患儿感染肠致病性大肠埃希菌的流行特征

英文题名：Epidemiological characteristics and clinical manifestation of Enteropathogenic Escherichia coli in diarrhea cases less than five years in Guagnzhou, China

作者：李湘津[1];孙春莲[2];刘丽君[1];颜娟[3];田利光[4,5];陈家旭[4,5];耿岚岚[6];王洪丽[6];张顺先[4,5]

第一作者：李湘津

机构：[1]兰州大学第一医院儿科,甘肃兰州730000;[2]曲靖市第一人民医院药械部;[3]甘肃中医药大学中医临床学院;[4]中国疾病预防控制中心寄生虫病预防控制;[5]卫生部寄生虫病原与媒介生物学重点实验室,世界卫生组织热带病合作中心,国家热带病研究中心;[6]广州市妇女儿童医疗中心

第一机构：兰州大学第一医院儿科,甘肃兰州730000

年份：2019

卷号：14

期号：8

起止页码：875

中文期刊名：中国病原生物学杂志

外文期刊名：Journal of Pathogen Biology

收录：CSTPCD;;北大核心:【北大核心2017】；CSCD:【CSCD2019_2020】；

基金：中国博士后基金项目(No.2018M643043);国家自然科学基金项目(No.81473022)

语种：中文

中文关键词：病例对照;肠致病性大肠埃希菌;流行病学特征;临床表现

外文关键词：Case-control;EPEC;epidemiological characteristics;Clinical manifestation

摘要：目的了解广州市5岁以下儿童感染肠致病性大肠埃希菌(Enteropathogenic Escherichia coli,EPEC)的流行特征和临床表现,为我国儿童EPEC感染的防治提供依据。方法在广州市3家哨点医院收集5岁以下腹泻儿童粪便标本745份,非腹泻儿童粪便标本275份,进行细菌培养。选择单个菌落,提取DNA,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。结果腹泻患者儿中EPEC检出率为4.64%(35/754,95%CI:3.35-6.39),其中急性腹泻患儿EPEC检出率为5.78%(27/467,95%CI:4.00-8.28),慢性腹泻患儿EPEC检出率为2.85%(8/281,95%CI:1.45-5.52),非腹泻患儿EP EC检出率为1.45%(4/275,95%CI:0.56-3.67),EPEC检出率在腹泻患儿高于非腹泻患儿(χ~2=5.746,P<0.05,OR=3.34,95%CI:1.176-9.486)。男、女腹泻患儿EPEC检出率差异无统计学意义(χ~2=0.570,P>0.05,OR=1.335,95%CI:0.63-2.822);按各年龄组分组统计,0岁~、1岁~、2岁~、3岁~、4岁~组腹泻患儿EPCE检出率差异有统计学意义(χ~2=16.767,P<0.01);腹泻患儿EPEC检出有明显季节性(χ~2=25.897,P<0.01),以夏季检出率较高(10.66%,21/197)。EPEC检出率在门诊腹泻患儿和住院腹泻患儿间差异无统计学意义(χ~2=0.101,P>0.05,OR=1.148,95%CI:0.491-2.686)。腹泻患儿EPEC阳性者腹泻天数(4,95%CI:3-7)与EPEC阴性者腹泻天数(6,95%CI:5-7)比较,差异无统计学意义(Z=0.414,P>0.05)。结论在广州市城区,EPEC是引起儿童腹泻的重要细菌性病原体之一,流行程度高,且无特异临床表现,容易造成漏诊和误诊。实验室检测可为EPEC相关腹泻的诊治提供参考。
Objective The aim of this study was to discover the epidemiological characteristics of Enteropathogenic Escherichia coli(EPEC)in diarrhea children less than five years in Guangzhou city,Guangdong Province,China,it can provide reference for the prevention and treatment of EPEC infection.Methods Three sentinel hospitals in Guangzhou city were selected,and a total of 745 diarrhea children and 275 non-diarrhea controls were recruited from these hospitals from January 2018 to December 2018.Fresh stool sample was collected from each subject.A structured questionnaire was used to record the demographic information and clinical symptom from each subject.The data analysis method was involved rank sum test,Chi-square test and multivariate logistic regression model according to the data nature.Culture and real-time polymerase chain reaction(PCR)method were applied to detect EPEC strain.Results The detection rate of EPEC was 4.64%(35/754,95%CI:3.35-6.39)in all diarrhea cases,the infection rate of EPEC was 5.78%(27/467,95%CI:4.00-8.28)in acute diarrhea children,and it was 2.85%(8/281,95%CI:1.45-5.52)in chronic diarrhea cases,in addition,the detection rate of EPEC was 1.45%(4/275,95%CI:0.56-3.67)in non-diarrhea controls.The detection rate of EPEC in diarrhea children was higher than that of in controls(χ~2=5.746,P<0.05,OR=3.34,95%CI:1.176-9.486).No significant difference of the EPEC prevalence was observed among male and female diarreha children(χ~2=0.570,P>0.05,OR=1.335,95%CI:0.63-2.822).The detection rate of EPEC was observed with statistical difference in several age groups(χ~2=16.767,P<0.01),the infection rate of EPEC was 4.23%(17/402)in diarrhea children with 0-1 years,it was 8.84%in(17/192)in diarrhea children with 1-2 years,and it was 1.96%(1/51)diarrhea children with 45 years.The prevalence of EPEC has significant seasonal trend(χ~2=25.897,P<0.01),the detection rate of EPEC was the highest in Summer(10.66%,21/197).The detecdtion rate of EPEC was no significant difference between outpatiets and inpatients(χ~2=0.101,P>0.05,OR=1.148,95%CI:0.491-2.686).The diarrha days was no significant difference(Z=0.414,P>0.05)among EPEC positive diarrhea children(4 days,95%CI:3-7)and EPEC negative diarrha cases(6 days,95%CI:5-7).Conclusion EPEC was one of the most important bacterial pathogen causing children diarrhea in Guangzhou.It was high prevalence and was no specific clinical symptom.The EPEC infection was easy to escape diagnosis or be misdiagnosed.Laboratory testing can provide reference for the diagnosis and treatment of EPEC infection.