ABSTRACT
Objective To analyze the pathogenic surveillance programs and related factors on bacillary dysentery in Beijing,2008-2017,to provide evidence for the practices of diagnosis,treatment and prevention of the disease.Methods Analysis was conducted on surveillance data of bacillary dysentery,collected from the surveillance areas of national bacillary dysentery in Beijing.Shigella positive rate of stool samples were used as the gold standard while detection rate of Shigella,diagnostic accordance rate and resistance were computed on data from the surveillance programs.Chi-square test was used to compare the rates and unconditional logistic regression was used to analyze the related factors of Shigella infection.Results Both the reported incidence rate on bacillary dysentery and detection rate of Shigella in diarrhea patients showed significantly decreasing trend,from 2008 to 2017.The accordance rate of bacillary dysentery was only 7.80％ (111/1 423).Shigella sonnei was the most frequently isolated strain (73.95％,159/215) followed by Shigella flexnery.Results from the multivariate logistic regression of Shigella positive rate revealed that among those patients who were routine test of stool positive vs.routine test of stool positive (OR=1.863,95％CI:1.402-2.475),onset from July to October vs.other months' time (OR=7.271,95％CI:4.514-11.709) temperature ≥38 ℃ vs.temperature ＜38 ℃ (OR=4.516,95％CI:3.369-6.053) and age from 6 to 59 years old vs.other ages (OR =1.617,95 ％ CI:1.085-2.410),presenting higher positive detection rates of Shigella from the stool tests.The resistant rates on ampicillin and nalidixic acid were 97.57％ (201/206) and 94.90％ (186/196),both higher than on other antibiotics.The resistant rates on ciprofloxacin (16.33％,32/196),ofloxacin (9.57％,11/115) and on amoxilin (15.05％,31/206) were relatively low.The resistant rate appeared higher on Shigellaflexnery than on Shigella sonnei.The proportion of strains with resistance on 3 more drugs,was 30.00％ (21/70).Conclusions The diagnostic accordance rate of bacillary dysentery in Beijing was low,with severe resistance of Shigella.Our findings suggested that clinicians should take multiple factors into account in their practices about epidemiological history,clinical symptom and testing results for diarrhea patients.
ABSTRACT
Objective To analyze the pathogenic surveillance programs and related factors on bacillary dysentery in Beijing,2008-2017,to provide evidence for the practices of diagnosis,treatment and prevention of the disease.Methods Analysis was conducted on surveillance data of bacillary dysentery,collected from the surveillance areas of national bacillary dysentery in Beijing.Shigella positive rate of stool samples were used as the gold standard while detection rate of Shigella,diagnostic accordance rate and resistance were computed on data from the surveillance programs.Chi-square test was used to compare the rates and unconditional logistic regression was used to analyze the related factors of Shigella infection.Results Both the reported incidence rate on bacillary dysentery and detection rate of Shigella in diarrhea patients showed significantly decreasing trend,from 2008 to 2017.The accordance rate of bacillary dysentery was only 7.80％ (111/1 423).Shigella sonnei was the most frequently isolated strain (73.95％,159/215) followed by Shigella flexnery.Results from the multivariate logistic regression of Shigella positive rate revealed that among those patients who were routine test of stool positive vs.routine test of stool positive (OR=1.863,95％CI:1.402-2.475),onset from July to October vs.other months' time (OR=7.271,95％CI:4.514-11.709) temperature ≥38 ℃ vs.temperature ＜38 ℃ (OR=4.516,95％CI:3.369-6.053) and age from 6 to 59 years old vs.other ages (OR =1.617,95 ％ CI:1.085-2.410),presenting higher positive detection rates of Shigella from the stool tests.The resistant rates on ampicillin and nalidixic acid were 97.57％ (201/206) and 94.90％ (186/196),both higher than on other antibiotics.The resistant rates on ciprofloxacin (16.33％,32/196),ofloxacin (9.57％,11/115) and on amoxilin (15.05％,31/206) were relatively low.The resistant rate appeared higher on Shigellaflexnery than on Shigella sonnei.The proportion of strains with resistance on 3 more drugs,was 30.00％ (21/70).Conclusions The diagnostic accordance rate of bacillary dysentery in Beijing was low,with severe resistance of Shigella.Our findings suggested that clinicians should take multiple factors into account in their practices about epidemiological history,clinical symptom and testing results for diarrhea patients.
ABSTRACT
Objective To investigate the etiological characteristics of diarrhea patients visiting enteric disease clinics in Beijing .Methods A total of 595 stool samples were collected among outpatients with diarrhea vistiting enteric disease clinics at two sentinel hospitals from July 2013 to June 2014 . Diarrheagenic Escherichia coli (E . coli) , Vibrio parahemolyticus , O1 or O139 Vibrio cholerae , Salmonella and Shigella were isolated according to standard methods . And rotavirus , norovirus , astrovirus and enteric adenovirus were identified by molecular techniques .The characteristics of population and temporal distribution , and serotypes of these pathogens were analyzed using descriptive epidemiological method .Chi‐square test was used for comparison between groups .Results Totally 128 bacterial strains were isolated from 595 samples ,and the detection rate was 21 .5% .Diarrheagenic E .coli was most common pathogenic bacteria (11 .4% ,68/595) ,followed by Vibrio parahemolyticus (6 .9% , 41/595) ,Salmonella (2 .4% ,14/595) and Shigella (2 .2% ,13/595) .No V ibrio cholerae was detected . One hundred and twelve viral strains were detected from all samples ,and the positive rate was 18 .8% . Norovirus was most common viral pathogen (9 .1% ,54/595) ,followed by rotavirus (8 .7% ,52/595) , astrovirus (1 .8% , 11/595 ) and enteric adenovirus (0 .7% , 4/595) . Enteropathogenic E .coli , enterotoxigenic E .coli and enteroadhesive E .coli were the most common types of diarrheagenic E .coli . The most common serotype of Vibrio parahaemolyticus was O4∶K8 .The detection rate of bacterial pathogens reached the peak from June to September ,while the highest detection rate of viral pathogens was found from November to the next March .Conclusion Norovirus and rotavirus are also the main pathogens of the diarnhea patients visiting enteric clinics ,which should be paid enough attention .