南宁市新生儿腹泻病源流行病学研究

Pathogenetic Epidemiology of Neonatal Diarrhea in Nanning

关键词:  新生儿腹泻  病原体  流行

Key words:  neonatal diarrhea  pathogen  epidemic

摘要:

为了掌握南宁市新生儿腹泻的病源谱和医院内感染特点,有效控制新生儿腹泻,作者于1988年3月至1993年2月对南宁市内5家医院787例新生儿腹泻粪便进行了病原检测和外环境监测。检出致泻病原体261例,总检出率33.2%。共检出病原体24种,细菌性感染占96.6%。社会获得性腹泻检出率为27.5%,病原性大肠菌为主要致泻菌(71.3%),以EPEC最多(88/160)。医院内获得性腹泻检出率49.0%,沙门氏菌为主(45.5%),次为EPEC、绿脓杆菌、变形杆菌。社会外环境(水源)病原性大肠菌连续监测结果,与同期新生儿病原性大肠菌肠炎粪便分离的菌型基本相同。医院内外环境监测结果表明,暴发性流行的传染源来自社会获得性患婴及住院患腹泻的产妇。医院内流行性腹泻的主要原因系婴儿粪便管理不当、消毒制度不严和工作人员双手不洁。

Abstract:

In order to understand both pathogens of neonatal diarrhea and the characteristics of hospital-aquired infection,and control the diseases effectively, we detected the pathogens in stool of 787 neonatal diarrhea patients from 5 hospitals in Nanning city and made surveillance in the hospitals from March 1988 to February 1993. 261 patients infected with the pathogens were found.The infection rate is 33.2%. 24 kinds of the pathogens were found, with bacteria accounting for 96.6%.The prevalence of society-aquired diarrhea is 27.5%. The major pathogens are Escherichia(71.3%) and most of them is EPEC(88/160).The prevalence of hospital-aquired diarrhea is 49.0%.The major pathogens are Salmonella(45.5%),the next is EPEC,Pseudomomas aeruginosa,Proteus,respectively.The type of pathogen from continuing surveillance of pathogenicitic Escherichia in social(natural) environment(in water) is similar to that isolated from stool of neonate with enteritis caused by pathogenicitic Escherichia during the same period.The result of surveillance in the hospital indicated that the sources of infection causing outbreak are neonate and in-parturient with society-aquired diarrhea.The major causes of epidemic diarrhea in hospitals are unadequate process of neonate's stool,unadquate sterilization and staff with dirty hands.