Objective: To understand the epidemiological characteristics of infectious diarrhea pathogens in Pudong New Areas of Shanghai from 2013 to 2017 to provide evidence for control and prevention of the disease. Methods: From Jan 2013 to Dec 2017, active surveillance program on diarrhea was conducted in 14 sentinel hospitals (three tertiary-level and nine secondary-level, and two primary-level hospitals) in Pudong New Areas of Shanghai, based on location, catchment areas and number of patients. All recruited outpatients were interviewed in hospitals, using a standard questionnaire. Stool specimens were collected and tested for five viral and eight bacterial pathogens. Results: A total of 9 301 cases with infectious diarrhea were included, and the overall positive rate was 55.7% (5 179). Positive rates of single virus, single bacteria and mixed infections were 26.7% (2 481), 17.0% (1 579) and 12.0% (1 119), respectively. For single infection, the most commonly detected viruses appeared as norovirus (15.4%, 1 428/9 301) and rotavirus (7.2%, 667/9 301). The most commonly detected bacteria were diarrheagenic Escherichia coli (6.7%, 619/9 301) and non-typhoid Salmonella (3.3%, 305/9 301). The most common mixed infections were caused by virus-bacteria (4.9%, 459/9 301). Norovirus (17.0%, 838/4 938) showed the highest positive rates, followed by Escherichia coli (7.2%, 354/4 938), both seen in the age group of 20-59 years old group. Rotavirus (9.4%, 178/1 896) and non-typhoid Salmonella (4.9%, 93/1 896) were the most common pathogens found in the age group of 0-4 years old. The prevalence of norovirus peaked both in spring and autumn. The other peaks were seen as: Rotavirus in winter, diarrheagenic Escherichia coli in summer and non-typhoid Salmonella in summer. Conclusions: Our data showed that the positive rates of infectious diarrhea pathogens were high in Pudong New Areas of Shanghai from 2013 to 2017. The dominant pathogens would include norovirus, rotavirus and diarrheagenic Escherichia coli but with differenct distributions in age groups. Obvious seasonal patterns were also observed.
目的： 了解2013-2017年上海市浦东新区感染性腹泻病原流行特征，为制定监测方案和开展感染性腹泻防治工作提供科学依据。 方法： 2013年1月至2017年12月，根据地理位置、覆盖人群和就诊量，在本区3所三级医院、9所二级医院和2所社区卫生服务中心开展腹泻病原主动监测，填写门诊病例个案调查表，采集粪便样品进行5类病毒和8类细菌的病原学检测。 结果： 共纳入感染性腹泻病例9 301例，病原阳性率为55.7%（5 179）。单一病毒、单一细菌和混合感染的阳性率分别为26.7%（2 481）、17.0%（1 579）和12.0%（1 119）。单一病毒阳性病例中，诺如病毒阳性率最高（15.4%，1 428/9 301），其次为轮状病毒（7.2%，667/9 301）；单一细菌阳性病例中，致泻性大肠埃希菌阳性率最高（6.7%，619/9 301），其次为非伤寒沙门菌（3.3%，305/9 301）；混合感染病例中，病毒-细菌阳性率最高（4.9%，459/9 301）。诺如病毒（17.0%，838/4 938）和致泻性大肠埃希菌（7.2%，354/4 938）阳性率在20~59岁年龄组最高，轮状病毒（9.4%，178/1 896）和非伤寒沙门菌（4.9%，93/1 896）阳性率在0~4岁年龄组最高。诺如病毒年度流行呈现春季和秋季2个高峰，轮状病毒呈现冬季高峰，致泻性大肠埃希菌呈现夏季高峰，非伤寒沙门菌呈现夏季小高峰。 结论： 2013-2017年上海市浦东新区感染性腹泻病原阳性率高，诺如病毒、轮状病毒和致泻性大肠埃希菌是本地区优势病原体，病原在不同年龄组分布存在差异，优势病原季节性流行特征明显。.
Keywords: Epidemiological characteristics; Infectious diarrhea; Outpatient cases; Pathogen.