| Objective:Diarrhea is a common intestinal infective disease with high incidence, may cause long-term harm on both the physical and mental development of the children and adults. China is considered as the high incidence region of infectious diarrhea, which includes bacterial diarrhea, viral diarrheaandparasite diarrheaetc. The common bacteria include Escherichia coli, Salmonella, Shigella, Pathogenic Vibrio (Vibrio cholera andVibrio parahaemolyticus), Plesiomonas shigelloides, Aeromonas and Yersinia enterocolitica etc. The major pathogens of viral diarrhea include rotavirus, calicivirus, intestinal adenovirus, astrovirus etc. E.coli is common in bacterial diarrhea.In many places of China, there have been also epidemics with severe harm, however, there is few viral diarrhea related reports in Zhejiang Province.Zhejiang is the high incidence region of diarrhea, as lack of data for diarrhea, in this study, we chose the Hangzhou as the research area to investigate the distribution of diarrheagenic Escherichia coli and the pathogen spectrum features of infectious diarrhea.Methods:532 stool specimens from patients with acute diarrhea in the First Affiliated Hospital, Zhejiang University in Zhejiang province in 2013 were collected for the further isolation and culture of the common causative pathogens by using the routine microbe examinations. DEC strains were identified by multiple PCR with the subsequent classification. The viruses were detected by RT-PCR. Then the causative bacteria and viruses of acute diarrhea were analyzed combined with the epidemiological data collected from the uniform questionnaires.Results:1. From the pathogen spectrum between January 2013 and December 2013, a total of 532 stool specimens were collected.285 diarrhea pathogenic strains were detected with the detection rate of 53.6%.158 bacterial strains were detected and accounted for 55.4%.127 viral strains were detected and accounted for 55.4%.Two pathogens or more occurred in 48 specimens. Bacterial viral Bacterial cases were 28, and Bacterial viral co-infectious cases were 20, accounted for 9.8% and 7.0%,respectively.2. Among bacterial diarrhea, the detection rate of diarrheagenic Escherichia coli accounted for 55.7% as the first bacterial pathogen, then Vibrio parahaemolyticus accounted for 10.8%, Aeromonas accounted for 10.8%, nontyphoidal Salmonella accounted for 4.4%, Vibrio cholera accounted for 4.4%, Shigella accounted for 2.5%, Plesiomonas Shigelloides accounted for 2.5%.3. Among viral diarrhea,72 strains (56.7%) were detected with norovirus,42 (33.1%) with rotavirus,10 (7.9%) with sappovirus,3 (2.4%) with astrovirus, enteric adenovirus was not detected in any specimens. Furthermore, the detection rate of norovirus type Ⅰ and type Ⅱ accounted for 9.7%(7/72),90.3%(65/72), respectively.4. Among diarrheagenic E. coli, the detection rate of enteroaggregative E. coli accounted for 53.4%, Enterotoxigenic E. coli accounted for 15.9%, Enteropathogenic E. coli accounted for 8.0%, Enteroinvasive E. coli accounted for 1.1%, Enterohemorrhagic E. coli was not detected in any specimens. Meanwhile,19 strains were detected with multiple types of virulence genes.5. From the total detection rate of DEC, there was no statistical difference between the groups with different ages, the detection rate between male and female, or among different seasons was close.Conclusions:1. The acute diarrhea infectious patients with outpatient emergency treatment in Hangzhou,2013 were affected mainly by diarrheagenic E. coli, Vibrio parahaemolyticus, calicivirus and rotavirus. Surveillance, control and prevention should be emphasized to reduce the morbidity of the infectious diarrhea.2. The detection rate of calicivirus was much higher than the rate of rotavirus, among caliciviruses, the detection rate of norovirus was much higher than the rate of sappovirus, norovirus type II was shown to be the major norovirus.3. EAEC is the major causative pathogen among diarrheagenic E. coli. There was significant statistical difference between the groups with different ages.The detection rates of EAEC in summer-autumn and in winter-spring also showed statistical difference. |
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