| Objective To study bacterial dysentery epidemic situation and epidemiological characteristics, understand etiological changes and clinical characteristics and risk factors, provide a basis to enrich and adjust the strategy for the prevention of bacterial dysentery. Discussion on the application of ARIMA model in prediction of bacterial dysentery incidence and provide scientific basis for the prevention of bacterial dysentery. Methods Based on the long-term monitor work, located in the urban area, area around the city, coastal areas and outer suburbs county hospital set up surveillance, 2008 to 2014 clinical diagnosis for adult and pediatric patients with bacillary dysentery as the object of study by epidemiological survey of unified design, the informed consent of patients or parents of children with collection of epidemiological and clinical features of patients and analysis of risk factors for infection. Drug resistance of Shigella using a Kirby-Bauer plate disk diffusion method to detect 13 kinds of antibiotics including ampicillin etc.. Application of SPSS 11.5 to Tianjin city from 2004 to 2012 bacillary dysentery monthly incidence rate of fitting ARIMA model, and use the resulting model to 2013-2014 bacillary dysentery monthly incidence predicted. The predicted values and the actual values were compared. Results 2008-2014 Tianjin report of bacillary dysentery 65179 cases, bacillary dysentery and the average annual incidence rate 72.00/ lakh, incidence of regional distribution differences are highlighted and morbidity from high to low in order to urban and suburban areas, Binhai New Area, outer suburb areas. Onset time appeared in the summer peak, the peak appeared in August.The incidence rate was higher at 5 years of age and children under age 85 or older, age and gender distribution showed a "high two, male is higher than female; middle low, women than male" feature. Occupation distribution to children and retirees. ARIMA(0,1,0)x(0,1,1) model to fitting the previous time of onset rate series and to 2013-2014 month incidence rate prediction values are consistent with the actual incidence trend. Bacterial dysentery cases stool specimens of Shigella positive 229 strains, the positive rate was 5.79%, of which 136 strains of Shigella sonnei, accounting for than 59.39% and 93 strains of S.flexneri, accounting for than 40.61%. Shigella detected 8 kinds of sub types, with F2 a based. The detection of 10-19 year olds Shigella highest positive rate of Shigella sonnei downtown highest suburb area of Shigella flexneri positive rate was the highest rate. 229 strains of Shigella to 13 kinds of antibiotics susceptibility test results show that the resistance rate in more than 50.00% of antibiotics in order to sulfamethoxazole(83.41%), ampicillin(82.97%), cefotaxime(53.08%). Higher sensitivity to imipenem(100%), amoxicillin + clavulanic acid(98.05%) and ciprofloxacin(89.15%). Shigella flexneri of sulfamethoxazole resistant rate was the highest(84.95%), followed by the ampicillin(73.12%), Shigella sonnei of ampicillin resistance rate was the highest(89.71%), followed by compound new debbi Ming(82.35%) and norfloxacin(68.66%). Shigella flexneri sensitive rate to imipenem was 100%, secondly to amikacin(95.51%) and amoxicillin + clavulanic acid(95.24%); Shigella sonnei strains to imipenem, amoxicillin + rod acid sensitive rate was 100%, followed by ciprofloxacin(96.27%). More than 5 years of age population in detection of Shigella and the undetected Shigella of multivariate logistic regression analysis. The results show that before the onset of illness contact history OR=2.176; before the onset of eating cold food, OR=1.399; before the onset of eating seafood, OR=1.566. There were significant differences in fever, stool and diarrhea between 5 years old and above. The economic burden of the patients investigated showed that cases of bacterial dysentery in 5-year-old children above median treatment costs of 134.0 yuan, 5 years old the following 108.1 yuan. Conclusion The incidence of bacillary dysentery in Tianjin city decreased year by year, so the prevention and control work in Tianjin city is still difficult to avoid the problem of public health. Time series model can simulate the change trend of the incidence of bacillary dysentery in time series, and provide scientific evidence for prevention and control. Incidence of focus groups scattered children and the elderly should be to strengthen the propaganda and health education to improve health consciousness of focus groups and routine nursing staff. Shigella bacteria over time in the constantly changing, need to continue monitoring changes, find out the law of the original dysentery bacteria. The clinical medication should be combined with the specific circumstances of a reasonable choice of drugs, treatment of dysentery should be preferred to Imipenem. Prior to the onset of cases of contact history, eat cold food and seafood are the risk factors, prompting residents have contacts in the symptoms patients pay attention to personal protection, try to avoid eating clean food of raw or cold food and undercooked seafood. |
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