A Survey Of Bacterial Diarrhea And Its Influencing Factors In A District Of Nanjing

Objectives1.To understand the epidemiological characteristics,potential risk factors and pathogenic bacteria distribution of bacterial diarrhea in a district of Nanjing,so as to provide reference for the prevention and control of bacterial diarrhea in this district.2.To understand the epidemiological characteristics,potential risk factors and pathogenic bacteria distribution of bacterial foodborne disease outbreaks in a district of Nanjing,so as to provide reference for the prevention and control of bacterial foodborne disease outbreaks in this district.Methods1.Disease monitoring and on-site investigation were used to colletct two types of study subjects,one from acute infectious diarrhea in outpost hospital,emergency department and foodborne disease acute infectious diarrhea in the jurisdiction from November 2016 to September 2019,and second from outbreak of foodborne diseases in a district of Nanjing from 2018 to 2019.Epidemiological investigation,bacteria testing,and drug sensitivity of12 common antibiotics were used to analyze the distribution of bacteria diarrhea and its influencing factors.2.SPSS 22.0 software was used to establish database and make statistical analysis.The mean value and standard deviation were used to describe the measurement data,and the frequency and percentage were used to describe the counting data.T-test,variance analysis or chi square test were used for the comparison between groups,otherwise non parametric test was used.The single factor analysis of age,gender,clinical symptoms,time of onset,dining place and other variables were carried out;the single factor variables with statistical significance were included in the multi factor analysis,and the non conditional logistic regression analysis was carried out with the detection of bacteria as the dependent variable.P less than 0.05 meant statistically significant.Results705 patients were included.The sex ratio of men and women was 1.27:1,with an average age of 42.39 ± 18.65 years.147 patients(20.85%)were positive.705 samples were collected with 154 bacterial strains(21.84%)isolated,the top of which were Vibrio parahaemolyticus(38.96%),Salmonella(26.62%)and diarrhea causing Escherichia coli(11.69%).There were many serum groups in Vibrio parahaemolyticus and Salmonella.The most types of Vibrio parahaemolyticus was o: 3 group(25%),and the most one of Salmonella was D group(24.39%).There was the one of the highest isolated bacterial strain in summer(68,44.16%).The six main intestinal pathogens(Vibrio parahaemolyticus,Salmonella,Escherichia coli,Aeromonas,orthomonas,proteus)were sensitive to meropenem(0%),resistant to ampicillin(87.09%,60.90%,88.88%,85.71%,40.00%,76.90%)and compound neoforman(83.33%,24.39%,83.33%,50.00%,20.00%,15.38%).The drug resistance of Vibrio parahaemolyticus and Escherichia coli to ampicillin were87.09% and 88.88%,and the one to compound neoforman was 88.88%.The resistance of Aeromonas to antibiotics was significantly higher than that of plesiomonas.The singlefactor influence factors were eating out,food of animal origin and disease history(P < 0.05).27 outbreaks of foodborne diseases were collected.A total of 178 cases were found without death.There were 23 events of bacteria detected,and the detection rate of bacteria was 85.18%(23/27).The attack rates in 2018 and 2019 were 6.14%(94/1530)and 5.99%(84/1402),respectively.The outbreak of foodborne diseases mainly occurred in August(13cases).The incidence was mainly concentrated in the 16-30 year-old group and the 31-45year-old group(28.65%).The outbreak of foodborne diseases mainly occurred in dinner,and the number of dinner events accounted for 77.78%.There were 12 events and 10 events respectively in restaurants and canteens,with 70 and 56 cases,accounting for 39.33% and31.46% respectively.In the season of high incidence,seafood,meat,eggs and egg products from animal sources are the main dangerous food,with 114 cases(64.04%).The single factor analysis showed that age,month,dining place,suspicious food,animal food and meal times were the risk factors(P < 0.05);the multi factor analysis showed that age,dining place and meal times were the main risk factors(P < 0.05).The main pathogens detected in the outbreak were Vibrio parahaemolyticus(45.16%),Salmonella(32.26%)and diarrhea causing Escherichia coli(14.52%).It was found that occupation and suspicious food were influence factors(P < 0.05)for both single factor and multi factor analysis when bacteria infection as dependent variable(cases group with no bacteria detected);and age and suspicious food were influence factors(P < 0.05)by single factor and multi factor analysis when bacteria infection as dependent variable(healthy group with no bacteria detected).ConclusionsNo matter routine monitoring or outbreak of bacterial diarrhea,Vibrio parahaemolyticus,Salmonella and diarrhea causing Escherichia coli were the main bacteria with obvious seasonality and drug resistance.The main risk factors of bacterial diarrhea were restaurants,animal food and specific occupation.Therefore,it should be took corresponding measures to prevent and control the epidemic characteristics of foodborne disease outbreaks.