Article(id=1321170175496405075, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170080579301694, articleNumber=null, orderNo=null, doi=10.11847/zgggws1142943, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1693152000000, receivedDateStr=2023-08-28, revisedDate=1710259200000, revisedDateStr=2024-03-13, acceptedDate=1720627200000, acceptedDateStr=2024-07-11, onlineDate=1792921115993, onlineDateStr=2026-10-25, pubDate=1736438400000, pubDateStr=2025-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921115993, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921115993, creator=13701087609, updateTime=1792921115993, updator=13701087609, issue=Issue{id=1321170080579301694, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='1', pageStart='1', pageEnd='128', issueExtLink='null', onlineDate='null', pubDate='1736438400000', pubDateStr='2025-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921093363, creator='13701087609', updateTime=1792921093363, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=95, endPage=99, ext={EN=ArticleExt(id=1321170175722897492, articleId=1321170175496405075, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Foodborne diarrhea cases among the 6–17 year-old population in Beijing sentinel hospitals from 2013 to 2022, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To provide a reference for the scientific prevention and control of foodborne diarrhea among the 6–17 year-old population by analyzing the surveillance data of foodborne diarrhea cases in this age group from sentinel hospitals in Beijing from 2013 to 2022.

Methods

The clinical information of foodborne diarrhea cases aged 6–17 years who visited 36 sentinel hospitals in Beijing from 2013 to 2022 was collected, and stool samples or anal swabs were collected for pathogen detection. The χ2 test was used for rate comparisons, and multivariate logistic regression was applied to analyze the influencing factors of pathogen infection.

Results

From 2013 to 2022, a total of 2 128 foodborne diarrhea cases aged 6–17 years were reported by Beijing sentinel hospitals, with males outnumbering females (1.95:1). The number of cases was highest in the outer suburbs, accounting for 36.75% (782/2 128). The peak period for pathogen detection was from July to September each year, while norovirus was mostly detected in winter and spring. Logistic regression results showed that compared with the 15–17 year-old group, the 12–14 year-old group (OR=0.512, 95%CI: 0.326–0.804) had a lower risk of pathogen infection. Compared with the outer suburbs, the risk of pathogen infection was higher in urban areas (OR=1.447, 95%CI: 1.029–2.034) and inner suburbs (OR=1.543, 95%CI: 1.119–2.129). Summer (OR=7.674, 95%CI: 3.688–15.968) was the season with the highest risk of pathogen infection, and the inner suburbs (OR=3.348, 95%CI: 1.690–6.634) had the highest risk of norovirus detection. Cases with fever (OR=1.806, 95%CI: 1.358–2.403) and diarrhea ≥10 times/24 h (OR=1.832, 95%CI: 1.300–2.581) had a higher risk of pathogen infection. Cases with abdominal pain (OR=2.109, 95%CI: 1.146–3.881) and dehydration (OR=2.327, 95%CI: 1.146–3.881) had a higher risk of norovirus detection.

Conclusion

From 2013 to 2022, foodborne diarrhea cases among the 6–17 year-old population in Beijing were predominantly male, with suburban areas being the key regions for prevention and control. The epidemiological and clinical characteristics of cases infected with different pathogens can be used to provide a basis for food safety and health education and clinical diagnosis.

, authors=Chao WANG, Yanlin NIU, Tongyu WANG, Yangbo WU, Jinru JIANG, Xiaochen MA, authorsList=Chao WANG, Yanlin NIU, Tongyu WANG, Yangbo WU, Jinru JIANG, Xiaochen MA, authorCompany=null, correspAuthors=Xiaochen MA, authorNote=null, correspAuthorsNote=
MA Xiaochen, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170176129744981, articleId=1321170175496405075, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2013—2022年北京市哨点医院6~17岁人群食源性腹泻病例特征分析, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

通过分析2013—2022年北京市哨点医院6~17岁人群食源性腹泻病例监测数据,为科学开展6~17岁人群食源性腹泻的防控提供参考依据。

方法

收集2013—2022年北京市36家哨点医院就诊的6~17岁食源性腹泻病例的患病信息,采集粪便样本或肛拭子进行病原学检测,率的比较采用χ2检验,应用多因素logistic回归进行病原感染的影响因素分析。

结果

2013—2022年北京市哨点医院共报告6~17岁食源性腹泻病例2 128例,男性多于女性(1.95:1),近郊病例数最多,占36.75%(782/2 128),每年7—9月为致病菌检出的高峰时段,诺如病毒的检出大多在冬春两季。logistic回归结果显示,以15~17岁年龄组作为参照,12~14岁年龄组(OR=0.512,95%CI=0.326~0.804)感染致病菌的风险较低,以远郊作为参照,城区(OR=1.447,95%CI=1.029~2.034)和近郊(OR=1.543,95%CI=1.119~2.129)感染致病菌的风险高,夏季(OR=7.674,95%CI=3.688~15.968)为感染致病菌风险最高的季节,近郊(OR=3.348,95%CI=1.690~6.634)为诺如病毒检出风险最高的地区。出现发热(OR=1.806,95%CI=1.358~2.403)和腹泻≥10次/24 h(OR=1.832,95%CI=1.300~2.581)的病例感染致病菌的风险更高。出现腹痛(OR=2.109,95%CI=1.146~3.881)和脱水(OR=2.327,95%CI=1.146~3.881)的病例检出诺如病毒的风险更高。

结论

2013—2022年北京市6~17岁人群食源性腹泻病例以男性为主,郊区为重点防控地区,可结合不同病原感染病例的流行病学及临床特征,为食品安全健康宣教和临床诊断提供依据。

, authors=王超, 牛彦麟, 王同瑜, 吴阳博, 姜金茹, 马晓晨*, *, authorsList=王超, 牛彦麟, 王同瑜, 吴阳博, 姜金茹, 马晓晨, authorCompany=null, correspAuthors=马晓晨, authorNote=

王超(1988—),副主任医师,硕士,研究方向:食源性疾病监测工作

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马晓晨,E-mail:
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journalName=null, refType=null, unstructuredReference=田祎, 钱海坤, 吕冰, 等. 2015—2018年北京市肠道门诊成年人急性细菌性腹泻监测结果分析[J]. 疾病监测, 2020, 35(5): 411-415., articleTitle=null, refAbstract=null), Reference(id=1321170183377502358, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=16, rfOrder=15, authorNames=null, journalName=null, refType=null, unstructuredReference=戴映雪, 速丽媛, 刘云升, 等. 2018年成都市学校和托幼机构诺如病毒感染性腹泻聚集性疫情及影响因素分析[J]. 预防医学情报杂志, 2020, 36(3): 269-275., articleTitle=null, refAbstract=null), Reference(id=1321170183452999831, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=17, rfOrder=16, authorNames=null, journalName=null, refType=null, unstructuredReference=连怡遥, 骆洪梅, 冉陆, 等. 中国 2014—2018年学校和托幼机构诺如病毒疫情流行病学分析[J]. 中国学校卫生, 2019, 40(3): 406-410., articleTitle=null, refAbstract=null), Reference(id=1321170183545274520, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=18, rfOrder=17, authorNames=null, journalName=null, refType=null, unstructuredReference=金迪, 郭宝福, 孙桂菊. 南京市2018年食源性疾病主动监测流行病学特征[J]. 中国公共卫生, 2021, 37(3): 564-567., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321170176356237398, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, xref=null, ext=[AuthorCompanyExt(id=1321170176364626007, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, companyId=1321170176356237398, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Nutrition and Food Hygiene, Beijing Center for Disease Prevention and Control, Beijing 100013, China), AuthorCompanyExt(id=1321170176377208920, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, companyId=1321170176356237398, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=北京市疾病预防控制中心营养与食品卫生所,北京 100013)])], figs=[ArticleFig(id=1321170180055613567, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=EN, label=Tab.1, caption=

Gender and regional distribution of foodborne diarrhea cases among the 6–17 year-old population in Beijing from 2013 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
项目6~11岁(n=480)12~14岁(n=317)15~17岁(n=1 331)合计(n=2 128)χ2值P值
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
性别11.2360.004
 男性30463.3323574.1386865.211 40766.11
 女性17636.678225.8746334.7972133.89
地区37.846<0.001
 城区17436.249229.0235126.3761729.00
 近郊12425.8411135.0254741.1078236.75
 远郊18237.9211435.9643332.5372934.25
), ArticleFig(id=1321170180135305344, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=CN, label=表1, caption=

2013—2022年北京市6~17岁人群食源性腹泻病例性别、地区分布

, figureFileSmall=null, figureFileBig=null, tableContent=
项目6~11岁(n=480)12~14岁(n=317)15~17岁(n=1 331)合计(n=2 128)χ2值P值
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
性别11.2360.004
 男性30463.3323574.1386865.211 40766.11
 女性17636.678225.8746334.7972133.89
地区37.846<0.001
 城区17436.249229.0235126.3761729.00
 近郊12425.8411135.0254741.1078236.75
 远郊18237.9211435.9643332.5372934.25
), ArticleFig(id=1321170180206608513, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=EN, label=Tab.2, caption=

Temporal distribution of foodborne diarrhea cases among the 6–17 year-old pop-ulation in Beijing from 2013 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份6~11岁(n=480)12~14岁(n=317)15~17岁(n=1 331)合计(n=2 128)χ2值P值
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
2013132.71226.94735.481085.08146.053<0.001
2014183.75237.261198.941607.52
2015398.133210.1014711.0421810.24
2016336.88237.2617613.2223210.90
2017418.54216.6215111.3421310.00
2018275.63288.831249.321798.41
20195210.835316.7219114.3529613.91
20206112.71247.57906.761758.22
202110020.835517.3516212.1731714.90
20229620.003611.36987.3623010.81
), ArticleFig(id=1321170180269523074, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=CN, label=表2, caption=

2013—2022年北京市6~17岁人群食源性腹泻病例时间分布

, figureFileSmall=null, figureFileBig=null, tableContent=
年份6~11岁(n=480)12~14岁(n=317)15~17岁(n=1 331)合计(n=2 128)χ2值P值
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
2013132.71226.94735.481085.08146.053<0.001
2014183.75237.261198.941607.52
2015398.133210.1014711.0421810.24
2016336.88237.2617613.2223210.90
2017418.54216.6215111.3421310.00
2018275.63288.831249.321798.41
20195210.835316.7219114.3529613.91
20206112.71247.57906.761758.22
202110020.835517.3516212.1731714.90
20229620.003611.36987.3623010.81
), ArticleFig(id=1321170180340826243, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=EN, label=Tab.3, caption=

Multivariate logistic regression analysis of infection status among foodborne diarrhea cases aged 6–17 years in Beijing from 2013 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
因素例数致病菌OR值(95%CI)P值例数诺如病毒OR值(95%CI)P值
阳性数/例检出率/%阳性数/例检出率/%
性别
 男性1 40717612.511.002(0.762~1.319)0.986522448.431.440(0.776~2.672)0.248
 女性7219513.181.000263155.701.000
年龄组/岁
  6~114806112.710.922(0.670~1.267)0.61516374.290.537(0.234~1.233)0.143
 12~14317247.570.512(0.326~0.804)0.00410565.710.676(0.277~1.650)0.390
 15~171 33118613.971.000517468.901.000
地区
 城区6178513.781.447(1.029~2.034)0.034174116.321.736(0.741~4.065)0.204
 近郊78211414.581.543(1.119~2.129)0.0083013611.963.348(1.690~6.634)0.001
 远郊729729.881.000310123.871.000
季节
 春季(3—5月)5175711.033.445(1.613~7.360)0.001208209.621.238(0.561~2.732)0.597
 夏季(6—8月)60513221.827.674(3.688~15.968)<0.001180168.891.049(0.463~2.376)0.908
 秋季(9—11月)779749.502.889(1.370~6.093)0.005269128.590.496(0.211~1.170)0.109
 冬季(12月—次 年2月)22783.521.000128117.521.000
), ArticleFig(id=1321170180416323716, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=CN, label=表3, caption=

2013—2022年北京市6~17岁人群食源性腹泻病例感染情况多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素例数致病菌OR值(95%CI)P值例数诺如病毒OR值(95%CI)P值
阳性数/例检出率/%阳性数/例检出率/%
性别
 男性1 40717612.511.002(0.762~1.319)0.986522448.431.440(0.776~2.672)0.248
 女性7219513.181.000263155.701.000
年龄组/岁
  6~114806112.710.922(0.670~1.267)0.61516374.290.537(0.234~1.233)0.143
 12~14317247.570.512(0.326~0.804)0.00410565.710.676(0.277~1.650)0.390
 15~171 33118613.971.000517468.901.000
地区
 城区6178513.781.447(1.029~2.034)0.034174116.321.736(0.741~4.065)0.204
 近郊78211414.581.543(1.119~2.129)0.0083013611.963.348(1.690~6.634)0.001
 远郊729729.881.000310123.871.000
季节
 春季(3—5月)5175711.033.445(1.613~7.360)0.001208209.621.238(0.561~2.732)0.597
 夏季(6—8月)60513221.827.674(3.688~15.968)<0.001180168.891.049(0.463~2.376)0.908
 秋季(9—11月)779749.502.889(1.370~6.093)0.005269128.590.496(0.211~1.170)0.109
 冬季(12月—次 年2月)22783.521.000128117.521.000
), ArticleFig(id=1321170180491821189, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=EN, label=Tab.4, caption=

Multivariate logistic regression analysis of clinical characteristics of foodborne diarrhea cases aged 6–17 years in Beijing from 2013 to 2022

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临床特征例数致病菌OR值(95%CI)P值例数诺如病毒OR值(95%CI)P值
阳性数/例检出率/%阳性数/例检出率/%
发热(≥37.3℃)
 是4338418.961.806(1.358~2.403)<0.0011421510.561.423(0.755~2.684)0.276
 否1 68518711.101.000643446.841.000
腹痛
 是1 14115213.321.028(0.783~1.349)0.8444054210.372.109(1.146~3.881)0.017
 否98711912.061.000380174.431.000
恶心
 是84111713.911.117(0.816~1.529)0.4913433610.501.378(0.711~2.669)0.342
 否1 28715411.971.000442235.201.000
呕吐
 是5968113.590.970(0.702~1.342)0.8562222410.811.258(0.667~2.373)0.477
 否1 53219012.401.000563356.221.000
脱水
 是1341712.690.884(0.516~1.517)0.655631117.462.327(1.100~4.922)0.027
 否1 99425412.741.000722486.651.000
腹泻次数/(次/24小时)
 ≥102505120.401.832(1.300~2.581)0.0019144.400.465(0.162~1.331)0.153
 <101 87822011.711.000694557.931.000
), ArticleFig(id=1321170180575707270, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170175496405075, language=CN, label=表4, caption=

2013—2022年北京市6~17岁人群食源性腹泻病例临床特征多因素logistic回归分析

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临床特征例数致病菌OR值(95%CI)P值例数诺如病毒OR值(95%CI)P值
阳性数/例检出率/%阳性数/例检出率/%
发热(≥37.3℃)
 是4338418.961.806(1.358~2.403)<0.0011421510.561.423(0.755~2.684)0.276
 否1 68518711.101.000643446.841.000
腹痛
 是1 14115213.321.028(0.783~1.349)0.8444054210.372.109(1.146~3.881)0.017
 否98711912.061.000380174.431.000
恶心
 是84111713.911.117(0.816~1.529)0.4913433610.501.378(0.711~2.669)0.342
 否1 28715411.971.000442235.201.000
呕吐
 是5968113.590.970(0.702~1.342)0.8562222410.811.258(0.667~2.373)0.477
 否1 53219012.401.000563356.221.000
脱水
 是1341712.690.884(0.516~1.517)0.655631117.462.327(1.100~4.922)0.027
 否1 99425412.741.000722486.651.000
腹泻次数/(次/24小时)
 ≥102505120.401.832(1.300~2.581)0.0019144.400.465(0.162~1.331)0.153
 <101 87822011.711.000694557.931.000
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2013—2022年北京市哨点医院6~17岁人群食源性腹泻病例特征分析
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王超 , 牛彦麟 , 王同瑜 , 吴阳博 , 姜金茹 , 马晓晨 *, *
中国公共卫生 | 调查报告与分析 2025,41(1): 95-99
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中国公共卫生 |调查报告与分析 2025 , 41 (1) : 95 -99
2013—2022年北京市哨点医院6~17岁人群食源性腹泻病例特征分析
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王超, 牛彦麟, 王同瑜, 吴阳博, 姜金茹, 马晓晨*, *
作者信息
  • 北京市疾病预防控制中心营养与食品卫生所,北京 100013
通讯作者:
马晓晨,E-mail:
作者简介:

王超(1988—),副主任医师,硕士,研究方向:食源性疾病监测工作

Foodborne diarrhea cases among the 6–17 year-old population in Beijing sentinel hospitals from 2013 to 2022
Chao WANG, Yanlin NIU, Tongyu WANG, Yangbo WU, Jinru JIANG, Xiaochen MA
Affiliations
  • Department of Nutrition and Food Hygiene, Beijing Center for Disease Prevention and Control, Beijing 100013, China
  • Corresponding Author:
    MA Xiaochen, E-mail:
出版时间: 2025-01-10 doi: 10.11847/zgggws1142943
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目的

通过分析2013—2022年北京市哨点医院6~17岁人群食源性腹泻病例监测数据,为科学开展6~17岁人群食源性腹泻的防控提供参考依据。

方法

收集2013—2022年北京市36家哨点医院就诊的6~17岁食源性腹泻病例的患病信息,采集粪便样本或肛拭子进行病原学检测,率的比较采用χ2检验,应用多因素logistic回归进行病原感染的影响因素分析。

结果

2013—2022年北京市哨点医院共报告6~17岁食源性腹泻病例2 128例,男性多于女性(1.95:1),近郊病例数最多,占36.75%(782/2 128),每年7—9月为致病菌检出的高峰时段,诺如病毒的检出大多在冬春两季。logistic回归结果显示,以15~17岁年龄组作为参照,12~14岁年龄组(OR=0.512,95%CI=0.326~0.804)感染致病菌的风险较低,以远郊作为参照,城区(OR=1.447,95%CI=1.029~2.034)和近郊(OR=1.543,95%CI=1.119~2.129)感染致病菌的风险高,夏季(OR=7.674,95%CI=3.688~15.968)为感染致病菌风险最高的季节,近郊(OR=3.348,95%CI=1.690~6.634)为诺如病毒检出风险最高的地区。出现发热(OR=1.806,95%CI=1.358~2.403)和腹泻≥10次/24 h(OR=1.832,95%CI=1.300~2.581)的病例感染致病菌的风险更高。出现腹痛(OR=2.109,95%CI=1.146~3.881)和脱水(OR=2.327,95%CI=1.146~3.881)的病例检出诺如病毒的风险更高。

结论

2013—2022年北京市6~17岁人群食源性腹泻病例以男性为主,郊区为重点防控地区,可结合不同病原感染病例的流行病学及临床特征,为食品安全健康宣教和临床诊断提供依据。

哨点医院  /  食源性腹泻  /  6~17岁  /  北京市
Objective

To provide a reference for the scientific prevention and control of foodborne diarrhea among the 6–17 year-old population by analyzing the surveillance data of foodborne diarrhea cases in this age group from sentinel hospitals in Beijing from 2013 to 2022.

Methods

The clinical information of foodborne diarrhea cases aged 6–17 years who visited 36 sentinel hospitals in Beijing from 2013 to 2022 was collected, and stool samples or anal swabs were collected for pathogen detection. The χ2 test was used for rate comparisons, and multivariate logistic regression was applied to analyze the influencing factors of pathogen infection.

Results

From 2013 to 2022, a total of 2 128 foodborne diarrhea cases aged 6–17 years were reported by Beijing sentinel hospitals, with males outnumbering females (1.95:1). The number of cases was highest in the outer suburbs, accounting for 36.75% (782/2 128). The peak period for pathogen detection was from July to September each year, while norovirus was mostly detected in winter and spring. Logistic regression results showed that compared with the 15–17 year-old group, the 12–14 year-old group (OR=0.512, 95%CI: 0.326–0.804) had a lower risk of pathogen infection. Compared with the outer suburbs, the risk of pathogen infection was higher in urban areas (OR=1.447, 95%CI: 1.029–2.034) and inner suburbs (OR=1.543, 95%CI: 1.119–2.129). Summer (OR=7.674, 95%CI: 3.688–15.968) was the season with the highest risk of pathogen infection, and the inner suburbs (OR=3.348, 95%CI: 1.690–6.634) had the highest risk of norovirus detection. Cases with fever (OR=1.806, 95%CI: 1.358–2.403) and diarrhea ≥10 times/24 h (OR=1.832, 95%CI: 1.300–2.581) had a higher risk of pathogen infection. Cases with abdominal pain (OR=2.109, 95%CI: 1.146–3.881) and dehydration (OR=2.327, 95%CI: 1.146–3.881) had a higher risk of norovirus detection.

Conclusion

From 2013 to 2022, foodborne diarrhea cases among the 6–17 year-old population in Beijing were predominantly male, with suburban areas being the key regions for prevention and control. The epidemiological and clinical characteristics of cases infected with different pathogens can be used to provide a basis for food safety and health education and clinical diagnosis.

sentinel hospitals  /  foodborne diarrhea  /  6–17 years old  /  Beijing city
王超, 牛彦麟, 王同瑜, 吴阳博, 姜金茹, 马晓晨. 2013—2022年北京市哨点医院6~17岁人群食源性腹泻病例特征分析. 中国公共卫生, 2025 , 41 (1) : 95 -99 . DOI: 10.11847/zgggws1142943
Chao WANG, Yanlin NIU, Tongyu WANG, Yangbo WU, Jinru JIANG, Xiaochen MA. Foodborne diarrhea cases among the 6–17 year-old population in Beijing sentinel hospitals from 2013 to 2022[J]. Chinese Journal of Public Health, 2025 , 41 (1) : 95 -99 . DOI: 10.11847/zgggws1142943
食源性疾病作为全球各国最关注的公共卫生问题之一,也是我国食品安全最主要的问题[1]。研究显示,2014—2015年我国居民因摄入被食源性致病菌污染的食物而罹患疾病为0.3次/人年,给社会造成巨大的经济负担[2]。6~17岁的儿童青少年正处在生长发育的关键时期,免疫功能尚未发育完善,是食源性疾病的易感人群[3],且该人群多为在校学生,人员相对集中。据报道,2003—2015年我国有37 281名学生因食源性疾病暴发而发病[4]。因此,本研究通过分析2013—2022年北京市36家哨点医院6~17岁人群食源性腹泻病例的流行病学特征及临床特征,以了解北京市儿童青少年食源性腹泻的发病特征,为制定针对性的防控措施提供参考依据。
2013—2022年在北京市16个区选取有代表性的医院作为食源性疾病主动监测哨点医院,每区至少有2家哨点医院,最终全市共选取36家哨点医院(三级25家,二级11家),收集报告的6~17岁病例信息及检测样本信息。收集主要内容包括:病例基本信息、临床症状与体征、初步诊断、饮食暴露史、样本采集信息及检测结果等。
在哨点医院就诊,由食品或怀疑由食品引起的,以腹泻为主诉,24 h内排便≥3次,粪便性状异常(稀便、水样便、粘液便或脓血便等),且排除服用抗生素或不恰当服用化学物质等导致的腹泻病例。
采集新鲜粪便样本至粪便盒中或者肛拭子到Cary-Blair运送培养基中4 ℃(副溶血性弧菌常温)条件下24 h送检,病毒检测样本如不能立即送检,应将样本放在–20 ℃。实验室按照《国家食源性疾病监测工作手册》[5]中规定的标准操作程序对样本进行沙门氏菌(Salmonella)、副溶血性弧菌(Vibrio parahaemolyticus)、致泻大肠埃希氏菌(diarrheagenic Escherichia coli)、志贺氏菌(Shigella)和诺如病毒(Norovirus)的检测,细菌检测的样本增菌后接种于相应的培养基进行培养和分离,病毒检测采用RT-PCR进行核酸扩增检测,操作方法和结果判定均按说明书要求进行,并将检测结果逐级报告。
应用WPS office 2016软件建立数据库,SPSS 21.0软件对数据进行描述性分析,应用χ2检验对不同组间率或构成比进行比较。采用多因素非条件logistic回归分别从流行病学特征和临床特征两方面分析病例感染的影响因素,以腹泻病例样本检测结果是否为阳性为因变量,自变量包括性别、年龄组、地区、季节及相关临床特征,采用后退法,自变量纳入标准为0.05,排除标准为0.10。双侧检验,以P<0.05为差异有统计学意义。
2013—2022年6~17岁人群共报告2 128例食源性腹泻病例,6~11岁480例,占22.55%(480/2 128),12~14岁317例,占14.90%(317/2 128),15~17岁1 331例,占62.55%(1 331/2 128);男性1 407例,占66.11%(1 407/2 128),女性721例,占33.89%(721/2 128),性别比为1.95:1,平均年龄为(14.08±3.16)岁。6~17岁人群食源性腹泻病例在性别和地区构成比上差异均有统计学意义(χ2=11.236,P=0.004;χ2=37.846,P<0.001)。男性病例多于女性;北京市16个区均有病例报告,近郊病例数最多,占36.75%(782/2 128),其中房山区和密云区上报病例数并列第一,各占11.04%(235/2 128),其次是怀柔区,占9.45%(201/2 128)
2013—2022年报告的6~17岁病例中,2021年报告的病例人数最多,占14.90%(317/2 128),从沙门氏菌、副溶血性弧菌、致泻大肠埃希氏菌和志贺氏菌(以下简称致病菌感染)的检出情况来看,每年7—9月为检出高峰时期,每年12月—次年2月检出相对较低,而诺如病毒的检出高峰月份并不稳定,大多集中在冬春两季,相对于其他月份,每年7月的检出较低。
以是否检出病原为因变量(是=1,否=0),以性别、年龄、地区和季节为自变量,对2 128例病例进行多因素非条件logistic回归分析,发现年龄、地区和季节为致病菌感染的影响因素。15~17岁年龄组检出率最高,为13.97%(186/1 331),与其相比,12~14岁病例致病菌感染风险降低48.80%(95%CI=0.326~0.804)。近郊地区的检出率最高,为14.58%(114/782),与远郊病例相比,城区和近郊病例致病菌感染风险分别为其1.447倍(95%CI=1.029~2.034)和1.543倍(95%CI=1.119~2.129)。夏季致病菌检出率明显高于其他季节,为21.82%(132/605),而冬季致病菌检出率最低,仅为3.52%(8/227),夏季、春季和秋季病例致病菌感染风险分别为冬季的7.674倍(95%CI=3.688~15.968)、3.445倍(95%CI=1.613~7.360)和2.889倍(95%CI=1.370~6.093)。共采集诺如病毒样本785份,多因素logistic回归分析结果显示,地区为其影响因素,近郊病例检出风险为远郊的3.348倍(95%CI=1.690~6.634)。
以是否检出病原为因变量(是=1,否=0),以发热(体温≥37.3 ℃)、腹痛、恶心、呕吐、脱水和腹泻次数为自变量,以年龄、地区和季节为调整因素,进行多因素非条件logistic 回归分析。结果显示,病例出现发热、腹泻≥10次/24小时是致病菌感染的危险因素。与不伴发热病例相比,出现发热的病例致病菌感染风险为前者的1.806倍(95%CI=1.358~2.403),而腹泻≥10次/24小时的病例致病菌感染风险是腹泻<10次/24小时病例的1.832倍(95%CI=1.300~2.581)。从诺如病毒检测病例的临床特征来看,是否出现腹痛和脱水症状是诺如病毒感染的影响因素,出现腹痛症状的病例诺如病毒感染风险是未出现该症状病例的2.109倍(95%CI=1.146~3.881),而出现脱水症状的病例感染风险是未出现该症状病例的2.327倍(95%CI=1.100~4.922)。
全球经济一体化的今天,网络与物流飞速发展,人们的饮食结构与就餐习惯在逐渐发生改变,因此食源性腹泻的发生比以往更加频繁[6],6~17岁人群正处在生长发育的关键时期,目前研究较关注该时期的膳食营养与身体发育等方面[7–8]。
本研究分析了2013—2022年北京市哨点医院6~17岁人群食源性腹泻病例的流行病学特征与临床特征,监测结果显示,6~17岁人群病例男性多于女性,与李为为[9]和朱慧丽[10]研究结果一致,可能与这个年龄段男性卫生习惯和饮食习惯有一定的关系。从病例地区分布来看,近郊病例最多(36.75%),城区病例最少(29.00%),这可能与北京不同地区经济状况和医疗条件等因素有关,提示有关部门,应加大对郊区6~17岁人群及其家长食品安全的宣传与教育。从发病时间来看,致病菌的检出主要集中在每年7—9月,诺如病毒的检出主要在冬春两季。一方面夏季气温高,湿度大,有利于微生物的繁殖,另一方面,暑期外出旅游和在外就餐机会增加,以上两方面均可导致食源性疾病发病风险升高,因此夏季是6~17岁人群食源性细菌性腹泻的重点关注季节。而冬春两季则是食源性诺如病毒感染暴发的高峰时期[11–12],因此学校应充分做好诺如病毒暴发疫情的应急预案,降低因处置不当造成的病原传播风险[13],监管部门则应加强对学校食堂和学校小卖部的监督管理[14],加强早期症状监测和报告、严格落实病例的隔离诊治。
从临床特征上来看,出现发热(体温≥37.3 ℃)和腹泻次数≥10次/24小时的病例致病菌感染风险较大[15],出现腹痛和脱水症状的病例检出诺如病毒的风险更高,这与既往研究[16–17]诺如病毒感染以呕吐为主要症状有所不同,可为临床诊断提供一定的参考。目前我国关于急性胃肠炎病原学的监测主要依赖于腹泻症状,但诺如病毒感染后出现呕吐的症状比例较大,尤其在低年龄组儿童中更为突出,因此会低估诺如病毒感染的比例。基于感染各病原体之间表现的一系列临床症状均不典型,有时与非感染性腹泻很难区分,应进一步建立快速的病原监测方法,以便患者就诊时可以快速给予针对性的治疗[15]。
通过此次对2013—2022年6~17岁人群食源性腹泻病例的特征分析,提示应加强北京市6~17岁人群食源性腹泻的监测,尤其是各区应增加6~17岁人群病例报告的比例。另一方面,应进一步加大对6~17岁人群食源性疾病知识的宣传力度,尤其是郊区地区,要提高6~17岁人群家长们的食品安全意识,注意家庭厨房卫生环境,严防食源性疾病的发生[18]。

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doi: 10.11847/zgggws1142943
  • 接收时间:2023-08-28
  • 首发时间:2026-10-25
  • 出版时间:2025-01-10
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  • 收稿日期:2023-08-28
  • 修回日期:2024-03-13
  • 录用日期:2024-07-11
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    北京市疾病预防控制中心营养与食品卫生所,北京 100013

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马晓晨,E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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