目的 了解上海市松江区腹泻患者、禽肉类来源弯曲菌的流行状况及耐药情况,探讨不同来源弯曲菌的相关性,为制定针对性预防措施提供科学依据.方法 对来自2017-2019年上海市松江区部分医院就诊的腹泻患者粪便或肛拭子以及来自农贸市场和超市的禽肉类样品进行弯曲菌分离培养和生化鉴定,应用微量肉汤稀释法进行药物敏感性试验,PFGE方法进行分子分型.结果 653份腹泻患者样品中分离出弯曲菌60株,阳性率9.19％,438份禽肉类样品中分离出弯曲菌51株,阳性率11.64％,二者阳性检出率差异无统计学意义(x2=1.730,P＞0.05).食品和腹泻患者来源的弯曲菌对环丙沙星(90.20％和90.00％)、萘啶酸(94.12％和88.33％)、四环素(88.24％和71.67％)耐药严重,耐药率＞71％.PFGE结果显示同源性大于等于90％的亚型群有24组,共79株弯曲菌,占71.17％.同源性100％的有21组,共63株菌,占56.76％,其中4组出现食品和腹泻患者来源弯曲菌100％同源的情况.结论 上海市松江区禽肉类和腹泻患者弯曲菌检出率较高,多重耐药情况严重,禽肉食品和腹泻患者来源的部分菌株具有100％同源性,提示腹泻患者感染弯曲菌可能与食用被弯曲菌污染的禽肉食品有关,为今后更好地预防弯曲菌相关疾病提供数据支持.

Objective To investigate the reported incidence of hepatitis B and the current status of its serum immunization in recent years in Songjiang District of Shanghai,to evaluate the effectiveness of hepatitis B control so as to provide a basis for further adopting measures.Methods Descriptive epidemiological method was used to analyze the reported incidence of hepatitis B in Songjiang District of Shanghai from 2006 to 2015.Seroepidemiological data from a national seroepidemiological survey of hepatitis B in the survey site of Songjiang District in 2014 were used to analyze the infection status of hepatitis B virus.Results A total of 6,339 cases of hepatitis B were accumulatively reported in Songjiang District from 2006 to 2015.The incidence rate was 54.14/ 100,000,and showed a declined tendency (x2trend=296.850,P=0.000) The incidence rate of acute hepatitis B was significantly lower than that of chronic hepatitis B (7.35/100,000 vs.45.09/100,000,x2 =3,179.779,P=0.000),and both the incidence rates showed a declined tendency (x2tnerd=487.127,P=0.000;x2trend=42.415,P=0.000) The reported incidence rate of hepatitis B was the highest in the age group of 35-years.The incidence rate before 40 years old increased with the increment of age (x2trend =1,388.621,P =0.000),while that after 40 years old decreased with the increment of age (x2trend =493.030,P =0.000).The high -risk age of hepatitis B infection was 20-54 years old.The incidence rate of males (77.79/100,000) was higher than that of females (28.95/100,000),of which the incidence rates of males with acute hepatitis B,chronic hepatitis B and undifferentiated hepatitis B were all higher than those of females (all P＜0.01).The positive rates of HBsAg and anti-HBs in resident population aged 1-29 years during the national seroepidemiological survey was 0.47％ and 58.60％ respectively.182 participants were confirmed to receive hepatitis B vaccine,and the vaccination rate was 84.65％,of which the vaccination rate of children aged less than 15 years was 100.00％.No statistically significant differences were found in the positive rate of HBV immunological marker and use of HBV vaccine between the two genders (both P＞0.05).HBsAg seropositivity was not detected among children aged below 15 years.The anti-HBs positive rate of the age group of 1-year was higher than those of the age groups of 5-years (x2 =17.038,P =0.000) and 15-29 years (x2 =5.502,P=0.019),but no statistically significant difference was found in the anti-HBs positive rate between the age groups of 5-years and 15-29 years (x2=2.835,P=0.092).The anti-HBc positive rate increased with the increment of age (P＜0.05).Conclusions Good results are achieved in the prevention and control of hepatitis B in Songjiang District of Shanghai in 2006-2015,especially among people received hepatitis B vaccine in the National Immunization Program.