摘要
目的:探究 2022-2023 年山东省枣庄市婴幼儿病毒性腹泻的危险因素,并对其病原学特征展开调查.方法:选取2022 年 1 月—2023 年 12 月山东省枣庄市报告的 183 例婴幼儿病毒性腹泻患儿作为观察组,择取同时间段的 183 例非病毒性腹泻患儿作为对照组,对所有的患儿监护人展开问卷调查,对婴幼儿病毒性腹泻的危险因素展开单因素、多因素分析;同时对所有患儿的粪便标本进行检验,调查其病原学特征.结果:观察组婴幼儿吮手指、7 d内接触过腹泻患者、7 d内去过医院诊所、7 d内服用过抗生素、父母文化程度在高中中专及以下、饲养宠物、饮用水未消毒、餐具奶具未消毒、菜刀板未生熟分开、喂养者/婴幼儿餐前未洗手比例高于对照组,差异有统计学意义(P<0.05).多因素分析显示,婴幼儿吮手指、7 d内接触过腹泻患者、7 d内去过医院诊所、7 d内服用过抗生素、父母文化程度在高中中专及以下、饲养宠物是婴幼儿病毒性腹泻的独立危险因素,饮用水消毒、餐具奶具消毒、菜刀板生熟分开、喂养者/婴幼儿餐前洗手是保护因素.183 例婴幼儿病毒性腹泻患儿中,单一病原体感染占比 84.15%,其中以轮状病毒(RV)感染最为常见,其次为人杯状病毒(HuCV)、肠道腺病毒(EAdV);混合感染占比 15.85%,以轮状病毒(RV)合并HuCV最多,其次是HuCV合并星状病毒(AstV)、RV合并EAdV.结论:本地区近 2 年的婴幼儿病毒性腹泻的危险因素包括病毒接触史、抗生素使用史、父母缺乏健康知识、居住环境较差有关,而良好的卫生习惯则为其保护因素;而且病原体以轮状病毒为主,临床应根据情况制定针对性预防措施.
Abstract
Objective:To explore the risk factors of viral diarrhea in infants and young children in Zaozhuang City,Shandong Province from 2022 to 2023,and to investigate its pathogenic characteristics.Method:A total of 183 infants and young children with viral diarrhea reported in Zaozhuang City,Shandong Province from January 2022 to December 2023 were included as the observation group,and 183 non viral diarrhea infants and young children during the same period were selected as the control group.A questionnaire survey was conducted on all guardians of the infants and young children,and univariate and multivariate analyses were conducted on the risk factors of viral diarrhea in infants and young children.At the same time,all fecal samples of the affected children will be examined to investigate their pathogenic characteristics.Result:The observation group had a higher proportion of infants and young children who sucked their fingers,had contact with diarrhea patients within 7 days,visited hospitals and clinics within 7 days,taken antibiotics within 7 days,had parents with a high school diploma or below,kept pets,had unpasteurized drinking water,unpasteurized tableware and dairy utensils,separated kitchen knives and utensils,and did not wash their hands before meals compared to the control group(P<0.05).Multivariate analysis showed that finger sucking in infants and young children,contact with diarrhea patients within 7 days,visits to hospitals and clinics within 7 days,use of antibiotics within 7 days,parents'education level of high school or below,and pet ownership were independent risk factors for viral diarrhea in infants and young children.Disinfection of drinking water,tableware and dairy utensils,separation of raw and cooked kitchen knives,and washing hands before meals by feeders/infants were protective factors.Among 183 infants and young children with viral diarrhea,single pathogen infection accounted for 84.15%,with Rotavirus(RV)infection being the most common,followed by Human ca-licivirus(HuCV)and Enteric Adenovirus(EAdV),mixed infection accounted for 15.85%,with RV combined with HuCV being the most common,followed by HuCV combined with Astrovirus(AstV)and RV combined with EAdV.Conclusion:The risk factors for viral diarrhea in infants and young children in this region in the past 2 years include a history of virus contact,antibiotic use,lack of health knowledge among parents,and poor living environment,while good hygiene habits are protective factors.Moreover,the pathogen is mainly rotavirus,and targeted preventive measures should be developed according to the situation in clinical practice.
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