Pathogen surveillance of adults diarrhea disease in Xuhui District, Shanghai, 2017-2023
- Author:
HE Li
;
CUI Xiaoxian
;
SHEN Xiaoting
- Publication Type:Journal Article
- Keywords:
Diarrhea;
metagenomic next-generation sequencing (mNGS);
quantitative real time polymerase chain reaction (qPCR);
pathogenic spectrum;
Shanghai
- From:
China Tropical Medicine
2024;24(12):1452-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the epidemiological characteristics, trends, risk factors, and pathogenic spectrum of adult diarrheal diseases in Xuhui District, Shanghai from 2017 to 2023, so as to provide scientific reference for pathogen monitoring and disease prevention and control of diarrheal diseases. Methods Samples of adult patients with diarrhea in sentinel hospitals of Xuhui District from 2017 to 2023 were collected, and nucleic acid detection of intestinal pathogens was conducted using real-time quantitative PCR. Thirty specimens were subjected to shotgun metagenomic next-generation sequencing (mNGS), with species identified as metagenomic positive pathogens at the level of genus or species by a threshold that at least one read per million of total reads identified by METAMIC. Pathogenic spectrum detected by qPCR and mNGS was listed and compared. Results A total of 1 265 adult diarrheal specimens were collected, showing a significant upward trend in pathogen positivity rates (χ2=23.493, P<0.05), peaking in 2023 at 64.9% (100/154). A higher incidence was found among males (52.9%, 669/1 265), with the primary affected age group being 26-45 years (51.8%, 655/1 265), and summer and autumn being peak seasons for infection (67.7%, 857/1 265). Most patients (72.3%, 914/1 265) sought medical attention within one day of onset. Before onset, 67.8% (858/1 265) of patients had eaten suspicious meat, eggs, dairy, or seafood products. qPCR results revealed the top three dominant pathogens as Norovirus GII (22.6%, 132/584), Campylobacter jejuni (20.0%, 117/584 ), and enterotoxigenic Escherichia coli (13.0%, 76/584). There were significant differences in pathogenic spectrum across different years (χ2=79.578, P<0.05), with enteroaggregative E. coli, Campylobacter jejuni, and Norovirus GII showing the most variation in prevalence. The difference in pathogenic spectrum detected by mNGS and qPCR was also significant (P<0.05), with the top three most abundant pathogens being Rotavirus (93.3%, 28/30), Vesiculovirus (83.3%, 25/30), and Herpesvirus (80.0%, 24/30). Factor analysis indicated that age, suspicious food, and fever were statistically significant related factors to the detection rates (P<0.05). Conclusions From 2017 to 2023, the overall positive rate of adults with diarrhea in Xuhui District exhibited an increasing trend. Summer and autumn were the peak infection seasons, with viruses predominantly detected in summer and bacteria in both summer and autumn. In addition, mNGS could be used as a complementary technology for conventional detection techniques to provide a scientific basis for the effective prevention and control of diarrhea.
- Full text:20251113150855051384.Pathogen surveillance of adults diarrhea disease in Xuhui District, Shanghai, 2017-2023.pdf
