摘要
目的探讨小儿感染性腹泻的病原菌分布特征及对抗菌药物的敏感情况,为临床防治及合理用药提供参考依据。方法选取426例感染性腹泻患儿作为研究对象,对患儿新鲜粪便标本进行细菌培养,分析病原菌的分布特点,采用纸片扩散法进行耐药性分析。结果 426份粪便培养共检出病原菌5种73株,检出率17. 14%(73/426),分别为沙门氏菌24株(32. 88%)、金黄色葡萄球菌11株(15. 07%)、志贺氏菌20株(27. 40%)、致病性大肠杆菌12株(16. 44%)、铜绿假单胞菌6株(8. 22%)。沙门氏菌中,O4群为优势菌型(11株,45. 83%),其他依次为O2群(9株,37. 50%)、O7群(4株,16. 67%)。志贺氏菌中,福氏志贺菌(B群)为优势菌型(9株,45. 00%),其他依次为宋内志贺菌(D群)(7株,35. 00%)、鲍氏志贺菌(C群)(3株,15. 00%)、痢疾志贺菌(A群)(1株,5. 00%)。沙门氏菌、志贺氏菌对氨苄西林(66. 67%、75. 00%)、环丙沙星(45. 83%、50. 00%)、头孢唑啉(37. 50%、40. 00%)的耐药性均较高,志贺氏菌的耐药率较沙门氏菌高。沙门氏菌和志贺氏菌对三代、四代头孢菌素以及复方新诺明、亚胺培南的敏感性较高。结论小儿感染性腹泻的病原菌以沙门氏菌和志贺氏菌为主,志贺氏菌的多重耐药问题较为严重,临床应规范合理用药,加强病原菌谱和耐药性检测。
Objective To analyze the distribution characteristics of pathogens in children with infectious diarrhea and their sensitivity to antibiotics,and to provide reference for clinical prevention and rational use of drugs.Methods A total of426children with infectious diarrhea who were admitted to our hospital were selected as study subjects.The fresh fecal specimens of children were collected for bacterial culture,and the distribution characteristics of pathogens were analyzed.The paper diffusion method was used to analyze the drug resistance.Results A total of73strains of pathogens were detected in426fecal culture mediums,and the detection rate was17.14%(73/426),including24strains of Salmonella(32.88%),11strains of Staphylococcus aureus(15.07%),20strains of Shigella(27.40%),12strains of pathogenic Escherichia coli(16.44%),6strains of Pseudomonas aeruginosa(8.22%).In Salmonella,O4flora was the dominant type(11strains,45.83%),followed by O2group(9strains,37.50%)and O7group(4strains,16.67%).In Shigella flora,shigella flexneri(Group B)accounted for the largest proportion(9strains,45.00%),followed by Shigellasonnei(Group D)(7strains,35.00%),Bao′s Shigella(group C)(3strains,15.00%),Shigella dysenteriae(group A)(1strain,5.00%),respectively.In Shigella flora,shigella flexneri(Group B)accounted for the largest proportion(9strains,45.00%),followed by Shigellasonnei(Group D)(7strains,35.00%),Bao′s Shigella(group C)(3strains,15.00%),Shigella dysenteriae(group A)(1strain,5.00%),respectively.Salmonella and Shigella had higher drug resistance to ampicillin(66.67%,75.00%),ciprofloxacin(45.83%,50.00%),cefazolin(37.50%,40.00%),so Shigella has higher drug resistance compared to Salmonella.And they were more sensitive to third-and fourth-generation cephalosporins,co-trimoxazole,and imipenem.Conclusion The pathogens of infectious diarrhea in children are mainly Salmonella and Shigella.Due to seriously multi-drug resistance of Shigella,the clinical rational use of drugs should be standardized,and the pathogen spectrum and drug resistance test should be strengthened.
作者
张海玉
ZHANG Haiyu(Department of Clinical Laboratory, Hanzhong People′s Hospital in ShaanxiProvince, Hanzhong, Shaanxi, 723000)
出处
《实用临床医药杂志》
CAS
2018年第23期88-90,94,共4页
Journal of Clinical Medicine in Practice
关键词
儿童感染性腹泻
病原学
耐药性
流行病
pediatric infectious diarrhea
etiology
drug resistance
epidemiology
