小儿痢疾杆菌菌群分布及耐药性分析

Analysis of the bacterium genus distribution and drug resistance of dysentery bacilli in children

目的:了解小儿痢疾杆菌菌群分布及耐药性情况。方法:对近8年肠道门诊患儿大便培养分离所得痢疾杆菌的分布及其对17种抗生素耐药情况进行分析。结果:8年共分离338株痢疾杆菌,福氏菌、宋内氏菌、鲍氏菌和志贺氏菌分别占78.7%、16.2%、3.0%和2.1%;复方新诺明、阿莫西林/克拉维酸、氨苄青霉素/舒巴坦、氨苄青霉素、氯霉素耐药率最高,舒普深、丁胺卡那霉素、头孢曲松耐药率最低。结论:本地区儿童痢疾杆菌仍以福氏菌占首位,但其他菌群近年来有增多趋势,建议治疗首选第3代头孢菌素,虽然氨基甙类药物耐药率较低,但应用时最好能在血药浓度监测下进行;同时要加强抗生素的管理和合理使用,并且及时监测细菌的耐药动态。

Objective To know the bacterium genus distribution and drug resist an ce of dysentery bacilli in children.Methods To analyse the bacterium genus distr ibution separated from stool culture and the drug resistance of dysentery bacill i to 17 kinds of antibiotics in these children who have been tested in our Intes tinal clinic since 1996. Result First,338 strains of dysentery bacilli were sepa rated in all. Among them, the Shigella flexneri, Shigella sonnei, Shigella boydi i and Shigella dysenteriae accounts for 78.7%, 16,2%,3.0%and 2.1%,respective ly. Second, SMZCO, amoxycillin/clavulanic acid, ampicillin/sulbactam, ampillin a nd chloramphenicol all have the highest rate of drug resistance, while ceftazidi me,amikacin and ceftriaxone have the least. Conclusion In our district, the Shig ella flexneri is the majority in dysentery bacilli in children. In the meantime, other bacterium genus have the tendency to increase in recent years. So we sugg uest that we should first-select the 3rd generation of cephalosporin. Although aminoglycosides have lower rate of drug resistance, we had better monitor their blood concentration when they are in use. Meanwhile, we should strengthen the ma nagement and use of antibiotics rationally, and monitor the dynamic drug resista nce changes in bacteria in time.