小儿急性细菌性痢疾6年菌群及药敏动态观察──290例分析

Six-year bacterial species distribution and drug sensitivity in childhood acute bacillary dysentery: An investigation of 290 cases

目的 了解1998年～2003年儿童细菌性痢疾病原学构成及细菌对药物的敏感状况变化,指导 临床用药。方法 对上海市第六人民医院1998年1月至2003年12月290例细菌性痢疾粪培养阳性者,应用改 良Kirby bauer法进行药敏试验。结果 培养出阳性菌株两型,D群宋氏志贺菌155株,B群福氏志贺菌135株。致 病菌株1998年～1999年以福氏菌为主,而2000年～2003年以宋氏菌为主。两种菌均对头孢克罗、丁胺卡那、庆 大霉素,头孢三嗪敏感性较强,对氨苄青霉素、复方新诺明等药耐药。结论 宋氏和福氏志贺菌是1998年～2003 年上海市第六人民医院收治的儿童菌痢的主要病原菌。头孢克罗副作用小,可以口服,且大部分菌株敏感,可以作 为药敏试验结果未出时儿童细菌性痢疾治疗的经验用药。

Objective To study the pathogen distribution and drug sensitivity in childhood bacillary dysentery and to provide a basis for selecting antibiotics clinically.Methods A total of 290 children who were definitely diagnosed with bacillary dysentery by stool culture between 1998 and 2003 were eligible to this study.A drug sensitive test was performed by an improved Kirby-bauer method. Results Of the 290 cases, there were two types of positive bacterial species: Sh.sonnei (type D, n = 155) and Sh.flexneri (type B, n = 135).Between 1998 and 1999, Type Sh.flexneri was the main bacteria, while from 2000 through 2003, Type Sh.sonnei was predominant. Both Sh.flexneri and Sh.sonnei were sensitive to cefaclor, amikacin, gentamycin, and ceftriaxine, and insensitive to ampicillin and trimoxazole. Conclusions Types Sh.flexneri and Sh.sonnei bacteria were the major pathogen of childhood bacillary dysentery between 1998 and 2003. Cefaclor is an oral drug with few side effects, which can efficiently kill Shiga′s bacillus, and may be recommended in the treatment of this disorder.