儿童腹泻病458例病原学及临床分析

Pathogenic analysis of 458 cases in diarrhea disease of inpatient children

目的:探讨儿童腹泻病的病原菌分布情况及临床特点。方法:对458例住院腹泻儿童患者进行了常见肠道致病菌的培养、分离鉴定、药敏试验及轮状病毒抗原检测。结果:169例检出病原菌,检出率为36.9%。本组病例婴幼儿占74.24%,7～9月感染性腹泻病发病率最高,其次为10～12月。婴儿期以轮状病毒为主要病原,幼儿期以痢疾杆菌、轮状病毒、大肠埃希菌为主要病原。痢疾杆菌对头孢噻肟耐药率最低、其次为丁胺卡那霉素、头孢呋辛,大肠埃希菌对丁胺卡那霉素耐药率最低,其次为头孢噻肟、头孢呋辛,金黄色葡萄球菌对丁胺卡那霉素耐药率最低,其次为头孢噻肟。传统的一线抗生素氨苄青霉素、庆大霉素、头孢唑啉普遍存在耐药情况。结论:儿童腹泻病原菌类型复杂、多样,在诊治中应重视病原学诊断和合理应用抗生素。

Objective:To explore dispersion of pathogen in diarrhea disease of inpatient children and provide scientific basis for correct diagnosis and treatment. Methods: Of 458 cases, common intestinal pathogens were cultured and separated and rotavirus antigen was examined. Results: Pathogen was detected in 169 cases, and the rate was 36.9%. In the group, 74.2% was infant and young children and incidence of infective diarrhea was the highest during 7～9 months, and higher during 10～12 months. The main pathogen of infant diarrhea was rotavirus, and the main pathogens of young children were dysentery bacillus, rotavirus and Escherichia coli. The lowest drug resistance of dysentery bacillus was cefotaxime; and the next was amikin and cefuroxine. The lowest drug resistance of Escherichia coli was amikin, and next was cefotaxime and cefuroxine; and drug resistance of staphylococcus aureus to amikin was the lowest, and cefotaxime was the nest. Traditional antibiotics , such as ampicillin, gentamycin, cefazolin was generally drug resistant. Conclusion: Many kind of complicated pathogen can cause diarrhea disease of children. Pathogenic diagnosis should be valued in clinical diagnosis and antibiotics should be applied reasonablely.