154例小儿细菌性痢疾菌型分布及耐药性变化

Bacterial Clump Distribution and Drug Resistance Rate of 154 Children With Bacterial Dysentery

目的了解近10年小儿细菌性痢疾病原菌菌型及耐药性变化,以指导临床用药.方法将154例经细菌学证实的小儿急性菌痢分为A组(1995～1999年)和B组(2000～2004年),比较菌型分布及药敏结果.结果两组均以福氏痢疾杆菌感染为主,B组宋氏较A组显著上升(P＜0.01).B组对头孢唑啉、氟哌酸的耐药率明显高于A组(P＜0.05),对SMZco耐药率显著下降(P＜0.01),痢疾杆菌对头孢噻肟、头孢三嗪耐药率最低.结论福氏痢疾杆菌仍为目前小儿菌痢的主要流行菌群,临床上应合理、交替选用敏感抗生素,第三代头孢菌素较为理想.

Objective To investigate the change trend of drug-tolerance and bacterial clump distribution of children bacterial dysentery in the decade to guide clinical drug usage. Methods The condition of bacterial clump distribution and drug sensitivity between two different stage, groups A （ 1995- 1999） and B （2000-2004） in 154 cases of bacterial dysentery were compared with bacteriological identification. Results Shigella flexneri was found to be predominant in both groups. Shigella sonnei in group B was significantly increased than that in group A （P〈0.01）. The resistance rates of cefazaline and norfloxacin in group B were much higher than that in group A （P〈0.05）. The resistance rate to SMZco in group B was significantly lower than that in group A （P〈 0.01）. The resistance rates to cefotaxime and ceftriaxone were the lowest. Conclusion Shigella flexneri continues to be the predominant epidemic clump. Sensitive drugs should be used rationally and alternatively in clinical practice, third generation cephalosporin is the most effective.