2002年至2007年太原地区儿童细菌性腹泻病原菌分布及耐药分析

Analysis of distribution and resistance to antibiotics of pathogenic bacteria in children′s diarrhea in Taiyuan area from 2002 to 2007

目的了解太原地区近6年儿童细菌性腹泻病原菌分布及耐药情况。方法对临床诊断细菌性腹泻病,便培养已分离到病原菌1080例作回顾性分析,分析其病原菌的分布及耐药情况。结果埃希菌属486株(45%),居于首位,前5位的病原菌依次为埃希菌属、肠球菌属、酵母样真菌、志贺菌属、假单胞菌属。各年均以大肠埃希菌为主要检出菌,志贺菌逐年减少。年龄分布中,婴儿的构成比最高(44.4%)。埃希菌属、志贺菌属、假单胞菌属、沙门菌属、气单胞菌属此5种杆菌对13种抗生素的平均耐药率依次为舒普深、痢特灵、头孢他啶、庆大霉素、环丙沙星、头孢哌酮、头孢曲松、丁胺卡那、头孢噻肟、诺氟沙星、头孢呋辛、哌拉西林、头孢唑啉。从埃希菌属近6年的耐药性变迁资料可以看出,对13种抗生素的耐药率均有不同程度上升。结论传统的致病菌志贺菌属、沙门菌属较少,而肠球菌属、假单胞菌属、枸橼酸杆菌属、克雷伯杆菌属、肠杆菌属、酵母样真菌等条件致病菌肠炎占有相当比例。各种致病菌的耐药性增加,第三代头孢除头孢他啶的耐药率较低外,其余都较高。提示应严格掌握抗生素用药指证,合理选用抗生素。

Objective To understand distrbution of pathogenic bacteria in children with diarrhea and their resistance to antibiotics last six years in Taiyuan area. Methods 1080 pathogenic bacteria were isolated from stool speeiments in patients with diarrhea, and their distrbution and resistance to antibiotics were reviewed and the clinical features were analyzed. Results There were 486 Escherichia（45% ） ,which rank first among the total of 1080 bacteria. The other four leading bacteria were Enterococcus, Saccharomyces, Shigella and Pseudomonas respectively. Escherichia dominated every year. Shigella decreased year by year. The detection rate of pathogenic bacteria presented highest in infancy. The 13 antibiotics to which the five bacilli, such as Escherichia, Shigella, Pseudomonas, Salmonella and Aeromonas spp, had the highest average resistance rates were sulperazone, furozolidone, ceftazidime, gentamyein, ciprofloxacin, cefoperazone, ceftriaxone, amikaein, eefotaxime, norfloxacin, eefurexime, piperaeillin, cefazoline respectively in a descending order. The resistance rates of Escherichia to these 13 antibiotics increased more or less in recent six years according to the literature. Conclusions Conventional pathogens such as Shigella and Salmonella oecupided much less than opportunistic pathogens such as Enterococcus, Pseudomonas, Citrobacter,Klebsiella ,Enterobacter and Saccharomyces. The resistance of all pathogens increased. The resistance rate to antibiotics are relatively high except to the third generation cephalosporin. We should control strictly the indicators of medication and choose antibiotics reasonably.