细菌性腹泻病416例病原学检测与临床治疗

Etiological detection and treatment of bacillary dysentery in 416 Chinese children

目的监测感染性腹泻病的病原菌及其耐药性，从而对抗生素的临床应用提出指导。方法应用肠道病原菌常规分离鉴定、药敏试验技术及临床疗效观察方法，对416例儿童细菌性肠炎患儿的病原学、药敏及治疗进行分析。结果从883例急性感染性腹泻患儿粪便中共分离出致泻性病原菌416株。其中志贺菌属317株，检出率为35．9％；沙门菌属36株，检出率为4．1％；弧菌属30株，检出率为3．4％；气单胞菌属11株，检出率为1．2％；类志贺邻单胞菌属11株，检出率为1．2％；侵袭性大肠杆菌11株，检出率为1．2％。临床疗效及药敏试验显示，头孢三嗪是治疗感染性腹泻病的高敏感性药物。结论志贺菌为陕西地区主要的腹泻病原菌，占总菌株的76．2％；头孢三嗪为治疗小儿感染性腹泻病的临床有效治疗药物。

Objective To investigate pathogenic bacteria of infectious dysentery and drug resistance of the bacillum so as to guide clinic use of antibiotics for bacillary dysentery. Methods Routine seperation and identification for enteric pathogenic bacteria, drug sensitivity and clinical observation of therapeutic effect were conducted to analyze etiology, drug sensitivity test and therapeutic effect of 416 children with this disease. Results 416 pathogenic strains that caused dysentery from feces of 883 children with acute infectious diarrhea were identified. Among them, 317 strains belonged to Shigellae and the detectable rate was 35.9% ; 36 strains belonged to Salmonellae and the detectable rate was 4.1% ; 30 strains belonged to Vibrio and the detectable rate was 3.4% ; 11 strains belonged to Aeromonas and the detectable rate was 1.2% ; 11 strains belonged to plesiomonal shigellooides and the detectable rate was 1.2% ; 11 strains belonged to invasive Bacillus coli and the detectable rate was 1.2%. The clinical therapeutic effect observation and drug sensitivity test shown that cefatrizine was a hypersensitive antibiotics for infectious dysentery. Conclusion Shigella is the major pathogen of dysentery in Shaanxi province and accounts for 76.2% of the total pathogenic strains. Cefatrizine is an effective drug for the disease.