广州地区儿童空肠弯曲菌感染的病原学研究

Investigation of campylobacter jejuni infection in children with diarrhea in Guangzhou

目的了解广州地区腹泻儿童空肠弯曲菌(CJ)的感染及耐药情况,为临床及时、合理诊断和治疗提供实验室依据。方法对2005年7月至2008年6月该院门诊3 351份腹泻患儿的粪便标本进行CJ的分离培养,并对分离菌株进行Lior分型及耐药试验。结果 3 351份腹泻患儿粪便标本共检出267株CJ,分离率为8.0%;婴幼儿(1个月至1岁)是CJ的易感人群,占91.0%(243/267);夏秋季是高发季节,占76.8%(205/267)。该菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦和氯霉素敏感,对大环内酯类和林可霉素类耐药率<5%,对氨苄西林、喹诺酮类和四环素耐药率在20% ～40%之间,对复方新诺明和头孢哌酮均耐药。Lior分型以Ⅰ型为主,占75.3%(201/267)。结论 CJ是婴幼儿腹泻的重要病原菌,其耐药形势日趋严重,应引起重视。临床应结合药敏试验结果选择抗菌药物治疗CJ感染。

Objective To investigate the incidence of campylobacter jejuni （ C J） infection and the drug resistance of CJ in children with diarrhea in Guangzhou. Methods The fecal samples of 3 351 children with diarrhea between July 2005 and June 2008 were collected for CJ culture. The species of CJ strains were identified by Lior methods. The drug susceptibility tests were performed by the Kirby-Bauer method. Results Two hundred and sixty-seven CJ strains （8.0%） were isolated from 3 351 samples. The children at age of 1 month to 1 year were susceptible to CJ, accounting for 91.0%. A higher incidence of CJ infection （76.8%） was found in summer and autumn. The CJ strains were susceptible to imipenem, amikacin, cefoperazone/sulbaetam, chloramphenicol, macrolides and lincomycins. Parts of CJ strains （20%- 40% ） were resistant to ampicillin, quinolones and ambramyein. All CJ strains were resistant to sulfamethoxazole/ trimethoprim and cefditoren. Two hundred and one strains （75.3%） were CJ biotype I. Conclusions CJ is an important pathogen of diarrhea in children from Guangzhou. CJ is resistant to some antibiotics used often in clinical practice, and so it is thus important to use antibiotics based on the results of drug susceptibility tests in children with CJ infection.