舟山海岛儿童细菌性腹泻病原菌分布及耐药分析

Analysis of pathogenic bacteria and drug resistance of bacterial diarrhea in Zhoushan islands′ children

目的：探讨近年舟山海岛儿童细菌性腹泻病原菌分布、流行趋势及耐药状况。方法：对2005-2007年间舟山三家医院门诊和住院儿童临床上诊断为细菌性腹泻病的患儿粪便进行培养鉴定及药敏试验。结果：1143份患儿粪便标本共检出病原菌273株,检出率为23.88%,主要病原菌有志贺菌73株（26.74%）、念珠菌56株（20.51%）、弧菌54株（19.78%）、沙门菌47株（17.22%）、克雷伯菌16株（5.86%）。对他唑西林、伊米配能、美洛配能敏感,对氨苄西林、优立新、哌拉西林、庆大霉素、阿米卡星等常用抗菌药物有较高耐药率。结论：舟山海岛儿童细菌性腹泻病原菌以福氏志贺菌、副溶血弧菌、白色念珠菌、宋内志贺菌、鼠伤寒沙门菌为主;可选用他唑西林、伊米配能、美洛配能等治疗。

Objective： To study pathogenic bacteria distribution,epidemical trend and drug resistance of children′s bacterial diarrhea in Zhoushan islands these years.Methods：To culture,identify and do drug sensitive test stool samples of children who were suspected to have bacterial diarrhea in three hospital of Zhoushan including clinic patients and hospitalers from 2005 to 2007.Results：273 strains were identified from 1143 samples with a positive rate of 23.88%,the main pathogenic bacteria were Shigella bacteria 73（26.74%）,monilial bacteria 56（20.51%）,vibrion 54（19.78%）,Salmonella bacteria 47（17.22%） and Klebsiella bacteria 16（5.86%）.The drug resistance rate of pathogenic bacteria to piperacillin-tazobactam,imipenem and meropenem were low,the rate to ampicillin,ampicillin-sulbactam,piperacillin,gentamicin and amikacin etc.usual antibacterial drug were high.Conclusion：The main pathogenic bacteria which cause children′s bacterial diarrhea in Zhoushan islands were Shigella flexneri,vibrio parahaemolyticus,Candida albicans,Shigella sonnel and Salmonella typhi murium.We can choose piperacillin-tazobactam,imipenem and meropenem etc.to cure it.