烟台市成人感染性腹泻533例病原学及药敏分析

Etiology and drug sensitivity analysis of 533 cases of adult infectious diarrhea in Yantai

目的探讨本地区成人感染性腹泻的病原学分布、细菌耐药情况与临床症状的关系，为临床合理用药提供依据。方法收集我院感染性疾病科肠道门诊2008年1月1日至12月31日期间诊治的腹泻病人并符合病例纳入条件者共533例，对患者采集病史临床检查、大便常规、细菌培养，并对分离出的细菌进行菌种鉴定及耐药分析。结果感染性腹泻533例中，共检出病原菌368株，其中以致病性弧菌为主，占71．7％（264／368）；志贺菌属次之，占14．9％（55/368）。细菌对氨苄西林耐药率高，喹诺酮类药物对大部分细菌敏感。大部分细菌感染的患者表现为腹痛，主要在志贺菌感染的患者中里急后重的临床表现常见。结论感染性腹泻患者主要致病菌为致病性弧菌，其中主要为副溶血弧菌；大便性状与细菌菌种有关；药物敏感试验显示致病性弧菌对氨苄西林、头孢噻吩、氯霉素、青霉素．G均具有较高的耐药性，大部分细菌对于喹诺酮敏感，可首选，也可选用敏感的头孢菌素及氨基糖甙类。

Objective To investigate the relations between etiological agent distribution, drug resistance status and the clinical symptoms of adult infectious diarrhea in order to provide basis for clinical treatment. Methods 533 cases of adult infectious diarrhea in the intestinal tract clinic service during 2008 were collected and the medical history, stool routine examination, bacterial culture were performed. The bacterial strain identification and the drug resistance results were obtained. Results In the total 533 case, 368 bacterial strains were detected. 264 cases （71.7%） were Vibrion, 55 cases （14.9%） were Shigella. The bacteria were mostly resistant to ampicillin; most of the bacteria were sensitive to quinolones. The most common symptom was stomachache. Conclusions The main pathogenic bacteria of infectious diarrhea was Vibrion; The stool character was decided by the bacteria strain; the pathogenic Vibrion was resistant to ampicillin, cafalotin, amphemycin, penicillin G; most of the bacteria were sensitive to quinolone, so the quinolones, cephalosporin and aminoglycosides could be selected.