丰台区急性感染性腹泻病原菌分布及耐药性分析

Analysis of the Distribution and Drug Resistance of Acute Diarrhea Pathogenic Bacteria in Fengtai District,Beijing

目的了解丰台区急性感染性腹泻病原菌的分布及对常用抗菌药物的耐药情况,为本地区细菌性腹泻防治提供依据。方法收集2012年4-10月丰台区2家哨点医院肠道门诊腹泻患者的粪便标本,按照中华人民共和国卫生行业标准WS 287-2008、WS 271-2007和WS 289-2008进行沙门菌、志贺菌、副溶血性弧菌、霍乱弧菌、致泻性大肠杆菌等常见肠道致病菌检测,按美国CLSI(临床实验室标准化协会)推荐的纸片扩散法进行药敏测定。结果 444份腹泻粪便标本中共分离到140株致病菌,阳性率为31.53%。病原菌中副溶血性弧菌居首位,占55.71%,其次为沙门菌,占21.43%。检出的副溶血性弧菌、志贺菌和沙门菌的优势血清型分别为O3K6型副溶血性弧菌、宋内志贺菌、山夫登堡沙门菌和肠炎沙门菌。不同病原菌对抗菌药物的敏感性不同,多数检出菌对头孢西丁、阿莫西林-克拉维酸、氨曲南敏感性较高,志贺菌多重耐药情况严重。结论丰台区细菌性腹泻病原菌主要以副溶血性弧菌和沙门菌为主,各种病原菌耐药性不同,应加强主动监测。

Objective To investigate the distribution and the drug resistance of the pathogenic bacteria of infectious diar- rhea in Fengtai district, so as to provide reference for the prevention and clinical treatment of bacteria diarrhea. Methods Stool samples were collected from diarrhea patients from 2 surveillant intestinal clinics in Fengtai district from April to October in 2012. Salmonella, Shigella, Vibrio parahaemol2cticus, Vibrio cholerae and Escherichia coli were tested according to the sani- tation industry standards of PRC, WS 287 - 2008, WS 271 - 2007 and WS 289 - 2008. The sensitivity of the pathogenic bacte- ria to antimicrobial agents were determined by Kirby - Bauer recommended by US CLSI （Clinical and Laboratory Standards Insti- tute）. Results Totally, 140 strains of pathogens were isolated from 444 specimens and the positive rate was 31.53%. Vibrio parahaemolyticus was the predominant pathogen, accounting for 55.71%, and Salmonella was the second, accounting for 21.43%. The dominant serotypes of Vibrio parahaemolyticus, Shigella and Salmonella were O3K6, Shigella Sonnei, Salmonella senftenberg and Salmonella enteritidis respectively. The sensitive rates of different pathogenic bacteria to antimicro- bial agents were different. Most of the isolates had high sensitivity to cefoxitin, amoxicillin - clavulanic acid and aztreonam. Mu- tidrug resistance was serious in ShigeUa. Conclusions Vibrio parahaemolyticus and Salmonella are the main pathogenic bacteria of infectious diarrhea in Fengtai district. Different species of pathogenic bacteria have different resistance to antimicrobial agents. Active surveillence should be strengthened.