某院儿童细菌感染性腹泻的病原学研究及药敏分析

Distribution and Antibiotic Resistance of Pathogens Isolated from Children with Infectious Diarrhea in A Hospital

目的分析本院儿童细菌感染性腹泻的病原构成及其耐药情况,为临床治疗提供实验室依据,以指导临床合理用药。方法研究对象是2010-01～2011-12本院门诊或住院部就诊的腹泻患儿,采集这些患儿的大便标本进行常规病原菌的分离培养,并统计分析病原菌的种类分布和耐药状况。结果从6 279份标本中检出348株病原菌,检出率5.54%。其主要病原菌有沙门菌191株,致病性大肠埃希菌118株。2种主要致病菌(沙门菌和致病性大肠埃希菌)对氨苄西林和复方新诺明的耐药率仍高(>70%),对第三代头孢菌素和加酶抑制剂的复方抗菌药物耐药率为13%左右,对亚胺培南无耐药性。结论肠道病原菌检出数量大幅上升,沙门菌检出量最多;第三代头孢菌素和加酶抑制剂的复方抗菌药物是治疗细菌感染性腹泻的有效抗菌药物。

Objective To study the distribution and antibiotic resistance of the isolated pathogens from children with infectious diarrhea in a hospital.Methods The fecal samples were collected from children with infectious diarrhea who visit doctors between January 2010 and December 2011.After being cultured,pathogenic bacterium were isolated and identified,and then using statistic method to study the distribution and antibiotic resistance of the isolated pathogens.Results 348 pathogenic bacterium were isolated from 6 279 fecal samples（positive rate 5.54%）,including Salmonella（n=191）,enteropathogenic Escherichia coli（n=118）,etc.All of isolates of the 2 major pathogenic bacterium,Salmonella and enteropathogenic Escherichia coli,were susceptive to imipenem and 13% around of the isolates were resistant to the third generation cephalosporins and β-lactamase inhibitors.However,the isolates showed a high resistance to ampicillin and sulfamethoxazole/trimethoprim（70%）.Conclusion The detection rate of enteric pathogens is higher than the past,especially the Salmonella,which is the highest.The third generation cephalosporins and β-lactamase inhibitors are effective for the treatment of bacterium infectious diarrhea.