急性炎症性肠炎的病原菌分布与耐药性分析

Distribution and drug resistance of pathogens causing acute inflammatory enteritis

目的探讨急性炎症性肠炎患者病原菌分布及其耐药性,旨在为临床合理用药提供依据。方法选取2010年12月-2013年12月收治的90例急性肠炎患者为研究对象,收集患者粪便标本进行病原菌检测及药敏试验;菌株鉴定按《全国临床检验操作规程》进行操作,药敏试验采用K-B纸片法,采用SPSS17.0和Excel软件进行统计分析。结果共分离出病原菌103株,前5位病原菌依次为志贺菌属、沙门菌属、副溶血弧菌、艰难梭菌、大肠埃希菌,分别占52.43%、21.36%、13.59%、6.80%、4.85%;志贺菌属、沙门菌属、副溶血弧菌对头孢哌酮/舒巴坦、阿莫西林/克拉维酸、阿米卡星、环丙沙星、庆大霉素高度敏感,耐药率<10.00%,沙门菌属对庆大霉素敏感率达100.00%,副溶血弧菌对头孢哌酮/舒巴坦及环丙沙星敏感率达100.00%,但对头孢曲松、头孢他啶、氨苄西林、头孢唑林、头孢拉定等高度耐药,耐药率均>70.00%。结论急性炎症性肠炎患者的病原菌分布较广,耐药性逐年增加,临床应加强病原菌检测及耐药性分析,有针对性的选择抗菌药物,减少抗菌药物的滥用。

OBJECTIVE To explore the distribution and drug resistance of pathogens causing acute inflammatory en‐teritis so as to provide guidance for reasonable clinical use of antibiotics .METHODS A total of 90 patients with a‐cute inflammatory enteritis who were treated from Dec 2010 to Dec 2013 were recruited as the study objects ,then the stool specimens were collected for the detection of pathogens ,the drug susceptibility testing was performed by using K‐B disk method ,the strains were identified by referring to national clinical laboratory procedures ,and the statistical analysis was carried out with the use of SPSS17 .0 software and Excel software .RESULTS Totally 103 strains of pathogens have been isolated;the Shigella,Salmonella,Vibrio parahaemolyticus ,Clostridium dif fi‐cile ,and Escherichia coli ranked the top five species of pathogens ,accounting for 52 .43% ,21 .36% ,13 .59% , 6 .80% ,and 4 .85% ,respectively .The Shigella ,Salmonella ,and V .parahaemolyticus were highly susceptible to cefoperazone‐sulbactam ,amoxicillin‐clavulanate ,amikacin ,ciprofloxacin ,and gentamicin ,with the drug resist‐ance rate less than 10 .0% ;the drug susceptibility rate of Salmonella to gentamicin was as high as 100 .0% ;the drug susceptibility rates of V .parahaemolyticus to cefoperazone‐sulbactam and ciprofloxacin were as high as 100 .0% ,however ,the drug resistance rates to ceftriaxone ,ceftazidime ,ampicillin ,cefazolin ,and cefradine were more than 70 .0% .CONCLUSION The pathogens causing the acute inflammatory enteritis widely distribute ,and the drug resistance of the pathogens is increased year by year .It is necessary for the hospital to strengthen the de‐tection of pathogens and analysis of the drug resistance ,reasonably use antibiotics ,and reduce the abuse of antibi‐o tics .