2006年-2014年杭州市儿童细菌性痢疾的菌谱分布及耐药性变迁

Bacterial spectrum distribution and drug resistance tendency of bacillary dysentery in children from 2006 to 2014 in Hangzhou

目的调查2006年1月-2014年12月杭州市细菌性痢疾的菌谱分布和耐药特点,为临床治疗及流行病学分析提供依据。方法对杭州市儿童医院2006年-2014年粪便标本中分离的211株志贺菌进行血清分型,并以K-B琼脂法进行药敏实验和耐药性统计分析。结果 211株志贺菌中福氏志贺菌(B群)139株,宋内志贺菌(D群)66株,鲍氏志贺菌(C群)6株,福氏志贺菌与宋内志贺菌的比值为2.11∶1,未检出痢疾志贺菌。福氏志贺菌耐药率普遍比宋内志贺菌耐药率高。结论细菌性痢疾病原体主要是福氏志贺菌,其次为宋内志贺菌。福氏志贺菌耐药率多高于宋内志贺菌,多重耐药率较高。临床治疗应以药敏为依据选用抗菌药物,可首选哌拉西林/他唑巴坦,其次选头孢他啶、头孢吡肟、头孢哌酮/舒巴坦经验治疗。

Objective To investigate the bacterial spectrum distribution and drug resistance of bacillary dysentery in Hangzhou from Jan. 2006 to Dec. 2014,so as to provide basis for the clinical treatment and epidemiological analysis. Methods 211 strains of Shigella isolated from stool specimens in Hangzhou Children＇s Hospital during 2006-2014 for detecting serotypes of Shigella isolates,and the sensitivity test and resistance analysis were conducted by Kirby-Bauer method. Results The 211 isolated strains included 139 S. flexneri（ B group）,66 S. sonnei（ D group） and 6 S. boydii（ C group）,with S. flexneri /S. Sonnei ratio of 2. 11∶1. S. dysenteriae was not detected. The drug-resistance rates were higher in S. flexneri than those in S. sonnei. Conclusion S. flexneri was the main pathogen causing bacillary dysentery in the current study,followed by S. Sonnei. S. flexneri showed higher resistance rates and multiple resistant rates than S. sonnei. More attention should be paid to drug susceptibility reports before using antibiotics in the clinical treatment,with piperacillin / tazobactam the first choice of antibacterials for bacillary dysentery,followed by ceftazidime,cefepime and cefoperazone / sulbactam.