珠三角地区儿童外阴阴道炎病原菌分布及药物敏感性分析

Pathogenic bacteria distribution and drug susceptibility in children with vulvovaginitis in Pearl River Delta

目的掌握不同年龄段及不同季节珠三角地区儿童外阴阴道炎的病原菌分布及药敏情况。方法 683例经临床确诊为外阴阴道炎并且临床资料完整的患儿按年龄分为0-3岁组,3-7岁组及>7岁组,同时按就诊时间分为1-3月份、4-6月份、7-9月份、10-12月份4个组。无菌操作方法取患儿阴道分泌物,行细菌、真菌、支原体培养并进行药敏实验。结果 1683例患儿中,472例培养阳性,阳性率69.1%,病原菌以流感嗜血杆菌(24.9%),大肠埃希菌(16.9%)和金黄色葡萄球菌(12.0%)为主;2流感嗜血杆菌和大肠埃希菌是3-7岁组的主要病原菌。>7岁组的病原菌以金黄色葡萄球菌为主(58.3%),与其他2组比较均差异有统计学意义(均P<0.05);3按时间分组中,7-9月份组阴道炎患儿数明显升高;4药物敏感试验显示,阿奇霉素、二、三代头孢菌素类对流感嗜血杆菌较敏感,大肠埃希菌50%可检出超广谱β-内酰胺酶,耐甲氧西林金黄色葡萄球菌的检出率为23%。结论不同年龄及不同季节珠三角地区儿童外阴阴道炎的致病性病原菌分布均存在一定的差异。各地应结合当地的环境、气候等特点,准确掌握本地区阴道炎的菌群分布,根据实验室药敏结果进行合理治疗。

Objective To investigate the pathogenic bacteria distribution and drug susceptibility in children with vul- vovaginitis in different age and different season in the Pearl River Delta region. Methods 683 children diagnosed as vul- vovaginitis were divided into three groups by age and four groups by seasons. Vaginal secretions collecting and culturing were used for bacteria and antimicrobial susceptibility test. Results ①Strains of bacteria were isolated from 472 chil- dren with the positive rate of 69. 1%. Haemophilus influenzae （ 24.9 %）, escherichia coli （ 16.9 %） and staphylococcus aureus（12.0%） were the most frequently isolated pathogen; ②Haemophilus influenzae and escherichia coil were the main pathogen bacteria in 3-7 year group, staphylococcus aureus was the most frequently isolated pathogen in 〈7 yesrs group（P〈0.05）. ③In the season groups, the number of children with vulvovaginitis increased significantly in July-Sep- tember group. ④Drug sensitivity showed that Azithromycin ,Second and third generation cephalosporins were sensitive to haemophilus influenzae. Escherichia coli can be detected 50 % of extended-spectrum 13-1aetamase. Methicillin-resistant Staphylococcus aureus detection rate was 23%. Conclusion The pathogens distribution and drug susceptibility in chil- dren with vulvovaginitis were varies in different age and different season. As a result,a treatment should be done based on the climate, environment,and pathogens distribution of a region.