儿童细菌感染性腹泻分离菌株的分布和耐药性分析

Distribution and antimicrobial resistance of isolated strains in children with infectious diarrhea

目的分析儿童细菌感染性腹泻分离菌株的构成和耐药情况,为临床诊断和合理用药提供依据。方法回顾性分析2015年1月-2016年12月西宁市第一人民医院腹泻患儿的粪便培养和药敏结果,采用Microscan WalkAway-40全自动微生物分析对粪便标本中的菌株进行鉴定,采用K-B纸片扩散法进行药敏试验,结果参照美国临床实验室标准化研究所文件2006版的标准判读。结果 817份标本中检出112株致病菌和条件致病菌,检出率为13.71%。主要病原菌包括志贺菌属(44株)、致病性大肠埃希菌(29株)、沙门菌属(17株)、肠球菌属(10株)、变形杆菌属(6株)。主要的革兰阴性致病菌对亚胺培南、第三代头孢菌素和加酶抑制剂的抗生素具有较高的敏感性,革兰阳性致病菌对利奈唑胺和万古霉素具有较高敏感性。结论儿童细菌感染性腹泻的病原菌仍以致病革兰阴性菌为主。在使用抗菌药物时应根据药敏试验结果合理选择抗生素。

Objective To investigate the species and antimicrobial resistance of isolated strains from stool of children with infectious diarrhea. Methods The Results of bacterial culture and antimicrobial susceptibility of children with infectious diarrhea were retrospectively analyzed in Xining No.1 People′s Hospital from January 2015 to December 2016. Bacteria identification was performed by Microscan WalkAway-40 system. Antimicrobial susceptibility was performed by Kirby-Bauer method. And Results were judged in accordance with the standard of Clinical and Laboratory Standards Institute （2006 version）. Results A total of 112 pathogenic and conditional pathogenic bacteria were detected from 817 stool samples, with positive rate of 13.71%. The major isolated bacteria stains included Shigella（44 stains）, enteropathogenic Escherichia coli（29 strains）, Salmonella（17 strains）, Enterococci（10 strains） and Proteus （6 strains）. The major gram-negative bacteria were susceptive to imipenem, the third generation cephalosporins, and beta-lactamase inhibitors. Gram-positive bacteria were susceptive to linezolid and vancomycin. Conclusions The majority of pathogens causing the infectious diarrhea in children is still pathogenic gram-negative bacteria. So it is important to choose antibiotics based on the Results of antimicrobial susceptibility.