2017年青岛市黄岛区医院感染性腹泻常见病原菌检测与耐药性分析

Detection and drug resistance analysis on the infectious diarrhea in Huangdao district,Qingdao city,2017

目的调查黄岛区感染性腹泻病原及其耐药普,了解青岛市黄岛地区医院感染性腹泻的发病特点,对感染性腹泻疾病的有效预防控制提供依据。方法收集2017年黄岛区一家哨点医院5~10月门诊腹泻病人的病历及腹泻便标本,了解病人的信息,然后对细菌进行增菌、培养、血清凝集等实验,进行鉴定。结果共收集腹泻高发期腹泻病人标本665份,分离主要致病菌株109份。其中,副溶血孤菌49份,占44.95%;沙门菌21份,占19.27%;变形杆菌15份,占13.76%;致泻大肠埃希菌15份,为13.76%;嗜水气单胞菌6份,占5.50%;志贺菌3例,占2.75%。感染性腹泻病人的年龄为15~30岁,男性高于女性。通过耐药试验得出副溶血孤菌对阿米卡星、庆大霉素、亚胺培南耐药性为0.00%;沙门菌对左氧氟沙星、复方新诺明、亚胺培南、氨曲南的耐药性为0.00%;变形杆菌群对头孢他啶、阿米卡星、氨曲南耐药性为0.00%;大肠埃希菌对阿米卡星、亚胺培南耐药性较低,分别为6.67%,6.67%;嗜水气单胞菌对阿米卡星、氨曲南、亚胺培南的耐药性为0.00%。结论黄岛区引起感染性腹泻病原主要是副溶血弧菌、沙门菌、变形杆菌、大肠埃希菌、嗜水气单胞菌(5种病原菌耐药谱见下文);其发病特点是2017年黄岛区感染性腹泻发病时间主要集中在7、8月份,这可能与地域的季节特点有关。

Objective To investigate Pathogenic bacteria about Infectious diarrhea and the drug resistance spectrum, and understand the characteristics of the Infectious diarrhea in Huangdao district,so as to provide the evidence for preventing and controlling the disease effectively. Methods Medical records and fecal specimens of patients were collected from a sentry-hospital in Huangdao District from May to October, 2017. The patient information were understand, then the specimens were identified by experiments including enrichment, germiculture, and serum agglutination. Results A total of 665 specimens were collected, 109 Pathogenic bacteria were isolated which including 49 Bacillus parahaemolyticus bacteria （ 44.95 % ）, 21 Salmonella bacteria （ 19.27 % ）, 15 Escherichia colibacteria （ 13.76 % ）, 15 Proteus bacteria （ 13.76 % ）, 6 Hydrophilia bacteria （5.50 %）, and 3 Shigella bacteria （2.75 %）. Most of the Infectious diarrhea patients were 15-30 years old in Huangdao District in 2017,and the number of the male patients were more than female;Drug resistance tests showed that Amikacin, Gentamycin,Imamipenem was absolutely useless to Vihrio paralytic; Levofloxacin, Trimethoprim, Imamipenem, Amtraxone was absolutely useless to Salmonella; Ceftazidime, Amikacin, Aminotramine was absolutely useless to Proteus species;The resistance of Escherichia coli to Amikacin and Amipenem was 6.67% and 6.67% respectively;Amikacin,Aminotramine,Imamipenem was absolutely useless to A. hydrophila. Conclusion Infectious diarrhea are mainly caused by Vibrio parolytic, Salmonella, Proteus species, Escherichia coliand A. hydrophila in Huangdao district in 2017（the drug resistance spectrum specified in the paper）;The cases are mainly concentrated in July and August, which may be related to the seasonal characteristics of the region.