2017-2019年新疆乌鲁木齐地区急性感染性腹泻常见病原菌分布及其耐药性分析

Analysis of the distribution of common pathogens and their drug resistance in acute infectious diarrhea in Urumqi in 2017-2019

目的了解新疆乌鲁木齐地区急性感染性腹泻人员的常见病原菌类型,探讨其耐药性。方法收集2017年5月至2019年5月乌鲁木齐地区的1200例急性感染性腹泻患者的粪便,进行常见病原菌的生化检测及血清学分型,进行菌株鉴定。使用法国梅里埃全自动细菌药敏仪进行药物敏感性检测。结果共检出腹泻病原菌1448株,其中副溶血性弧菌、沙门菌、志贺菌、致泻性大肠杆菌、金黄色葡萄球菌、霍乱弧菌、其他(气单胞菌和邻单胞菌)占比分别为7.87%、44.3%、30.5%、8.70%、6.98%、1.17%、0.48%。中国患者上述病原菌的构成比均高于外籍患者;不同年龄组的病原菌组成有差异;药敏结果中副溶血性弧菌对阿莫西林/克拉维酸钾、头孢吡肟、头孢西丁、环丙沙星、亚胺培南、四环素敏感性为100%,沙门菌对阿莫西林/克拉维酸钾以及志贺菌对阿莫西林/克拉维酸钾、头孢西丁和亚胺培南的敏感性为100%,致泻性大肠杆菌对亚胺培南、哌拉西林以及霍乱弧菌对环丙沙星、亚胺培南、哌拉西林的耐药率均为0。结论乌鲁木齐地区急性感染性腹泻人员病原菌类型多样,以沙门菌、志贺菌感染多见,不同年龄段和外籍患者病原菌感染风险有所差异,血清型也各有不同,需加强饮食及水源等卫生管理工作,根据不同感染菌的类型及药敏实验结果合理指导临床用药。

Objective To investigate the common pathogen types and drug resistance of people with acute infectious diarrhea in Urumqi.Methods Feces of 1200 patients with acute infectious diarrhea in Urumqi from May 2017 to May 2019 were collected,and the common pathogens,biochemical and serological typing,and strain identification was detected.French Merier automatic bacterial drug sensitivity instrument was used to detect drug sensitivity.Results A total of 1448 strains of diarrhoeal pathogens were detected,of which Vibrio parahaemolyticus,Salmonella,Shigella,Diarrhoeal Escherichia coli,Staphylococcus aureus,Vibrio cholera and other(Aeromonas and O-Sigella)ccounted for 7.87%,44.3%,30.5%,8.70%,6.98%,1.17%and 0.48%,respectively.The constituend ratio of the above-mentioned pathogens in Chinese patients was higher than that in foreign patients,and the composition of pathogens in different age groups was different.The sensitivity of Vibrio parahaemolyticus to amoxicillin/potassium clavulanate,cefepime,cefoxitin,ciprofloxacin,imipenem and tetracycline was 100%;the sensitivity of Salmonella to amoxicillin/potassium clavulanate,Shigella to amoxicillin/potassium clavulanate,cefoxitin and imipenem was 100%.The resistance rate of cathartic Escherichia coli to imipenem and piperacillin,and Vibrio cholera to ciprofloxacin,imipenem and piperacillin was 0.00%.Conclusion The pathogen types of acute infectious diarrhea personnel in Urumqi area are diverse,with Salmonella and Shigella infections are common,the risk of pathogen infection is different among different age groups and patients at home and abroad,and serotypes are different.It is necessary to strengthen the hygienic management of diet and water source,and guide the clinical medication according to the types of infection bacteria and the results of drug sensitivity experiments.