腹泻病原在儿童中的感染流行特征及耐药性分析

Epidem iological characteristics and drug resistance analysis of pathogens in children infected diarrhea

目的分析无锡地区儿童感染性腹泻病原的流行分布及其耐药特征,为制定相应的防控措施和临床合理用药提供依据。方法采集2015年-2017年无锡地区感染性腹泻儿童的新鲜粪便标本,分别进行肠道致病菌分离培养和腹泻病毒检测,并对肠道致病菌的耐药性进行研究。结果从389例腹泻粪便标本中共检出阳性标本104例,阳性率为26.74%。诺如病毒、轮状病毒、致泻性大肠埃希菌、沙门菌是检出率最高的4种病原,分别为9.25%、6.43%、5.40%和3.86%。致泻性大肠埃希菌对四环素(61.90%)和氨苄西林(52.38%)的耐药率最高,而沙门菌对环丙沙星(66.67%)和氨苄西林(60.00%)最为耐药,有超过半数的致泻性大肠埃希菌、沙门菌均出现了多重耐药现象。结论无锡地区的儿童腹泻以诺如病毒、轮状病毒、致泻性大肠埃希菌和沙门菌感染为主,且病原菌多重耐药现象严重,需进一步加强对腹泻儿童的病原学和耐药监测。

Objective To investigate the epidemiological characteristics and drug resistance of pathogens from children infected diarrhea in Wuxi,and provide basis for effective decision making and clinical rational drug use.Methods Stool specimens were collected from diarrheal children in Wuxi during 2015-2017,and detected for pathogenic bacteria and virus.Drug susceptibility test was then applied to analyze these isolated bacterial pathogens.Results A total of 104 cases were positive in 389 stool specimens,with the detection rate of 26.74%.Norovirus,rotavirus,diarrheal Escherichia coli and Salmonella had the highest detection rate,respectively accounting for 9.25%,6.43%,5.40%and 3.86%•The drug resistance rates of diarrheal Escherichia coli to tetracycline(61.90%)and ampicillin(52.38%)were the highest,and that of Salmonella to ciprofloxacin(66.67%)and ampicillin(60.00%)were the highest,more than half of diarrheal Escherichia coli and Salmonella were multi-drug resistant.Conclusion Children infected diarrhea in Wuxi were mainly caused by norovirus,rotavirus,diarrheal Escherichia coli and Salmonella,and the multi-drug resistance to pathogenic bacteria was serious.It is necessary to strengthen the surveillance on children with diarrhea for etiologic and drug resistance monitoring.