2015—2019年丽水地区细菌性腹泻病原分布及耐药性分析

Pathogens and drug resistance in bacterial diarrhea in Lishui City from 2015 to 2019

【目的】分析2015—2019年浙江省丽水地区细菌性腹泻病原分布及耐药情况,为细菌性腹泻的防治提供科学依据。【方法】收集2015—2019年丽水市人民医院腹泻患者粪便标本,采用飞行时间质谱仪和血清凝集反应鉴定细菌,使用VITEK 2 Compact全自动细菌鉴定药敏分析仪对可疑菌进行药敏鉴定。【结果】2015—2019年共检测粪便样本2937份,其中阳性样本191份,男性感染率为6.65%,女性感染率为6.32%。21~30岁年龄段检出率最高,51~60岁次之,细菌性腹泻呈夏季高发。不同菌属检出率分别为沙门氏菌3.98%、副溶血弧菌1.43%、气单胞菌0.48%、志贺菌0.37%及其他3.66%。沙门菌对头孢呋辛、阿米卡星等耐药率高;副溶血弧菌、志贺菌对氨苄西林耐药率高;气单胞菌对氨苄西林、氨苄西林/舒巴坦等耐药率高。【结论】2015—2019年丽水地区细菌性腹泻病原菌有性别、年龄、季节差异,以沙门氏菌为主,多重耐药现象严重,需加强细菌性腹泻病原菌和耐药的监测。

[Objective]To determine the pathogens and drug resistance in patients with bacterial diarrhea in Lishui City of Zhejiang Province from 2015 to 2019,and provide scientific evidence for prevention and treatment of bacterial diarrhea.[Method]Fecal specimens were collected from patients with diarrhea in the People’s Hospital of Lishui City from 2015 to 2019.Bacteria were identified by time-of-flight mass spectrometer and serum agglutination reaction.Drug sensitivity in the suspected bacteria was identified by VITEK 2 Compact system.[Results]A total of 2937 fecal samples were tested from 2015 to 2019,of which 191 were positive for bacteria.The prevalence was 6.65%in male and 6.32%in female.It was highest in the age group 21‒30 years old,followed by the group 51‒60 years old.Summer was the season with the highest prevalence of bacteria.Furthermore,the bacterial species included salmonella(3.98%),Vibrio parahaemolyticus(1.43%),aeromonas(0.48%),shigella(0.37%)and other bacteria(3.66%).Salmonella had high resistance to cefuroxime and amikacin.Vibrio parahaemolyticus and shigella had high resistance to ampicillin.Aeromonas had high resistance to ampicillin and ampicillin/sulbactam.[Conclusion]Prevalence of bacteria differs by gender,age and seasons in patients with bacterial diarrhea in Lishui from 2015 to 2019.Salmonella is the principal pathogen in bacterial diarrhea.Additionally,multiple drug resistance is commonly identified.Therefore,it warrants strengthening the pathogenic surveillance on bacteria and drug resistance in bacterial diarrhea.