兰州地区683例细菌性腹泻病原菌分布和耐药性分析  

Pathogen distribution and antibiotic resistance analysis in 683 patients with infectious diarrhea in Lanzhou area

作　　者：徐宇仙[1] 焦建中[2] 朱平[2] 胡利斌[1] 张红英[1] 

机构地区：[1]武警总医院医务部,北京100039 [2]解放军第一医院,兰州730030

出　　处：《武警医学》2010年第6期488-490,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的了解兰州市细菌性腹泻患者的菌群分布及耐药性特征,为临床预防、治疗提供依据。方法应用回顾性调查分析的方法,对解放军第一医院3年腹泻患者的大便进行培养,对分离的病原菌及细菌的耐药性进行分析。结果 683例细菌性腹泻患者粪便分离出病原菌41株,总检出率为6.0%。病原菌以志贺菌居首位,占65.9%(27/41),鼠伤寒沙门菌占17.1%(7/41),念珠菌占17.1%(7/41)。各菌属对抗生素的敏感率不同,福氏志贺菌和沙门菌多重耐药较多,第四代头孢菌素较敏感,敏感率在90%以上。药物耐药性依次为:青霉素类、氨基糖甙类、磺胺类、青霉素类复方制剂、喹诺酮类及头孢菌素类;碳烯青霉类和β-内酰氨类未检出耐药菌。结论志贺菌属是细菌性腹泻的首要病原菌。细菌性腹泻病原菌的耐药性在逐渐增加,对腹泻患者应进行耐药性监测,根据细菌及耐药性鉴定结果合理应用抗生素。Objective To investigate the acute infectious diarrhea pathogens and their antibiotic sensitivity in Lanzhou in order to contribute to clinical prevention and therapy. Methods By retrospective analysis, the stood of 683 patients of diarrhea underwent bacteriological culture, identification and antibiotic sensitivity test, and comparative analysis. Results From these samples, a total of 41 pathogens were detected, with an isolation rate of 6.0% （41/683）. Shigella bacteria were on the top of the list, accounting for 65. 9% （27/41）, followed by Salmonella that aeeouned for 17.1% （7/41）, nostoc accounting for 17.1% （7/41）. The rate of sensitivity to antibiotics was different. Shigella and Salmonella had higher multi - drug resistance. They were sensitive to the fourth generation of cephalosporin,with a sensitive rate above 90%. Drug resistance was exhibited in penicillin, aminoglycosides, sulfonamides, drug combination of penicillin, quinolones and cephalosporin. No drug - resistant bacteria were detected in β - lactams. Conclusions Shigellae are the most important pathogenic bacteria in acute bacterial diarrhea. Rational use of antibiotics should be based on the results of identification and monitoring of drug resistance.

关 键 词：细菌性腹泻 病原菌 耐药性 抗生素 

分 类 号：R442.2[医药卫生—诊断学] R453.2[医药卫生—临床医学]