急性空肠弯曲菌肠炎的临床特征及耐药性分析  

Clinical features and drug resistance in patients with acute Campylobacter jejuni-induced enteritis

作　　者：陈杰[1] 孙新婷[1] 曾争[1] 王贵强[1] 于岩岩[1] 

机构地区：[1]北京大学第一医院感染性疾病科,100034

出　　处：《传染病信息》2011年第1期21-22,25,共3页Infectious Disease Information

摘　　要：目的分析急性空肠弯曲菌肠炎的临床特征及耐药性特点,为北京地区该病流行病学的研究、临床诊断及合理用药提供依据。方法回顾性分析2005—2009年夏秋季我院142例急性空肠弯曲菌肠炎患者的临床特点,应用Kirby-Bauer纸片扩散法行药敏检查。结果 6月为发病高峰,发病者以20～29岁最多(49例),临床表现为腹泻,以稀水样或黏液样便为主(138例,97.2%),脓血便或黏液脓血便少见。腹痛103例(72.5%)、发热92例(64.8%)、恶心30例(21.1%)、里急后重26例(18.3%)、呕吐15例(10.6%)。对60例分离的空肠弯曲菌菌株行耐药检测,其中红霉素耐药4株(6.7%)、庆大霉素耐药7株(11.7%)、阿奇霉素耐药1株(1.7%)、头孢派酮耐药60株(100.0%)、左氧氟沙星耐药36株(60.0%)。无死亡病例和并发吉兰-巴雷综合征及反应性关节炎者。结论急性空肠弯曲菌肠炎临床表现及耐药状况呈多样化和复杂化,绝大多数患者表现为良性临床经过。患者对头孢类抗生素敏感程度低,红霉素类可考虑作为抗菌治疗的首选抗生素之一。Objective To investigate clinical features and drug resistance in patients with acute Campylobacterjejuni-induced enteritis and to provide evidence for epidemiological study, clinical diagnosis and rational drug use of the disease in Beijing. Methods Clinical features were analyzed retrospectively in 142 patients with acute Campylobacter jejuni-induced enteritis treated in our hospital in the summer or autumn from 2005 to 2009. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method. Results Campylobacterjejuni-induced enteritis developed the most frequently in June and in the population aged 20-29. Diarrhea manifested itself mainly as watery stool or mucous stool （97.2%）, and seldomly as bloody purulent stool or mucopu- rulent bloody stool. Other clinical manifestations were abdominal pain （72.5%）, fever （64.8%）, nausea （21.1%）, tenesmus （18.3%） and vomiting （10.6%）. Antimicrobial susceptibility testing was performed on 60 strains of Campylobacter jejuni and 6.7% of the isolates were resistant to erythromycin, 11.7% to gentamicin, 1.7% to azithromycin, 100.0% to cefoperazone and 60.0% to levofloxacin. No patients died and no ones were combined with Guillain-Barre syndrome and reactive arthritis. Conclusions Acute Campylobacter jejuni-induced enteritis has diverse and complicated clinical manifestations and drug resistance, and runs a benign clinical course in the majority of the patients. The patients are lowly susceptible to cefoperazone and when antibiotics are necessary, erythromycin can be chosen firstly.

关 键 词：空肠弯曲杆菌 抗药性 体征和症状 

分 类 号：R378.32[医药卫生—病原生物学] R915[医药卫生—基础医学]