2010-2012年北京市丰台区感染性腹泻病原菌分布及耐药性分析  

Distribution and drug resistance of enteric pathogenic bacteria in Fengtai,Beijing,2010-2012

作　　者：封会茹[1] 曲梅[2] 耿荣[1] 秦萌[1] 余红[1] 尉秀霞[1] 赵伟[1] 邢洪光[1] 杨军勇[1] 董晓根[1] 赵建忠[1] 

机构地区：[1]北京市丰台区疾病预防控制中心,北京100071 [2]北京市疾病预防控制中心

出　　处：《疾病监测》2013年第2期96-100,共5页Disease Surveillance

基　　金：国家"十二五"科技重大专项(No.2012X10004215-003-001);北京市科技计划项目(No.Z11111005680000)~~

摘　　要：目的了解北京市丰台区感染性腹泻致病菌的病原构成、流行特征及病原菌耐药情况,监测病原谱变迁趋势,为本地区细菌性腹泻防治提供依据。方法收集2010-2012年4-10月丰台区4家哨点医院肠道门诊腹泻患者的粪便标本,按照中华人民共和国卫生行业标准WS 287-2008、WS 271-2007和WS 289-2008进行沙门菌、志贺菌、副溶血性弧菌、霍乱弧菌、致泻性大肠埃希菌等常见肠道致病菌检测,并对病原菌的时间分布、人群分布、血清型别构成进行统计学分析,按美国CLSI(临床实验室标准化协会)推荐的纸片扩散法对近期分离的140株致病菌做了药敏测定。结果从收集到的1108份标本中共分离到357株致病菌,阳性率为32.22%。阳性菌中居首位的是副溶血性弧菌,占50.98%,其次为沙门菌,占18.49%。病原菌的检出具有明显的季节性,7-9月是高峰。不同年龄组之间检出率的差异有统计学意义(P<0.05),副溶血性弧菌在不同性别间检出率差异有统计学意义(P<0.01)。检出的副溶血性弧菌、志贺菌和沙门菌的优势血清型分别为O3K6型副溶血性弧菌、宋内志贺菌、山夫登堡沙门菌和肠炎沙门菌。各种病原菌对抗菌药物的敏感性不同,多数检出菌对头孢西丁、阿莫西林-克拉维酸、氨曲南敏感性较高。结论丰台区细菌性腹泻病原菌主要以副溶血性弧菌和沙门菌为主,病原谱已发生变迁,各种病原菌耐药性不同,应加强主动监测。Objective To understand the category, epidemiological characteristics and drug resistance of pathogenic bacteria causing infectious diarrhea in Fengtai, Beijing, and provide evidence for the prevention and clinical treatment of bacterial diarrhea. Methods Stool samples were collected from diarrhea patients in 4 sentinel hospitals from 2010 to 2012 to conduct the detection of Salmonella, Shigella, Vibrio parahaemolyticus, Vibrio cholerae and Escherichia coll. The time, population and serotype distributions of the pathogens were analyzed by statistical methods. The susceptibility of 140 strains of pathogens to antibiotics was tested by Kirby-Bauer method recommended by US Clinical and Laboratory Standards Institute. Results Totally 357 strains of pathogens were isolated from 1108 specimens （32. 22% ）. V. parahaemolyticus was predominant, accounting for 50.98% , followed by Salmonella （18.49%）. The seasonality of the positive detection of pathogens was obvious, the detection rate was high during July-September. The differences in detection rate in different age groups were statistical significant （ P 〈 0. 05 ）. The difference in positive rate of V. parahaemolyticus between males and females was statistical significant （ P 〈 0. 01 ）. The major serotype of V. parahaemolyticus was O3K6, the major serotype of Shigella was Shigella Sonnei and the major serotype of Salmonella were Salmonella Enteritidis and Salmonella senftenberg. The sensitivity of different pathogens to antibiotics varied. Most isolated strains were highly sensitive to cefoxitin, amoxicillin-clavulanic acid and aztreonam. Conclusion V. parahaemolyticus and Salmonella were the main pathogenic bacteria causing infectious diarrhea in Fengtai. The pathogen spectrum had changed. Different pathogenic bacterium had different resistance to antibiotics. The active surveillance of these pathogenic bacteria should be strengthened.

关 键 词：病原菌 感染性腹泻 耐药性 

分 类 号：R181.3[医药卫生—流行病学]