三亚市小学生志贺菌菌型分布和药敏特征分析  

Analysis of the distribution and drug sensitivity of Shigella in primary school in Sanya City

作　　者：邓陈哲 陈朱[1] 吴南卫 邓瑶[1] 黄梅香[1] 颜天阳 朱兰兰 黄春梅[1] 

机构地区：[1]海南省三亚市疾病预防控制中心,海南三亚572000

出　　处：《现代预防医学》2016年第2期267-269,共3页Modern Preventive Medicine

基　　金：海南省卫计委科技项目(琼卫2013自筹-35)

摘　　要：目的探讨三亚市小学生志贺菌的分布及药物敏感状况，为痢疾的临床用药及预防控制提供依据。方法粪便标本进行志贺菌分离培养、鉴定和血清分型，并用K—B法进行药物敏感试验。结果3803名小学生志贺菌携带率为0．71％，男性携带率（0．71％）与女性携带率（0．69％）差异无统计学意义（x^2=0．030，P=0．863）；乡村小学生携带率（0．95％）高于城区（0．34％），差异有统计学意义（x^2=4．760，P=0.029）。检出宋内志贺菌4株，福氏志贺菌23株，主要有F2a、F2h、F4e和F1a等血清型。药敏显示耐药率较高的是复方新诺明（96．30％）、四环素（92．59％）、氨苄西林（85．19％）、哌拉西林（81．48％）、氯霉素（70．37％），对氟喹诺酮类和第三代头孢类抗菌素耐药率低（3．70％。14．81％），对氨曲南、亚胺培南和美罗培南100％敏感，多重耐药率为92．60％，福氏和宋内志贺菌的耐药性差异无统计学意义（P=1，P〉0．05）。结论小学生隐性感染以福氏志贺菌为主，其次是宋内志贺菌。志贺菌多重耐药严重，治疗时首选氨曲南、亚胺培南和美罗培南，其次为第三代头孢类抗菌素。Objective This work was to investigate the distribution and drug sensitivity of Shigella in primary school of Sanya, so as to provide the reference for choosing medicine and preventing of dysentery, Methods Shigella were isolated from feces. The drug sensitivity was tested with Kirby-Bauer method. Results Shigella detection rate was 0.71% among 3803 primary students. The detection rate among boys and girls were 0.71% and 0.69%, respectively, and there was no significant difference between them （L3=0.030, P=-0.863）. The detection rate among country student was 0.95%, higher than that of 0.34% among city students, and the difference was significant between them （x^2=4.760, P=0.029）. There were 4 cases of Shigella sonnei and 23 cases of Shigella flexneri. The major serotypes were F2a, F2b, F4c, Fla. The drug sensitivity test showed that Shigella had higher drug resistance rate to Sulfamethoxazole （96.30%）, Tetracychne （92.59%）, Ampicillin （85.19%）, Piperacillin （81.48%） and chloroamphenicol （70.37%）. ShigeUa had low drug resistance rate （3.70%-14.81%） to fluoroquinolone and third-generation cephalosporin antibiotic. Shigella had 100% sensitivity to aztreonam, imipenem and meropenem, and the multiple drug resistance rate was 92.60%.There was no significantly difference between the drug resistance rate of Shigella sonnei and Shigellaflexneri （P=1, P〉0.05）. Conclusion Most primary students had recessive infection with Shigellaflexneri, and the next was Shigella sonnei. Shigella had serious multiple drug resistance. Aztreonam, imipenem and meropenem were the primary choices for clinic medicine, and third-generation cephalosporin antibiotics were the second choices.

关 键 词：志贺菌 药敏试验 小学生 血清分型 

分 类 号：R446[医药卫生—诊断学]