浙江嘉善2014年-2015年感染性腹泻监测结果分析及菌株耐药性研究  

Analysis of surveillance results of infectious diarrhea in Jiashan,Zhejiang from 2014 to 2015 and research on the antibiotic resistance of isolates

作　　者：陈云[1] 袁永娟[1] 朱建民[1] 凌勤芳[1] 

机构地区：[1]嘉善县疾病预防控制中心,浙江嘉善314100

出　　处：《中国卫生检验杂志》2017年第3期400-403,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江嘉善科技局计划项目(2014A28)

摘　　要：目的了解嘉善县感染性腹泻病原菌的构成、季节变迁、年龄和职业分布,以及病原菌耐药情况。方法采集2014年6月-2015年5月在嘉善县第一人民医院肠道门诊就诊患者粪便标本;用常规培养和荧光PCR法对标本进行病原菌分离鉴定并进行药敏试验,对结果和患者信息进行统计分析。结果 417份标本中分离到病原菌58株,检出率为13.9%,其中致泻性大肠埃希菌构成比居首位,占53.44%;男女检出率分别为8.04%和20.73%,差异有统计学意义(χ2=13.94,P<0.05);6月-8月为病原菌检出率高峰时段;分别有13株和7株致泻性大肠埃希菌和沙门菌对4种以上抗菌药物耐药,有3株致泻性大肠埃希菌对11种以上抗菌药物耐药。结论致泻性大肠埃希菌是引起嘉善县感染性腹泻的主要病原菌;病原分布有明显的性别差异;夏季为感染高峰;致泻性大肠埃希菌和沙门菌对多种抗生素耐药。本区域应加强夏季腹泻和病原菌耐药性监测。Objective To investigate the composition,the seasonal changes,age and occupation distribution of diarrheagenic bacteria in Jiashan,as well as the antibiotic resistance of its pathogens. Methods Stool specimens were collected from intestinal outpatients in the First People＇s Hospital of Jiashan from June 2014 to May 2015. Conventional culture and fluorescent PCR were performed on the specimens for the isolation and identification of pathogens and antibiotic sensitivity test,the results and patient information were subjected for statistical analysis. Results 58 pathogenic bacteria strains were isolated from 417 specimens,with the positive rate of 13. 9%,Escherichia coli was the dominant pathogen which accounted for 53. 44% among all isolates. Positive rates were 8. 04% in male and 20. 73% in female outpatients,and the difference of positive rate were statistically significant（ χ^2= 13. 94,P〈0. 05）. Peak positive rate was recorded during June- August. 13 diarrheagenic E. coli isolates and7 Salmonella isolates were resistant to more than 4 antibiotics,and 3 diarrheagenic E. coli isolates were resistant to more than 11 antibiotics. Conclusion Diarrheagenic Escherichia coli is the dominant pathogen causing infectious diarrhea in Jiashan area.The infection had obvious gender differences and peaked in summer. Diarrheagenic E. coli and Salmonella are resistant to multiple antibiotics. Surveillance on diarrhea and drug resistance of pathogen should be strengthened in summer in this area.

关 键 词：感染性腹泻 流行特征 药敏 

分 类 号：R446.5[医药卫生—诊断学]