小儿感染性腹泻流行特征、病原及耐药性分析  

Analysis of epidemiological features, pathogens and drug resistance of infectious diarrhea in children

作　　者：李建明[1] 陈莉[1] 吴伟波[1] 杨柳青[1] 

机构地区：[1]深圳市第三人民医院感染科,518112

出　　处：《中国实用医药》2017年第10期7-9,共3页China Practical Medicine

摘　　要：目的研究小儿感染性腹泻流行特征、病原及耐药性。方法回顾性分析555例小儿腹泻患儿的临床资料,查看门诊及住院电子病历,分析小儿感染性腹泻的流行特征、病原及耐药性。结果本组555例患儿,5岁以下患儿患病率占92%;男女患儿比例分别是59%和41%;检出病原422份,检出率为76.0%;轮状病毒、致泻性大肠杆菌、沙门菌及志贺菌的检出率依次为30%、25%、11%、4%,其他不明原因病原体占24%。轮状病毒是儿童腹泻主要病原,以秋冬季(9、10、11、12月及次年1月)为主要发病季节。细菌性腹泻以夏秋季(6、7、8、9、10月)为主要发病季节。小儿细菌性腹泻以致病性大肠杆菌(EPEC)、鼠伤寒沙门菌、宋内志贺菌为优势血清型,其对氨苄西林、阿奇霉素、复方新诺明均存在较高耐药率。致泻性大肠杆菌、沙门菌、志贺菌、肺炎克雷伯对亚胺培南、哌拉西林他唑巴坦及环丙沙星耐药率低。结论分析小儿感染性腹泻的流行特征、病原及耐药性,显示致泻性大肠杆菌、沙门菌、志贺菌、肺炎克雷伯对亚胺培南、哌拉西林他唑巴坦及环丙沙星耐药率低,临床可以作为优先选用,可为小儿感染性腹泻正确诊治及合理用药提供参考依据。Objective To study epidemiological features, pathogens and drug resistance of infectious diarrhea in children. Methods Retrospectively analysis were made on clinical data of 555 infectious diarrhea children, and their outpatient service and electronic medical records were checked to analyze epidemiological features, pathogens and drug resistance of infectious diarrhea in children. Results Among 555 children, the morbidity rate under 5 years old was 92%, with proportion of male and female respectively as 59% and 41%. 422 pathogens were checked out, with positive rate as 76.0%, and positive rate of rotavirus, pathogenic escherichia coli, salmonella and shigella respectively as 30%, 25%, 11% and 4%, along with unknown pathogens accounting for 24%. Rotavirus was the main pathogens of diarrhea in children, with autumn and winter（September, October, November, December and January of the following year） as the primary seasons, and summer and autumn（June, July, August, September and October） were main onset seasons of bacterial diarrhea. The superiority serotypes of bacterial diarrhea in children were enteropathogenic escherichia coli（EPEC）, salmonella typhimurium, shigella sonnei, and these bacteria had high drug resistance rate for ampicillin, azithromycin, and these bacteria to ampicillin, azithromycin, and compound sulphatrim tablets, and pathogenic escherichia coli, salmonella, shigella and klebsiella pneumoniae had low drug resistance rate for imipenem, piperacillin-tazobactam and ciprofloxacin. Conclusion Analysis of epidemiological features, pathogens and drug resistance of infectious diarrhea in children shows that pathogenic escherichia coli, salmonella and shigella, klebsiella pneumoniae have low drug resistance rate for imipenem, piperacillin-tazobactam and ciprofloxacin, so they can be taken as prior selection, to provide reference basis for correct diagnosis and treatment of infectious diarrhea in children and rational drug use.

关 键 词：感染性腹泻 儿童 流行病学特征 病原体 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R725.1[医药卫生—临床医学]