北京地区腹泻病原菌流行病学及耐药特征和检测技术研究  

The study on characteristics of epidemiological,antibiotic resistance and detecting techniques of diarrhea pathogens in Beijing

作　　者：陈素明[1] 贾天野[1] 张敬霞[1] 张树永[1] 王慧珠[2] 娄金丽[3] 徐旋 鲍春梅[1] 曲芬[1] Chen Su-ming;Jia Tian-ye;Zhang Jing-xia;Zhang Shu-yong;Wang Hui-zhu;Lou Jin-li;Xu Xuan;Bao Chun-mei(Clinical Laboratory Center,302 Hospital of PLA,Beijing 100039;Department of Clinical Laboratory,Beijing Ditan Hospital,Capital Medical University,B eijing 100015;Department of Clinical Laboratory,B eijing Youan Hospital,Capital Medical University,Beijing 100069)

机构地区：[1]解放军第302医院临床检验医学中心,北京100039 [2]首都医科大学附属北京地坛医院检验科,北京100015 [3]首都医科大学附属北京佑安医院临检中心,北京100069

出　　处：《中国抗生素杂志》2018年第9期1083-1088,共6页Chinese Journal of Antibiotics

基　　金：首都市民健康项目培育(No.Z151100003915151)

摘　　要：收集2015年6月至2017年12月北京市的传染病医院腹泻样本,对腹泻病原菌进行分离及药敏测定,分析腹泻病原菌的流行病学特征及耐药特点,并探讨不同检测方法的实用性。共收集腹泻标本1335份,分离到8个属33个种/群,235株腹泻病原菌,阳性率为17.6%。检出率最高病原菌是沙门菌(53.62%),其次是弧菌(20.00%);年龄以中青年为主(38.30%),职业以民工、自由职业及待业者占优势(59.58%),男性高于女性(χ~2=18.174,P=0);检测技术包括Microflex LT、VITEKⅡ和血清凝集,Microflex LT鉴定所需时间和成本消耗最低。腹泻病原菌耐药率较高的抗生素为氨苄西林和复方磺胺甲噁唑,对亚胺培南、头孢美唑、头孢曲松、左氧氟沙星的耐药率较低。由此,北京市腹泻病原菌组成种类多,流行特点鲜明,细菌鉴定推荐使用及时、快速的质谱鉴定技术,必要时辅以血清凝集的方法,各种病原菌耐药性不同,应加强监测。Diarrhea samples from infectious disease hospitals in Beijing from June 2015 to December 2017 were collected. Diarrhea pathogens were isolated. Antibiotic susceptibility test, analysis of epidemiological characteristics and antibiotic resistance characteristics of diarrhea pathogens were performed. The practicality of different detection methods was explored. A total of 235 diarrhea pathogens were isolated from 1,335 samples, with a positive rate of 17.6%. Salmonella positive rate was the highest （53.62%）, followed by Vibrio（20.O0%）. Young people（38.30%）, migrant workers and unemployed people （59.58%） had the highest rates of diarrhea; males were higher than females（X2=18.174, P=0）. Detection techniques included Microflex LT, VITEK II, and Serological agglutination. The Microflex LT identification required the least time and cost. The antibiotics with higher resistance rates against diarrhea pathogens were ampicillin and compound sulfamethoxazole. Imipenem, cefmetazole, ceftriaxone, and levofloxacin had lower resistance rates. Thus, there were many types of diarrheal pathogenlc bacteria in beijing, and the epidemiological characteristics were clear. It was recommended to use timely and rapid Microflex LT techniques for the identification of bacteria, supplemented with serological agglutination when necessary, and the monitoring of the resistance of various pathogens should be strengthened.

关 键 词：感染性腹泻 腹泻病原菌 检测技术 耐药性 

分 类 号：R978.1[医药卫生—药品]