2016-2018年急性传染性腹泻致病菌类型分析  

Analysis of pathogens of acute infectious diarrhea from 2016 to 2018

作　　者：陶理智 TAO Li-zhi(First affiliated hospital of army medical university,400038)

机构地区：[1]陆军军医大学第一附属医院急诊医学科

出　　处：《现代消化及介入诊疗》2020年第1期16-20,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的调查重庆市急性传染性腹泻致病菌类型、流行病学分布及耐药性。方法收集2016-2018年重庆市各医院肠道门诊就诊急性腹泻患者的粪便、肛拭子或呕吐物标本,进行9种常见致病菌的分离、培养、鉴定和药敏试验,并采用统计学方法分析各致病菌的流行病学分布特征。结果3128例标本中,共检测出阳性致病菌1282株,检出率为40.9%,不同菌属检出率由高到低依次为:副溶血弧菌25.4%、志贺菌属6.6%、大肠埃希菌4.7%、沙门菌4.2%。副溶血弧菌、ETEC、EHEC、沙门菌和志贺菌感染主要分布于20~40岁青壮年,不同年龄段患者沙门菌、志贺菌、副溶血弧菌、ETEC检出率差异有统计学意义(P<0.05)。男性患者志贺菌性检出率显著高于女性患者(P<0.05)。肠道致病菌感染主要集中分布在6~10月份,其中:副溶血弧菌主要分布在8~9月份,沙门菌主要分布在6~8月份,ETEC和志贺菌主要分布在7~8月份;不同月份志贺菌、EIEC、沙门菌、副溶血弧菌、ETEC和EPEC的检出率比较差异有统计学意义(P<0.05)。肠道致病菌对8种抗菌药敏感率由高到低依次为:阿米卡星95.2%、头孢噻肟91.7%、庆大霉素80.9%、复方新诺明69.0%、头孢唑啉62.6%、诺氟沙星32.5%、环丙沙星27.0%、氨苄西林13.7%。结论重庆市肠道门诊感染性腹泻致病菌以弧菌为主,好发于20~40岁青壮年男性,集中在6~9月份,阿米卡星和头孢噻肟可作为经验性治疗的首选药物。Objective To investigate the type,epidemiological distribution and drug resistance of acute infectious diarrhea hospital of Xuzhou.Methods from 2016 to 2018,the fecal,anal swabs or vomit samples of patients with acute diarrhea in the intestinal clinic of xxx Hospital were collected.The isolation,culture,identification and drug sensitivity test of 9 kinds of common pathogenic bacteria were carried out,and the epidemiological distribution characteristics of each pathogenic bacteria were analyzed by statistical method.Results Among the 3128 specimens,1282 positive pathogens were detected,and the detection rate was 40.98%.The detection rates of different strains were from high to low:25.40%of Vibrio parahaemolyticus and 6.60%of Shigella.Escherichia coli 4.70%,Salmonella 4.20%.The infections of Vibrio parahaemolyticus,ETEC,EHEC,Salmonella and Shigella were mainly distributed in young adults aged 20-40 years.The age distribution was statistically significant(P<0.05);Shigella,more men than women,the gender distribution was statistically significant(P<0.05);intestinal pathogenic infections mainly concentrated in June to October,including Shigella,EIEC,Salmonella,Vibrio parahaemolyticus,The time distribution of ETEC and EPEC was statistically significant(P<0.05).Among them,Vibrio parahaemolyticus was mainly distributed from August to September,Salmonella was mainly distributed from June to August,and ETEC and Shigella were mainly distributed in 7~.August.The susceptibility of intestinal pathogens to 8 kinds of antibacterial drugs in descending order is:amikacin 95.2%,cefotaxime 91.7%,gentamicin 80.9%,compound sinomine 69.0%,and ceftizolin 62.6%,Norfloxacin 32.5%,ciprofloxacin 27.0%,and ampicillin 13.7%.Conclusion Vibrio is the main pathogen of infectious diarrhea in intestinal clinic Hospital.Vibrio is the most common pathogen in young and middle-aged men aged 20 to 40 years old,and it is concentrated in June to September.Amikacin and cefotaxime can be used as the first empirical treatment.Choose drugs.

关 键 词：感染性腹泻 肠道致病菌 流行病学特征 耐药性 

分 类 号：R515[医药卫生—内科学]