小儿急性细菌性痢疾的病原菌分布特征及耐药性分析  

Distribution characteristics and drug resistance of pathogenic bacteria in children with acute bacterial dysentery

作　　者：陆迪雅[1] 许磊 马兰[1] 张雪雷[1] 王利平[1] 张秀芳[2] 王卫 高有方[1] LU Di-ya;XU Lei;MA Lan;ZHANG Xue-lei;WANG Li-ping;ZHANG Xiu-fang;WANG Wei;GAO You-fang(Department of Infection,Bozhou People’s Hospital,236800,China)

机构地区：[1]亳州市人民医院感染科,236800 [2]亳州市人民医院检验科,236800

出　　处：《传染病信息》2020年第2期176-178,182,共4页Infectious Disease Information

摘　　要：目的探究小儿急性细菌性痢疾的病原菌分布特征并对其耐药情况进行分析,为小儿急性细菌性痢疾的治疗提供参考依据。方法选取2016年1月—2019年7月亳州市人民医院确诊为小儿急性细菌性痢疾的80例患儿作为研究对象,对其临床资料如体温、腹泻次数、粪便状态等及实验检查如粪便病原菌培养和药物敏感试验结果进行统计分析。结果小儿急性细菌性痢疾病原菌以福氏志贺菌(S.flexneri)检出率最高、宋内氏志贺菌(S.sonnei)其次、鲍氏志贺菌(S.boydii)最低;3群志贺菌同时耐药的抗生素有11种,耐药率较高的抗生素有氨苄西林、氨苄西林舒巴坦、环丙沙星、庆大霉素;敏感率较高的有厄他培南、亚胺培南、哌拉西林他唑巴坦、头孢他啶;3群志贺菌对哌拉西林他唑巴坦敏感率均为100%;各群志贺菌耐药情况在各年度大致相同,氨苄西林舒巴坦、庆大霉素与妥布霉素耐药例数逐年递增,S.sonnei和S.boydii耐药抗生素相对S.flexneri较少。结论小儿急性细菌性痢疾病原菌耐药情况不容乐观,要加强对小儿急性细菌性痢疾的病原菌培养及耐药监测,合理使用抗生素,控制病原菌耐药演变与流行。Objective To explore the distribution characteristics of pathogens,analyze drug resistance in children with acute bacterial dysentery and provide evidence for the treatment of acute bacterial dysentery in children.Methods Eighty children diagnosed with acute bacterial dysentery in Bozhou People’s Hospital were included in this study.The clinical data including body temperature,diarrhea frequency,fecal state and the experimental examination such as fecal pathogen culture and drug sensitivity assay were analyzed statistically.Results Among the pathogens in children with acute bacterial dysentery,S.flexneri had the highest detection rate,followed by S.sonnei,and S.boydii had the lowest detection rate.All 3 major Shigella were resistant to 11 antibiotics.The resistance rate against ampicillin,ampicillin sulbactam,ciprofloxacin,gentamicin was relatively higher.The sensitivity rate against ertapenem,imipenem,piperacillin tazobactam,ceftazidime were relatively higher.All 3 major Shigella were sensitive to piperacillin tazobactam,accounting for 100%.The drug resistance was identical in recent years.The number of cases resistant to ampicillin sulbactam,gentamicin and tobramycin increased year by year,S.sonnei and S.boydii were resistant to less antibiotics than S.flexneri.Conclusions The drug resistance of pathogenic bacteria in children with acute bacterial dysentery is unfavorable.The pathogen culture and drug resistance monitoring of acute bacterial dysentery in children should strengthen to propose reasonable application of antibiotics and control the evolution and progression of drug resistant pathogens.

关 键 词：细菌性痢疾 志贺菌 流行病学 耐药 

分 类 号：R446.5[医药卫生—诊断学]