2016年-2018年急性传染性腹泻致病菌类型分析  

Analysis of pathogenic bacteria of acute infectious diarrhea from 2016 to 2018

作　　者：邵婷婷[1] SHAO Ting-ting(Zhejiang Provincial Tongde Hospital,Hangzhou,Zhejiang 310000,China)

机构地区：[1]浙江省立同德医院,浙江杭州310000

出　　处：《中国卫生检验杂志》2021年第1期124-128,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的调查本院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年-2018年本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 1 564份标本中,共检测出阳性致病菌641株,检出率为41.00%,不同菌属检出率由高到低依次为副溶血性弧菌25.40%、志贺菌属6.60%、大肠埃希菌4.70%、沙门菌4.20%。其中,副溶血性弧菌、ETEC、EHEC感染主要分布于20岁~40岁青壮年,年龄分布差异有统计学意义(P <0.05);沙门菌、志贺菌、副溶血性弧菌、ETEC感染男性多于女性,性别分布差异有统计学意义(P <0.05);沙门菌、副溶血性弧菌、ETEC的时间分布差异有统计学意义(P <0.05),副溶血性弧菌主要分布在8月-9月,沙门菌主要分布在6月-8月,ETEC主要分布在7月-8月;各肠道致病菌对8种抗菌药敏感率由高到低依次:阿米卡星95.30%、头孢噻肟89.76%、庆大霉素76.98%、头孢唑啉68.91%、环丙沙星55.79%、复方新诺明55.19%、诺氟沙星33.97%、氨苄西林21.54%。结论肠道门诊感染性腹泻致病菌以弧菌为主,好发于20岁~40岁青壮年男性,集中在6月-9月,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 types,epidemiological distribution and drug resistance of acute infectious diarrhea in intestinal clinic of Hospital. Methods From 2016 to 2018,the fecal,anal swabs or vomit samples of patients with acute diarrhea in the intestinal clinic of a 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 A total of 641 strains of positive pathogenic bacteria were detected in 1 564 specimens,and the detection rate was 41. 00%. The order of detection rate of different bacteria was as follows: Vibrio parahaemolyticus( 25. 40%),Shigella( 6. 60%),Escherichia coli( 4. 70%) and Salmonella( 4. 20%). Among them,Vibrio parahaemolyticus and ETEC,EHEC infection were mainly distributed in 20-40 years old and young adults;and Salmonella,Shigella,Vibrio parahaemolyticus and ETEC infection were more in males than in females,and there was statistical significance on the differences in gender distribution between males and females( P < 0. 05). Vibrio parahaemolyticus is mainly distributed in August-September,Salmonella is mainly distributed in June-August,and ETEC is mainly distributed in July-August. The sensitivity of the intestinal pathogenic bacteria to 8 antibacterial drugs was 95. 30% to amikacin,89. 76% to cefotaxime,76. 98% to gentamicin,68. 91% to cefazolin,55. 79% to ciprofloxacin,55. 19% to cotrimoxacin,33. 97% to norfloxacin and21. 54% to ampicillin,in descending order. Conclusion The pathogenic bacteria of infectious diarrhea in the outpatient department of intestinal tract of a hospital is mainly Vibrio parahaemolyticus,which usually occur in young men aged 20-40 years old,concentrated in June-September. Amikacin and cefotaxime can be used as the preferred drugs for empirical treatment.

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：R378[医药卫生—病原生物学]