郑州市儿童感染性腹泻病原菌监测结果  

Surveillance of pathogens of infectious diarrhea among children in Zhengzhou City

作　　者：赵雪蕾 周鹏 安戈[1] 李羿 张晓甍 程春荣[1] ZHAO Xuelei;ZHOU Peng;AN Ge;LI Yi;ZHANG Xiaomeng;CHENG Chunrong(Microbiological Laboratory,Zhengzhou Center for Disease Control and Prevention,Zhengzhou,Henan 450007,China)

机构地区：[1]郑州市疾病预防控制中心微生物检验所,河南郑州450007

出　　处：《预防医学》2022年第4期389-394,共6页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：河南省细菌性传染病病原谱流行规律及变异研究(2018ZX10713003-002-003)。

摘　　要：目的分析2020年郑州市儿童感染性腹泻病原谱,为儿童腹泻病防治提供依据。方法收集2020年郑州市儿童医院腹泻门诊230份感染性腹泻病例粪便标本。采用分离培养法检测致泻性大肠埃希菌、沙门菌、志贺菌、副溶血性弧菌、弯曲菌和气单胞菌等病原菌,并对沙门菌进行脉冲场凝胶电泳(PFGE)分型和耐药性检测。描述性分析儿童感染性腹泻主要病原菌分型及耐药性。结果共230例腹泻病例,男童152例,女童78例,男女比为1.95∶1。0~3岁173例,占75.22%。病例数以6—8月最多,82例占35.65%。共分离检出病原菌71株,检出率为30.87%。其中沙门菌检出35株,检出率最高,为15.22%;其次为致泻性大肠埃希菌,检出20株,检出率为8.70%。沙门菌分为11种血清型,主要为肠炎沙门菌和鼠伤寒沙门菌;分子分型有25种带型,相似度为11.85%~100%。沙门菌对亚胺培南、美罗培南、多黏菌素B和阿米卡星均敏感;对链霉素、氨苄西林和磺胺异噁唑耐药率较高,分别为85.71%、80.00%和80.00%;多重耐药29株,多重耐药率为82.86%。结论2020年郑州市儿童感染性腹泻病原菌种类广泛,主要为沙门菌和致泻性大肠埃希菌。沙门菌PFGE指纹图谱呈高度多态性,耐药率较高。Objective To analyze the pathogenic spectrum of infectious diarrhea among children in Zhengzhou City in2020,so as to provide insights into the management of childhood infectious diarrhea.Methods A total of 230 stool samples were collected from children with diarrhea in the Diarrhea Clinic of Zhengzhou Municipal Children’s Hospital in 2020.Diarrheagenic Escherichia coli,Salmonella,Shigella,Vibrio parahaemolyticus,Campylobacter and Aeromonas were isolated.Salmonella was typed using pulsed-field gel electrophoresis(PFGE)and antimicrobial resistance was tested in Salmonella.The main types and drug resistance of pathogens were descriptively analyzed.Results The 230 children with diarrhea included 152 males and 78 females,with a male to female ratio of 1.95:1.There were 173 cases at ages of 3 years and below(75.22%),and 82 cases seen between June and August(35.65%).A total of 71 pathogenic bacteria strains were isolated,with a detection rate of 30.87%.Salmonella was the most frequently isolated pathogen(35 strains,15.22%prevalence),following by diarrheagenic E.coli(20 strains,8.70%).Eleven serotypes of Salmonella were identified,which mainly included S.enteritidis and S.typhimurium.PFGE typing revealed 25 band patterns of Salmonella,with a similarity ranging from 11.85%to 100%.Salmonella were sensitive to imipenem,meropenem,polymyxin B and amikacin and highly resistant to streptomycin(85.71%),ampicillin(80.00%)and sulfaisoxazole(80.00%).A 82.86%proportion of multi-drug resistance was detected in the 29 Salmonella strains.Conclusions A wide range of pathogenic bacteria were detected from the childhood infectious diarrhea in Zhengzhou City in 2020,which mainly included Salmonella and diarrheagenic E.coli.A high polymorphism level was seen in PFGE fingerprints of Salmonella,which presented high-level resistance to antimicrobial agents.

关 键 词：感染性腹泻 病原菌 沙门菌 多重耐药 

分 类 号：R18[医药卫生—流行病学]