200例急性感染性腹泻患者细菌病原学及抗菌药物耐药性分析  

Analysis of bacterial etiology and antimicrobial resistance in 200 patients with acute infectious diarrhea

作　　者：田军花 TIAN Junhua(Department of Clinical Laboratory of Puyang County Second People’s Hospital,Puyang 457100 Henan,China)

机构地区：[1]濮阳县第二人民医院检验科,河南濮阳457100

出　　处：《中国民康医学》2023年第19期28-30,34,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析急性感染性腹泻患者病原菌分布及其对抗菌药物的耐药性。方法:回顾性分析2020年3月至2021年12月该院收治的200例急性感染性腹泻患者的临床资料,采集粪便标本行病原菌培养和药敏试验,了解病原菌分布情况及细菌耐药性。结果:200例患者中共检出细菌218株,其中,肠球菌属最多,共70株(32.11%),其次为志贺菌属,共58株(26.61%)。肠球菌属中屎肠球菌对青霉素、氨苄西林的耐药率较高,均>70%;粪肠球菌对庆大霉素、氯霉素、红霉素耐药性较高,均≥50%,铅黄肠球菌对红霉素、环丙沙星耐药性较高,均≥70%;福氏志贺菌对环丙沙星、氨苄西林耐药率较高,均>75%;克雷伯菌属对庆大霉素、哌拉西林、氨苄西林、复方磺胺甲噁唑耐药率较高,均为100.00%;致病性大肠埃希菌对哌拉西林、氨苄西林耐药率较高,均为100.00%。肠球菌属对利奈唑胺、万古霉素耐药率较低,福氏志贺菌对亚胺培南、头孢哌酮、头孢曲松耐药率较低,均<15%;克雷伯菌属对氨苄西林-舒巴坦、环丙沙星、头孢哌酮、头孢曲松的耐药率较低,均<10%,对亚胺培南耐药率为0;致病性大肠埃希菌对庆大霉素、氨苄西林-舒巴坦、复方磺胺甲噁唑、头孢哌酮耐药率较低,均<20%,对亚胺培南耐药率为0。结论:本地区急性细菌性腹泻患者的病原菌中以肠球菌属、志贺菌属占比最多,且主要病原菌耐药性较严重,对常用的青霉素类药物、大环内酯类药物耐药性较高,部分细菌对限制使用级、特殊使用级抗生素耐药,临床用药需重视药敏分析,尽量选择敏感药物治疗,避免长时间使用广谱抗生素。Objective:To analyze pathogen distribution and their resistance to antibiotics in patients with acute infectious diarrhea.Methods:The clinical data of 200 patients with acute infectious diarrhea admitted to this hospital from March 2020 to December 2021 were retrospectively analyzed.Fecal specimens were collected for pathogen culture and drug sensitivity test in order to understand the pathogen distribution and the bacterial resistance.Results:A total of 218 strains of bacteria were detected in the 200 patients.Among them,Enterococcus was the most,with 70 strains(32.11%),followed by Shigella,with 58 strains(26.61%).The resistance rates of Enterococcus faecium to Penicillin and Ampicillin were higher than 70%.Enterococcus faecalis had high resistance to Gentamicin,Chloramphenicol and Erythromycin,all of which were≥50%.Enterococcus casseliflavus had high resistance to Erythromycin and Ciprofloxacin,all of which were≥70%.The resistance rates of Shigella flexneri to Ciprofloxacin and Ampicillin were higher than 75%.The resistance rates of Klebsiella to Gentamicin,Piperacillin,Ampicillin and compound Sulfamethoxazole were 100.00%.The resistance rates of pathogenic Escherichia coli to Piperacillin and Ampicillin were 100.00%.The resistance rates of Enterococcus to Linezolid and Vancomycin were low,and the resistance rates of Shigella flexneri to Imipenem,Cefoperazone and Ceftriaxone were low,all were<15%.The resistance rates of Klebsiella to Ampicillin-Sulbactam,Ciprofloxacin,Cefoperazone and Ceftriaxone were lower than 10%,and the resistance rate to Imipenem was 0.The resistance rates of pathogenic Escherichia coli to Gentamicin,Ampicillin-Sulbactam,compound sulfamethoxazole and Cefoperazone were lower than 20%,and the resistance rate to Imipenem was 0.Conclusions:Among the pathogenic bacteria of the patients with acute bacterial diarrhea in this area,Enterococcus and Shigella account for the most,and the drug resistance of the main pathogenic bacteria is serious.Their resistance to commonly used Penicillin and Ma

关 键 词：感染性腹泻 细菌性腹泻 病原分布 耐药性 药敏试验 

分 类 号：R181.3[医药卫生—流行病学]