2021~2023年北京经济技术开发区感染性腹泻病原谱及耐药性分析  

An Analysis of the Pathogen Spectrum and Drug Resistance of Infectious Diarrhea in Beijing Economic-Technological Development Area from 2021 to 2023

作　　者：孙宇峰[1] 岳正源 田晓波[1] 刘向祎[1] SUN Yufeng;YUE Zhengyuan;TIAN Xiaobo;LIU Xiangyi(Department of Clinical Laboratory,Beijing Tongren Hospital,Capital Medical University,Beijing100730,China)

机构地区：[1]首都医科大学附属北京同仁医院检验科,北京100176

出　　处：《标记免疫分析与临床》2024年第9期1593-1599,共7页Labeled Immunoassays and Clinical Medicine

基　　金：教育部产学合作协同育人项目(编号:231107010282307)。

摘　　要：目的了解北京经济技术开发区感染性腹泻患者常见的病原菌种类、流行趋势和耐药性,从而为该地区的流行病学研究及临床治疗提供科学依据。方法收集2021年1月1日至2023年12月31日就诊于首都医科大学附属北京同仁医院感染科肠道门诊、儿科、急诊科6902例感染性腹泻患者的粪便标本进行增菌、分离培养,用基质辅助激光解析电离飞行时间质谱仪(MALDI-TOF MS)鉴定菌种,用凝集试验确定血清型,用K-B纸片法测定抗菌药物敏感性。结果在6902例标本中,检出390株病原菌,总体检出率为5.65%。其中沙门菌属和副溶血弧菌是最常见的两种病原菌,分别占检出的390株病原菌的32.14%和28.32%。检测出的沙门菌属中,优势血清型为肠炎沙门氏菌。27株霍乱弧菌中非O1/O139血清群霍乱弧占92.59%,且近年呈现增长态势。不同年龄组和病原菌的检出差异具有统计学意义(P<0.001),其中21~30岁年龄组和31~40岁年龄组感染性腹泻患者最多,另外0~10岁年龄组、11~20岁年龄组和>60岁年龄组以沙门菌属为主,其余组以副溶血弧菌为主。不同月份和病原菌的检出差异具有统计学意义(P<0.001),肠道致病菌在7~8月检出率最高,而沙门菌属高发期则在6~7月。不同病原菌对各类抗菌药物的敏感性存在差异,其中氨基青霉素类抗菌药物显示出较高的耐药性。单环β-内酰胺类、喹诺酮类、氨基糖苷类药物敏感性较高,多重耐药情况也有发生。结论弧菌属和沙门菌属是北京经济技术开发区感染性腹泻的主要病原菌,各种病原菌耐药性不同,因此必须紧密关注感染性腹泻病原菌及其对各类抗菌药物的耐药性情况。Objective To understand the common pathogenic bacteria species,epidemic trends,and drug resistance of infectious diarrhea patients in Beijing Economic-Technological Development Area,thereby providing a scientific basis for epidemiological research and clinical treatment in this region.Methods From January 1,2021 to December 31,2023,fecal samples from 6902 patients with infectious diarrhea who visited the Gastrointestinal Clinic,Pediatrics,and Emergency Department of Beijing Tongren Hospital affiliated with Capital Medical University were collected for the sampling process including enrichment,isolation,and culture.Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS)was applied for bacterial species identification,while agglutination tests were u sed to determine serotypes,and the Kirby-Bauer disk diffusion method was used to determine antimicrobial susceptibility.Results Among the 6902 samples,390 strains of pathogenic bacteria were detected,with an overall detection rate of 5.65%.Salmonella and Vibrio parahaemolyticus were the two most common pathogens,accounting for 32.14%and 28.32%of the 390 detected strains,respectively.Among the detected Salmonella species,the dominant serotype was Salmonella enteritidis.Of the 27 Vibrio cholerae strains,92.59%belonged to the non-O1/O139 serogroup,and there was an increasing trend in recent years.The differences in detection among different age groups and pathogens were statistically significant(P<0.001),with the 21-30 and 31-40 age groups having the most patients with infectious diarrhea.Additionally,the 0-10,11-20,and>60 age groups were mainly infected with Salmonella,while the rest were mainly infected with Vibrio parahaemolyticus.The differences in detection among different months and pathogens were statistically significant(P<0.001),with enteropathogenic bacteria having the highest detection rate in July-August,and Salmonella peaking in June-July.Different pathogens showed differences in sensitivity to various antimicrobial drugs,wi

关 键 词：肠道致病菌 感染性腹泻 耐药性 

分 类 号：R378[医药卫生—病原生物学]