摘要
目的探讨近10年儿童细菌性腹泻病原菌的变迁及近年菌株的耐药情况。方法收集北京儿童医院1998—2007年粪便细菌培养阳性的细菌性腹泻患儿859例,对其临床资料进行回顾性研究,统计学处理用SPSS13.0软件进行。结果(1)859株检出菌中,包括志贺菌585株,沙门菌89株,大肠埃希菌56株,变形杆菌92株,金黄色葡萄球菌37株。(2)志贺菌构成比由1998年的82.5%降为2007年的52.9%。金黄色葡萄球菌、大肠埃希菌分别自2001年、2002年开始检测,渐升至2007年的9.4%和14.1%。(3)夏秋季为发病高峰(73.9%),沙门菌、大肠埃希菌、条件致病菌在小年龄组检出率高。(4)肠道病原菌对青霉素类、复方磺胺耐药率均在50%以上。除大肠埃希菌外,肠道病原菌对喹诺酮类、三代头孢、亚胺培南耐药率低,分别为13.0%～24.2%、5.9%～62.5%、0。大肠埃希菌对丁胺卡那霉素及亚胺培南耐药率分别为7.5%、0,对其他抗生素耐药率均在50%以上。结论儿童细菌性腹泻病原菌构成及耐药谱在不断发生变化,临床应注重病原及药敏监测,合理选用抗生素。
Objective To study variation of pathogens of bacterial diarrhea in children during recent 10 years, and to analyze drug resistance of these bacterial strains. Methods A total of 859 cases, who were hospitalized in Beijing Children＇s Hospital due to bacterial diarrhea from 1998 to 2007, with positive stool culture, were included in our study. And their clinical data were also studied retrospectively. Statistics was analyzed by SPSS13.0. Results （ 1 ）Among 859 bacterial trains of positive stool culture, there were 585 Shigella, 89 Salmonella, 56 E coli, 92 Proteus, and 37 Staphylococcus aureus. （2）The ratio of Shigella decreased from 82.5% of 1998 to 52.9% of 2007.Detection of Staphylococcus aureus and E coli were began at 2001 and 2002, respectively, and their ratios gradually increased to 9.4% and 14.1% in 2007, respectively. （3）The peak onset （73.9%） of bacterial diarrhea was in summer and autumn. Salmonella, E coil, and conditional pathogenic bacteria were found with high detection ratio in younger-aged group. （4）The drug resistance ratio of enteric pathogenic bacteria to penicillin and sulfamethoxazole were both above 50%. Except E coli, the enteric pathogens showed low drug resistance to quinolones, third generation cephalosporins and imipenem, with ratios of 13.0% 24.2%, 5.9 % -62.5% and 0, respectively. The resistance ratios of E coil to amikacin and imipenem were 7.5% and 0%, respectively, and its ratios to other antibiotics were all above 50%. Conclusion The structure of pathogens of bacterial diarrhea in children and their drug resistance pattern are changing continuously. It should be emphasized to monitor pathogens and drug resistance in order to select antibiotics reasonably.
出处
《中国实用儿科杂志》
CSCD
北大核心
2009年第12期934-936,共3页
Chinese Journal of Practical Pediatrics
关键词
儿童
腹泻
病原菌
耐药性
children
diarrhea
pathogenic bacteria
drug resistance
