摘要
目的了解蚌埠医学院第一附属医院近3年小儿急性细菌性痢疾的临床特点、致病菌群分布以及耐药情况。为临床合理使用抗生素提供依据。方法对2010年1月至2012年12月收住该院儿科的44例急性细菌性痢疾患儿为研究对象,对患儿的一般资料、症状、血常规、生化常规以及病原菌的分型以及耐药性情况的临床特点及药敏结果进行回顾性分析。结果小儿细菌性痢疾多流行于5～11月,以1～6岁患儿高发。病例多以普通型为主,偶有中毒型。脓血便已不是细菌性痢疾的典型表现。血液学检测白细胞增高,中性粒细胞,C反应蛋白明显增高。福氏志贺菌是主要流行菌群。志贺菌属对头孢唑啉、氨苄青霉素几乎全部耐药,对喹诺酮类以及氨基糖苷类以及头孢曲松的耐药率也较高,对哌拉西林他唑巴坦、头孢派酮舒巴坦则全部敏感。结论小儿细菌性痢疾临床表现亦趋于不典型和多样化,尽早做大便培养以明确。在治疗上应当首选含有β-内酰胺酶抑制剂的复方制剂。
Objective To investigate the clinical features of bacillary dysentery in children and its pathogen distribution and drug resistance,and provide evidence for clinical use of antibiotics.Methods A retrospective analysis was conducted in child patients with bacillary dysentery from January 2010 to December 2012.The data of age,symptoms,blood test,pathogen type and its drug resistance were analyzed.Results Most cases occurred from May to November.The prevalence was higher in children from 1 to 6 years old.Most cases were of common type.Few were of toxic type.Pus and blood stool was no longer a typical symptom.The count of white blood cell,neutrophils and CRP increased.The result of bacterial typing revealed that S.flexneri was the primary epidemic pathogen.The drug-resistant rates of Shigella to ampicillin and cefazolin were even up to 100%.The resistance rates to quinolones,cefteixone,aminoglycosides and SMZ had beome higher.The drug-sensitive rates of Shigella to cefoperazon-sulbactam and piperacillin-tazobactam were up to 100%.Conclusion Clinical features of bacillary dysentery in children tend to be itypical and diversified.Stool culture should be done as early as possible.It is suggested that compound preparations containing β-lactamase inhibitors be chosen as the first choice.
出处
《中国微生态学杂志》
CAS
CSCD
2013年第5期574-576,共3页
Chinese Journal of Microecology
关键词
细菌性痢疾
儿童
病原学
药物敏感试验
Bacillary dysentery
Children
Etiology
Drug sensitive test
