摘要
目的:分析单中心儿童肠道感染非伤寒沙门菌及志贺菌的菌群分布状态及药敏动态变化情况,指导临床用药。方法:对2010年1月至2014年12月我院肠道门诊接受诊治的肠道感染患儿留取大便标本进行分离和培养,对分离出的菌株进行鉴定及药敏试验。结果:在送检的2 119份大便标本中共培养检出415例非伤寒沙门菌和志贺菌,总检出率为19.58%(415/2 119)。在415例阳性标本中有374例非伤寒沙门菌,占90.12%,41例志贺菌,占9.88%。非伤寒沙门菌包括鼠伤寒沙门菌110例(29.41%),肠炎沙门菌106例(28.34%),其他种沙门菌属158例(42.25%)。志贺菌包括宋内志贺菌28例(68.29%),福氏志贺菌11例(26.83%),痢疾志贺菌2例(4.88%),未发现鲍曼志贺菌。非伤寒沙门菌药物敏感显示其对磷霉素耐药率最低3.0%[95%CI(1.5%,5.6%)],而对氨苄西林耐药率最高69.8%[95%CI(64.8%,74.4%)];在2010年1月至2014年12月期间对头孢曲松钠耐药率增加,对复方磺胺甲唑和氯霉素的敏感性增加。志贺菌药物敏感显示其对磷霉素耐药率最低2.6%[95%CI(0.1%,15.1%)],而对氨苄西林耐药率最高100%[95%CI(89.3%,100%)]。结论:上海地区肠道门诊患儿大便培养以鼠伤寒沙门菌、肠炎沙门菌和宋内志贺菌检出率较高。近年来该地区非伤寒沙门菌和志贺菌对氨苄西林和头孢曲松耐药率增加,而对磷霉素的敏感性较高。
Objective： To investigate the dynamic changes of bacteria distribution and drug sensitivity of nontyphoidal Salmonella（ NTS） and Shigella in children with intestinal infection in a single medical center. Methods： The stool samples were collected from children with intestinal infection in our hospital from January 2010 to December 2014. Stool bacterium cultures were performed,and drug sensitive tests were done for the isolated strains. Results： A total of 2,119 stool specimens were collected and performed bacterium culture. The results showed that 415 cases were positive for NTS or Shigella（ 19. 58%,415 / 2,119）. In these 415 positive cases,374 cases were positive for NTS and 41 cases were Shigella. In NTS positive cases,Salmonella typhimurium were 110 cases（ 29. 41%）,followed by Salmonella enteritidis 106 cases（ 28. 34%） and other strains of Salmonella genus were detective in 158 cases（ 42. 25%）. Of the 41 Shigella isolates,28 cases（ 68. 29%） were Shigella Sonnei,11 cases（ 26. 83%） of Shigella Flexneri,2 cases（ 4. 88%） of Shigella dysenteriae. Bowman’s Shigella was not detected. The drug resistance rate of NTS to fosfomycin was 3% [95% CI（ 1. 5%,5. 6%） ],and to ampicillin was 69. 8% [95% CI（ 64. 8%,74. 4%） ]. During 2010 to 2014,the drug resistance rate of NTS to ceftriaxone was increased,the sensitivity of NTS to compound sulfamethoxazole and chloramphenicol were increased. Drug sensitivity test showed that the lowest of Shigella resistant rate was to fosfomycin with 2. 6% [95% CI（ 0. 1%,15. 1%） ],and the highest was to ampicillin with 100% [95% CI（ 89. 3%,100%） ]. Conclusion： Salmonella typhimurium,Salmonella enteritidis and Shigella Sonnei are dominant strains isolated from stool specimens in Shanghai region. The resistance to ampicillin and ceftriaxone has been increased pattern in recent years. However,these strains isolated from stool samples are high sensitive to fosfomycin.
作者
廖炀
林凯
张泓
张婷
Liao Yang Lin Kai Zhang Hong Zhang Ting(Shanghai Children＇ s Hospital, Children＇ s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200062, Chin)
出处
《儿科药学杂志》
CAS
2017年第2期39-42,共4页
Journal of Pediatric Pharmacy
关键词
非伤寒沙门菌
志贺菌
肠道感染
耐药
nontyphoidal Salmonella
Shigella
intestinal infection
drug resistance
