摘要
目的了解小儿腹泻病原的流行病学特点及其耐药的情况,为临床诊治提供依据。方法采集2011年7月到2012年6月来本院门诊和住院治疗的小儿腹泻大便进行粪常规、轮状病毒的检测以及细菌培养和药物敏感性试验。结果 654例腹泻患儿的大便共培养出致病菌109例（16.7%）,检出A群轮状病毒115例（17.6%）、寄生虫4例（0.6%）,感染性腹泻占34.9%,非感染性腹泻占65.1%。感染性腹泻主要发生在1~6岁儿童,轮状病毒感染是首位原因,细菌次之;细菌性感染主要发生在秋季,病毒感染主要发生在冬季;非感染性腹泻75.8%发生在3岁以下婴幼儿。细菌性感染前5位分别是志贺菌（28.4%）,致病性大肠埃希菌（25.7%）,沙门菌（11.0%）,致病性弧菌（7.3%）和真菌（6.4%）。3种主要致病菌对亚胺培南无耐药,对第3代头胞及加酶抑制剂的抗菌药物耐药率低,志贺菌和大肠埃希菌对氨苄西林和复方新诺明的耐药率高（〉82.1%）,沙门菌对氨苄西林和庆大霉素耐药率高（〉66.7%）。结论小儿腹泻病因多,临床医生和家属应根据粪常规、粪培养和药物敏感试验结果合理用药。病毒感染及非感染性腹泻患儿禁用抗生素,以免造成肠道菌群失调或二重感染。
Objective To understand the etiological feature and drug resistance of pathogenic bacteria so as to provide the evidence for improving the clinical diagne and treatment. Methods From July 2011 to June 2012, 654 stool samples of children with diarrhea were examined for routine, rotavirus （RV）, bacterium culture, and drug susceptibility. Results There were 109 cases of pathogenic bacteria （16.7%）, 115 cases of RV （17.6%）, and 4 cases of parasites （0.6%）. The infectious diarrhea accounted for 34.9%, and non-infectious diarrhea accounted for 65.1%. Infectious diarrhea mainly occurred in children aged from one to six years., and RV was the major pathogen, followed by bacteria. The bacterium infection mainly happened in the autumn, and virus infection appeared mainly during the winter. Non-infectious diarrhea mainly appeared in infants aged below 3 years old （75.8%）. The top of five strains in bacterium infection were Shigella （28.4 % ）, Escherichia coli （25.7 % ）, Salmonella （ 11.0 % ）, athogenic vibrio （ 7.3 % ）, and fungus （6.4%）. Three mainly pathogenic bacteria had not drug-resistance to imipenem and little resistance to third generation cepbalosporin and antibiotics of β-lactanase inhibitors. The resistance of Shigella and E. coli were high to ampieillin and sulfamethoxazole/trimethoprim （ ）〉 82. 1% ）. The resistance of Salmonella was high to ampicillin and gentamicin （ 〉 66.7 % ）. Conclusions The causes of diarrhea of children were more. The clinicians should choose suitable antibiotics based on the results of faces routine, culture and drug susceptibility examinations. The children with infect virus diarrhea or non-infectious diarrhea should not use antibiotics to prevent dysbacteriosis of intestines and superinfection.
出处
《中国校医》
2013年第6期448-450,共3页
Chinese Journal of School Doctor
关键词
婴儿
儿童
腹泻
病因学
细菌感染
微生物学
病毒性疾病
病毒学
粪便
微生物学
粪便
病毒学
抗药性
细菌
Infant
Child
Diarrhea/etiology
Bacterial Infection/microbiology
Virus Disease/virology
Feces/ microbiology
Feces/virology
Drug Resistance, Bacterium
