广州地区儿童感染性腹泻的病原学研究

Distribution and antibiotic resistance of pathogens isolated from children with infectious diarrhea in Guangzhou

摘要:

目的：掌握广州地区儿童细菌感染性腹泻的病原构成及其耐药情况，为临床及时准确诊断和治疗提供实验室依据。方法：采集2006年1月至2007年12月广州市儿童医院腹泻患儿的大便标本进行常规病原菌的分离培养，通过细菌生化反应和血清凝集试验进行鉴定和分型，采用Kirby-Bauer纸片扩散法进行药敏试验。结果：从2 409份标本中检出448株病原菌，检出率为18.6％。其中志贺菌159株，致病性大肠埃希菌141株，沙门菌76株，致泻弧菌11株，真菌41株，空肠弯曲菌20株。三种主要致病菌对亚胺培南无耐药，对第三代头孢菌素和加酶抑制剂的复合抗菌药物耐药率较低（<10％），对氨苄西林和复方新诺明的耐药率较高（>75％）。结论：广州地区儿童细菌感染性腹泻的主要病原菌是志贺菌、致病性大肠埃希菌和沙门菌。第三代头孢菌素和加酶抑制剂的复合抗菌药物是治疗细菌感染性腹泻的有效抗菌药物，氨苄西林和复方新诺明已经不适合临床治疗细菌感染性腹泻。［中国当代儿科杂志，2009，11（2）：107-109］

Abstract:

OBJECTIVE: To study the distribution and antibiotic resistance of the isolated pathogens from children with infectious diarrhea in Guangzhou. METHODS: The fecal samples of 2 409 children with infectious diarrhea between January 2006 and December 2007 were collected and cultured. Pathogenic bacterium were isolated and identified by biochemical and serological methods. The antibiotic susceptibilities were tested by the Kirby-Bauer method. RESULTS: A total of 448 isolates of pathogenic bacterium (18.6%) were obtained, including Shigella (n=159), enteropathogenic Escherichia coli (n=141), Salmonella (n=76), Vibrion (n=11), fungus (n=41), and C jejuni (n=20). All of isolates of the three major pathogenic bacterium, Shigella, enteropathogenic Escherichia coli and Salmonella, were susceptive to imipenem and less than 10% of the isolates were resistant to the third generation cephalosporins and β-lactamase inhibitors. However, the isolates showed a high resistance to ampicillin and sulfamethoxazole/trimethoprim (>75%). CONCLUSIONS: Shigella, enteropathogenic Escherichia coli and Salmonella were major pathogenic bacterium of diarrhea in children from Guangzhou. The major isolates were susceptive to imipenem, the third generation cephalosporins and βlactamase inhibitors, but were resistant to ampicillin and sulfamethoxazole/trimethoprim.［Chin J Contemp Pediatr, 2009, 11 (2):107-109］