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目的了解婴幼儿感染性腹泻微生物病原谱及耐药性。方法收集2013年3月—12月在温州市2家三甲医院门诊就诊的婴幼儿(≤5岁)腹泻患者的粪便标本,进行常见感染性腹泻致病菌培养与病毒核酸检测。结果 517份粪便标本中检出病原微生物201份,总检出率为38.88%。其中肠道致病菌检出74份(14.31%),以致泻性大肠埃希菌(36份)最多,其中O抗原分布广泛,2份带有STX2肠毒素基因;其次为沙门菌31份,其中肠炎沙门菌(7份)和鼠伤寒沙门菌(6份)为优势菌;腹泻相关病毒检出127份(24.56%),其中诺如病毒Ⅱ型(56份)、A组轮状病毒(40份)和诺如病毒Ⅰ型(24份)检出较多。沙门菌对氨苄西林耐药率达64.52%,致泻大肠埃希菌对氨苄西林、四环素和复方新诺明等耐药率均>70.00%,阪崎肠杆菌和嗜水气单胞菌对17种药物中的大部分敏感。利福平、新生霉素对所有细菌均100%耐药。结论温州市婴幼儿感染性腹泻病原菌以致泻性大肠埃希菌、沙门菌为主要流行株;病毒以诺如病毒、A组轮状病毒为主要流行株,应加强主动监测,选择合适的抗生素治疗细菌性腹泻。
Objective To understand the microbial spectrum and drug resistance of infectious diarrhea in infants and young children. Methods Stool samples from infants and young children (≤5 years old) with diarrhea in two top-three outpatient clinics in Wenzhou City from March 2013 to December 2013 were collected for common infectious diarrhea pathogens culture and viral nucleic acid detection. Results A total of 201 pathogenic microorganisms were detected in 517 stool samples, with a total detection rate of 38.88%. Among them, 74 (14.31%) were intestinal pathogens, which led to the largest number of diarrheal Escherichia coli (36 isolates), of which O antigen was widely distributed, 2 were infected with STX2 enterotoxin gene, 31 were Salmonella, Among them, Salmonella enteritidis (7 copies) and Salmonella typhimurium (6 copies) were dominant bacteria. 127 (24.56%) were detected in diarrhea-related viruses including Norovirus type II (56), Group A rotavirus 40) and Norovirus type I (24) detected more. Salmonella ampicillin resistance rate of 64.52%, diarrhea Escherichia coli ampicillin, tetracycline and cotrimoxazole resistance rates were> 70.00%, Enterobacter sakazakii and Aeromonas hydrophila 17 Most of the drugs are sensitive. Rifampicin, novobiocin 100% of all bacteria resistant. Conclusions The pathogenic bacteria of infectious diarrhea in infants and young children in Wenzhou are diarrheal Escherichia coli and Salmonella. The virus is mainly epidemic strains such as Norovirus and A group rotavirus. Active surveillance should be strengthened to select suitable antibiotics Bacterial diarrhea.