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目的研究小儿感染性腹泻流行特征、病原及耐药性。方法回顾性分析555例小儿腹泻患儿的临床资料,查看门诊及住院电子病历,分析小儿感染性腹泻的流行特征、病原及耐药性。结果本组555例患儿,5岁以下患儿患病率占92%;男女患儿比例分别是59%和41%;检出病原422份,检出率为76.0%;轮状病毒、致泻性大肠杆菌、沙门菌及志贺菌的检出率依次为30%、25%、11%、4%,其他不明原因病原体占24%。轮状病毒是儿童腹泻主要病原,以秋冬季(9、10、11、12月及次年1月)为主要发病季节。细菌性腹泻以夏秋季(6、7、8、9、10月)为主要发病季节。小儿细菌性腹泻以致病性大肠杆菌(EPEC)、鼠伤寒沙门菌、宋内志贺菌为优势血清型,其对氨苄西林、阿奇霉素、复方新诺明均存在较高耐药率。致泻性大肠杆菌、沙门菌、志贺菌、肺炎克雷伯对亚胺培南、哌拉西林他唑巴坦及环丙沙星耐药率低。结论分析小儿感染性腹泻的流行特征、病原及耐药性,显示致泻性大肠杆菌、沙门菌、志贺菌、肺炎克雷伯对亚胺培南、哌拉西林他唑巴坦及环丙沙星耐药率低,临床可以作为优先选用,可为小儿感染性腹泻正确诊治及合理用药提供参考依据。
Objective To study the epidemic characteristics, pathogens and drug resistance of infectious diarrhea in children. Methods The clinical data of 555 children with pediatric diarrhea were retrospectively analyzed. The outpatient and inpatient electronic medical records were reviewed. The epidemic characteristics, pathogens and drug resistance of children with infectious diarrhea were analyzed. Results The prevalence rate of 555 children and children under 5 years old was 92% in this group, 59% and 41% respectively. 422 pathogens were detected, the detection rate was 76.0%. Rotavirus, The detection rates of diarrheal Escherichia coli, Salmonella and Shigella were 30%, 25%, 11% and 4%, respectively. Other pathogens with unknown causes accounted for 24%. Rotavirus is the main pathogen of childhood diarrhea, with autumn and winter (9, 10, 11, December and January) as the main season. Bacterial diarrhea in summer and fall (6, 7, 8, 9, October) as the main season of onset. Bacterial diarrhea in children with pathogenic E. coli (EPEC), Salmonella typhimurium, Shigella sonnei dominant serotype, its ampicillin, azithromycin, cotrimoxazole have a higher resistance rate. Diarrhea Escherichia coli, Salmonella, Shigella, Klebsiella pneumoniae imipenem, piperacillin tazobactam and ciprofloxacin low resistance rate. Conclusions The prevalence, pathogen and drug resistance of infantile infectious diarrhea were analyzed. It was shown that diarrheal Escherichia coli, Salmonella, Shigella, Klebsiella pneumoniae imipenem, piperacillin tazobactam and cyclopropane Sand star resistance rate is low, the clinical can be used as a priority, can provide a reference for the correct diagnosis and treatment of infectious diarrhea in children and rational drug use.