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 epidemiological characteristics and drug resistance of pediatric diarrhea pathogens and provide the basis for clinical diagnosis and treatment. Methods The stool samples of pediatric diarrhea from July 2011 to June 2012 in our outpatient department and inpatient hospital were collected for stool routine examination, rotavirus test, bacterial culture and drug susceptibility test. Results A total of 109 cases (16.7%) of pathogens were detected in the stool of 654 children with diarrhea. Among them, 115 cases (17.6%) of group A rotavirus, 4 parasites (0.6%) and 34.9% , Non-infectious diarrhea accounted for 65.1%. Infectious diarrhea mainly occurs in children aged 1 to 6 years. Rotavirus infection is the primary reason followed by bacteria. Bacterial infection mainly occurs in autumn and virus infection mainly occurs in winter. Non-infectious diarrhea 75.8% occurs in children under 3 years old Infants and young children. The top 5 bacterial infections were Shigella (28.4%), pathogenic Escherichia coli (25.7%), Salmonella (11.0%), pathogenic Vibrio (7.3%) and fungi . The three main pathogenic bacteria were imipenem-resistant, resistant to the 3rd generation of cephalic cells and antibacterials plus enzyme inhibitor, and Shigella and Escherichia coli were resistant to ampicillin and cotrimoxazole (> 82.1%), Salmonella resistance to ampicillin and gentamicin (> 66.7%). Conclusions There are many causes of pediatric diarrhea. Clinicians and their families should be given appropriate medication according to fecal routine, fecal culture and drug susceptibility test results. Antibiotics are disabled in children with viral and non-infectious diarrhea to avoid an imbalance or double infection of the gut flora.