中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2011年
1期
33-35
,共3页
于国慧%董方%刘锡清%许宏%宋文琪%徐樨巍
于國慧%董方%劉錫清%許宏%宋文琪%徐樨巍
우국혜%동방%류석청%허굉%송문기%서서외
感染性腹泻%病原学%耐药性%轮状病毒%儿童
感染性腹瀉%病原學%耐藥性%輪狀病毒%兒童
감염성복사%병원학%내약성%륜상병독%인동
Infectious diarrhea%Etiology%Drug resistance%Rotavirus%Children
目的 研究北京地区儿童急性感染性腹泻的病原学变化、流行病学特征及耐药性变迁情况.方法 对2009年1月~10月肠道门诊疑诊为细菌性腹泻病者便标本做细菌培养和血清分型鉴定,药敏试验采用纸片扩散法,以免疫层析双抗体夹心法定性检测A群轮状病毒抗原.结果 256份标本检出病原菌4种87株(有1份便标本同时检出2种菌),检出率为34.0%.男女检出比为1.69∶1,2岁以下患儿55例(64.0%).沙门菌40株(46.0%),志贺菌23株(26.4%),致泻性大肠杆菌2株(2.3%),金黄色葡萄球菌22株(25.3%).志贺菌中D群13株(56.5%),22株金黄色葡萄球菌有20株发生于<1岁婴儿.沙门菌和志贺菌的耐药率分别为:氨苄西林(65.0%;95.7%)、复方新诺明(20.0%;78.3%)、环丙沙星(7.5%;8.7%)、头孢曲松(15.0%;73.9%).256份标本中A群轮状病毒检测阳性47份,其中同时便培养阳性者13份.结论 2009年北京地区儿童细菌性腹泻的病原菌以非伤寒沙门菌为主,志贺菌以D群为主要流行株,二者的易感人群以2岁以下婴幼儿为主,金黄色葡萄球菌感染以1岁以下婴儿为主,阳性检出男孩居多.多重耐药仍以志贺菌明显,细菌与轮状病毒混合感染的比例上升.
目的 研究北京地區兒童急性感染性腹瀉的病原學變化、流行病學特徵及耐藥性變遷情況.方法 對2009年1月~10月腸道門診疑診為細菌性腹瀉病者便標本做細菌培養和血清分型鑒定,藥敏試驗採用紙片擴散法,以免疫層析雙抗體夾心法定性檢測A群輪狀病毒抗原.結果 256份標本檢齣病原菌4種87株(有1份便標本同時檢齣2種菌),檢齣率為34.0%.男女檢齣比為1.69∶1,2歲以下患兒55例(64.0%).沙門菌40株(46.0%),誌賀菌23株(26.4%),緻瀉性大腸桿菌2株(2.3%),金黃色葡萄毬菌22株(25.3%).誌賀菌中D群13株(56.5%),22株金黃色葡萄毬菌有20株髮生于<1歲嬰兒.沙門菌和誌賀菌的耐藥率分彆為:氨芐西林(65.0%;95.7%)、複方新諾明(20.0%;78.3%)、環丙沙星(7.5%;8.7%)、頭孢麯鬆(15.0%;73.9%).256份標本中A群輪狀病毒檢測暘性47份,其中同時便培養暘性者13份.結論 2009年北京地區兒童細菌性腹瀉的病原菌以非傷寒沙門菌為主,誌賀菌以D群為主要流行株,二者的易感人群以2歲以下嬰幼兒為主,金黃色葡萄毬菌感染以1歲以下嬰兒為主,暘性檢齣男孩居多.多重耐藥仍以誌賀菌明顯,細菌與輪狀病毒混閤感染的比例上升.
목적 연구북경지구인동급성감염성복사적병원학변화、류행병학특정급내약성변천정황.방법 대2009년1월~10월장도문진의진위세균성복사병자편표본주세균배양화혈청분형감정,약민시험채용지편확산법,이면역층석쌍항체협심법정성검측A군륜상병독항원.결과 256빈표본검출병원균4충87주(유1빈편표본동시검출2충균),검출솔위34.0%.남녀검출비위1.69∶1,2세이하환인55례(64.0%).사문균40주(46.0%),지하균23주(26.4%),치사성대장간균2주(2.3%),금황색포도구균22주(25.3%).지하균중D군13주(56.5%),22주금황색포도구균유20주발생우<1세영인.사문균화지하균적내약솔분별위:안변서림(65.0%;95.7%)、복방신낙명(20.0%;78.3%)、배병사성(7.5%;8.7%)、두포곡송(15.0%;73.9%).256빈표본중A군륜상병독검측양성47빈,기중동시편배양양성자13빈.결론 2009년북경지구인동세균성복사적병원균이비상한사문균위주,지하균이D군위주요류행주,이자적역감인군이2세이하영유인위주,금황색포도구균감염이1세이하영인위주,양성검출남해거다.다중내약잉이지하균명현,세균여륜상병독혼합감염적비례상승.
Objective To investigate the etiology, epidemiologic features and drug resistance tendency of acute infectious diarrhea among children in Beijing area. Methods Enteric pathogenic bacteria were isolated, cultured and identified for serotype from the stool specimens of children with the initial clinical diagnosis of acute bacterial diarrhea in the intestinal clinic from January to October in 2009 ,and the antibiotic susceptibility of bacteria was tested by disk diffusion method. The cluster A rotavirus antigen was also detected by the qualitative technique of immunochromatographic double-antibody sandwich assay. Results Of the 256 stool specimens, 87 strains of 4 species of pathogenic bacteria were detected with the detectable rate of 34. 0% ,of which 2 strains were detected in one stool sample ,including 40 strains of salmonella (46. 0%) ,23 strains of shigella (26. 4%) ,2 strains of diarrheogenic escherichia coli (2. 3%) and 22 strains of staphylococcus aureus (25.3%). The positively detected patients consisted of 54 males and 32 females with the ratio of 1.69∶1 ,of whom 55 cases (64. 0%) were under 2 years of age. Of the 13 strains of shigella, 13 were sonnei shigella (56. 5%). And of the 22 strains of staphylococcus aureus,20 were detected among the infants under 1 year of age. The rates of crug resistance to certain antibiotics were lower in salmonella than in shigella (ampicillin :65. 0% vs. 95.7% ;compound sulfamethoxazole:20. 0% vs. 78. 3% ;ciprofloxacin:7.5% vs.8. 7% ;ceftriaxone: 15.0% vs. 73.9%). Of the 256 stool specimens ,47 were found positive for cluster A rotavirus,of whom 13 were also positive in stool bacteria culture. Conclusion Salmonella is the major pathogen among children with bacterial diarrhea in Beijing in 2009, and sonnei shigella is the main epidemic strains of shigella diarrhea. lnfants under 2 years of age are the susceptible population of the above two species of bacteria, while staphylococcus aureus mainly infect the infants under 1 years of age. Multi-resistance in shigella is still serious. The incidence of mixed infections of bacteria and rotavirus increases in children with infectious diarrhea.