CAJ | 학술논문

目的：了解急性腹泻患者粪便细菌菌群分布及其抗菌药物耐药情况，为临床合理使用抗菌药物提供科学依据。方法对该院2011年1月至2012年12月544例肠道门诊患者的粪便标本进行分离鉴定和药物敏感试验。结果544份粪便标本共分离到97株致病菌，总检出率为17．83％，其中致泻性大肠埃希氏菌属、非伤寒沙门氏菌属、弯曲菌属、副溶血性弧菌、其他气单胞菌、类志贺邻单胞菌、志贺氏菌属和嗜水气单胞菌的检出率分别为4．78％、3．68％、2．57％、2．39％、1．84％、1．28％、0．92％和0．37％。药敏试验结果为致泻性大肠埃希氏菌、沙门氏菌和副溶血性弧菌对氧氟沙星、阿莫西林、头孢他啶、氯霉素、头孢吡肟、庆大霉素较为敏感，敏感率均在80％以上，腹泻常见致病菌对各种常用抗菌药物均产生了不同程度的耐药性，其中，氨苄青霉素、萘啶酸耐药性最为明显。结论致泻性大肠埃希氏菌、非伤寒沙门氏菌、弯曲菌及副溶血性弧菌是主要病原菌，条件致病菌出现增多的趋势，且对各种抗菌药物均出现了不同程度的耐药性，临床医师应根据药敏结果合理选择抗菌药物，避免经验用药，从而提高感染性腹泻的疗效。
목적：료해급성복사환자분편세균균군분포급기항균약물내약정황，위림상합리사용항균약물제공과학의거。방법대해원2011년1월지2012년12월544례장도문진환자적분편표본진행분리감정화약물민감시험。결과544빈분편표본공분리도97주치병균，총검출솔위17．83％，기중치사성대장애희씨균속、비상한사문씨균속、만곡균속、부용혈성호균、기타기단포균、류지하린단포균、지하씨균속화기수기단포균적검출솔분별위4．78％、3．68％、2．57％、2．39％、1．84％、1．28％、0．92％화0．37％。약민시험결과위치사성대장애희씨균、사문씨균화부용혈성호균대양불사성、아막서림、두포타정、록매소、두포필우、경대매소교위민감，민감솔균재80％이상，복사상견치병균대각충상용항균약물균산생료불동정도적내약성，기중，안변청매소、내정산내약성최위명현。결론치사성대장애희씨균、비상한사문씨균、만곡균급부용혈성호균시주요병원균，조건치병균출현증다적추세，차대각충항균약물균출현료불동정도적내약성，림상의사응근거약민결과합리선택항균약물，피면경험용약，종이제고감염성복사적료효。
Objective To investigate the bacterial spectrum and antimicrobial resistance of pathogens isolated from stool of acute diarrhea outpatients ,and provide scientific evidence for clinic rational use of antibiotics .Methods Bacteria was detected by conven‐tional feces culture method ,including separation and biochemistry appraisal sure strains .The predominant bacteria were conducted antimicrobial resistance testing in acute diarrhea outpatients .Results 544 stool specimens were collected from acute diarrhea outpa‐tients from January 2011 to December 2012 .The total positive rate was 17 .83% .Positive rates of Escherichia coli ,Salmonella , Campylobacter ,Vibrio parahaemolyticus ,Other Aeromonas ,Shiga Plesiomonas ,Shigella and Aeromonas hydrophila were 4 .78% ,3 .68% ,2 .57% and 2 .39% ,1 .84% ,1 .28% ,0 .92% and 0 .37% ,respectively .Salmonella ,Campylobacter and Vibrio parahaemolyticus were susceptible to Ofloxacin ,Amoxicillin ,Ceftazidime .They were different resistance to conventional antibiot‐ics ,which were commonly used by clinic ,and the most serious resistance are ampicillin and nalidixic acid .Conclusion Escherichia coli ,Salmonella ,Campylobacter and Vibrio parahaemolyticus are predominant bacteria pathogens .It is important to better under‐stand pathogens spectrum and antimicrobial resistance of bacteria for controlling infection in acute diarrhea outpatients .