厦门地区156株儿童感染性腹泻沙门菌的血清学分型及耐药性分析

发布时间：2018-06-04 12:20

本文选题：儿童 + 感染性腹泻　；参考：《现代预防医学》2016年13期

【摘要】：目的分析致儿童感染性腹泻的沙门菌的分布特征及耐药状况,为临床诊断及治疗提供依据。方法对2009-2014年期间来我院就诊的3 287例感染性腹泻患儿,取大便标本进行沙门菌增菌培养及分离鉴定,采用BD Phoenix100全自动细菌鉴定药敏分析系统进行沙门菌属确认和药敏试验,并对确认菌株行血清学分型。结果分离出156株沙门菌分属于5个群,23种不同血清型,其中B群鼠伤寒沙门菌和D群肠炎沙门菌分离率较高,分别占53.8%和12.2%。夏秋季节5-10月份检出率5.0%,高于冬春季节11-4月检出率3.2%,差异有统计学意义(=5.93,P=0.015)。对氨苄西林耐药率高达59.6%,对氯霉素、复方新诺明、环丙沙星和三代头孢菌素均有不同程度耐药,对β-内酰胺类加酶抑制剂的哌拉西林/他唑巴坦基本敏感。超广谱β-内酰胺酶(ESBLs)检出率高达16.7%,多重耐药菌(MDRO)检出率17.3%。结论本地区儿童感染性腹泻沙门菌以B群的鼠伤寒沙门菌居首位,其次为D群肠炎沙门菌。夏秋季节检出率明显高于冬春季节。耐药现象不容忽视,临床应依据药敏结果选用抗菌药物。
[Abstract]:Objective to analyze the distribution and drug resistance of Salmonella in children with infectious diarrhea and to provide evidence for clinical diagnosis and treatment. Methods from 2009 to 2014, 3 287 children with infectious diarrhea in our hospital were collected for salmonella culture and isolation and identification. BD Phoenix100 automatic bacterial identification and drug sensitivity analysis system was used to identify Salmonella and drug sensitivity test. Serological typing of confirmed strains was performed. Results 156 strains of Salmonella were isolated from 5 groups of 23 different serotypes. The isolation rates of Salmonella typhimurium B and Salmonella enteritidis group D were higher, accounting for 53.8% and 12.2%, respectively. The detection rate in May to October in summer and autumn was 5.0, which was higher than that in November to April in winter and spring, and the difference was statistically significant. The resistance rate of ampicillin to ampicillin was as high as 59.6. It was resistant to chloramphenicol, compound sulfamethoxacin, ciprofloxacin and third generation cephalosporins, and was basically sensitive to piperacillin / tazobactam, a beta-lactam inhibitor. The detection rate of extended-spectrum 尾 -lactamase ESBLswas as high as 16.7%, and the detection rate of MDRO-multidrug resistant bacteria was 17.3%. Conclusion Salmonella typhimurium group B was the first group of infectious diarrhea Salmonella in children, followed by group D enteritis Salmonella. The detection rate in summer and autumn was higher than that in winter and spring. The phenomenon of drug resistance can not be ignored. Antibiotics should be selected according to the results of drug sensitivity in clinic.
【作者单位】：厦门市妇幼保健院;厦门市疾病预防控制中心;
【分类号】：R725.1;R446.5

【参考文献】