感染性肠炎的病原学特点与耐药性分析

发布时间：2018-08-07 12:52

【摘要】：目的分析感染性肠炎患者的病原菌特点及其耐药性,为临床工作提供依据。方法选取2014年3月-2016年3月医院收治的382例感染性肠炎患者为研究对象,对患者粪便标本进行细菌培养及药敏试验,统计病原菌分布及其耐药性,分析引发感染性肠炎的主要诱因。结果共检出病原菌477株,其中革兰阳性菌92株占19.29%,革兰阴性菌351株占73.58%,真菌34株,占7.13%;革兰阴性菌中大肠埃希菌和志贺氏菌属对头孢唑林、头孢噻肟、阿莫西林耐药性较强,耐药率分别为95.97%、91.28%、97.32%和94.02%、97.44%、92.31%,而对头孢哌酮/舒巴坦、美罗培南等抗菌药物的敏感性较高;革兰阳性菌中的金黄色葡萄球菌和肠球菌属对青霉素、红霉素、阿奇霉素等耐药性较强,耐药率分别为93.62%、63.83%、63.83%和100.00%、58.33%、58.33%,对万古霉素、替考拉宁、利奈唑胺的敏感性较高;生吃食物、感染性肠炎患者接触史及外出就餐史是引起感染性肠炎的主要诱因。结论感染性肠炎的致病菌以革兰阴性菌为主,常见敏感药物为头孢哌酮/舒巴坦、美罗培南等,生吃食物、感染性肠炎患者接触史及外出就餐史为引发感染性肠炎的主要诱因;因此,临床对怀疑感染性肠炎患者,应立即进行粪便培养,明确病原菌类型,选择敏感抗菌药物进行治疗,以提高感染性肠炎的治疗效果。
[Abstract]:Objective to analyze the characteristics and drug resistance of pathogenic bacteria in patients with infectious enteritis and to provide evidence for clinical work. Methods 382 patients with infectious enteritis from March 2014 to March 2016 were selected as study subjects. Bacterial culture and drug sensitivity test were performed on fecal samples of patients. The distribution of pathogenic bacteria and their drug resistance were analyzed. To analyze the main causes of infectious enteritis. Results A total of 477 strains of pathogenic bacteria were detected, of which 92 were Gram-positive bacteria (19.29), 351 were Gram-negative bacteria (73.58), 34 were fungi (7.13), and among Gram-negative bacteria, Escherichia coli and Shigella were highly resistant to cefazolin, cefotaxime and amoxicillin. The drug resistance rates of 91.28% and 94.022% were 97.32% and 94.022%, respectively, and 92.31%, respectively, while the sensitivity to cefoperazone / sulbactam, meropenem and other antimicrobial agents was higher; Staphylococcus aureus and Enterococcus belonging to Gram-positive bacteria were more resistant to penicillin, erythromycin, azithromycin, etc. The drug resistance rates were 93.62% 63.83% and 100.005%, 58.33% and 58.33%, respectively. The sensitivity to vancomycin, teicoplanin and linazolamine was higher, and food consumption, contact history of infectious enteritis patients and dining out history were the main inducements of infectious enteritis. Conclusion Gram-negative bacteria are the main pathogens of infectious enteritis, the common sensitive drugs are cefoperazone / sulbactam, meropenem, raw food, contact history of infectious enteritis patients and dining out history are the main inducements of infectious enteritis. Therefore, in order to improve the therapeutic effect of infectious enteritis, fecal culture should be carried out immediately in patients with suspected infectious enteritis, the types of pathogenic bacteria should be determined and the sensitive antimicrobial agents should be selected to treat the patients with infectious enteritis.
【作者单位】：绍兴市立医院感染性疾病科;
【基金】：浙江省医药卫生科技计划基金资助项目(2013KYB267)
【分类号】：R446.5;R516.1

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