豫东瞧县住院腹泻患者致泻病原学研究

为了解住院腹泻患者致泻病原情况，１９９０年１－１２月对豫东睢县住院腹泻患者３７２例进行了致泻细菌、轮状病毒、致泻寄生虫的一次性同步调查分析．结果：２０１例（５４．０３％）检出致泻病原，共检出１２种病原体计２３７株，检出率６３．７１％，其中致泻细菌检出率４４．３５％、轮状病毒检出率１２．１０％、致泻寄生虫检出率７．２６％。主要致泻病原为鼠伤寒沙门菌和轮状病毒，其构成比为４４．３０％及１８．９９％。住院腹泻患者主要为０～１岁婴幼儿（占６７．６０％），各季度病原检出率差别不显著，发病人数以第３、４季度为多。还对流行病学主要特征、临床诊断及发病因素进行分析。     

豫东瞧县农村居民感染性腹泻病原学调查研究

为了解农村居民中感染性腹泻病原学情况，我们于１９９０年１－１２月对睢县刘小庄、王老集两个自然村进行了调查。结果：检查腹泻病人３１８例，检出病原者１３２例（４１．５１％），检出病原１５种１７２株，检出率４９．３７％；检查健康人群３１０名，检出病原者６３名（２０．３２％），检出病原１２种６９株，检出率２２．２６％；检查外环境标本４０５份，其中４０份（９．９７％）检出病原菌，共检出病原菌６种４４株，检出率１０．９７％。各类标本检出的主要病原为ＥＴＥＣ（ＬＴ）、变型杆菌，其次为志贺菌、轮状病毒。文章对发病原因进行了讨论。     

1988—1993在南宁市新生儿腹泻病原谱及耐药性监测研究

为掌握南宁市新生儿腹泻病原谱及医院内感染的特点，有效地控制新生儿腹泻的发生，建立快速简便、稳定实用的诊断方法，作者于１９８８－１９９３年对南宁市５家医院７８７例新生儿腹泻患者进行了病原学检测及耐药性监测，检出各类病原体２６１例，检出率３３．２％，病原性大肠菌为主要致泻菌，占总检出率的５３．２％，揭示病原性大肠菌蝻宁市亲徨儿腹泻的主要病原。医院内感染以沙门氏菌和致病性大肠菌为主，同时对５种常见的致泻     

豫东睢县农村居民感染性腹泻病原学调查研究

为了解农村居民中感染性腹泻珠病原学情况，我们于１９９０年１～１２月对睢县刘小庄，王老集两个自然进行了调查，结果：检查腹泻病人３１８例，检出病原者１３２例（４１．５１％），检出病原１５种１７２株，检出率４９．３７％，检查健康人群３１０名，检出病原者６３名（２０．３２％），检出病原１２种６９株，检出率２２．２６％，检查外环境标要４０５份，其中４０份（９．９７％），检出病原菌，共检出病原菌６种４４株，检     

腹泻婴幼儿600例粪便标本的病原学分析

目的探讨婴幼儿腹泻标本病原学特点，为临床诊断及治疗提供依据。方法对河南省新乡医学院第二附属医院2007年1—12月门诊及住院的600例婴幼儿的腹泻标本进行细菌学检查。结果600例婴幼儿腹泻标本病原学阳性307例（51．17％），检出病原菌17种309株，内源性肠道条件致病菌、外源性肠道病原菌以及轮状病毒3种病原构成比依次为33．98％、33．33％、32．69％。病原主要为轮状病毒101株（32．69％），志贺菌55株（17．80％），克雷伯菌40株（12．95％），致泻性大肠埃希菌33株（10．68％），枸橼酸杆菌31株（10．03％）。结论引起婴幼儿腹泻的病原种类繁多，轮状病毒居首位，内源性肠道条件致病菌在腹泻标本中的构成比大于外源性肠道致病菌，已成为腹泻的重要病原菌。     

安徽省儿童医院2016—2021年住院腹泻患儿病原学监测

目的 调查安徽省儿童医院住院腹泻患儿病原学监测结果。方法 采用传统法检测安徽省儿童医院2016—2021年1 334例住院腹泻患儿粪便细菌，实时荧光PCR检测病原体核酸（包括沙门菌、致泻性大肠杆菌、志贺菌、小肠结肠炎耶尔森菌、类志贺邻单胞菌、轮状病毒、诺如病毒、札如病毒、腺病毒、星状病毒），并分析不同年份、年龄、性别、居住地及不同季节的住院腹泻患儿病原菌分布特点。结果 2016—2021年共收集病例1 334例，在1 334份粪便标本中检出770株病原微生物，检出率为57.72%，其中致病菌290株（21.74%），病毒480株（35.98%）。检出率最高的致病菌为沙门菌（7.35%）和致泻性大肠杆菌（7.12%），检出率最高的病毒是轮状病毒（17.32%）和诺如病毒（10.72%）。2017年病原菌检出率最高，为66.10%,2021年病原菌检出率最低，为50.38%，随时间的推移，住院腹泻患儿病原菌检出率下降。不同年龄段腹泻儿童病原菌、病毒及总病原体检出率差异均有统计学意义（P<0.05），其中11～14岁儿童致病菌检出率最高（30.45%），而0～5岁儿童病毒检出率最高（4...     

1988～1993年南宁市新生儿腹泻病原谱及耐药性监测研究

为掌握南宁市新生儿腹泻病原谱及医院内感染的特点，有效地控制新生儿腹泻的发生，建立快速简便、稳定实用的诊断方法，作者于１９８８～１９９３年对南宁市５家医院７８７例新生儿腹泻患者进行了病原学检测及耐药性监测，检出各类病原体２６１例，检出率３３．２％，病原性大肠菌为主要致泻菌，占总检出率的５３．２％，揭示病原性大肠菌是南宁市新生儿腹泻的主要病原。医院内感染以沙门氏菌和致病性大肠菌为主。同时对５种常见的致泻病原作了药敏试验观察，均呈现出不同程度的耐药情况，提示新生儿腹泻病原菌耐药现象日趋严重，这可能与医院不合理使用抗生素有关，文中对此作了分析与讨论。     

云贵川渝2012-2015年腹泻病原谱分析

目的 了解云南省、四川省、贵州省和重庆市腹泻病原流行特征.方法 回顾性分析2012-2015年4省市监测点对应哨点医院收集的腹泻病例特征,归纳分析4省市腹泻病原的构成情况.结果 腹泻病例约从每年的7月份开始增加,9-11月达到峰值,男性为女性的1.49倍,2岁以下病例占66.49％(3 489例).腹泻病毒和细菌检出率分别是30.90％(1 305/4223)和9.50％(364/3 830),寄生虫检出3例.四川、云南、重庆以轮状病毒为主要的腹泻病毒,分别占43.06％、56.90％和49.87％,贵州省主要是诺如病毒(38.18％).腹泻细菌病原谱贵州省和云南省以致泻性大肠埃希菌为主,分别占51.09％和76.30％,而四川省和重庆市是非伤寒沙门菌占优势,分别占50.41％和81.58％.仅病毒感染的腹泻患者占76.83％,细菌感染次之,病毒和细菌混合感染6.03％.结论 腹泻患者婴幼儿较多,病毒为主要病原体,应加强夏秋季节婴幼儿腹泻性疾病的防控工作.     

西安市急性感染性腹泻细菌病原学监测结果分析

目的 为掌握西安市急性感染性腹泻细菌病原特点。方法 1995、1997、1998年5－10月对西安市三家医院的490例腹泻患者进行了细菌病原学监测。结果 从164例患者粪样中,检出各类病原菌167株,检出率34．08％,其中志贺氏菌占79．6％。对76株志贺氏菌进行了药物敏感性试验,对16种抗生素呈严重耐药。结论 志贺氏菌是西安市急性感染性腹泻的主要病原菌致泻性大肠杆菌次之,初步揭示了西安市细菌性腹泻病原谱。     

上海市浦东新区5岁以下儿童腹泻病病原谱监测分析

[目的]了解上海市浦东新区5岁以下儿童腹泻病的病原谱构成、病原特征,为制定预防控制措施提供依据。[方法]对2012年2月-2013年1月浦东新区人民医院、儿童医学中心2家监测点医院的619例腹泻患儿进行个案调查,同时采集粪便标本进行肠道致病菌和病毒的检测。[结果]诺如病毒、轮状病毒、肠道腺病毒、扎如病毒、星状病毒的检出率分别为11．95％、7．27％、2．91％、1．45％、0．97％;致泻性大肠埃希菌、非伤寒沙门菌、弯曲菌、嗜水气单胞菌、志贺菌、小肠结肠炎耶尔森菌的检出率分别为5．65％、2．42％、0．81％、0．65％、0．48％、0．32％。病毒检出率8月至次年的3月为27．70％,高于其他月份的18．48％（χ2＝7．18,P＜0．05）;细菌检出率4-10月为15．34％,远高于其他月份的3．15％（χ2＝31．22,P＜0．05）。[结论]诺如病毒为浦东新区5岁以下儿童病毒性腹泻的最主要病原,致泻性大肠埃希菌为细菌性腹泻的最主要病原。细菌性腹泻的防控应以夏秋季为重点,病毒性腹泻应以全年为重点。     

Diarrhoeagenic bacterial pathogens in HIV-positive patients with diarrhoea in rural communities of Limpopo Province,South Africa

Potential enteric bacterial pathogens in 60 HIV-positive patients with chronic diarrhoea in rural communities of the Limpopo Province, South Africa, were identified using standard microbiological methods. The Kirby-Bauer disk-diffusion method was employed to determine antibiograms of isolated bacteria. Results revealed that diarrhoeagenic bacterial agents were isolated from 48 (80%) of the 60 HIV-positive patients with diarrhoea. Forty-four (73.3%) and 16 (26.7%) of the 60 patients were female and male respectively in the age range of 17-55 years with a mean of 34 years. Bacterial pathogens isolated comprised Campylobacter species (20.0%), Plesiomonas shigelloides (16.6%), Aeromonas species (13.3%), and Escherichia coli, Shigella and Salmonella species (10.0% each). No attempts were made to isolate parasites, fungi, or viruses. Antibiotic susceptibility profiles revealed resistance of the isolates to ampicillin, cephalothin, chloramphenicol, erythromycin, and streptomycin. However, all (100%) of P. shigelloides and Salmonella species were sensitive to nalidixic acid and ciprofloxacin. Most isolates were susceptible to nalidixic acid, ciprofloxacin, and gentamicin, indicating the usefulness of these drugs, although antibiograms may not always correlate with clinical usefulness.     

Role of Escherichia coli in acute diarrhoea in tribal preschool children of central India

Five hundred and eighty preschool children belonging to tribal areas of Madhya Pradesh were followed up daily for the presence of diarrhoea for a period of 1 year. In all, 1236 episodes of diarrhoea were recorded with an average of 2.13 episodes per child per year. Stool samples were collected during 780 episodes. They were cultured to isolate Escherichia coli as well as non-E. coli enteropathogens. Ten different genes were detected to identify all diarrhoeagenic E. coli using multiplex polymerase chain reaction. Enteroaggregative E. coli was the commonest diarrhoeagenic E. coli and was isolated from 64 children, followed by enteropathogenic E. coli (27), enterotoxigenic E. coli (10) and enterohaemorrhagic E. coli (2). Other enteropathogens detected were bacteria such as Shigella sp, Vibrio cholerae and Salmonella sp, parasites such as Giardia lamblia and Entameba histolytica, and rotavirus. Most of the bacterial pathogens were multi-drug resistant. The study shows that diarrhoeagenic E. coli contribute significantly to the burden of acute diarrhoea in tribal preschool children.     

某院2006—2009年血液培养病原体分布及耐药性变迁

目的了解某院近4年血液培养标本分离的病原体构成及其耐药性,为临床合理用药提供依据。方法收集2006年1月-2009年12月该院门诊及住院患者送检的血液培养标本资料,并对其分离病原体分布及耐药性作统计分析。结果4年血液培养标本分离病原体633株,阳性率10.32%（633/6 135）。其中,革兰阴性（G-）菌240株（37.92%）,革兰阳性（G+）菌354株（55.92%）,假丝酵母菌属39株（6.16%）。金黄色葡萄球菌、大肠埃希菌、表皮葡萄球菌为检出病原体的前3位,分别占18.17%、17.22%、15.64%。G-菌对亚胺培南最敏感,耐药率仅为1.67%;对氨苄西林、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、氨曲南的耐药率, 2009年显著高于2006年（P＜0.05）。G+菌对万古霉素除发现2株肠球菌属菌株耐药外,未发现其他耐药菌株;对青霉素、头孢噻肟、左氧氟沙星、克林霉素、阿奇霉素的耐药率呈不断上升趋势,2009年显著高于2006年（P＜0.05）。结论该院血液培养病原体中,金黄色葡萄球菌、大肠埃希菌分别居检出G+菌和G-菌的首位,耐药菌株逐年增加;应及时检测病原体及其耐药性,指导临床合理用药。     

2012-2017年某院儿童肺炎链球菌感染分布特点及耐药性

Objective To understand the distribution, drug resistance and change trend of Streptococcus pneumo-niae (S. pneumoniae) infection in children in a hospital. Methods Sputum, blood and cerebrospinal fluid specimens of pediatric inpatients from January 2012 to December 2017 were cultured, bacteria were isolated and identified, antimicrobial susceptibility testing and result judgment were conducted according to Clinical and Laboratory Standards Institute (CLSI) M100-S28, data were statistically analyzed. Results A total of 2 384 strains of S. pneumoniae were isolated, 54.32% of which were isolated from male, 45.68% were from female, 63.38% of children were 0.5-3 years old, 21.10% were ≤ 0.5 year old, 15.52% were >3 years old. S. pneumoniae accounted for 18.08% of all isolated bacteria, according to the quarterly statistics, the proportion of bacteria isolated in the fourth quarter (20.62%, 839/4 068) > first quarter (18.77%, 762/4 059) > second quarter (18.42%, 557/3 024) > third quarter (11.11%, 226/2 034), but difference with the change of quarter was gradually narrowing. Resistance rates of S. pneumoniae to erythromycin, compound sulfamethoxazole, clindamycin and tetracycline were high (73.21%-99.62%), while resistance rates to levofloxacin, chloramphenicol, cefuroxime, cefotaxime, amoxicillin and penicillin were low (0.19%-33.92%), no S. pneumoniae was found to be resistant to vancomycin, quinupristin/dalfopristin, linezolid and moxifloxacin. Conclusion S. pneumoniae is mainly isolated from children with respiratory tract infection, most infection occurred in children aged ≤ 3 years. Difference in S. pneumoniae isolation rate with the change of quarter is gradually narrowing, and its time distribution characteristics becomes less and less obvious. Amoxicillin and penicillin can be used as first-line agents for treatment of S. pneumoniae infection in children.     

Aetiology of Diarrhoea and Virulence Properties of Diarrhoeagenic Escherichia coli among Patients and Healthy Subjects in Southeast Nigeria

Diarrhoeal diseases are one of the most important causes of illness and death all over the world. In Nigeria, the aetiology of diarrhoeagenic bacteria and the virulence of various Escherichia coli pathotypes have not been well-studied because most currently-published data were from the southwestern axis of the country. In total, 520 stool samples were collected from infants, young children, and other age-groups with acute diarrhoeal diseases in Enugu and Onitsha, southeastern Nigeria. Stool samples were collected from 250 apparently-healthy individuals, with similar age distribution and locality, who were considered control subjects. The stool samples were screened for diarrhea-causing bacterial agents. E. coli strains were isolated from both the groups and were examined by polymerase chain reaction (PCR) for 16 virulence genes. Of the 520 stool samples in the diarrhoea group, 119 (44.74%) were E. coli. Fifty (49.02%) were enteropathogenic E. coli (EPEC), 22 (21.57%) were enterotoxigenic E. coli (ETEC) while 7.84% was enteroaggregative E. coli (EAEC). Sex had no effect on the distribution of diarrhoeagenic bacteria, except for EIEC. The E. coli strains isolated from the diarrhoea and healthy asymptomatic age-matched control groups examined by PCR for 16 virulence genes indicate that the detection of EAEC, ETEC, EPEC, and EIEC was significantly associated with diarrhoea (p=0.0002). The study confirmed that several bacterial pathogens, such as E. coli, play an important role in the aetiology of acute diarrhoea in southeastern Nigeria. A routine surveillance, especially for diarrhoeagenic E. coli, would be useful in identifying outbreaks and help identify the potential reservoirs and transmission routes.Key words: Diarrhoea, Escherichia coli, Virulence, Nigeria     

Identification of enteric pathogens in HIV-positive patients with diarrhoea in northern India

Enteric pathogens associated with chronic diarrhoea in HIV-positive patients were studied. The study was conducted during January 1995-December 1998. Stool specimens from all diarrhoea patients (n = 26) were examined microscopically for ova and parasites using wet preparations and stained smears. Stool samples from diarrhoea patients were also cultured on appropriate media to isolate enteric bacterial pathogens. Of the 59 patients, 26 (44%) had prolonged diarrhoea for more than 4 weeks. Enteric pathogens were detected in 19 (73%) of the 26 patients: 17 patients harboured a single pathogen, and 2 patients had mixed pathogens. The detection rate of emerging parasites, including Isospora, Cryptosporidium, Blastocystis hominis, and Strongyloides stercoralis as a single agent, was significantly higher than conventional pathogens (50% vs 19.2%; p < 0.05). Only one patient harboured both conventional and emerging pathogens (Entamoeba histolytica and Cryptosporidium). Isospora belli was detected in 8 (31%) of the 26 diarrhoea patients: in 7 (27%) patients as a single agent and in one patient with S. stercoralis. Cryptosporidium was identified in 3 (11%) diarrhoea patients: in 2 (8%) patients as a single agent and in one patient with E. histolytica, followed by B. hominis in 2 (8%) patients. E. histolytica was most commonly isolated (3/26; 11.5%), followed by Giardia lamblia, enteropathogenic Escherichia coli, and Campylobacter jejuni (one patient each). Parasitic pathogens were frequently associated with HIV-positive patients with diarrhoea in northern India. I. belli was the most frequent parasite isolated, followed by Cryptosporidium. Stools of all HIV-positive patients with diarrhoea should thoroughly be investigated to identify aetiologic agents for proper management.     

2009年医院感染病原菌分布特点及对照研究

目的探讨邯郸市中心医院2009年住院患者医院感染病原菌分布特点,并与唐山市工人医院相应数据进行比较。方法对2009年分离的3889株病原菌分布特点进行分析。结果邯郸市中心医院感染病原菌以革兰阴性杆菌为主,占66.57%,其次为革兰阳性球菌,占23.38%,真菌占10.05%;与唐山市工人医院相应数据比较,革兰阴性杆菌和革兰阳性球菌构成比低于邯郸市中心医院,真菌构成比显著高于邯郸市中心医院。结论唐山市工人医院在控制革兰阴性杆菌和革兰阳性球菌医院感染方面好于邯郸市医院,在控制真菌医院感染方面邯郸市中心医院好于唐山市工人医院。     

普通外科病房病原体分布及其耐药性

目的调查某院普通外科病房病原体分布及其耐药性，为临床医生合理选择抗菌药物提供依据。方法对该院普通外科2011年1月-2012年12月临床送检各类标本分离的病原体种类、分布及耐药性进行回顾性分析。结果共分离病原体859株，其中革兰阴性（G-）菌563株(占65.54%)，革兰阳性（G+）菌233株(占27.12%)，真菌63株(占7.33%)；G-菌以大肠埃希菌(40.40%) 居多，G+菌以粪肠球菌(3.96%) 居多，真菌主要为白假丝酵母菌。病原体标本来源主要为腹腔引流/抽出液（65.43%，562株），其次为伤口或切口分泌物（10.94%，94株）、痰液（9.90%，85株）、胆汁（6.75%，58株）等。肠杆菌科细菌对亚胺培南、美罗培南不耐药，对阿米卡星、阿莫西林/克拉维酸、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率均＜20%，对头孢菌素的耐药率较高。鲍曼不动杆菌对亚胺培南、美罗培南的耐药率高达51.85%、47.37%，对其他大部分抗菌药物的耐药率均＞60%，耐药率较低的是左氧氟沙星、阿米卡星，耐药率均＜20%。G+球菌对万古霉素的耐药率＜3.40%。结论该院普通外科住院患者医院感染主要病原体以G-菌为主，了解普通外科病房病原菌分布及加强细菌的耐药性监测，对临床医生合理选择抗菌药物，提高疗效，防止耐药菌株的产生及传播具有重要意义。     

2012-2017年某院儿童肺炎链球菌感染分布特点及耐药性

目的 了解某院儿童肺炎链球菌感染分布特点、耐药性及其变化趋势。方法 对该院2012年1月—2017年12月儿科住院患儿的痰、血、脑脊液标本进行分离培养和细菌鉴定，参照美国临床实验室标准化协会（CLSI）文件M100-S28标准进行药敏试验和结果判定，对数据进行统计分析。结果 共分离2 384株肺炎链球菌，男性占54.32%，女性占45.68%；0.5~3岁年龄段患儿占63.38%，≤0.5岁者占21.10%，> 3岁者占15.52%。肺炎链球菌占所有分离细菌的18.08%，按季度统计其占细菌分离的比率，四季度（20.62%，839/4 068） > 一季度（18.77%，762/4 059） > 二季度（18.42%，557/3 024） > 三季度（11.11%，226/2 034），但随季度变化的差异在逐步缩小。肺炎链球菌对红霉素、复方磺胺甲唑、克林霉素、四环素耐药率高（73.21%~99.62%），对左氧氟沙星、氯霉素、头孢呋辛、头孢噻肟、阿莫西林、青霉素的耐药率较低（0.19%~33.92%），未发现对万古霉素、奎奴普丁/达福普汀、利奈唑胺、莫西沙星耐药的肺炎链球菌。结论 肺炎链球菌主要分离于呼吸道感染患儿，≤3岁儿童是感染主体。肺炎链球菌分离率随季度变化的差异正在逐步缩小，其时间分布特点越来越不明显。阿莫西林、青霉素可作为治疗儿童肺炎链球菌感染的一线药物。