小儿腹泻病原学特点及pH值检测

目的:探讨小儿腹泻的病原学特点及流行病学特征,寻求小儿感染性腹泻的快速诊断方法。方法:对该院2003年10月~2005年9月门诊及住院的1160例2个月~5岁腹泻患儿的腹泻标本进行细菌学检查及pH检测。结果:1160例患儿腹泻标本中,6个月~2岁患儿881例(69.91%)。病原学检查阳性605例(52.16%),检出病原20种621株,外源性肠道病原菌、内源性肠道条件致病菌以及轮状病毒3种病原构成比依次为35.75%、32.69%、31.56%。主要病原:轮状病毒196株(31.56%),志贺菌118株(19.00%),克雷伯菌86株(13.85%),枸橼酸杆菌67株(10.79%),致泻性大肠埃希菌60株(9.66%)。轮状病毒腹泻多发于秋冬季、大便为水样、多见于2岁以内婴幼儿。志贺菌以夏秋季与脓血便检出率较高。病原菌分离阳性腹泻标本pH值>7占明显优势,轮状病毒阳性标本、病原检查阴性标本、健康体检对照标本pH值<6占明显优势,前者pH值与后3者pH值统计学比较,差异有统计学意义(均P<0.01)。结论:引起小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亦接近外源性肠道致病菌而成为腹泻的重要病原菌。大便pH值可作为急性腹泻病早期简单、快速、准确、价廉的初步诊断及合理应用抗生素的重要指标。

Characteristic of pathogenic bacteria in children with diarrhea and measuring of pH value

Objective:To discuss pathogenic bacteria characteristic in children with diarrhea and their epidemiology ,seeking the frequent diagnosis methods of children infective diarrhea.Methods:To analyze the result of bacteriological examination and pH value of 1160 stool specimens of children with diarrhea from October 2003 to September 2005.Results:There were 1160 stool specimens of children with diarrhea,which contained 881 (69.91%)cases from 6months to 2 years old' s children. 605(52.16%) positive-strains cases were isolated from 1160 stool specimens,of which was composed 20 kinds,621strains. The component proportion of exterior enteric pathogenic bacteria,endogenous enteric conditional pathogenic bacteria and rotavirus was 35.75%,32.69%,31.56% respectively. Main Pathogen : Rotavirus occupied 31.56%,Shigella occupied 19.00%,Klebsiella occupied 13.85%,Citrobacter occupied 10.79%,diarrheal E. colic occupied 9.66%.0ne hand,Rotavirus diarrhea mostly happened in autumn and winter whose shape looks as water, on the other hand,Shigella was mostly found in bloody and mucous feces in summer and autumn. And what's more,pathogenic bacteria positive-strains cases' pH value was mostly above 7,while pH value of positive-rotavirus specimens,negative-pathogen specimens and controls were mostly under 6. The pH value existed significant differences between the first and the last three(P<0.01).Conclusion:Rotavirus is the major pathogenic microorganism in children with diarrhea. The component proportion of endogenous enteric conditional pathogenic bacteria is approach to exterior enteric pathogenic bacteria,so it becomes the important pathogenic bacteria .what' more,the pH value of stool is considered as one frequent diagnosis method of examining children' bacterial infective diarrhea,and the important characteristic of using antibiotic in reason.