儿童腹泻病原学检测及流行病学特征分析

目的：了解苍南地区儿童腹泻病的病原学分布、对抗生素耐药情况及流行病学分析,为临床医师治疗儿童腹泻提供参考。方法：对2011年1月-2013年12月期间该地区在医院门诊及住院治疗628例腹泻患儿的粪便标本进行分离培养,鉴定病原菌种类并用K-B法进行药敏实验,胶体金试纸法检测轮状病毒抗原,对腹泻发生的季节、年龄等流行病学资料进行分析总结。结果：腹泻患儿粪便病原菌的检出率为58.72%,排名前三位的病原菌依次为沙门菌属（43.88%）、大肠埃希菌属（21.17%）和轮状病毒（13.78%）。病原菌对抗生素的耐药率呈逐渐上升趋势。夏秋是儿童腹泻病的高发季节,且不同年龄段儿童引起腹泻的病原菌所占比例不同。结论：革兰阴性菌和轮状病毒是儿童腹泻的主要病原菌,由于抗生素不合理使用,病原菌对抗生素的耐药性不断增加。季节和年龄是儿童腹泻病发生的影响因素。对患儿进行病原学诊断,有助于合理用药,提高治疗效果。

Etiological detection and epidemiological analysis of pediatric diarrhea disease

Objective To explore the distribution of pathogens,antibiotic resistance and epidemical characteristics of pediatric diarrhea disease in the local district.Methods We chose 628 diarrhea patients treated in Qianku Central Health Centers from January 2011 to December 2013,and conducted feces culture and pathogenic identification.The K-B method was used for drug sensitivity test and the colloidal gold assay for rotavirus antigen detection.The epidemiological information such as age and season were analyzed.Results The detection rate of pathogenic bacteria in feces was 58.72%,and the three top-ranked pathogens were salmonella（43.88%）,escherichia coli（21.17%）and rotavirus（13.78%）.The antibiotics resistance of pathogen was increased.Summer and autumn were high-incidence seasons for diarrhea and the proportions of bacterial diarrhea were different in children with different ages.Conclusions Gram negative bacteria and rotavirus are the two major pathogens of pediatric diarrhea disease.The antibiotics resistance of pathogen was increased due to unreasonable usage of antibiotics.Season and age are the two impact factors of pediatric diarrhea.The pathogen diagnosis and drug sensitivity test can help the rational use of drugs and enhance the treatment effect.