急性腹泻患者粪便细菌培养及临床特征分析

目的:对急性腹泻患者的粪多细菌培养结果和临床特征分析。方法:在2010年4月-2011年3月在东方医院和佑安医院肠道门诊就医的急性腹泻患者中,随机抽取158例粪标本作细菌培养,对其临床诊断、临床特征、细菌培养结果进行综合分析。结果:158例中包括急性肠炎60例,急性菌痢17例,胃肠功能紊乱58例,消化不良7例,腹泻待查16例;粪细菌培养阳性41例(25.95%、41/158),包括副溶血弧菌17例(41.46%、17/41)、志贺菌属10例(24.39%、10/41)、沙门菌7例(17.07%、7/41)、类志贺邻单胞4例(9.76%、4/41)、温和气单胞2例(4.88%、2/41)、霍乱弧菌1例(2.44%、1/41)。41例粪细菌培养阳性患者的临床诊断分别为:急性肠炎24例,急性菌痢10例,胃肠功能紊乱3例,腹泻待查3例,消化不良1例。结论:北京市丰台区急性腹泻患者肠道致病菌以副溶血弧菌为主,志贺菌属次之;急性腹泻的临床诊断存在过分依赖便常规化验结果的情况,值得临床医师引起重视。

Clinical features and bacterial culture on stools of patients with acute diarrhea

Objective: To analyze clinical features and multi-bacteria culture result of acute diarrhea patients.Methods: Among the acute diarrhea patients who seek medical advice in intestinal outpatient service in Dongfang Hospitital and Youan Hospitital from April in 2010 to March in 2011,158 cases were randomly selected carry out the dung bacteria culture,then their clinical diagnosis,clinical features and the multi-bacteria culture result were analyzed.Results: Among the 158 cases,60 cases were acute enteritis,17 cases were acute bacterial dysentery,58 cases were gastrointestinal dysfunction,7 cases were indigestion,and 12 cases were diarrhea referred;41 cases were found dung bacteria culture positive(25.95%,41/158),which consist of 17 cases of(41.46%,17/41)Vibrio parahaemolyticus,10 cases of Shigella(24.39%,10/41),7 cases of Salmonella(17.07%,7/41),4 cases of plesiomonas shigelloides(9.76%,4/41),2 cases of aeromonas(4.88%,2/41)and 1 cases of vibrio Cholerae(2.44%,1/41).The clinical diagnosis of the 41 cases whose dung bacteria culture were positive,including 24 case of acute enteritis,10 case of acute bacterial dysentery,3 case of gastrointestinal dysfunction,1 case of indigestion,and 1 case diarrhea referred.Conclusion: The main pathogenic bacteria of acute diarrhea in Fengtai area of Beijing was Vibrio parahaemolyticus, followed by Shigella;the clinical diagnosis of acute diarrhea often excessively rely on the conventional chemical examination result of dung,which was worth paying attention by clinicians.