儿童细菌感染性腹泻临床特点及病原体分析

目的:分析儿童细菌感染性腹泻的临床特点、病原菌分布及耐药性,指导临床诊治。方法:回顾性分析本院2017年1-12月诊治的296例细菌感染性腹泻患儿的临床资料。结果:296例患儿中,男171例,女125例,男女比为1.37∶1;5岁以下儿童239例,占80.74%;发病时间集中于5~9月(79.39%);临床表现为腹泻、发热、腹痛、黏液糊便,部分表现为血便,大便次数以5~10次居多;沙门菌166例(56.08%),大肠埃希菌73例(24.66%),类志贺邻单胞菌41例(13.85%),副溶血弧菌15例(5.07%),志贺菌1例(0.34%)。所有细菌对亚胺培南、哌拉西林/他唑巴坦均敏感(敏感率100%);沙门菌和致泻性大肠埃希菌对头孢他啶的敏感率分别为75.00%、93.55%,对头孢曲松的敏感率分别为67.31%、80.65%,对三代头孢菌素药物有不同程度耐药;副溶血弧菌药物敏感性较高。结论:儿童细菌感染性腹泻发病率高,传播快,耐药率高。临床应尽早完善病原学检查,合理选用抗生素。

Clinical Characteristics and Pathogens of Children with Bacterial Diarrhea

Objective:To analyze the clinical characteristics,pathogenic bacteria and drug resistance of children with bacterial diarrhea,so as to guide clinical diagnosis and treatment.Methods:Retrospective analysis was conducted on clinical data of 296 children with bacterial diarrhea admitted into our hospital from Jan.to Dec.2017.Results:Among the 296 children,171 cases were male and125 cases were female,the ratio of male to female was 1.37∶1.There were 239 children under 5 years old,accounting for 80.74%.The onset time was concentrated in 5 to 9 months(79.39%).The clinical manifestations were diarrhea,fever,abdominal pain,mucous stool,some of which were bloody stool,and the number of stools was 5 to 10 times.There were 166 cases(56.08%)of Salmonella,73 cases(24.66%)of Escherichia coli,41 cases(13.85%)of Orthomonas shigella,15 cases(5.07%)of Vibrio parahaernolyticus,and1 case(0.34%)of Shigella.All bacteria were sensitive to imipenem and piperacillin tazobactam(with sensitivity rate of 100%).The sensitivity rates of Salmonella and diarrhogenic E.coli to ceftazidime and cefatriaxone were 75.00%,93.55%and 67.31%,80.65%,respectively,with different degrees of resistance to the three generation cephalosporins.V.parahaemolyticus was highly sensitive to drugs.Conclusion:Children with bacterial diarrhea have higher incidence,faster transmission and higher drug resistance.Clinical examination should be completed as soon as possible,and antibiotics should be chosen rationally.