急性感染性腹泻病原菌的分布及耐药性

目的:分析急性感染性腹泻病原菌的分布及耐药性,为临床合理用药提供依据。方法:收集213例急性肠炎患者粪便标本进行细菌分离培养,并对常见的病原菌进行药敏检查,对相关结果进行统计分析。结果:213例患者粪便标本中分离出203例病原菌,其中革兰氏阴性菌151例(74.38%),革兰氏阳性菌46例(22.66%),真菌6例(2.96%)。引起急性感染性腹泻的常见病原菌依次为大肠埃希菌、粪肠球菌、肺炎克雷伯菌、金黄色葡萄球菌、阴沟肠杆菌和鲍曼不动杆菌等。革兰氏阴性菌对亚胺培南(0.66%)和哌拉西林/他唑巴坦(5.30%)的耐药率低,对氨苄西林(86.09%)、头孢唑啉(78.81%)和复方新诺明(90.73%)等高度耐药;革兰氏阳性菌对万古霉素的耐药率最低(0.00%),其次呋喃妥因(2.17%)和利奈唑烷(4.35%)对克林霉素及苯唑西林耐药性较高,达到100.00%;真菌的药物敏感性均较高。结论:急性感染性腹泻患者粪便标本中以革兰氏阴性菌占主导地位,且病原菌分布较广,耐药性增加,临床医师需要加强病原菌的检测和耐药性分析,有针对性地选择抗菌药物。

The Distribution and the Drug Tolerance of Acute Infectious Diarrhea Pathogen

Objective:To provide the reference for rational drug use in clinic by analyzing the distribution and drug tolerance of acute infectious diarrhea (AID) pathogen.Methods:Fecal samples of 213 patients were collected to perform the isolation of bacteria and culture,drug sensitivity of the common pathogen was tested,and the related results were statistically analyzed.Results:All 203 kinds of pathogens were isolated from fecal samples of 213 patients,among them;there were 151 cases of Gram-negative bacteria (74.38％),46 cases of Gram-positive bacteria (22.66％),six cases of fungi (2.96％).The common pathogens causing AID were E.coli,Enterococcus faecalis,klebsiella pneumoniae,Staphylococcus aureus,Enterobacter cloacae,baumanii and others.The drug tolerances of Gram-negative bacteria to imipenem (0.66％) and piperacillin/Tazobactam (5.30％) were low,high drug tolerances to ampicillin (86.09％),cefazolin (78.81％),bactrim (90.73％) and others;The drug tolerance of Gram-negative bacteria tovancomycin was the lowest (0.00％),the next were furadantin (2.17％) and Linezolid (4.35％),high drug tolerances to clindamycin and oxazocilline,which reached 100％;the drug sensitivity of fungi to the drugs were better.Conclusion:Gram-negative bacteria hold the leading role in the fecal samples of AID patients,and the pathogens are widely distributed,drug tolerance increases,clinical physician should choose antibacterials purposefully by enhancing the detection of pathogen and drug tolerance analysis.