摘要
目的分析感染性肠炎患者的病原菌特点及其耐药性,为临床工作提供依据。方法选取2014年3月-2016年3月医院收治的382例感染性肠炎患者为研究对象,对患者粪便标本进行细菌培养及药敏试验,统计病原菌分布及其耐药性,分析引发感染性肠炎的主要诱因。结果共检出病原菌477株,其中革兰阳性菌92株占19.29%,革兰阴性菌351株占73.58%,真菌34株,占7.13%;革兰阴性菌中大肠埃希菌和志贺氏菌属对头孢唑林、头孢噻肟、阿莫西林耐药性较强,耐药率分别为95.97%、91.28%、97.32%和94.02%、97.44%、92.31%,而对头孢哌酮/舒巴坦、美罗培南等抗菌药物的敏感性较高;革兰阳性菌中的金黄色葡萄球菌和肠球菌属对青霉素、红霉素、阿奇霉素等耐药性较强,耐药率分别为93.62%、63.83%、63.83%和100.00%、58.33%、58.33%,对万古霉素、替考拉宁、利奈唑胺的敏感性较高;生吃食物、感染性肠炎患者接触史及外出就餐史是引起感染性肠炎的主要诱因。结论感染性肠炎的致病菌以革兰阴性菌为主,常见敏感药物为头孢哌酮/舒巴坦、美罗培南等,生吃食物、感染性肠炎患者接触史及外出就餐史为引发感染性肠炎的主要诱因;因此,临床对怀疑感染性肠炎患者,应立即进行粪便培养,明确病原菌类型,选择敏感抗菌药物进行治疗,以提高感染性肠炎的治疗效果。
OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from the patients with infectious enteritis so as to provide guidance for clinical treatment.METHODS A total of 382 patients with infectious enteritis who were treated in the hospital from Mar 2014 to Mar 2016 were recruited as the study objects, the stool specimens that were obtained from the patients were cultured, the drug susceptibility testing was performed, the distribution and drug resistance of pathogens were statistically analyzed, and the predisposing factors for the infectious enteritis were observed.RESULTS Totally 477 strains of pathogens were isolated, of which 19.29% （92 strains） were gram-positive bacteria, 73.58% （351 strains） were gram-negative bacteria, and 7.13% （34 strains） were fungi.Among the gram-negative bacteria, the drug resistance rates of Escherichia coli strains to cefazolin, cefotaxime and amoxicillin were 95.97%, 91.28%, and 97.32%, respectively;the drug resistance rates of Shigella strains were 94.02%, 97.44%, and 92.31%, respectively;however, the strains were highly susceptible to cefoperazone-sulbatam and meropenem.Among the gram-positive bacteria, the drug resistance rates of Staphylococcus aureus strains to penicillin, erythromycin and azithromycin were 93.62%m 63.83%, and 63.83%, respectively;the drug resistance rates of the Enterococcus strains were 100.00%, 58.33%, and 58.33%, respectively;however, the strains were highly susceptible to vancomycin, teicoplanin, and linezolid.Eating raw food, history of contact with patients with infectious enteritis, and history of eating outside were the major predisposing factors for the infectious enteritis.CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the infectious enteritis and are susceptible to cefoperazone-sulbactam and meropenem.Eating raw food, history of contact with patients with infectious enteritis, and history of eating outside are the major predisposing factors for the infectious enteritis.It is necessary for the hospital to conduct the culture of stool specimens for the patients with suspected infectious enteritis, identify the species of pathogens, and choose sensitive antibiotics for treatment so as to improve the therapeutic effect of infectious enteritis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第16期3677-3680,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技计划基金资助项目(2013KYB267)
关键词
感染性肠炎
病原学
耐药性
Infectious enteritis
Etiology
Drug resistance
