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目的了解上海市奉贤区感染性腹泻的病原菌构成及其耐药情况,为有效防控提供依据。方法采用病原菌分离鉴定技术和药敏试验方法,对上海市奉贤区监测点医院肠道门诊采集腹泻患者的粪便标本进行病原菌检测和药敏试验。结果 2014年从该区监测点医院肠道门诊共采集感染性腹泻患者粪便标本1 218份,分离到病原菌114株,检出率为9.36%。分离的病原菌中,居前3位的分别是沙门菌、副溶血弧菌和致泻性大肠埃希菌,构成比依次为41.23%、40.35%和15.79%。临床分离的感染性腹泻病原菌对氨苄西林、阿莫西林和四环素的耐药性较高,对头孢呋辛、头孢吡肟、头孢西丁和亚胺培南等抗菌药物比较敏感。结论该区感染性腹泻病原菌以沙门菌和副溶血弧菌为主,多数菌株出现不同程度耐药,应加强哨点监测并合理选用抗菌药物。
Objective To understand the constitution and drug resistance of infectious diarrhea in Fengxian District of Shanghai and provide evidence for effective prevention and control. Methods The pathogen identification and drug sensitivity test were carried out on the stool samples of patients with diarrhea collected from the gut clinic of Fengxian Hospital in Shanghai. Results A total of 1 218 stool samples of infectious diarrhea patients were collected from the gut clinics of the monitoring hospitals in the district in 2014, and 114 strains of pathogens were isolated, the detection rate was 9.36%. Among the isolated pathogens, the top three were Salmonella, Vibrio parahaemolyticus and diarrheal Escherichia coli, the constituent ratios were 41.23%, 40.35% and 15.79%, respectively. Clinically isolated infectious diarrheal pathogens are more resistant to ampicillin, amoxicillin and tetracycline and are more sensitive to antibacterials such as cefuroxime, cefepime, cefoxitin and imipenem. Conclusions Salmonella and Vibrio parahaemolyticus are the main pathogens of infectious diarrhea in this area. Most of the isolates have drug resistance to varying degrees, and sentinel surveillance should be strengthened and antibacterial drugs should be selected rationally.