摘要
目的 探讨急性感染性腹泻患者的常见病原体分布、病原体血清型及病原体耐药性情况.方法 采用描述性流行病学方法,选择2022年1月—2023年11月郑州颐和医院收治的急性感染性腹泻患者2337例,分析急性感染性腹泻患者标本病原体分布及血清型、耐药性情况.结果 共检出病原体4007株,其中感染病原体种类≥2种病原体感染者692例,占29.61％.副溶血性弧菌占54.03％、沙门菌占20.56％、志贺菌占9.51％、致泻性大肠埃希菌占7.86％、金黄色葡萄球菌占7.09％、其他(气单胞菌和邻单胞菌)占0.75％、霍乱弧菌占0.20％.2165株副溶血性弧菌中O3K6型占比为67.39％、O4K8型占比为24.39％、其他型占比为4.13％.824株沙门菌中山夫登堡沙门菌占比为35.07％、肠炎沙门菌占比为26.70％、汤卜逊沙门菌占比为20.75％、鼠伤寒沙门菌占比为17.48％.381株志贺菌中宋内志贺菌占比为53.28％、福氏志贺菌(F2a)占比为24.93％、福氏志贺菌(F4a)占比13.91％及其他型占比7.87％.315株致泻性大肠埃希菌以O126型为主占比为53.65％、O86型占比为29.21、O111型占比为13.02％.其他型占比为4.13％.284株金黄色葡萄球菌中SEA型占48.94％、SEC型占比为32.04、其他型占比为5.28％.8株霍乱弧菌均为VBO9.副溶血性弧菌对阿莫西林/克拉维酸、头孢吡肟、头孢西丁、环丙沙星、亚胺培南、复方磺胺甲噁唑、氯霉素、四环素的耐药率均<10.00％;沙门菌对头孢西丁、环丙沙星的耐药率均为0;志贺菌对头孢西丁和亚胺培南的耐药率均为0;致泻性大肠埃希菌对亚胺培南、哌拉西林的耐药率均为0;金黄色葡萄球菌对环丙沙星、万古霉素、利奈唑胺的耐药率均为0.霍乱弧菌对头孢西丁、环丙沙星的耐药率均为0;霍乱弧菌纳入患者较少,无≥2种抗菌药物耐药,其他5种病原体(副溶血性弧菌、沙门菌、志贺菌、致泻性大肠埃希菌、金黄色葡萄球菌)均同时对2种以上抗菌药物耐药情况发生.结论 急性感染性腹泻患者年龄分布广泛,病原体类型多样,临床上需根据实验室检验结果合理用药,加强饮食卫生管理.
Abstract
Objective Objective Explore the distribution,serotypes,and drug resistance of common pathogens in patients with acute infectious diarrhea. Methods 2337 patients with acute infectious diarrhea admitted to Zhengzhou Yihe Hospital from January 2022 to November 2023 were selected. Descriptive epidemiological methods were used to analyze the distribution of pathogenic bacteria,serotypes,and drug resistance in the specimens of patients with acute infectious diarrhea. Results A total of 4007 strains of pathogens were detected,of which 692 cases were infected with over 2 types of pathogens,accounting for 29.61％. Vibrio parahaemolyticus accounted for 54.03％,Salmonella 20.56％,Shigella 9.51％,Escherichia coli 7.86％,Staphylococcus aureus 7.09％,others (Aeromonas and Pseudomonas) 0.75％,and Vibrio cholerae 0.20％. Among the 2165 strains of Vibrio parahaemolyticus,O3K6 accounted for 67.39％,O4K8 accounted for 24.39％,and other types accounted for 4.13％. Among 824 strains of Salmonella,Salmonella Schaffdenburg accounted for 35.07％,Salmonella enteritis accounted for 26.70％,Salmonella enteritis accounted for 20.75％,and Salmonella typhimurium accounted for 17.48％. Among 381 strains of Shigella,Shigella sonnei accounted for 53.28％,Shigella flexneri (F2a) accounted for 24.93％,Shigella flexneri (F4a) accounted for 13.91％,and other types accounted for 7.87％. 315 strains of diarrhea causing Escherichia coli,with O126 type accounting for 53.65％,O86 type accounting for 29.21％,and O111 type accounting for 13.02％. The proportion of other types was 4.13％. Among 284 strains of Staphylococcus aureus,SEA type accounted for 48.94％,SEC type accounted for 32.04％,and other types accounted for 5.28％. 8 strains of Vibrio cholerae were all VBO9. The resistance rates of Vibrio parahaemolyticus to amoxicillin/clavulanic acid,cefepime,cefoxitin,ciprofloxacin,imipenem,compound sulfamethoxazole,chloramphenicol,and tetracycline were all less than 10.00％;The resistance rate of Salmonella to cefoxitin and ciprofloxacin was 0;The resistance rates of Shigella to cefoxitin and imipenem were both 0;The resistance rate of diarrhea causing Escherichia coli to imipenem and piperacillin was 0;The resistance rate of Staphylococcus aureus to ciprofloxacin,vancomycin,and linezolid was 0. The resistance rate of Vibrio cholerae to cefoxitin and ciprofloxacin was 0;There were relatively few patients included with Vibrio cholerae,and there is no resistance to at least two antibiotics. The other five pathogens (Vibrio parahaemolyticus,Salmonella,Shigella,Escherichia coli,and Staphylococcus aureus) all exhibited resistance to two or more antibiotics simultaneously. Conclusion The types of pathogenic bacteria in patients with acute infectious diarrhea are widely distributed in patients with different age groups. Rational drug use and dietary hygiene management should be strengthened according to the experimental results.
维普
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