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目的探讨少儿腹泻患儿的志贺菌菌群分布特征与耐药特征,为临床防治提供依据。方法选用志贺菌与沙门菌琼脂培养基进行培养,对于可疑的菌株经VITEK-32细菌鉴定仪与血清凝集鉴定到群,采用K-B的方法分析抗生素的耐药性。结果 151株志贺菌中主要为宋内志贺菌(85株,占56.3%)和福氏志贺菌(64株,占42.4%),且感染患儿主要集中在0~10岁年龄段,占总感染率的72.2%(109/151)。药敏结果显示,福氏志贺菌和宋内志贺菌对氨苄西林、氨苄西林/舒巴坦、哌拉西林和复方磺胺甲噁唑的耐药率较高,均大于50%,对三代头孢及四代头孢的耐药率均在35%以下;福氏志贺菌对环丙沙星和左氧氟沙星的耐药率分别为29.6%和21.8%,未发现宋内志贺菌对环丙沙星和左氧氟沙星耐药,且两者对哌拉西林/三唑巴坦和亚胺培南全部敏感。31株多重耐药菌经纸片确认试验均为超光谱β-内酰酯酶(ESBLs)阳性菌株,但未发现头孢菌素酶(Amp C)酶阳性者。结论腹泻患儿以感染宋内志贺菌与福氏志贺菌的婴幼儿为主,两种志贺菌对抗生素的药敏性差别比较大。
Objective To investigate the distribution and drug resistance of Shigella flexneri in children with infantile diarrhea and provide the basis for clinical prevention and treatment. Methods Shigella and Salmonella agar were selected for culture. The suspicious strains were identified by agglutination with VITEK-32 bacterial analyzer and serum, and the antibiotic resistance was analyzed by K-B method. Results Among the 151 Shigella strains, Shigella sonnei (85 strains, accounting for 56.3%) and Shigella flexneri (64 strains, accounting for 42.4%) were mainly found in 151 Shigella strains. , Accounting for 72.2% (109/151) of the total infection rate. Drug susceptibility results showed that the resistance rates of Shigella flexneri and Shigella sonnei to ampicillin, ampicillin / sulbactam, piperacillin and sulfamethoxazole were all higher than 50% The resistant rates of cephalosporins and fourth generation cephalosporins were below 35%. The resistance rate of Shigella flexneri to ciprofloxacin and levofloxacin were 29.6% and 21.8% respectively. Star and levofloxacin resistant, and both the piperacillin / tazobactam and imipenem are all sensitive. All the 31 multidrug-resistant strains were confirmed to be hyperspecific β-lactamase (ESBLs) -positive strains by paper identification test, but none of them were positive for Amp C enzyme. Conclusions Infants with diarrhea are mainly infected with Shigella sonnei and Shigella flexneri in infants and young children. The differences in antibiotic susceptibility between the two Shigella strains are relatively large.