小儿细菌性痢疾临床特点及药敏试验分析.DOCVIP

小儿细菌性痢疾临床特点及病原学分析 诸宏伟 孙琦 沈怀云 彭万胜 王磊 蚌埠医学院第一附属医院儿科 e-mail:zhuhongwei51136@126.com tel【摘要】 目的 了解我院近3年小儿急性细菌性痢疾的临床特点、致病菌群分布以及耐药情况。为临床合理使用抗生素提供依据。方法 对2010年1月-2012年12月收住我院儿科的44例急性细菌性痢疾患儿为研究对象，对患儿的一般资料、症状、血常规、生化常规以及病原菌的分型以及耐药性情况的临床特点及药敏结果进行回顾性分析。结果 小儿细菌性痢疾多流行于5-11月，以1-6岁患儿高发。病例多以普通型为主，偶有中毒型。脓血便已不是细菌性痢疾的典型表现。血液学检测白细胞增高，中性粒细胞，C反应蛋白明显增高。福氏志贺菌氏主要流行菌群。志贺菌属对头孢唑啉、氨苄青霉素几乎全部耐药，对喹诺酮类以及氨基糖苷类以及头孢曲松的耐药率也较高，对哌拉西林他唑巴坦、头孢派酮舒巴坦则全部敏感。结论：小儿细菌性痢疾临床表现亦趋于不典型和多样化，尽早做大便培养以明确。在治疗上应当首选含有β-内酰胺酶抑制剂的复方制剂。 【关键词】 细菌性痢疾 儿童 病原学 药物敏感试验 Clinical features and etiological analysis of bacillary dysentery in children ZHU Hongwei,SUN Qi,SHEN Huaiyun,PEN Wansheng,WANG Lei.Department of Pediatrics,The First Hospital Affiliated to Bengbu Medical College, Bengbu,Anhui233004,China [Abstract] Objective To investigate the clinical features of bacillary dysentery in children and its pathogen distribution and drug resistance,and to provide evidence for clinical use of antibiotics.Methods A retrospective analysis was conducted in children patient with bacillary dysentery from January 2010 to December 2012.The data of age,symptoms,blood test,pathogen type and its drug risistance were analyzed. Results Most cases occurred from May to November．The prevalence was higher in children from 1 to 6 years old． Most cases belonged to common type .Toxic type is few. pus and blood stool were not the tipical symptom.The count of white blood cell,neutrophils and CRP increased. The result of bacterial typing revealed that S．flexneri was the primary epidemic pathogen. Drug-resistant rates of Shigella to ampicillin，cefazolin even up to 100%. Quinolones, cefteixone,aminoglycosides,smz have higher drug-resistant rates. Drug-sensitive rates of Shigella to cefoperazon-sulbactam and piperacillin- tazobactam even up to 100%.．Conclusion clinical features of bacillary dysentery in children has tendeny to itypital and diversification.Stool should be cultured as quickly as possible. It is a suggestion that the compoun