山西省儿童医院2014—2019年小儿感染性腹泻细菌谱及耐药性变化分析

Analysis of bacterial spectrum and drug resistance changes in children with infectious diarrhea in Shanxi Children′s Hospital from 2014 to 2019

  • 摘要:
      目的  探讨近年来山西省儿童医院小儿感染性腹泻细菌谱及耐药性的变化。
      方法  回顾性分析2014—2019年山西省儿童医院感染性腹泻住院患儿粪便培养阳性病例细菌谱及耐药性变化。
      结果  2014—2016年分离最多的是肺炎克雷伯杆菌; 主要细菌感染无性别、发病季节显著差异,感染以0~1岁患儿为主。2017—2019年分离最多的是非伤寒沙门氏菌,细菌感染患儿性别比较,差异无统计学意义(P > 0.05); 肺炎克雷伯杆菌以冬季分离率最高,非伤寒沙门氏菌、大肠埃希菌以夏秋季分离率最高; > 1岁的患儿的非伤寒沙门氏菌的阳性率更高,肺炎克雷伯杆菌、金黄色葡萄球菌以0~1岁阳性率更高。2017—2019年较2014—2016年,非伤寒沙门氏菌对氨苄西林、头孢他啶、头孢噻肟耐药性增加,差异有统计学意义(P < 0.05); 2017—2019年较2014—2016年,致泻性大肠埃希菌对头孢曲松耐药性增加,差异有统计学意义(P < 0.05)。
      结论  近年来,山西省儿童医院收治感染性腹泻患儿主要致病菌为非伤寒沙门氏菌,患儿发病年龄多集中在0~1岁,发病季节多集中在夏秋季,多数细菌对三代头孢类抗生素耐药率增加。

     

    Abstract:
      Objective  To investigate the changes of bacterial spectrum and drug resistance in children with acute infectious diarrhea in Shanxi Children′s Hospital in recent years.
      Methods  The changes of bacterial spectrum and drug resistance in fecal culture positive inpatients with infectious diarrhea in Shanxi Children's Hospital from 2014 to 2019 were retrospectively analyzed.
      Results   The proportion of Klebsiella pneumoniae accounted for the most in all the isolated strains from 2014 to 2016. There was no significant difference in gender and season of onset of the main bacterial infections, and the infection mainly occurred in children aged 0 to 1 year. Nontyphoidal Salmonella were the most isolated strains from 2017 to 2019, and there was no significant difference in sex between children with bacterial infection (P > 0.05). The isolation rate of Klebsiella pneumoniae was the highest in winter. Nontyphoidal Salmonella and Escherichia coli were the highest in summer and autumn. The positive rates of Nontyphoidal Salmonella were higher in children over one year old. Compared with the period of 2014 to 2016, the resistance of Nontyphoidal Salmonella to ampicillin, ceftazidime and cefotaxime increased significantly in the period of 2017 to 2019. Compared with the period of 2014 to 2016, the resistance of diarrhegenic Escherichia coli to ceftriaxone was significantly increased in the period of 2017 to 2019 (P < 0.05).
      Conclusion   In recent years, the main pathogenic bacteria in children with infectious diarrhea admitted in Shanxi Children′s Hospital is Nontyphoidal Salmonella. The onset age of the children is mostly at 0 to 1 year old, and the onset season is mostly in summer and autumn. The resistance rate of most bacteria to the third generation of cephalosporin antibiotics is increased.

     

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