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目的了解天津市感染性腹泻病的病原构成及其表型和分子生物学等特征。方法于2007—2010年天津市区5所哨点医院采集感染性腹泻患者粪便样本,检测腹泻病原菌。采用平板纸片扩散法检测志贺菌14种常用抗生素耐药性。结果样本中病毒阳性率为35.4(164/463),肠道病原菌阳性率为41.6%(178/428)。病毒性腹泻病原仍是诺如病毒(NV)和轮状病毒(RV)为主,阳性率分别为14.9%(69/164)和8.2%(38/164),RV基因型以G3和P[8]为主,分别占29.5%和24.1%。细菌性腹泻中志贺菌,宋内和福氏型,肠毒素Ⅰ、Ⅱ型多达53.5%。志贺菌对复方新诺明的耐药率高达94.8%(55/58),对氨苄西林的耐药率为58.6%(34/58),对诺氟沙星耐药率为34.5%(20/58),宋内志贺菌的耐药率更高,对上述3种抗生素的耐药率分别为100%(31/31)、87.1%(27/31)和61.3%(19/31),多重耐药普遍。结论天津市感染性腹泻疾病病原学趋于复杂,志贺菌耐药情况普遍。
Objective To understand the pathogenic constitution, phenotype and molecular biology of infectious diarrhea in Tianjin. Methods Stool samples of patients with infectious diarrhea were collected from 5 sentinel hospitals in Tianjin City from 2007 to 2010. The pathogen of diarrhea was detected. 14 kinds of commonly used antibiotics resistant to Shigella were detected by flat disk diffusion method. Results The positive rate of virus in samples was 35.4 (164/463), and the positive rate of intestinal pathogens was 41.6% (178/428). The main pathogens of viral diarrhea were still nociceavirus (NV) and rotavirus (RV), the positive rates were 14.9% (69/164) and 8.2% (38/164), respectively. The RV genotypes included G3 and P [ 8], accounting for 29.5% and 24.1% respectively. Shigella in bacterial diarrhea, Song and Fu type, enterotoxin type Ⅰ, Ⅱ up to 53.5%. The resistance rates of Shigella to cotrimoxazole were as high as 94.8% (55/58), 58.6% (34/58) for ampicillin and 34.5% (20%) for norfloxacin / 58). The resistance rates of Shigella sonnei were higher, and the resistance rate to these three antibiotics was 100% (31/31), 87.1% (27/31) and 61.3% (19/31), respectively, Multi-drug resistance is common. Conclusion The etiology of infectious diarrhea in Tianjin tends to be complicated and the resistance of Shigella is common.