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目的：调查本地区导致儿童细菌性腹泻病的病原菌分布及耐药趋势，为临床合理选用抗生素提供依据。方法：调阅2009 年 01 月至2012 年02 月在我院诊断并治愈的细菌性腹泻病的患儿病历，统计分析患儿粪便中致病菌的鉴定、药物敏感性及超广谱茁- 内酰胺酶(ESBLs)检测结果。结果：期间共收治226 例细菌性腹泻患儿，均获得痊愈，除经过经验性药物治疗治愈而未进行粪便培养的病例外，209例患儿进行便培养，192 例培养出致病菌，培养阳性率91.9%，获取菌株337 株，其中65 例培养出超过两种以上细菌。培养出的细菌中：埃希菌属、志贺菌属、肠杆菌属及变形杆菌属4 种致病菌占总分离菌株的78.6%；肠球菌属、克雷伯菌属、非发酵菌属、枸橼酸杆菌属及酵母样真菌等致病菌占总菌数的21.4%。常见的三种致病菌中，埃希菌属、志贺菌属、肠杆菌属三种细菌的耐药性均比较严重，对常见抗生素的耐药均处在较高比率。结论：儿童腹泻病致病菌谱的分布具有显著的地域性差异；部分致病菌具有较高的耐药性应引起临床重视；临床应用抗生素治疗儿童感染性腹泻病时应在确定致病菌及其耐药情况后有针对性地进行。

英文摘要:

Objective:In order to provide reasonable proposal for treating with paediatric bacterial diarrhea (PBA) clinically by investigating the pathogenic bacteria distribution and antibiotic resistance trend of children bacterial diarrhea in our locality.Methods:Medical files of PBA who had been diagnosed with PBA, accepted treatment and got cure from January 2009 to February in our hospital were reviewed. The pathogenic bacterium isolated from feces of PBA were identified, antibiotic susceptibility and extended spectrum 茁-lactamases were also detected, all the data were bring into statistical analysis. Results:There were 226 children altogether that were diagnosed with PBA, all of them get recovery after they were given experienced antibiotic treatment except for those who had not accepted stool culture. In all, 209 PBA children proceed stool culture and 192 of them were positive in stool culture and the positive of stool culture was 91.9%.337 strains were cultured altogether and there were 65 stool specimen from which two or more stains were cultured. Escherichia, Shigella spp, Enterobacter and Proteus were the four leading pathogenic bacterium and they all made up 78.6%. The rest were Enterococcus, Klebsiella, Zymobacterium, CitricAcid Acidobacterium and Yeasts-like fungus, they accounted for the left 21.4%. The antibiotic resistance situation of three most frequent pathogenic bacteriumsuch as Escherichia, Shigella and Enterobacter was rather serious, and their rate of antibiotic resistance to the most common antibiotics used at clinic were rather high.Conclusion:There was distinguished regional diversity in the pathogenic bacterium spectrum of paediatric bacterial diarrhea; Some of the pathogenic bacterium had higher rates of antibiotic resistance and this situation should be given much attention at clinic; Pathogenic bacterium and their antibiotic resistance should be confirmed firstly before the treatments were given directly.

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