【目的】 了解厦门地区儿童感染性腹泻病原菌分布及耐药情况,指导临床合理选用抗菌药物治疗。 【方法】 对2007年8月-2011年12月临床诊断为感染性腹泻的1 951例患儿,取大便接种SS和麦康凯培养基进行细菌培养,用法国梅里埃ATB Expression系统鉴定细菌,再用诊断血清凝集进行分型确认,以K-B纸片扩散法进行药敏分析。 【结果】 1 951例大便标本,检出92例病原菌,阳性率为4.72%,其中62株沙门菌,占检出病原菌的67.39%,大肠埃希菌(致病性、侵袭性)21株,占22.83%,志贺氏菌9株,占9.78%。分离的致泻大肠埃希菌对β-内酰胺类抗菌药物(加酶抑制剂除外)普遍耐药。沙门、志贺氏菌对三代头孢和β-内酰胺类加酶抑制剂抗菌药物基本敏感。所有菌株对哌拉西林/他唑巴坦、亚胺培南均敏感。 【结论】 本地区儿童感染性腹泻分离病原菌以沙门氏菌为主,尤以鼠伤寒沙门菌居多,第一代、二代头孢菌素不应报告敏感;致泻大肠埃希菌对β-内酰胺类抗菌药物耐药较为严重,临床应根据药敏试验结果合理选用抗菌药物进行治疗。

【Objective】 To analyze the distribution and drug resistance of bacterial diarrhea of children in Xiamen,and to provide the reference for rational use of drugs. 【Methods】 1 951 cases from August 2007 to December 2011 for clinical diagnosis of infectious diarrhea,took shit vaccination SS and MaiKangKai culture medium for the bacteria cultures.Bacteria identified with France's merry ATB Expression system,and the diagnosis was confirmed with parting serum aggregation.The antimicrobial susceptibility was tested by Kirby-Bauer. 【Results】 92 cases of pathogens were screened out of 1 951 cases of stool specimens,positive rate was 4.72%.Among which 62 plants salmonella spp(67.39%),escherichia coli (pathogenic,aggressive) 21 strains(22.83%),shigella spp 9 strains(9.78%).The resistance to β-lactam antimicrobial was relatively serious in cause diarrhea escherichia coli.Salmonella and shigella were highly sensitive to three generation of cephalosporins and β-lactam add enzyme inhibitors.No resistance found to piperacillin/tazobactam or imipenem. 【Conclusions】 This district children infective diarrhea separation with salmonella bacteria is given priority to,especially in rat typhoid salmonella bacteria are in the majority.The first generation,the second generation cephalosporin should not report sensitive.The resistance to β-lactam antimicrobial is relatively serious in cause diarrhea escherichia coli.Clinical should choose antimicrobial agents for treatment according to antimicrobial susceptibility test results.