
广州地区儿童空肠弯曲菌感染的病原学研究
Investigation of campylobacter jejuni infection in children with diarrhea in Guangzhou
目的:了解广州地区腹泻儿童空肠弯曲菌(CJ)的感染及耐药情况,为临床及时、合理诊断和治疗提供实验室依据。方法:对2005年7月至2008年6月该院门诊3 351份腹泻患儿的粪便标本进行CJ的分离培养,并对分离菌株进行Lior分型及耐药试验。结果:3 351份腹泻患儿粪便标本共检出267株CJ,分离率为8.0%;婴幼儿(1个月至1岁)是CJ的易感人群,占91.0%(243/267);夏秋季是高发季节,占76.8%(205/267)。该菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦和氯霉素敏感,对大环内酯类和林可霉素类耐药率<5%,对氨苄西林、喹诺酮类和四环素耐药率在20%~40%之间,对复方新诺明和头孢哌酮均耐药。Lior分型以Ⅰ型为主,占 75.3%(201/267)。结论:CJ是婴幼儿腹泻的重要病原菌,其耐药形势日趋严重,应引起重视。临床应结合药敏试验结果选择抗菌药物治疗CJ感染。[中国当代儿科杂志,2009,11(6):422-424]
OBJECTIVE: To investigate the incidence of campylobacter jejuni (CJ) infection and the drug resistance of CJ in children with diarrhea in Guangzhou. METHODS: The fecal samples of 3 351 children with diarrhea between July 2005 and June 2008 were collected for CJ culture. The species of CJ strains were identified by Lior methods. The drug susceptibility tests were performed by the Kirby-Bauer method. RESULTS: Two hundred and sixty-seven CJ strains (8.0%) were isolated from 3 351 samples. The children at age of 1 month to 1 year were susceptible to CJ, accounting for 91.0%. A higher incidence of CJ infection (76.8%) was found in summer and autumn. The CJ strains were susceptible to imipenem, amikacin, cefoperazone/sulbactam, chloramphenicol, macrolides and lincomycins. Parts of CJ strains (20%-40%) were resistant to ampicillin, quinolones and ambramycin. All CJ strains were resistant to sulfamethoxazole/trimethoprim and cefditoren. Two hundred and one strains (75.3%) were CJ biotype I. CONCLUSIONS: CJ is an important pathogen of diarrhea in children from Guangzhou. CJ is resistant to some antibiotics used often in clinical practice, and so it is thus important to use antibiotics based on the results of drug susceptibility tests in children with CJ infection.[Chin J Contemp Pediatr, 2009, 11 (6):422-424]
Campylobacter jejuni / Infectious diarrhea / Pathogen / Child
[1]吴蜀豫,张立实,冉陆.弯曲菌及弯曲菌病的流行现状[J].中国食品卫生杂志, 2004, 16(1):58-61.
[2]吴铮,范文辉.GBS与空肠弯曲菌感染[J].神经科学通报, 2005, 21(1):87-90.
[3]李冰,杨立彬,黄铁栓,陈黎,胡雁,廖建湘.急性感染性多发性神经根炎患儿空肠弯曲菌感染与抗神经节苷脂GM1抗体关系[J]. 中国当代儿科杂志, 2003, 5(6):533-536.
[4]Newell DG. Campylobacter concisus:an emerging pathogen[J]. Eur J Gastroenrol Hepatol, 2005, 17(10):1013-1014.
[5]沈和萍,吴蔚.小儿空肠弯曲菌肠炎534例分析[J].中国儿童保健杂志, 2006, 14(6):640-641.
[6]Moore JE, Corcoran D, Dooley JS, Fanning S, Lucey B, Matsuda M, et al. Campylobacter[J].Vet Res, 2005, 36(3):351-382.
[7]陈小旦,陈波.非大环内酯类抗生素治疗空肠弯曲菌肠炎效果观察[J].浙江预防医学, 2007, 19(5):74.
[8]Wardak S, Szych J, Zasada AA, Gierczynski R. Antibiotic resistance of Campylobacter jejuni and Campylobacter coli clinical isolates from Poland[J].Antimicrob Agents Chemother, 2007, 51(3):1123-1125.
[9]许海燕,黄金林,包广宇,高玉,张弓,苏洁,等.扬州市腹泻人群空肠弯曲菌和结肠弯曲菌流行状况及耐药性分析[J].中国人畜共患病学报,2008,24(1):58-62.
[10]郑惠,蔡方成,钟敏,邓兵,李欣,张晓萍,等.壳聚糖-DNA疫苗预防空肠弯曲菌感染的实验研究[J].中华预防医学杂志,2007,41(5):375-379.