周筠,刘威
ZHOU Jun,LIU Wei (Guangzhou Children's Hospital

• 1:广州市儿童医院药剂科
• 2:广州市儿童医院药剂科 广州510120
• 3:广州510120

摘要(Abstract)：

目的观察志贺氏流行菌种及10种常用抗生素的敏感性以指导临床用药。方法经大便培养痢疾杆菌阳性而确诊急性细菌性痢疾64例,应用纸片扩散法行药物敏感性试验,回顾性分析抗菌药使用的临床资料。结果福氏志贺菌53株,宋内志贺菌9株,鲍氏志贺菌2株。舒普深、阿米卡星、环丙沙星、诺氟沙星敏感性分别为100%、92.31%、94.74%、81.82%,罗氏芬、头孢噻肟、马斯平的敏感性在70%左右,氯霉素、复方新诺明、氨苄青霉素的敏感性在18%以下。各类抗菌药使用频度由高到低依次为罗氏芬、可利迈仙、磷霉素、黄连素。结论菌痢仍以福氏痢疾杆菌感染为主。本组抗菌药的使用基本合理。志贺菌对罗氏芬已呈现耐药趋势,建议舒普深等三代头孢与β-内酰胺酶抑菌剂组成的复方制剂为重症患儿的首选药物。阿米卡星可做为7岁以上普通型痢疾的首选;氯霉素、复方新诺明、氨苄青霉素的耐药较为严重,不宜应用于痢疾的治疗。静脉滴注+口服敏感抗生素联合用药可增加疗效。
Objective To observe the epidemic strains of shigella and the sensitivity of 10 kinds of frequently used antibiotics and to guide clinical medication.Method Final diagnosis was acute bacillary dysentery by stool cultivation for 64 cases.Susceptibility test was assessed by K-B disc diffusion.The clinical datas were analyzed retrospectively.Result Shigella flexneri 53 strains,shigella sonnei 9 strains,shigella boydii 2 strains.The sensitivity of Sulperazone,Amikacin,Ciprofloxacin,Norfloxacin were 100%,92.31%,94.74%,81.82%,The sensitivity of Rocephin,Cefotaxime,Maxipime were about 70%.The sensitivity of Chloromycin,SMZ-TMP and Ampicillin were under 18%.The using frequency of each antibiotic species from high to low were Rocephin,Colimycin,Fosfomycin,Berberine.Conclusion Shigella flexneri was in the majority among this bacillary dysentery.The usage of antibiotic was basically rational in this group.There is a tendency of drug resistance for Rocephin.It is a suggestion that the compound preparation which consists of Third generation cephalosporin and β-lactamase inhibitors like Sulperazone as a choice drug for severe case.Amikacin as a priority choice drug for popular type bacillary dysentery for more than 7 years old children.Chloromycin,SMZ-TMP and Ampicillin should not be used for bacillary dysentery because there is a serious drug resistance.Combination with IV drop and peros will increase curative effect.

关键词(KeyWords)： 小儿;细菌性痢疾;药敏试验;临床用药分析
pediatric;bacillary dysentery;susceptibility test;clinical medication;analysis

Abstract:

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基金项目(Foundation):

作者(Author): 周筠,刘威
ZHOU Jun,LIU Wei (Guangzhou Children's Hospital

参考文献(References)：

• [1]范连芹,张立中,陈洪山,等.171例菌痢患儿痢疾杆菌药敏结果分析[J].微生物学杂志,2002,22(1):60.
• [2]陈智.福氏痢疾杆菌的药敏分析及用药对策[J].广西医学,2004,26(3):408-409.
• [3]刘法永,杨福荫,谢晓慧.阿米卡星全日剂量1次用药毒副作用观察[J].中国抗生素杂志,2000,25(4):314-316.
• [4]杨锡强.喹诺酮类药物在儿科的应用[J].药物不良反应杂志,2001(1):5-9.