Analysis of etiology and drug resistance of infectious diarrhea among children in Beijing area in 2009 / 中国小儿急救医学

ABSTRACT

Objective To investigate the etiology, epidemiologic features and drug resistance tendency of acute infectious diarrhea among children in Beijing area. Methods Enteric pathogenic bacteria were isolated, cultured and identified for serotype from the stool specimens of children with the initial clinical diagnosis of acute bacterial diarrhea in the intestinal clinic from January to October in 2009 ,and the antibiotic susceptibility of bacteria was tested by disk diffusion method. The cluster A rotavirus antigen was also detected by the qualitative technique of immunochromatographic double-antibody sandwich assay. Results Of the 256 stool specimens, 87 strains of 4 species of pathogenic bacteria were detected with the detectable rate of 34. 0% ,of which 2 strains were detected in one stool sample ,including 40 strains of salmonella (46. 0%) ,23 strains of shigella (26. 4%) ,2 strains of diarrheogenic escherichia coli (2. 3%) and 22 strains of staphylococcus aureus (25.3%). The positively detected patients consisted of 54 males and 32 females with the ratio of 1.69∶1 ,of whom 55 cases (64. 0%) were under 2 years of age. Of the 13 strains of shigella, 13 were sonnei shigella (56. 5%). And of the 22 strains of staphylococcus aureus,20 were detected among the infants under 1 year of age. The rates of crug resistance to certain antibiotics were lower in salmonella than in shigella (ampicillin65. 0% vs. 95.7% ;compound sulfamethoxazole20. 0% vs. 78. 3% ;ciprofloxacin7.5% vs.8. 7% ;ceftriaxone 15.0% vs. 73.9%). Of the 256 stool specimens ,47 were found positive for cluster A rotavirus,of whom 13 were also positive in stool bacteria culture. Conclusion Salmonella is the major pathogen among children with bacterial diarrhea in Beijing in 2009, and sonnei shigella is the main epidemic strains of shigella diarrhea. lnfants under 2 years of age are the susceptible population of the above two species of bacteria, while staphylococcus aureus mainly infect the infants under 1 years of age. Multi-resistance in shigella is still serious. The incidence of mixed infections of bacteria and rotavirus increases in children with infectious diarrhea.