目的 研究近年来肠道门诊细菌性痢疾流行概况及志贺菌耐药特点,为细菌性痢疾临床治疗和预防控制提供依据.方法 采用志贺菌及沙门菌琼脂培养基培养,可疑菌株经VITEK-32细菌鉴定仪及血清凝集鉴定到群,K-B法检测抗菌药物的酎药性,纸片确认试验检测产超广谱β-内酰胺酶(ESBLs),三维试验检测AmpCp-内酰胺酶(AmpC酶).结果 279例细菌性痢疾感染患者主要以宋内志贺菌(201株,占72.4％)和福氏志贺菌(76株,占27.2％)感染为主,且患者主要集中在0～11岁年龄段,占总感染率的71.3％(199/279),高发季节为7-11月.药敏结果显示,志贺菌对氨苄西林、哌拉西林和复方新诺明的酎药率较高,均＞60％；对环丙沙星和左旋氧氟沙星的耐药率较低,均＜40％,未发现耐哌拉西林/他唑巴坦和亚胺培南的志贺菌.151株志贺菌纸片确认试验为产ESBLs阳性菌株,占54.1％(151/279);未发现AmpC酶阳性者.结论 我院肠道门诊细菌性痢疾以感染宋内志贺菌和福氏志贺菌的婴幼儿为主,且宋内志贺菌有增高趋势,2种志贺菌对部分种类的抗菌药物药敏性差别较大,临床医师应根据菌群鉴定及药物敏感试验结果合理选择抗菌药物.%To investigate the epidemic characteristics and antibiotic resistance of Shigella group causing Bacillary dysen-tery in patients in recent years for the guidance of clinical treatment and prevention and control of bacillary dysentery. Suspi-cious strains isolated from Shigella and Salmonella agar culture were identified to the group by VITEK-32 instrument and ser-um agglutination of bacteria, and K-B method was used to study the antimicrobial resistance. The test of paper confirm was used to studuy the producing extended-spectrum β-lactamases ( ESBLs), and three-dimensional test for detection AmpC β lacta-mases ( AmpC enzymes). Among 279 infected patients, the most common groups were Shigella sonnei (201 striains, account for 72.4%) and Shigella flexneri (76 strains, account for 27.2%), and the most infected patients were 0 to 11 year-old (ac-count for 71. 3% of the total infection rate, 199/279). High incidence from July to November. The results of antibiotic suscep-tibility test in vitro showed the resistance rates of Shigella flexneri and Shigella sonnei to ampirillin, piperacillin and cotri-moxazole were higher than 60%, and to ciprofloxacin and levofloxacin were low than 40% , In addition, no isolate was resistant to piperacillin/tazobactam and imipenem.151 strains were confirmed to be ESBLs positive (account for 54. 1% of the total in-fection rate, 151/279), but not AmpC enzyme. In our hospital, the major patient groups infected by Shigella flexneri and Shigella sonnei were infants and young children, and Shigella sonnei had an increasing tendency. The sensitivity of the two kind of Shigella to some antibiotics varied greatly. Therefore, clinician should selected reasonably antibiotics according to the bacteria identification and drug susceptibility of Shigella.
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