儿童细菌性腹泻的病原微生物检验的效果及价值.pdf
《儿童细菌性腹泻的病原微生物检验的效果及价值.pdf》由会员分享,可在线阅读,更多相关《儿童细菌性腹泻的病原微生物检验的效果及价值.pdf(3页珍藏版)》请在文库网上搜索。
1、2023 年 8 月第 21 卷 第 24 期中国医药指南检验医学139儿童细菌性腹泻的病原微生物检验的效果及价值侯 丽(辽宁省盘锦市盘山县疾病预防控制中心,辽宁 盘锦 124100)【摘要】目的探讨儿童细菌性腹泻的病原微生物检验的效果及价值。方法选取 2021 年 6 月至 2023 年 6 月哨点医院收治的 75 例腹泻患儿为研究对象,取患儿的腹泻粪便为标本,进行细菌培养后行分离鉴定,记录患儿的病原菌分布及临床特征,经针对性治疗后分析治疗效果,并采用多因素 Logistic 回归分析影响疗效的相关因素。结果病原菌分布显示,75 例患儿共检出 56 株细菌,其中大肠埃希菌 17 株(30.3
2、5%),沙门菌属 12 株(21.43%),弧菌属 11 株(19.64%),气单胞菌 9 株(16.07%),其他菌属 6 株(10.71%);临床特征显示,75 例患儿中病情严重程度为轻度 39 例(52.00%)、中度 27 例(36.00%)、重度 9 例(12.00%),发病季节在秋季32 例(42.67%)、夏季 25 例(33.33%),年龄 3 岁共计 59 例(78.67%)。经治疗后,75 例患儿中,治愈 28 例(37.33%),显效23 例(30.67%),有效 18 例(24.00%),无效 6 例(8.00%),患儿整体有效率为 92.00%。多因素 Logisti
3、c 回归分析显示,年龄小、病情重是影响患儿疗效的主要危险因素。结论引起儿童细菌性腹泻的病原菌种类较多,常见的主要病原菌有大肠埃希菌、沙门菌属、弧菌属、气单胞菌及其他菌属等;患儿发病主要集中于夏秋季节,3 岁为细菌性腹泻的主要易感人群;年龄小、病情重是治疗无效的主要危险因素,因此,临床应采取针对性的治疗措施。【关键词】儿童细菌性腹泻;病原微生物检验;效果;价值中图分类号:R725;R446.5 文献标识码:B 文章编号:1671-8194(2023)24-0139-03The Effect and Value of Pathogenic Microbial Testing in Children
4、 with Bacterial DiarrheaHOU Li(Panshan Center for Disease Control and Prevention,Panjin 124100,China)Abstract Objective To explore the effectiveness and value of pathogenic microbial testing for bacterial diarrhea in children.Method A total of 75 children with diarrhea admitted to our hospital from
5、June 2021 to June 2023 were selected as the research objects.The diarrhea feces of the children were taken as specimens for isolation and identification after bacterial culture.The distribution of pathogenic bacteria and clinical characteristics of the children were recorded.The therapeutic effect w
6、as analyzed after targeted treatment,and the related factors affecting the curative effect were analyzed by multivariate Logistic regression.Result The distribution of pathogenic bacteria showed that 56 strains of bacteria were detected in 75 children,including 17 strains of Escherichia coli(30.35%)
7、,12 strains of Salmonella(21.43%),11 strains of Vibrio(19.64%),9 strains of Aeromonas(16.07%),and 6 strains of other bacteria(10.71%).The clinical features showed that among the 75 children,the severity of the disease was mild in 39 cases(52.00%),moderate in 27 cases(36.00%),and severe in 9 cases(12
8、.00%).The onset season was in autumn in 32 cases(42.67%)and summer in 25 cases(33.33%).A total of 59 cases(78.67%)were 3 years old.After treatment,among the 75 children,28 cases(37.33%)were cured,23 cases(30.67%)were markedly effective,18 cases(24.00%)were effective,6 cases(8.00%)were ineffective,an
9、d the overall effective rate was 92.00%.Multivariate Logistic regression analysis showed that young age and severe disease were the main risk factors affecting the efficacy of children.Conclusion There were many kinds of pathogenic bacteria causing bacterial diarrhea in children.The common main path
10、ogenic bacteria were Escherichia coli,Salmonella,Vibrio,Aeromonas and other bacteria.The incidence of children was mainly concentrated in summer and autumn,and 3 years old was the main susceptible population of bacterial diarrhea.Young age and severe disease are the main risk factors for ineffective
11、 treatment.Therefore,targeted treatment measures should be taken clinically.Key words Bacterial diarrhea in children;Pathogenic microbial testing;Effect;value细菌性腹泻是常见的消化系统疾病之一,为肠道传染病,多发于儿童,临床表现主要有腹痛、大便次数增多、大便水样化等1-2。该类疾病发病急,病情进展快,患儿体内水分丢失严重,可能会引发电解质紊乱,严重影响患儿身心健康。因此,对于免疫功能较差、症状较为严重的患儿,早期合理应用抗菌药物治疗是改善
12、治疗预后的关键。了解该区域一段时间内的病原菌分布、流行病学特征可为临床的治疗方案提供理论基础3-5。且由于儿童机体发育尚未成熟,临床药物治疗需要注意的问题较多。因此,明确病原微生物检验价值对细菌性腹泻相关疾病的诊断及治疗均具有重要意义,为进一步明确病原微生物对细菌性腹泻的检验价值,本次研究对在该院接受治疗的75例腹泻患儿病相关原微生物进行了测定及分析,报道如下。1资料与方法1.1 研究对象 选取2021年6月至2023年6月哨点August 2023,Vol.21,No.24Guide of China Medicine140检验医学医院收治的75例腹泻患儿为研究对象。其中男性患儿33例,女性
13、患儿42例,年龄18岁,平均年龄(5.251.76)岁;病程17 d,平均病程(4.76 1.58)d。纳入标准:确诊为细菌感染腹泻,符合感染性腹泻的诊断标准6。存在大便次数增多、大便性状改变等临床症状。经镜检,白细胞数 目10109/L,经细菌培养后存在明显菌落。依从性良好,能过够配合各项检查及治疗。家长同意参与本次研究并签订知情同意文件。排除标准:其他原因导致的腹泻。合并心肝肾等重要脏器功能异常者。合并精神类疾病的患儿。临床资料缺失或不完整者。该研究经医院伦理学会审批同意。1.2 方法1.2.1 病原菌的培养与鉴定 患儿入院后,对其进行常规检查及病原微生物检查。病原菌分布:在同一时间,收集
14、患儿3 d内的粪便标本,将标本接种于琼脂平板上,在35 条件下培养24 h,行大肠大肠埃希菌、沙门菌属、弧菌属、气单胞菌等可疑条件致病菌的培养,依据全国临床检验操作规程7中的相关标准操作进行标本采集、菌落分离及纯化等,采用全自动细菌鉴定仪(法国梅里埃,型号:VITEK 2 Compact)进行鉴定。1.2.2 收集患儿临床资料 收集患儿的年龄、性别、身高、体质量、发病季节、病情严重程度8等。1.2.3 药物治疗 治疗原则依据儿童急性感染性腹泻病诊疗规范(2020年版)8,治疗5 d后进行临床疗效的评价。1.3 观察指标 菌群分布:检测并分析细菌性腹泻患儿菌群分布情况。治疗效果:对患儿的治疗效果
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 儿童 细菌性 腹泻 病原微生物 检验 效果 价值