Analysis Of The Bacterial Spectrum And Drug Resistance Changes Of Infantile Infectious Diarrhea In Shanxi,2014-2019

Objective:To understand the bacterial spectrum and drug resistance changes of children with acute infectious diarrhea in Shanxi Province from 2014 to 2019,so as to provide a basis for the clinical diagnosis of children with infectious diarrhea and the rational use of antibiotics.Methods:A retrospective study was conducted on the positive fecal culture cases of hospitalized children with acute infectious diarrhea in Shanxi Children’s Hospital from January 2014 to December 2019.The cases covered 11 prefecture-level cities and 26county-level cities and counties under the administration of cities and their subordinate counties in Shanxi Province.Since the methods of fecal bacteria culture,isolation and identification in Shanxi Children’s Hospital have been improved since 2017,the results of culture and isolation from 2014 to 2016 and 2017 to 2019 were analyzed and discussed respectively.The changes of bacterial spectrum and drug resistance in fecal culture positive cases of infectious diarrhea were analyzed.Micro Scan Walk-Away-40 automatic microbiological analysis was used to identify the bacterial strains in fecal samples,and the drug susceptibility test was performed by K-B paper diffusion method.SPSS22.0 software was used for χ2 test and statistical analysis of medical records.Results:A total of 260 isolates were isolated from 2014 to 2016,and the top four isolates were Klebsiella pneumoniae(96 isolates,37.5%),Escherichia coli(48 isolates,18.8%),non-typhoid and non-paratyphoid Salmonella(47 isolates,18.4%),and Staphylococcus aureus(31 isolates,12.1%).Among them,there was no statistical significance in the positive rate of infection of the four bacteria in terms of gender and onset season.The positive cases of Klebsiella pneumoniae,Escherichia coli and Salmonella non-typhoid and non-paratyphoid were mainly in children aged 0-1 years,and the differences were statistically significant.A total of 992 isolates were isolated from 2017 to 2019,and the main isolates included non-typhoid and non-paratyphoid Salmonella(469 isolates,47.3%),Escherichia coli(135 isolates,13.6%),Klebsiella pneumoniae(130 isolates,13.1%),and Staphylococcus aureus(65 isolates,6.6%).There was no statistical significance in the positive rate of infection of the four kinds of bacteria.In terms of disease season,Klebsiella pneumoniae had the highest isolation rate in winter,Escherichia coli had the highest rate in summer and autumn,and Staphylococcus aureus had the highest detection rate in spring and autumn.The seasonal distribution difference of the above bacteria was statistically significant.The detection rate of non-typhoid and non-paratyphoid was the highest in summer and autumn,but the difference was not statistically significant.In terms of age of onset,the positive rate of non-typhoid and non-paratyphoid Salmonella was higher at the age of >,the positive rate of Klebsiella pneumoniae and Staphylococcus aureus was higher at the age of 0-1,and the differences were statistically significant,while the positive rate of Staphylococcus aureus was not statistically significant at the age of onset.Non-typhoid non-paratyphoid Salmonella to ceftazidime,cefotaxime resistance increased significantly;The resistance of diarrheogenic Escherichia coli to ceftriaxone increased significantly.Staphylococcus aureus to erythromycin,clarithromycin,azithromycin resistance rate is higher.Conclusion:1.The main pathogenic bacteria of infectious diarrhea among children in Shanxi Province from 2014 to 2016 was Klebsiella pneumoniae.There was no significant difference in gender and onset time of most bacterial infections,and the onset age was mainly 0-1 years old.The main pathogenic bacteria from 2017 to 2019 were non-typhoid and non-paratyphoid Salmonella.There was no significant gender difference in most bacterial infections,and the incidence was mostly concentrated in summer and autumn.The age of high incidence of infectious diarrhea was related to bacteria species.2.In recent years,the resistance rate of pathogenic bacteria to commonly used antibiotics has been on the rise.Most bacteria have higher resistance to the first and second generation cephalosporin antibiotics,while the resistance to the third generation cephalosporin antibiotics has been on the rise.