Objective To realize the distribution and antimicrobial resistance and their changes of Shigella spp the main bacteria isolated from diarrheal patients between 1993 and 2002 in Beijing. Methods Stool were collected from patients presenting with diarrhea and cultured in SS agar and identified by standard microbiological methods. Drug susceptibility test was done according to NCCLS. Statistic analysis was performed with Stata software. Results We found that the distribution of shigellosis group had changed and the flood tide of shigellosis spp infected was in Summer and in Autumn, but it tends to move to Autumn during the decade. At the same time, the results show that about 80% of the Shigella strains tested were resistant to ampicillin, trimethoprim/sulfamethoxazole in 2002. The resistance of Shigella sonnei to most of antimicrobial, with the exception of ampicillin, no difference during the decade. But the resistant rates of Shigella flexneri toampicillin, ciprofloxacin, ofloxacin, and norfloxacin were higher than those of Shigella sonnei (P＜0. 001 ). The resistant rates were increased to ampicillin, cefotaxime, and ceftriaxone (P＜ 0. 05), particularly ciprofloxacin, ofloxacin, and norfloxacin (P＜0. 001) in Shigella flexneri but not in Shigella sonnei, except that ampicillin during the study period. Conclusion The results indicated that the distribution and antimicrobial resistance had changed in different Shigellosis group during the decade. The application of drugs should follow the reports of laboratory test result. Our findings prompt that the distribution of Shigellosis group and resistance of antibiotic should be closely monitored.%目的了解1993年和2002年10年间北京地区分离自腹泻患者志贺菌群的分布及耐药性变化,为临床经验用药提供依据.方法采取腹泻患者的粪便标本接种于SS琼脂培养基,筛出致病菌后经生化及血清学进一步鉴定到种、群.致病菌对抗生素的敏感性测定采用NCCLS推荐的Kirby-Bauer法,应用WHONET5软件进行药敏统计和分析.数据统计处理采用Stata软件.结果志贺菌群的感染高峰在夏秋季,有向秋季转移的倾向.菌群的构成比有变化.2002年福氏志贺菌对氨苄西林、复方磺胺甲(口恶)唑的耐药率均在80%以上.宋氏志贺菌对除氨苄西林外的抗生素耐药率10年间无显著差别.但福氏志贺菌对环丙沙星、氧氟沙星、诺氟沙星的耐药率显著高于宋氏志贺菌(P＜0.001),也高于氨苄西林、头孢曲松、头孢噻肟(P＜0.05).结论10年间志贺菌群的分布有变化,对抗生素的耐药率有差别,临床用药应根据实验室报告区别对待.应密切监测志贺菌群及抗生素耐药率的变化.
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