腹泻病人和健康人群感染气单胞菌流行病学及耐药特征  

Epidemic characteristics and drug resistance analysis of Aeromonas infection in patients with diarrhea and healthy people

作　　者：赖妙儿[1] 洪敏丽[1] 金玉娟[1] 杨慧[1] 杜文旗 洪泽涛 LAI Miao-er;HONG Min-li;JIN Yu-juan;YANG Hui;DU Wen-qi;HONG Ze-tao(Department of Microbiology,Longgang Center for Disease Control and Prevention of Shenzhen,Shenzhen,Guangdong 518172,China)

机构地区：[1]深圳市龙岗区疾病预防控制中心微生物检验科,广东深圳518172

出　　处：《热带医学杂志》2022年第3期327-332,共6页Journal of Tropical Medicine

基　　金：国家自然科学基金(81871631);深圳市龙岗区科创局项目(LGKCYLWS2019000569,LGKCXGZX2020003)

摘　　要：目的了解2017-2018年深圳市龙岗区腹泻病人及健康人群气单胞菌的感染情况,并对其进行分子分型及耐药情况分析。方法对龙岗区2017-2018年采集的腹泻病人粪便及健康人群的肛拭子进行气单胞菌分离培养,分离出来的气单胞菌用脉冲场凝胶电泳(PFGE)进行分子分型,BioNumerics 8.0进行聚类分析,并用VITEK 2Compact全自动微生物鉴定系统进行生化鉴定和药敏试验。结果从628份样本(394份健康人群和234份腹泻病人)中分离出52株气单胞菌,检出率为8.3%。腹泻病人样本中气单胞菌分离率(11.1%)明显高于健康人群(6.6%),差异有统计学意义(P<0.05)。腹泻病人优势菌型为豚鼠气单胞菌(30.8%),其次为嗜水和维氏气单胞菌(均为26.9%);而在健康人群中分离率最高的是嗜水气单胞菌(38.5%)、其次为维氏气单胞菌(23.1%)和豚鼠气单胞菌(15.4%)。气单胞菌对氨苄西林(AMP)、氨苄西林/舒巴坦(AMS)和头孢唑啉(CFZ)耐药率最高,分别为94.2%、86.5%和36.5%。嗜水气单胞菌对头孢唑林的耐药率明显高于其他气单胞菌,差异有统计学意义(P<0.05)。52株菌呈现11种耐药谱,最常见的耐药谱为AMP-AMS和AMP-AMS-CFZ,分别为42.3%和26.9%。44.2%气单胞菌对三种或四种抗生素耐药。除2株无法进行分型以外,50株菌株有48个PFGE带型。结论人群气单胞菌携带率较高,不同样品来源该菌优势菌型存在差异,建议将气单胞菌纳入常规的腹泻病原菌监测体系。气单胞菌不同地区、不同菌型耐药率存在差异,建议加强对气单胞菌耐药进行监测,合理使用抗生素。Objective To understand the infection status of Aeromonas in diarrhea patients and healthy people in Longgang district,Shenzhen from 2017 to 2018,and conduct molecular typing and drug resistance analysis for Aeromonas.Methods Aeromonas was isolated and cultured from stools of diarrhea patients and anal swabs of healthy people in Longgang district from 2017 to 2018.The Aeromonas strains were typed using pulsed field gel electrophoresis(PFGE);cluster analysis was performed using BioNumerics,and drug susceptibility testing was performed using the VITEK 2Compact automatic microbial identification system.Results A total of 52 strains of Aeromonas were isolated from 628samples(394 healthy people and 234 diarrhea patients).The detection rate was 8.3%.The isolation rate of Aeromonas in samples from diarrhea patients(11.1%)was significantly higher than that of healthy people(6.6%)(P<0.05).The predominant bacterial type of diarrhea patients was Aeromonas caviae(30.8%),followed by A.hydrophila and A.veronii(both 26.9%);while the highest isolation rate among healthy people was A.hydrophila(38.5%),followed by A.veronii(23.1%)and A.caviae(15.4%).Aeromonas had the highest resistance rates to ampicillin(AMP),ampicillin/sulbactam(AMS)and cefazolin(CFZ),which were 94.2%,86.5%and 36.5%,respectively.The resistance rate of A.hydrophila to cefazolin was significantly higher than other Aeromonas(P<0.05).52 strains showed 11 kinds of drug resistance spectrum,the most common spectrums were AMP-AMS and AMP-AMS-CFZ,which were 42.3%and 26.9%,respectively.44.2%of Aeromonas were resistant to three or four antibiotics.Except for 2 strains that could not be typed,50 strains had 48 PFGE band patterns.Conclusions The carrying rate of Aeromonas in the population of Longgang district was relatively high.The dominant types of Aeromonas were different from different sample sources.It was recommended that Aeromonas should be included in the routine diarrhea pathogen monitoring system.

关 键 词：腹泻病人 健康人群 气单胞菌 耐药率 同源性分析 

分 类 号：R446.5[医药卫生—诊断学] R574.62[医药卫生—临床医学]