扬州市区腹泻人群空肠弯曲菌和结肠弯曲菌流行状况及耐药性分析  

Prevalence and antimicrobial susceptibility of Campylobacter spp. in diarrhea patients in Yangzhou

作　　者：许海燕[1] 黄金林[1] 包广宇[2] 高玉[3] 张弓[1] 苏洁[1] 姜峰[1] 潘志明[1] 刘秀梵[1] 焦新安[1] 

机构地区：[1]江苏省人兽共患病学重点实验室,扬州225009 [2]江苏省扬州市第一人民医院中心实验室 [3]江苏省苏北人民医院中心实验室

出　　处：《中国人兽共患病学报》2008年第1期58-62,共5页Chinese Journal of Zoonoses

基　　金：国家高技术研究发展计划(863计划,2007AA02Z419);国家杰出青年科学基金(30425031);扬州大学研究生培养创新工程项目;江苏省社会发展指导性科技计划(BS2006535)

摘　　要：目的了解扬州市区腹泻人群中空肠弯曲菌和结肠弯曲菌的感染流行和耐药性状况。方法采用多重PCR方法对扬州市区两所医院门诊部和住院部的腹泻人群进行空肠弯曲菌和结肠弯曲菌感染状况调查,采用琼脂扩散法测定分离株的耐药性。结果在2937份粪便样品中,142份空肠弯曲菌阳性、平均阳性率4.83%,10份结肠弯曲菌阳性、平均阳性率0.34%。不同医院间感染率差异不显著(P>0.05),门诊部感染率极显著高于住院部(P<0.01),7岁以下幼儿感染率极显著高于其它人群(P<0.01),6月-8月感染率显著高于其它月份(P<0.05)。93株空肠弯曲菌分离株对21种抗生素高度敏感的是:庆大霉素91.40%、阿齐红霉素89.25%、红霉素88.46%、阿莫西林87.10%、链霉素83.87%、头孢噻肟81.72%、卡那霉素81.72%,高度耐药的是:头孢哌酮100%、复方新诺明100%、头孢拉定97.85%、头孢克罗93.55%、环丙沙星91.40%、萘啶酸91.40%、左旋氧氟沙星88.17%、土霉素87.50%。耐药菌株耐药谱主要集中在9耐至14耐,达81.71%,两医院分离株多重耐药性无显著性差异(P>0.05),不同诊区分离菌多重耐药性存在显著性差异(P<0.05)。结论扬州市区腹泻人群空肠弯曲菌和结肠弯曲菌的流行及耐药状况呈现多样化和复杂化,研究结果为正确评价腹泻人群弯曲菌的流行状况和制定切实可行的防控措施提供了科学依据。A epidemiological survey of Campylobacter jejuni and Campylobacter coli was performed by using multiplex PCR, and K-B method was used to detect the susceptibility of Campylobacterjejuni isolates against 21 antibiotics. 142 strains of C. jejuni and 10 strains of C. coli were isolated from 2 937 human feces samples, with the average positive rates of 4.83% and 0. 34% respectively. Outpatients and children before 7 years of age had higher prevalence rate than that of hospitalized patients （P〈0.01）. The detection rate of infection during June to August had higher prevalence rate than that of other monthes （P〈0.05）. Antibiotic sensitivity of 93 isolated strains were evaluated with 21 antibiotics, and the results showed that these isolated strains were highly sensitive to 7 antibiotics such as gentamicin（91.40 %）, azithromycin（89.25 %）, erythromycin （88. 46%）, amoxicillin（87. 10%）, streptomycin（83.87%）, cefotaxime（81.72%）, kanamycin（81.72%）,but resist to some frequently used medicines such as cefoperazone（ 100 % ）, co-trimoxazole（100 % ）, cephalexin（97.85% ）, cefaclor（93. 550.% ）, cipro- floxacin （91.40 % ）, nalicixic acid（91.40 % ）, levofloxacin（88.17 % ）, oxytetracycline （87.50 % ）. The percentage of isolates was 81.71% with resistance to 9 to 12 antimicrobials, and the multidrug resistance of isolated strains from outpatients was more severity than that of other isolated strains. These results demonstrate the endemic and the druy-resistance of Campglobacterspp.in Yangzhou district are variable and complicated, providing well foundation for the right evaluation measures to control this kind of infection.

关 键 词：空肠弯曲菌 结肠弯曲菌 多重PCR 腹泻 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]