肠沙门菌副伤寒甲血清型的萘啶酸抗性和克隆扩散  

Nalidixic acid resistance and clonal expansion of Salmonella enterica serotype Paratyphi A in Yuxi city,China

作　　者：姚颖波[1] 王树坤[1] 储从家[2] 山德生[2] 阚飙[3] 刁保卫[3] 吴强[1] 杨汝松[1] 

机构地区：[1]玉溪市疾病预防控制中心,云南玉溪653100 [2]玉溪市人民医院,云南玉溪653100 [3]中国疾病预防控制中心传染病预防控制研究所,北京102206

出　　处：《中国微生态学杂志》2010年第3期244-249,共6页Chinese Journal of Microecology

摘　　要：目的了解玉溪市1999年至2008年甲型副伤寒患者肠沙门菌甲型副伤寒血清型(SPA)分离株的萘啶酸抗性和克隆扩散。方法采用有对照的K-B纸片扩散技术对4060株SPA进行抗微生物药物敏感性试验;对随机选择的166个萘啶酸抗性(NAR)株和20个萘啶酸敏感(NAS)株进行SpeI消化染色体DNA脉冲场凝胶电泳(PFGE)分型、聚类分析以及氟喹诺酮最小抑菌浓度(MIC)测定。结果分离株的NAR率由1999年的12.5%、2000年82.2%、2001年93%上升到2008年的100%;NAS株在1999年占优势,但在2000年以后被NAR株替代;166个NAR株都降低了对氟喹诺酮类药物的敏感性,其MIC值比20个NAS株的高得多。186个菌株SpeI消化产物得出以SpeI01、SpeI02型占优势的9种PFGE型。结论萘啶酸筛检实验可用于检测SPA降低氟喹诺酮敏感性,SpeI01和SpeI02是玉溪流行的主要克隆,建议制定并实施氟喹诺酮药物抗性株引起爆发流行的处理方案。Objective To understand the nalidixic acid resistance and clonal expansion of Salmonella enterica serotype Paratyphi A（SPA） recovered from patients with paratyphoid fever A in Yuxi City from 1999 to 2008.Method Antimicrobial susceptibility testing was performed with 4060 SPA isolates by the controlled Kirby-Bauer disc diffusion technique.A group of 166 NAR and 20 NAS isolates of SPA were randomly selected.186 isolates were typed by pulsed-field gel electrophoresis（PFGE） with SpeI PFGE patterns were analyzed by cluster analysis.The MICs for nalidixic acid,ciprofloxacin,levofloxacin,ofloxacin,norfloxacin,and gatifloxacin were determined.Result The incidence of resistance to nalidixic acid of the isolates increased from 12.5% in 1999,82.2% in 2000,93.0% in 2001,to 100% in 2008.Nalidixic acid-susceptible（NAS） isolates predominated in 1999 but was replaced by nalidixic acid-resistant（NAR） isolates after 2000.SpeI digestion of 186 isolates gave nine different PFGE patterns with predominance of the SpeI01 and SpeI02 epidemic patterns.All NAR isolates studied had a reduced susceptibility to flu-oroquinolone,with the MICs being higher than that for 20 NAS isolates.Conclusion We validate the use of the nalidixic acid screening test in the detection of decreased fluoroquinolone susceptibility in SPA.PFGE patterns SpeI01 and SpeI02,the main clones of the epidemics,are highly prevalent in Yuxi.Recommendation for the emergency treatments of outbreaks and epidemics caused by a fully fluoroquinolone-resistant strain can be made.

关 键 词：肠沙门菌副伤寒血清型 抗微生物药物敏感性 脉冲场凝胶电泳 克隆扩散 

分 类 号：R378.24[医药卫生—病原生物学]