伤寒与甲型副伤寒沙门菌基因分型与耐药性研究  

Genotyping and antimicrobial resistance about Samonella typhi and Salmonella Paratyphi A

作　　者：徐景野[1] 许国章[1] 金春光[1] 章丹阳[1] 沈玄艺[1] 石优章[1] 林辉[1] 宋启发[1] 胡荣华 

机构地区：[1]浙江省宁波市疾病预防控制中心,浙江宁波315010 [2]浙江省宁波市卫生监督所,浙江宁波315010

出　　处：《中国卫生检验杂志》2010年第12期3145-3151,共7页Chinese Journal of Health Laboratory Technology

摘　　要：目的:通过追溯菌株的流行优势型,了解菌株的耐药性,分析流行因素,为查明宁波地区伤寒、副伤寒疫情回升原因提供科学依据。方法:水产品检测采用GB、PCR和mini VIDAS联合检测方法;病人、从业人员检测采用全国临床操作规程或GB方法;菌株鉴定采用VITEK、ATP方法;药物敏感试验采用K-B纸片扩散法;基因分型采用PFGE方法。结果:从11类1500份海产品中检出6株沙门菌,检出率为0.40%,其中甲型副伤寒沙门菌2株,检出率为0.13%,肠炎等沙门菌3株,检出率为0.20%,伤寒沙门菌1株,检出率为0.07%;住院病人及暴发疫情标本中分离到沙门菌593株,其中伤寒沙门菌25株,占4.22%,乙型副伤寒沙门菌1株,占0.17%,甲型副伤寒沙门菌567株,占95.62%;食品、公共场所从业人员检出甲型副伤寒沙门菌2株;病人胆汁中分离到甲型副伤寒沙门菌1株。182株甲型副伤寒沙门菌和3株伤寒沙门菌药敏试验显示,大多数菌株对常用多种抗生素均敏感,其中1株分离于水产品伤寒沙门菌出现多重耐药。14株伤寒沙门菌可分为3个PFGE型,364株甲型副伤寒沙门菌可分为12个PFGE型。结论:宁波地区伤寒、副伤寒疫情回升与食源性有关,同源性试验提示菌株来是同一克隆系的可能性较大,优势流行型为PFGE 2型,且发现宁波地区副伤寒疫情的流行强度与此型细菌相关。检出的伤寒、副伤寒沙门菌对氧哌嗪青霉素、妥布霉素及头孢哌酮等第3代头孢菌素药物显示良好的敏感性,可作为当前预防和治疗的首选药物。伤寒出现多重耐药株,应引起我们的关注。PFGE分型有助于病原的追溯,分析菌株的变迁,为流行病学进一步分析病因提供支持,在确定传播途径等方面具有重要意义。Objective：To study antimicrobial Resistance and analyze epidemic factors by tracing prevailing epidemic strains so as to provide scientific basis for confirming the reasons of rising-again epidemic situation about Samonella Typhi and Salmonella Paratyphi A in Ningbo area.Methods： Aquatic food product were examined by combined methods： national standard procedure,PCR and mini-Vidas.For patients and relative employees,samples were examined by National Guide to Clinical Laboratory Procedures and Nation standard methods.Strains were identified by vitek and ATP.Antimicrobial resistance were examined by K-B method.PFGE was used for genotyping.Results： 6 strains of Samonella were detected from 11 kinds of（1500 samples） sea foods（detecting rate is 0.40%）,including 2 strains of Salmonella Paratyphi A（detecting rate is 0.13%）,3 strains of Salmonella enteritidis（detecting rate is0.20%）,1 strain of Samonella Typhi（detecting rate is 0.07%）.593 strains of Samonella were separated from patients and samples of out-breaking epidemic cases,including 25 strains of Samonella Typhi（4.22%）,1 strain of Salmonella paratyphi B（0.17%）,567 strains of Salmonella Paratyphi A（95.62%）.2 strains of Salmonella Paratyphi A were separated from employees serving in the public,1 strain of Salmonella Paratyphi A were separated from a patient′s bile.182 strains of Salmonella Paratyphi A and 3 strains of Samonella Typhi were examined for antimicrobial Resistance,and the results showed that most of them were susceptible to common antibiotics except 1 strain of Samonella Typhi separated from aquatic food product was resistant to multiple antibiotics.14 strains of Samonella Typhi were separated to 3 kind of PFGE types respectively.364 strains of Salmonella Paratyphi A separated to 12 kinds of PFGE type.Conclusion： The recovery of epidemic situations about Samonella Typhi and Salmonella paratyphi is related to foods.The homology analysis indicates that they maybe derive from them same clone.The prevailing strain

关 键 词：伤寒、副伤寒 检测 PFGE分型 药敏 流行研究 

分 类 号：R378.2[医药卫生—病原生物学]