广西桂林市1999—2008年甲型副伤寒病带菌者菌株的耐药性分析  

Analysis of drug-resistance of S.paratyphi A in carrier of paratyphoid fever A from 1999 to 2008 in Guilin city

作　　者：麦浩[1] 杨进[2] 李秀苾 潘定权[1] 李革莉 马小垒[4] 龙虎[1] 秦金勇 

机构地区：[1]桂林市疾病预防控制中心,广西桂林541001 [2]广西壮族自治区疾病预防控制中心,广西南宁530021 [3]阳朔县疾病预防控制中心,广西桂林541900 [4]全州县疾病预防控制中心,广西桂林541500

出　　处：《微生物学免疫学进展》2014年第1期40-43,共4页Progress In Microbiology and Immunology

基　　金：广西自然科学基金项目(2011GXNFFA018199);广西卫生厅科研立项(Z2010202)

摘　　要：目的了解甲型副伤寒病后带菌者菌株对常用抗生素耐药情况,指导临床合理规范用药。方法随访桂林市1999—2008年发病的甲型副伤寒病患者,采集其3次粪便标本培养甲型副伤寒菌,对培养出的菌株进行18种抗生素的耐药检测。结果 328名既往甲型副伤寒患者中检出恢复期病例20例,检出带菌6例,恢复期带菌率30.0%,95%CI(12.0%,54.0%),恢复期带菌者发病时用药不规范。病后3个月至9年的既往甲型副伤寒患者308例,检出慢性带菌1例,慢性带菌率为0.32%,95%CI(0.1%,5.6%)。所有菌株对喹诺酮类药物敏感率不高,对萘啶酸耐药率为100%。对氨卞西林、一代头孢、氨曲南、链霉素、磺胺等药物不同程度中介或耐药。慢性带菌者的菌株除萘啶酸耐药外,对其他抗生素均敏感。结论治疗甲型副伤寒患者时应做到抗生素的规范、合理使用,以减少病后带菌发生。Objective To understand antibiotics sensitivity of S.paratyphi A in carrier of paratyphoid fever A , and offer a guidance of reasonable application of antibiotics .Methods The cases were followed up , which were definited as a paraty-phoid fever A from 1999 to 2008, the patient’s stool specimens were collected for three times to culture S.paratyphi A, and the drug sensitive test was carried out with these strains for resistance of 18 kinds of antibiotics .Results From the 328 pa-tients with a previous paratyphoid fever A , 6 carriers were found in 20 convalescents, positive rate was 30.0%, 95%CI （ 12 .0%, 54 .0%） .The treatment was not in a regular mode for the carriers in convalescence when they were in the course of disease.One chronic carrier was found in 308 patients with a previous paratyphoid fever A from 3 months to 9 years after recovered , the chronic carry rate was 0.3%,95%CI（0.1%,5.6%）.The strains are not sensitive to quinolones , and are all resistant to nalidixic acid .There are in varying degrees of resistance to ampicillin , the first generation cephalosporins , aztreonam, streptomycin, and sulfanilamide.The strain of the chronic carrier is sensitive to other antibiotics except for nali -dixic acid.Conclusion The treatment of patients with S.paratyphi A should use of antibiotics in a regular and suitable mode, in order to reduce carrying of the causative bacteria after recovered .

关 键 词：甲型副伤寒杆菌 慢性带菌 药物敏感试验 

分 类 号：R446.5[医药卫生—诊断学]