旺兹沃思沙门菌耐药分子流行病学特征研究  

Study on molecular epidemiology and antibiotic resistance of Salmonella Wandsworth

作　　者：黄峥[1] 刘芸[2] 汤泓[1] 李颖[1] 石维敏 张静[4] 李勇[5] 林征[1] 张岭[1] 金汇明[6] 王传清[7] 阚飙[8] 史贤明[9] 许学斌[6] 

机构地区：[1]上海市长宁区疾病预防控制中心,上海长宁200051 [2]上海市闵行区疾病预防控制中心,上海闵行201100 [3]上海科玛嘉微生物技术中心,上海虹口200434 [4]上海市虹口区疾病预防控制中心,上海虹口200082 [5]上海市普陀区疾病预防控制中心,上海普陀200333 [6]上海市疾病预防控制中心,上海长宁200336 [7]复旦大学附属儿科医院,上海闵行201102 [8]中国疾病预防控制中心传染病预防控制所,北京昌平102206 [9]上海交通大学农业与生物学院,上海闵行200240

出　　处：《疾病监测》2015年第1期50-57,共8页Disease Surveillance

基　　金：国家"863"项目(No.2012AA101601);国家科技重大专项(No.2012ZX10004215-003);中美新发和再发传染病合作项目(No.1U2GGH000961-01和No.5U2GGH000961-02)~~

摘　　要：目的研究旺兹沃思沙门菌的耐药分子流行病学特征。方法基于上海市网络实验室连续性监测腹泻病例和环境食品的旺兹沃思沙门菌进行抗生素耐药和脉冲场凝胶电泳(PFGE)分析。结果 2005-2012年上海市网络实验室诊断临床病例分离沙门菌4553株,居前10位的20个血清型均为A^F群,旺兹沃思沙门菌在少见的非A^F群中居首位,5岁以下和60岁以上人群普遍易感,偶见血流感染重症病例。确认食源环境沙门菌1805株,前10位血清型明显比人源更具多样性,旺兹沃思沙门菌亦在少见型中居首位,多源自牛蛙、甲鱼和淡、海水养殖鱼介类。旺兹沃思沙门菌的人源和非人源株间的耐药性差异无统计学意义(P>0.05)。PFGE分5个克隆族:克隆族A为多重耐药克隆,疑似暴发的2株12重耐药MDR-ACSSu T-SH009型菌株和1株6重耐药的SH009型甲鱼源菌株100%同源;克隆族B、D、E和C分别是成年人和低年龄组感染克隆,均对抗生素敏感。结论旺兹沃思沙门菌虽属相对少见菌型,近年病例数呈上升趋势。上海市近期分离的旺兹沃思沙门菌与牛蛙、甲鱼和淡、海水养殖鱼介类菌株存在高度相似性,建议对致病且多重耐药克隆加强监测,并预警餐饮机构在操作牛蛙和甲鱼时可能存在交叉污染或接触感染的暴露风险。Objective To understand the molecular epidemiological and antibiotic resistant characteristics of Salmonella Wandsworth in Shanghai. Methods Antibiotic susceptibility test and pulsed field gel electrophoresis （PFGE） were conducted for S. Wandsworth strains isolated form diarrhea cases, environment samples and food samples in Shanghai. Results A total of 4 553 clinical Salmonella strains were isolated by the laboratory network in Shanghai from 2005 to 2012. The top 10 serotypes included 20 serotypes and all belonged to A - F serogroups, while S. Wandsworth was the most common serotype in rare non-A - F serogroups. People aged 〉 60 years and children aged 〈 5 years are susceptible to S. Wandsworth. Bloodstream infection is rarely observed. Totally 1805 Salmonella strains were isolated from food and environment samples, and the strains in top 10 serotypes had more multiformity than the strains from human. S. Wandsworth strains, most common among rare serotypes, were mainly isolated form bullfrogs, green turtles, freshwater fish and sea fish. There was no significant difference in antibiotic resistance between human source strains and other source strains （ P 〉 0. 05 ）. The S. Wandsworth strains isolated belonged to 5 clones indicated by PFGE, the strains in clone A were multi-drug resistant. Moreover, 2 ACSSuT-SH009 cluster strains which were resistant to 12 antimicrobials and SH009 strain from green turtle resistant to 6 antibiotics shared 100% homology. The strains in clone B, D and E were from adults, and the strains in clone C were from young children, all of these strains were sensitive to antibiotics. Conclusion Although S. Wandsworth is rare serotype, the infection caused by this pathogen increased in recent years. Highly homologous was found among the S. Wandsworth strains isolated from bullfrog, green turtle, freshwater fish and sea fish in Shanghai. It is necessary to strengthen the surveillance for pathogenic MDR clones and the early warnings of the risk of cross contamination and contact in

关 键 词：旺兹沃思沙门菌 低年龄组 多重耐药克隆 感染 

分 类 号：R446.5[医药卫生—诊断学]