2010-2014年上海市志贺菌菌群分布及耐药性分析  

Distribution and antibiotics resistance of Shigella spp.in Shanghai China,2010-2014

作　　者：张雯霞[1,2] 陈敏[2] 张曦[2] 陈洪友[2] 吴雯[2] 屠丽红[2] 王文静[1,2,3] 

机构地区：[1]东华大学化学化工与生物工程学院,上海201620 [2]上海市疾病预防控制中心,上海200336 [3]上海交通大学公共卫生学院,上海200020

出　　处：《现代预防医学》2016年第5期896-899,共4页Modern Preventive Medicine

基　　金：上海市卫生计生系统优秀学科带头人培养计划(XBR2011051);上海市公共卫生重点学科卫生微生物学(12GWZX0801);致病性新型分子血清分型系统的建立(2013ZX10004216-001-004)

摘　　要：目的探讨近五年来上海市肠道门诊腹泻患者中分离到的志贺菌菌群分布及其耐药特点,为细菌性痢疾临床治疗和预防控制提供依据。方法采用改良的K-B法检测志贺菌对抗菌药物的耐药性,并应用PCR法对耐药基因进行检测。结果共分离出382株志贺菌,其中宋内志贺菌243株（占63.6%）,福氏志贺菌139株（占36.4%）。菌株对萘啶酸、链霉素、氨苄西林、四环素、复方新诺明和磺胺异恶唑的耐药率依次为97.4%、96.1%、84.4%、77.7%、77.2%和67.8%,其中92.7%的菌株至少对3种及以上的抗生素产生了耐药,6.3%的菌株对10~13种抗生素产生了耐药,且存在对氟喹诺酮类和第三、四代头孢的耐药株。结论志贺菌耐药情况严重,且福氏和宋内两种志贺菌对部分抗菌药物的抗药性差别较大,临床医师应根据菌群鉴定及药物敏感试验结果合理选择抗菌药物。Objective To investigate the distribution and antibiotics resistance of Shigella spp. isolated from diarrhea outpatients in Shanghai in recent five years,so as to guide the clinical treatment and prevention of bacillary dysentery. Methods The improved K- B method was used to detect the antibiotics resistances and PCR was used to identify the antibiotic- resistant genes. Results Among 382 strains of Shigella isolated,243 strains were S. sonnei jl（ 63. 3%） and 139 strains were S. flexneri（ 36. 4%）. The resistance rates of Shigella spp. to Nalidixan,Streptomycin,Ampicillin,Tetracycline,Selectrin and Sulfisoxazole were 97. 4%,96. 1%,84. 4%,77. 7%,77. 2% and 67. 8% respectively. Approximately 92. 7% of the isolated bacterial strains were resistant to at least 3 kinds of antimicrobial agents,6. 3% of them were resistant to 10 ~ 13 kinds of antimicrobial agents and the co- resistance to Fluoroquinolones and the third / fourth- generation Cephalosporins was also identified. Conclusion The antibiotics resistance of Shigella spp. was in serious condition,and the difference of antibiotics resistance between S. flexneri and S. sonnei was great. Clinicians should select of antimicrobial agents reasonably according to the bacteria identification and drug sensitive test results.

关 键 词：志贺菌 耐药分析 菌群分布 耐药基因 

分 类 号：R117[医药卫生—公共卫生与预防医学]