河南省2011-2015年非伤寒沙门菌病原学与耐药监测  

Etiology and drug resistance of non-typhi Salmonella in Henan province, 2011-2015

作　　者：赵嘉咏[1] 穆玉姣[1] 张白帆[1] 夏胜利[1] 苏佳[1] 黄学勇[1] 许汴利[1] 

机构地区：[1]河南省疾病预防控制中心传染病所病原微生物实验室,郑州450016

出　　处：《中华流行病学杂志》2016年第9期1253-1256,共4页Chinese Journal of Epidemiology

摘　　要：目的 检测与分析2011-2015年自河南省腹泻多病原监测系统腹泻病例粪便中分离的1 351株非伤寒沙门菌血清型别及耐药表型。方法 采集河南省5家监测哨点医院肠道门诊及住院病例腹泻样本，进行沙门菌分离培养、生化鉴定与血清学分型；根据美国临床与实验室标准协会（CLSI）沙门菌K-B法药敏测试方案，对其进行8类12种抗生素的药敏测试与表型分析。结果 1 351株非伤寒沙门菌感染病例男女比例1.5：1（811：540），以低龄儿童和青壮年为主；分离时间多集中于每年的5-10月，具有较典型的春夏季节特征。1 351株非伤寒沙门菌共分为58个血清型，以肠炎（S.enteritidis）、鼠伤寒（S.typhimurium）、阿贡那（S.agona）等7种血清型为主。药敏结果显示，其对广谱合成类青霉素氨苄西林（AMP）、三代头孢类抗生素头孢他啶（CAZ）、头孢噻肟（CTX）、四代头孢类抗生素头孢吡肟（FEP）、三代氟喹诺酮类抗生素环丙沙星（CIP）、氨基糖苷类抗生素庆大霉素（GEN）等12种抗生素均存在不同程度的耐药与多重耐药性。结论 河南省感染人群的非伤寒沙门菌血清型别众多；部分菌株对临床常用的12类抗生素具有较高的耐药率且多重耐药问题日益严重。Objective To analyze the serotypes and antibiotic resistance phenotypes of non-typhi Salmonella strains in Henan province from 2011 to 2015. Methods The stool samples were collected from diarrhea patients, and enriched with SBG enrichment broth and the pathogen isolation was conducted with CHROMAgar selective culture medium at 37℃ for 18-24 hours using KIA/MIU biochemical action and API20E biochemical system slab to identify Salmonella strains. The serotypes of all the positive strains were detected with SSI Salmonella typing sera. According to K-B drug susceptibility testing method published by USA clinical and Laboratory Standards Institute （CLSI）, the antibiotics resistant phenotype of the positive strains were analyzed. Results A total of 1 351 strains of non-typhi Salmonella were isolated, in which 811 were from males, 540 were from females. The ratio of men to women was 1.5：1. Children and young adults were mainly affected. The pathogen isolation was mainly in May-October during a year. The 1 351 strains of non-typhi Salmonlla were divided into 58 serotypes. S. enteritidis, S. typhimurium, S. agona, S. derby, S. indiana, S. senftenberg and S. thompson ranked 1st-7th. The drug-resistance rate of the 1 351 strains was 46.1% to synthetic broad-spectrum penicillin ampicillin （AMP）, 19.5% and 21.2% to the three generation cephalosporin ceftazidime （CAZ） and cefotaxime （CTX）, 8.8% to the four generation cephalosporins cefepime （FEP）, 58.7% to the one generation of quinolones nalidixic acid （NAL）, 14.7% to the three generation fluoroquinolone ciprofloxacin （CIP） and norfloxacin （NOR）, 25.0% and 35.6% to aminoglycoside antibiotic gentamicin （GEN） and streptomycin （STR）, 35.4% to amphenicols （CHL）, 31.7% to sulfonamide trimethoprim （TMP） and 37.8% to tetracycline （TET）. Totally 879 strains were multidrug resistant （65.1%）：350 strains were resistant to 3-4 kinds of antibiotics （25.9%）, 309 strains were resistant to 5-7 kinds of antibiotics （22.9%）,

关 键 词：非伤寒沙门菌 血清分型 药敏测试 

分 类 号：R446.5[医药卫生—诊断学]