2011-2015年河南省细菌性痢疾病原学与耐药监测分析  

Analysis of the etiology and drug resistance surveillance for Shigellosis in Henan Province from 2011 to 2015

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

机构地区：[1]河南省疾病预防控制中心,河南郑州450016

出　　处：《现代预防医学》2017年第18期3403-3407,共5页Modern Preventive Medicine

基　　金："十二五"国家科技重大专项(No.2012ZX10004201和No.2013ZX10004203);河南省科技攻关课题"细菌性病原体分子分型与网络化溯源技术应用研究(152102310133)";河南省医学科技攻关计划项目(201602306)

摘　　要：目的检测分析2011-2015年分离自河南省5家腹泻病监测哨点医院病人粪便中的516株志贺菌血清型别、毒力基因及耐药表型.方法收集腹泻病人粪便,SS平板37℃分离培养18~24 h,疑似菌落进行API20E系统生化鉴定;阳性菌株进行志贺菌血清分型(玻片凝集法);多重PCR检测4种毒力基因(SHET-1B/SHET-2/ial/ipa H)并进行12种抗生素的药敏试验(K-B法,CLSI2015)。结果 516株志贺菌分离自19 217份粪便,检出率2.7%;阳性病例男女比例1.4∶1(301/215),以低龄儿童和青少年为主;分离时间多集中于每年的6-10月,具有较典型的夏秋季特征。菌株分为福氏(335株)和宋内(181株)2个群共9个血清型;394株志贺菌携带4种毒力基因,1种组合型别,122株携带3种毒力基因,3种组合型别。516株志贺菌对12种抗生素具有不同的耐药率,多重耐药菌株(R>3)为511株(99.1%),耐9种以上抗生素的菌株呈逐年上升趋势。结论河南省自监测系统中分离的志贺菌以福氏(B群)和宋内(D群)血清群为主,包含多种血清型别;菌株携带有不同的毒力基因并存在较为严重的耐药和多重耐药问题。Objective To detect and analyze the serotypes, virulence genes and drug-resistant phenotypes of Shigella strains isolated from five sentinel hospitals in Henan Province from 2011 to 2015. Methods Stool samples were cultured with SS selective medium in 37℃ for 18-24 hours, suspected strains were identified by API20 E biochemistry system. Positive strains were made serological type and did multiplex PCR to detect virulence genes. Drug-resistant phenotypes were tested with AST（K-B method, CLSI2015）. Results 516 strains of Shigella isolated from 19 217 stools, sex ratio of positive cases rate was 1.4：1, young children and teenagers were main infected population. Separation time, more centered on June to October annually with a typical summer-autumn season characteristics. A total of 9 serotypes were divided into flexneri（335 strains） and sonnei（181 strains） serogroups. All strains carried different virulence genes including SHET-1B, SHET-2, ial and ipa H with4 kinds combination types. 516 strains showed different resistance rates to 12 kinds of antibiotics, 511 strains were multiple drug-resistant strains（R 〉3）. Strains resistant to more than 9 antibiotics showed an upward tendency year by year.Conclusion The main serogroup of shigella in Henan Province was flexneri（B group） and sonnei（D group） containing 9 kinds serotypes and carried different virulence pathogenic factor. The drug sensitivity test showed that there were relatively serrious problems in Shigella strains isolated from sentinel hospitals and multiple drug resistance.

关 键 词：志贺菌 血清学分型 毒力基因 药敏试验 

分 类 号：R183.4[医药卫生—流行病学]